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High emotional stress in medical students has been observed in many studies. Our aim in this article was to assess the prevalence of symptoms of anxiety and depression among Estonian medical students and to find relationships between sleep complaints and emotional symptoms. The study group consisted of 413 medical students, ages 19-33 years, at the University of Tartu. Each was asked to complete two questionnaires: the Emotional State Questionnaire (EST-Q), containing 28 questions, and the Questionnaire on Sleep and Daytime Habits, with 25 questions. The anxiety and depression subscales from the EST-Q were applied. From the study group, 21.9% students had symptoms of anxiety, and 30.6% had symptoms of depression. The frequency of anxiety and depressive symptoms was higher in females. In regression and multiple regression analysis, we determined which sleep problems were related to emotional symptoms. The associations were different for men and women. In women, anxiety remained significantly related to waking up because of nightmares and feeling tired in the morning; depressive symptoms were related to difficulties in getting to sleep at night, waking up because of nightmares and nocturnal eating habits, daytime sleepiness, and sleepiness during school lessons. In men, significant relations were clear only for depression: difficulties in falling asleep at night before an exam and subjective sleep quality. The study demonstrated that a high percentage of medical students had emotional symptoms. We found that some sleep problems indicated underlying symptoms of anxiety and depression.

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The purpose of this case–control genetic association study was to explore potential relationships between polymorphisms in the limbic system-associated membrane protein (LSAMP) gene and mood and anxiety disorders. A total of 21 single-nucleotide polymorphisms (SNPs) from the LSAMP gene were analyzed in 591 unrelated patients with the diagnoses of major depressive disorder (MDD) or panic disorder (PD) and in 384 healthy control subjects. The results showed a strong association between LSAMP SNPs and MDD, and a suggestive association between LSAMP SNPs and PD. This is the first evidence of a possible role of LSAMP gene in mood and anxiety disorders in humans.

Studies so far have provided contradictory results on immune system markers during use of antidepressants. There are no data on changes in immune parameters after treatment augmentation. The present study aimed to clarify whether the addition of bupropion in escitalopram-resistant patients with major depression causes changes in the immune system and whether treatment response could be predicted by baseline levels of cytokines. We recruited 28 depressive patients (11 men and 17 women) who did not respond to 12-week treatment with escitalopram (20 mg/d) for an augmentation trial with bupropion (150-300 mg/day). The levels of soluble interleukin-2 receptor, interleukin-8 (IL-8) and tumor-necrosis factor-alpha were measured before and 6 weeks after addition of bupropion. For a control group, we recruited 45 healthy volunteers (19 men and 26 women). The results indicated that the baseline levels of studied cytokines did not predict treatment response to bupropion augmentation. Concentration of IL-8 increased during the treatment similarly in both responder and non-responder groups. Although bupropion augmentation had increased the response rate in escitalopram-resistant patients, this clinical improvement was not accompanied by specific changes in studied cytokine levels.