Metabolic syndrome and depression: a cross-sectional analysis

OBJECTIVE: To examine the prevalence of the metabolic syndrome in depressive outpatients and to identify its correlates in depression. METHOD: This cross-sectional analysis was performed on 121 depressive outpatients from January 2002 through January 2004 who were diagnosed at baseline with the Structured Clinical Interview for DSM-III-R. The metabolic syndrome was diagnosed at 6-year follow-up according to the modified criteria of the National Cholesterol Education Program. The severity of depressive symptoms was assessed at follow-up with the Beck Depression Inventory and the Hamilton Rating Scale for Depression, and general psychopathology was assessed with the Symptom Checklist-90. RESULTS: At 6-year follow-up, the prevalence of metabolic syndrome in the study group of depressive outpatients was 36% (N = 44). The syndrome was associated with a current diagnosis of major depression and overeating, but not with age or sex. CONCLUSION: The metabolic syndrome is highly prevalent among patients with a history of depression, especially those with current major depression. This may have implications for treatment. Furthermore, attention should be focused on the physical health of those suffering from depression.     

The course of dissociation in the general population: a 3-year follow-up study

OBJECTIVE: There have been no previous general population studies on the stability of dissociative symptoms. The aim of this study was to examine the course of and the changes in dissociative symptoms and factors associated with these changes during a 3-year follow-up of a Finnish general population sample. METHODS: The general population sample included a cohort of 1497 subjects. Dissociative symptoms were assessed with the Dissociative Experiences Scale (DES) and the DES-taxon (DES-T). Depressive symptoms and suicidal ideation were measured with the Beck Depression Inventory (BDI). The sample was categorized into low dissociators with DES scores less than 20 and high dissociators with DES scores of 20 or more. RESULTS: At baseline, 98 subjects were high dissociators. On follow-up, 28 of them were still high dissociators, whereas among 70 subjects, the DES score declined below the cutoff score. During the follow-up period, 28 of 1399 subjects became new high dissociators, and constantly low dissociators consisted of 1371 of 1399 subjects. Dissociative taxon membership was detected in 39 subjects either at baseline or at follow-up, but only 4 of them met the criteria at both assessments. Stable high dissociation was associated with an increase in the BDI score on follow-up, baseline suicidal ideation, a younger age, a reduced working ability, and smoking. Risk factors for becoming a new high dissociator were an increase in the BDI score, a younger age at baseline, and a reduced working ability. Among the baseline high dissociators, recovery from high dissociation was associated with a decline in the BDI score at follow-up and with no suicidal thoughts, older age, and a good working ability at baseline. CONCLUSIONS: Only a small proportion of the general population had constantly high levels of dissociative symptoms. The stability of dissociative taxon membership was weaker than the stability of the continuous variables of dissociation. The dissociative experiences had a tendency to change, and these changes were associated with changes in the BDI scores. Further studies are needed to reveal the factors associated with the changes in dissociative symptoms.     

Depression and associated factors in patients with lumbar spinal stenosis

Purpose. To investigate the prevalence of depression and associated factors in patients (n = 100) with lumbar spinal stenosis selected for surgical treatment.

Method. Depression was assessed with the 21-item Beck Depression Inventory. Psychological well-being was assessed with Life Satisfaction Scale, Toronto Alexithymia Scale and Sense of Coherence Scale. Physical functioning and pain were assessed with the Oswestry disability index, the questionnaire devised by Stucki and the Visual Analogue Scale. All questionnaires were administered before surgical treatment of lumbar spinal stenosis.

Results. Twenty percent of the patients with LSS were found to have clinically important depression. In univariate analyses, subjective disability measured with the Oswestry disability index, low sense of coherence and poor life satisfaction were common in depressed patients. In the multiple logistic regression analyses, being dissatisfied with life was associated with depression. When sense of coherence score was included in the model, then only low sense of coherence was independently associated with depression. Neither socio-demographic nor pain-related factors associated with depression.

Conclusions. Clinically important depression is rather common among preoperative patients with lumbar spinal stenosis. The factors associated with depression are subjective disability of everyday living and decreased life satisfaction. A low sense of coherence is an important correlate of depression. The results underline the importance of assessing depression in clinical practice dealing with these patients.     

Plant food allergens homologous to pathogenesis-related proteins

In general, pathogenesis-related (PR) proteins are expressed by plants in response to stress conditions like infection, exposure to certain chemicals, wounding and environmental conditions. In some plant tissues, however, PR proteins are constitutively expressed, e.g. in pollens or fruits, tissues that are more likely to be attacked (by insects or fungi) or exposed to atmospheric conditions (e.g. UV irradiation). PR proteins display multiple effects within the plant and possess antimicrobial activity, and can thus be regarded as a part of the plant's defense system. Analyzing known amino acid sequences and functions of characterized (cloned) food allergens, it is remarkable that many of these molecules can be classified as PR proteins. Many PR proteins are stable at low pH, and display considerable resistance to proteases, requirements to act as food allergens. According to sequence characteristics and their enzymatic or biologic activity, PR proteins can be divided into 14 groups. Seven of these 14 groups contain proteins with allergenic properties, six groups contain food allergens.     

The relationship between psychological and somatoform dissociation in the general population

We assessed psychological and somatoform dissociation and their relationships in the general population. The study questionnaires included the Dissociative Experiences Scale, the Somatoform Dissociation Questionnaire, the Beck Depression Inventory, and background characteristics. Four study groups were formed: subjects with low dissociation scores (N = 1334), with high psychological dissociation (N = 93), with high somatoform dissociation (N = 93), and with high psychological and somatoform dissociation (N = 65). Those with high psychological and somatoform dissociation differed clearly from the other groups. They had depressive symptoms, suicidal ideation, a reduced working ability, a poor financial situation, poor general health, and inadequate social support more frequently than subjects in the other groups. Thus, a considerable amount of ill health was recorded in this group.     

Partial remission in major depression: a two-phase, 12-month prospective study

We conducted an interview-based survey to predict the clinical course of major depressive disorder during a follow-up period of 12 months. Altogether 86 patients were investigated. A SCID I interview for DSM-III-R axis-I diagnosis was conducted at baseline and a SCID II interview for personality disorders at the 6-month follow-up. Beck Depression Inventory scores indicated the level of depression and were compiled at baseline and at 6 and 12 months. A BDI score between 9 and 14 was considered to indicate partial remission, and score of 0-8 indicated remission. At the 6-month assessment 33% of the patients had remission, 20% were in partial remission, and 47% were in the depressive phase. Older age, personality disorder, and alexithymia were associated with poor response at 6 months. At 12 months 37% had remission, 28% were in partial remission, and 35% were still in the depressive phase. Treatment at the early stage should be effective enough to achieve remission. If the response is not satisfactory within 6 months, a renewed search should be conducted for factors hindering recovery. Comorbid personality disorder is the main factor predicting a poor short-term response in major depressive disorder.     

Expression of allergens in E. coli and plants--benefits and drawbacks

Recombinant allergens are quickly becoming the reagents of choice for diagnosis and therapy of type I allergic diseases. Consequently, the different methods for the production of recombinant proteins that are available today are of great interest to allergologists. Without doubt, bacterial expression will continue to play a pivotal role. In addition, plant-based expression systems will be needed to overcome problems inherent in the E. coli systems and to allow the production of glycoallergens or allergens of more complex folding.     

Changes in Listing's plane after sustained vertical fusion

PURPOSE: To determine whether prolonged fusion of an imposed vertical disparity leads to a change in the orientation of Listing's plane, even when measured during monocular viewing. METHODS: Four normal subjects (age range, 24-37 years) wore Fresnel prisms of increasing power for 72 hours to produce a final left-over-right disparity (range, 7-11 prism diopters [approximately 3.9 - 6.2 degrees]) that was still fusible. Eye movements were measured binocularly, using three-axis search coils, as subjects fixed on an array of light-emitting diodes (LEDs) arranged on a flat screen, 124 cm away. A regression was used to fit the data points to a plane (Listing's plane) during monocular and binocular viewing. From each planar fit, the horizontal and vertical components of primary position (the direction of gaze that is perpendicular to Listing's plane) were calculated. Baseline data were collected in the unadapted state, either just before or at least 4 days after wearing the prisms. RESULTS: After the period of viewing through the prisms, there was a change in vertical phoria (prism adaptation) ranging from 1.6 to 3.3. There was a significant (P < 0.01) shift of the relative orientation of the vertical component of primary position between the two eyes of 6.3 +/- 1.7 degrees (right eye value minus left eye, up being positive, each measured during monocular viewing). There was no consistent pattern of change in the horizontal component of primary position. CONCLUSIONS: Prolonged fusion of a vertical disparity is associated with a change in the orientation of Listing's plane that persists under monocular viewing. Possible mechanisms include phoria adaptation, the prolonged fusional effort itself, and the residual disparity that must be overcome by sensory mechanisms.     

Motorische und sensorische Antworten bei Fusion vertikaler Disparitäten in verschiedenen Konvergenzstellungen

To study motor and sensory responses in vertical fusion at different angles of horizontal vergence in normal humans. METHODS: The study included 12 normal subjects. A cross (+) extending 3.4 degrees x3.2 degrees was presented dichoptically. Vertical disparity was introduced by changing the vertical position of the cross in front of one eye. The disparity was incremented by 0.08 degrees every 8 s. Distance viewing was tested with 1 degrees of convergence demand, near vision with 6-15 degrees convergence demand. Eye movements were recorded using three-axis search coils. RESULTS: Vertical fusion capability was larger at near vision than at distance in 9 of 12 subjects. For the entire group, total vertical fusion capability (motor plus sensory response) differed between distance (mean 1.68 degrees ) and near (mean 2.39 degrees ). The motor component differed significantly between distance (mean 1.42 degrees ) and near (mean 2.13 degrees ). No difference in the sensory component was seen between distance (mean 0.26 degrees ) and near (mean 0.27 degrees ). CONCLUSIONS: Vertical fusion capability increases with convergence. This increase is mainly due to an increase of the motor response.