Changes in the prevalence of symptoms of depression and depression across Greece

Summary This paper reports on the regional prevalence of symptoms of depression and clinical depression (current major depressive episodes) in Greence in the years 1978 and 1984. Prevalence rates were estimated from two extensive, nationwide cross-sectional home surveys on psychosocial issues and health, carried out in four geographical areas: the Greater Athens area, the Greater Thessaloniki area, the rest of the urban areas and rural areas. The methodology used, the sampling procedure and the screening instrument (The Center for Epidemiologic Studies-Depression Scale) were the same in both surveys. Within the 6-year period a substantial increase in the prevalence of symptoms of depression in all geographic areas was observed, with the Athenian respondents expressing a higher number of symptoms of depression than their counterparts from the other areas. The prevalence of current major depressive episodes, according to specific criteria matched with criteria from the DSM III R, was increased in 1984 in Athens and in the rural areas only. We suggest that economic instability between 1978 and 1984 probably contributed to the changes in the rates of depressive disorders.     

Thyrotropin and prolactin responses to ECT in schizophrenia and depression

Thyroid stimulating hormone (TSH) and prolactin (PRL) plasma levels were studied during electroconvulsive therapy (ECT) in five schizophrenic patients in a simulated ECT (SECT) controlled experimental design. The data were compared to those obtained from a group of 10 depressed patients treated with ECT. In the schizophrenic group, both PRL and TSH increased significantly during ECT compared to SECT, as they did in the depressive group during ECT. Thus, the hormonal TSH and PRL profile during ECT is similar in schizophrenia and depression. It is concluded that the changes in TSH and PRL induced by ECT are specifically linked to the current or the seizure, and are not related to the type of psychopathology.     

Neuropsychological assessment of HIV-seropositive haemophiliacs.

Neuropsychological findings from investigation of 46 HIV-seropositive asymptomatic and 14 HIV-seropositive symptomatic haemophiliacs without AIDS-related complex (ARC) or AIDS, with known duration of HIV seropositivity were compared with 29 seronegative controls. Subjects were assessed blindly using a battery of sensitive computerized neuropsychological tests. They underwent a thorough neurological examination, were assessed for mood and screened for psychopathology. Symptomatic HIV-positive haemophiliacs without ARC or AIDS showed statistically significant decreased performances compared with HIV-negatives in choice reaction, visuomotor coordination and global attentional performance (P = 0.018, 0.039 and 0.044, respectively). HIV-positive asymptomatic subjects gave lower performances than HIV-negative subjects in all tests, although these differences were not statistically significant. However, there was a statistically significant trend for these findings between seronegative, asymptomatic and symptomatic groups. Impairment was not associated with mood factors. Duration of seropositivity was found to be a more important factor than Centers for Disease Control stage in the choice reaction test (P less than 0.01). These findings indicate that mild cognitive impairment observed during the natural history of HIV infection in haemophiliacs without ARC or AIDS may be a progressive phenomenon not necessarily associated with the clinical expression of HIV infection.     

Defining the Role of Surgery for Primary Gastrointestinal Tract Melanoma

Objective The objective of the study was to determine the outcomes for primary gastrointestinal melanomas (PGIM). Material and methods The Surveillance, Epidemiology, and End Results database (1973–2004) was queried. Results Overall, 659 cases of PGIM were identified. The annual incidence of PGIM was approximately 0.47 cases per million in 2000. Overall median survival time was 17 months. Tumors were identified in the oral–nasopharynx (32.8%), anal canal (31.4%), rectum (22.2%), esophagus (5.9%), stomach (2.7%), small bowel (2.3%), gallbladder (1.4%), and large bowel (0.9%). Univariate analysis demonstrated age, tumor location, stage, surgery, and lymph node status were significant predictors of improved survival. MST has not been reached for tumors located in the large bowel, while tumors located in the stomach demonstrated the shortest median survival (5 months). Improvement in MST was observed for those patients undergoing surgical resection. The presence of lymph node involvement conferred a poorer prognosis. Multivariate analysis of the cohort identified that location, advanced tumor stage, failure to undertake surgical resection, positive lymph node status, and age were all independent predictors of poorer outcome. Conclusion PGIM occurs most often in the oral–nasopharynx and anal canal. Surgical extirpation is the only identifiable treatment modality that significantly improves survival.     

Recent developments in the care, treatment, and rehabilitation of the chronic mentally ill in Greece

The chronic mentally ill in Greece are primarily cared for in large public mental hospitals or by their families because of the absence of community-based alternatives and the centralization of existing services in Athens and Thessaloniki. However, in the last decade new legislation to improve the lives of the chronically ill has been passed, additional day care facilities have been opened, and the development of decentralized mental health services has been scheduled by the National Health System. A case report illustrates the care provided at Greece's first community mental health center, established in 1979 in Athens.     

Genetic association between the phospholipase A2 gene and unipolar affective disorder: a multicentre case-control study

The co-segregation in one pedigree of bipolar affective disorder with Darier's disease whose gene is on chromosome 12q23-q24.1, and findings from linkage and association studies with the neighbouring gene of phospholipase A2 (PLA2) indicate that PLA2 may be considered as a candidate gene for affective disorders. All relevant genetic association studies, however, were conducted on bipolar patients. In the present study, the possible association between the PLA2 gene and unipolar affective disorder was examined on 321 unipolar patients and 604 controls (all personally interviewed), recruited from six countries (Belgium, Bulgaria, Croatia, Germany, Greece, and Italy) participating in the European Collaborative Project on Affective Disorders. After controlling for population group and gender, one of the eight alleles of the investigated marker (allele 7) was found to be more frequent among unipolar patients with more than three major depressive episodes than among controls (P<0.01); genotypic association was also observed, under the dominant model of genetic transmission (P<0.02). In addition, presence of allele 7 was correlated with a higher frequency of depressive episodes (P<0.02). These findings suggest that structural variations at the PLA2 gene or the chromosomal region around it may confer susceptibility for unipolar affective disorder.     

Priming B cell-mediated anti-HIV envelope responses by vaccination allows for the long-term control of infection in macaques exposed to a R5-tropic SHIV

The potential of vaccine-elicited anti-HIV envelope antibodies to control HIV-infection was evaluated by immunizing macaques with the HIV envelope protein and transiently depleting them of their CD8+ cells before intravenous challenge with the pathogenic CCR5-tropic SIV/HIV chimeric virus, SHIV(SF162P4). Although sterilizing immunity was not achieved, all vaccinated animals effectively controlled infection and remained free of disease for the duration of observation (over 3 years). In contrast, during the same period, the control animals progressed to disease. Both the vaccinees and the controls developed robust cell-mediated antiviral and neutralizing antibody responses following infection. A comparative analysis of these responses suggests that the more effective long-term control of infection by the vaccinated animals is due to the more rapid development of anti-HIV envelope antibodies. These studies suggest that priming by vaccination of B cell anti-HIV envelope responses maybe crucial for the long-term control of HIV infection.     

Electrode Placement and Prolactin Response to Electroconvulsive Therapy

Study of serum prolactin during electroconvulsive therapy (ECT) in depressive patients revealed a greater prolactin increase after bilateral than after unilateral ECT. A linear correlation between the two types of prolactin response was found for a group of 10 patients, a finding that suggests a quantitative rather than a qualitative difference between bilateral and unilateral ECT with regard to their prolactin-releasing properties. The magnitude of prolactin response did not differ between right and left unilateral ECT, nor in a systematically studied case of postictal dysphoric excitement that occurred after right, but not after left, unilateral ECT. In this case, maximal prolactin response occurred earlier with right than with left unilateral ECT. Prolactin increase after ECT was not correlated with such factors as severity of depression nor seizure duration.     

A rational approach to the diagnosis of hypertrophic pyloric stenosis: do the results match the claims?

The currently accepted premise that the diagnosis of hypertrophic pyloric stenosis (HPS) should be made on clinical grounds, with ultrasound (US) and upper gastrointestinal series (UGIS) reserved for those with a negative clinical examination, was tested. Variable clinical skills of initial examiners, including pediatric surgeons, made abdominal palpation no more sensitive or specific than US or UGIS. For those with a negative clinical examination, proceeding directly to a UGIS will result in monetary savings, especially if good clinical performance decreases the probability of HPS among those without palpable pyloric "tumors." The benefits of a "US first" approach (no radiation, better patient and parent acceptance, no contrast medium) are less apparent but no less important and increase as clinical experience declines and performance of US improves. Criteria for the clinical or sonographic diagnosis of HPS should be kept strict to avoid false-positive results; false-negatives and other causes of vomiting should be identified by UGIS.