The construction of a depression rating scale designed to be particularly sensitive to treatment effects is described. Ratings of 54 English and 52 Swedish patients on a 65 item comprehensive psychopathology scale were used to identify the 17 most commonly occurring symptoms in primary depressive illness in the combined sample. Ratings on these 17 items for 64 patients participating in studies of four different antidepressant drugs were used to create a depression scale consisting of the 10 items which showed the largest changes with treatment and the highest correlation to overall change. The inner-rater reliability of the new depression scale was high. Scores on the scale correlated significantly with scores on a standard rating scale for depression, the Hamilton Rating Scale (HRS), indicating its validity as a general severity estimate. Its capacity to differentiate between responders and non-responders to antidepressant treatment was better than the HRS, indicating greater sensitivity to change. The practical and ethical implications in terms of smaller sample sizes in clinical trials are discussed.

A new depression scale designed to be sensitive to change.

This review provides the rationale and background for the development of diagnostic criteria for depression of Alzheimer disease (AD), including risk factors and neurobiological correlates, epidemiology, and clinical characteristics, along with course, assessment, treatment, economics, a description of the criteria, and future research directions. Overall, there is substantial research to suggest that the depression that may co-occur with AD is different from other depressive disorders. Further research is needed to better define core symptoms, clinical course, and efficacy of treatments.

Provisional diagnostic criteria for depression of Alzheimer disease: rationale and background.

Pharmacological prevention of suicidal behaviour.

Objective: Sleep problems may adversely affect neuronal health. We examined a subjective report of change (reduced duration and/or depth) in sleep pattern in relation to subsequent risk of incident ...

A Change in Sleep Pattern May Predict Alzheimer Disease

Object--The aim of this investigation was in the first place to study the relation between mental retardation and other mental disturbances. The second aim was to study the frequency of severe and mild mental retardation in an adult Swedish population and to throw some light on the socio-medical situation of the adult mentally retarded. Methods--A primary sample, stratified with respect to population density, was extracted from the population in the age group 20-60 years, resident in Kopparberg County, Sweden, on 1 July 1977. The mildly and severely mentally retarded in this sample were identified. Enquiry was made into the presence of additional handicaps in the mentally retarded. Social conditions including alcohol consumption and the occurrence of abuse and criminality were studied in the two retarded groups and a control group representing the rest of the population. The three groups were compared by rating with the Comprehensive Psychopathological Rating Scale (CPRS), by classification of any mental illness present according to the Diagnostic and Statistical Manual of Mental Disorders (DSM-III) and by determining their intake of psychotropic drugs and anti-epileptics. The mildly mentally retarded and the control group were also compared with respect to neuroticism and extraversion-introversion by rating with the Eysenck Personality Inventory (EPI). Results--The study revealed a prevalence of 0.27% for severe (IQ less than 53) and 0.32% for mild (IQ 53-73.7) mental retardation in the age group 20-60 years. All the severely retarded, but only just over half the mildly retarded, were known to the care authority. The majority of the former were living in some form of institution, whereas this applied to only 15% of the mildly retarded. Nineteen per cent of the severely retarded and 4% of the mildly retarded had manifest epilepsy. Defects of movement and of hearing were most prominent among the mildly retarded, while the frequency of specific speech disturbances was greater among the severely retarded, approximately 10% of whom had no power of verbal communication. Visual defects were recorded in about one-third of both groups. The study showed that alcohol intake was lower among both the severely and mildly mentally retarded than among the persons in the control group and that the frequency of abuse and criminality was as high among persons of higher intelligence as among the mentally retarded. The severely retarded, particularly the men, showed a raised psychiatric morbidity as compared with the mildly retarded and the control group.(ABSTRACT TRUNCATED AT 400 WORDS)

Psychiatric illness among the mentally retarded. A swedish population study.

To test the reliability and robustness of the CPRS in use by different disciplines we obtained 49 pairs of ratings on depressed patients in England and Sweden during treatment. Each rater pair consisted of a psychiatrist trained as a rater plus either a psychologist, a general practitioner, or a nurse, who had not been trained as a rater. The 17 most commonly rated items in depressive illness showed good inter-rater reliability for all groups and demonstrated the robustness of the scale even in training sessions. The implications of this for future interdisciplinary research are discussed along with suggestions for the use of the CPRS for teaching purposes.

Reliability of the CPRS between the disciplines of psychiatry, general practice, nursing and psychology in depressed patients.

54 English and 52 Swedish patients suffering from primary depressive illness were rated on the full 65 item CPRS scale to examine cross cultural differences. The correlation of the frequencies of items scored in the different patient samples was highly significant (r = 0.88). Of the most commonly scored items (occurring in more than 70% of any of the patient groups) 17 were common to both samples. The three items not in common for the two centres are compared and discussed. The inter rater reliabilities of the Swedish and English teams are compared alongside the inter rater reliabilities of a Swedish rater and an English rater on English patients and are generally good. The remarkable similarity of the psychopathology of primary depressive illness in both cultures and some of the implications are discussed.

Cross cultural studies on the use of cprs in english and swedish depressed patients

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Reliability of the CPRS between the disciplines of psychiatry, general practice, nursing and psychology in depressed patients.

Cross cultural studies on the use of cprs in english and swedish depressed patients