Longitudinal trajectories of depression and anxiety in a prospective community study: the Zurich Cohort Study.

Background: The dearth of long-term follow-up studies of community-based samples and differences in methodology in existing studies highlight the need for research designed to examine the stability, comorbidity, and diagnostic thresholds of depression and anxiety in the community.

Methods: Prospective study of a community-based cohort aged 19 and 20 years from the canton of Zurich, Switzerland. Semistructured diagnostic interviews were administered by clinically experienced interviewers at 5 assessment points during a 15-year period.

Recurrence of bipolar disorders and major depression. A life-long perspective.

Objective: It is not known whether the risk of recurrence declines with time in bipolar disorders and in major depression. This study describes the life-long recurrence risk of bipolar I, bipolar II and major depressive disorders.

Method: 160 bipolar-I, 60 bipolar-II and 186 depressive patients hospitalised between 1959 and 1963 were followed up every five years from 1965 to 1985.

Diagnostic issues in bipolar disorder.

Bipolar disorder is a highly recurrent and chronic psychiatric condition that shortens life expectancy, causes functional impairment and disruption to social, work and family life. Several forms of bipolar disorder are recognised, including both bipolar I and bipolar II disorder. Bipolar I is characterised by recurrent episodes of depression and mania whereas bipolar II disorder is characterised by recurrent depression and hypomania, a milder form of mania.

Risk factors for the bipolar and depression spectra.

Objective: To identify risk factors for mood disorders in a community sample studied from the ages of 20 to 35 years.

Method: Social characteristics, a family history of mood disorders and some personality features were analysed as risk factors for bipolar and depressive disorders by means of logistic regression.

Results: Frequent 'ups and downs' of mood were the strongest risk factor for both bipolar and depressive disorders; a weaker risk factor for both was emotional/vegetative lability (neuroticism).

The Zurich Study: participation patterns and Symptom Checklist 90-R scores in six interviews, 1979-99.

Objective: The Zurich study is a longitudinal study in psychiatric epidemiology that started in the late 1970s. The sixth interview in 1999 provides the basis to investigate and update the participation and drop-out patterns of the Zurich subjects.

Method: Aside from descriptive analyses, particular attention was paid to the Symptom Checklist 90-R (SCL-90-R), used initially to stratify the Zurich sample.

Is recurrent brief depression an expression of mood spectrum disorders in young people? Results of a large community sample.

The clinical relevance of Recurrent Brief Depression (RBD) has not received sufficient attention to date and continues to represent a controversial issue. The present study was carried out in a community sample to evaluate the lifetime prevalence of RDB, the degree of comorbidity, as well as possible risk factors. Subjects from a community survey in Sardinia (Italy) were randomly selected from registers of a rural, an urban and a mining area (n=1040, 461 males, 579 females).

Cyclothymic OCD: a distinct form?

Background: Clinical research on the comorbidity of obsessive compulsive disorder (OCD) and other anxiety disorders has largely focused on depression. However in practice, resistant or severe OCD patients not infrequently suffer from a masked or hidden comorbid bipolar disorder.

Method: The rate of bipolar comorbidity in OCD was systematically explored among 453 members of the French Association of patients suffering from OCD (AFTOC) as well as a psychiatric sample of OCD out-patients (n=175).

Recurrent brief depressive disorder reinvestigated: a community sample of adolescents and young adults.

Background: This article presents prospective lower bound estimations of findings on prevalence, incidence, clinical correlates, severity markers, co-morbidity and course stability of threshold and subthreshold recurrent brief depressive disorder (RBD) and other mood disorders in a community sample of 3021 adolescents.

Method: Data were collected at baseline (age 14-17) and at two follow-up interviews within an observation period of 42 months. Diagnostic assessment was based on the Munich Composite International Diagnostic Interview (M-CIDI).

Treatment of depressive disorders with and without medication - a naturalistic study.

Objective: Although randomized clinical trials are the standard method for comparing the efficacy of various depression treatments, the external validity and generalizability of findings obtained by this approach can be questioned for several reasons. In this naturalistic study, we compared the effectiveness of treatments conducted by psychiatrists and clinical psychologists without prescription of drugs to treatments by psychiatrists and physicians using antidepressant agents in patients with depressive disorders in a representative sample of the normal population. Our assumption was that this sample is more representative for subjects treated for depressive disorders than subjects included in controlled trials.

Toward a re-definition of subthreshold bipolarity: epidemiology and proposed criteria for bipolar-II, minor bipolar disorders and hypomania.

Background: The boundaries of bipolarity have been expanding over the past decade. Using a well characterized epidemiologic cohort, in this paper our objectives were: (1). to test the diagnostic criteria of DSM-IV hypomania, (2).

Factor structure of hypomania: interrelationships with cyclothymia and the soft bipolar spectrum.

Background: No systematic data exists on the phenomenology and psychometric aspects of hypomania. In this report we focus on the factor structure of hypomania and its relationships with cyclothymic temperament in unipolar (UP) and bipolar II (BP-II) spectrum (soft bipolar) patients.

Method: The combined sample of UP and BP-II spectrum patients (n=427) derives from the French National multi-center study (EPIDEP).

A new bipolar spectrum concept: a brief review.

Research on the broad bipolar spectrum is dependent on the definition of hypomania. We recently proposed a new, softer syndromal definition with clinical validity. This broadens the diagnosis of bipolar II (BP-II) disorder at the expense of major depressive disorder (MDD).

World Federation of Societies of Biological Psychiatry (WFSBP) Guidelines for Biological Treatment of Unipolar Depressive Disorders, Part 1: Acute and continuation treatment of major depressive disorder.

These practice guidelines for the biological treatment of unipolar depressive disorders were developed by an international Task Force of the World Federation of Societies of Biological Psychiatry (WFSBP). The goal for developing these guidelines was to systematically review all available evidence pertaining to the treatment of unipolar depressive disorders, and to produce a series of practice recommendations that are clinically and scientifically meaningful based on the available evidence. These guidelines are intended for use by all physicians seeing and treating patients with these conditions.

World Federation of Societies of Biological Psychiatry (WFSBP) Guidelines for Biological Treatment of Unipolar Depressive Disorders, Part 2: Maintenance treatment of major depressive disorder and treatment of chronic depressive disorders and subthreshold depressions.

These practice guidelines for the biological treatment of unipolar depressive disorders were developed by an international Task Force of the World Federation of Societies of Biological Psychiatry (WFSBP). The goal for developing these guidelines was to systematically review all available evidence pertaining to the treatment of the complete spectrum of unipolar depressive disorders, and to produce a series of practice recommendations that are clinically and scientifically meaningful based on the available evidence. These guidelines are intended for use by all physicians seeing and treating patients with these conditions.

Gender differences in depression. Epidemiological findings from the European DEPRES I and II studies.

Background: While there is ample evidence that the prevalence rates for major depressive disorder (MDD) in the general population are higher in women than in men, there is little data on gender differences as regard to symptoms, causal attribution, help-seeking, coping, or the consequences of depression.

Method: The large DEPRES Study dataset covering representative population samples of six European countries (wave I: 38,434 men and 40,024 women; wave II: 563 men and 1321 women treated for depression) was analyzed for gender differences.

Results: In wave I marked gender differences were found in the six-month prevalence rate for major depression but less so for minor depression; the gender differences for major depression persisted across all age groups.

Multimorbidity of psychiatric disorders as an indicator of clinical severity.

The present study examines the clinical and research significance of the high frequency of multiple diagnoses emanating from the non-hierarchical descriptive approach to classification in the current psychiatric diagnostic systems. Data from a 15-year prospective cohort study of young adults from the general community were employed to evaluate the frequency of multiple disorders (i. e.

Toward validation of atypical depression in the community: results of the Zurich cohort study.

Aims: This paper (1) examines the validity of the atypical subtype of depression in a community-based longitudinal cohort study, (2) presents estimates of the prevalence and sex differences of DSM-IV atypical depression and a newly more broadly defined atypical syndrome in the community and (3) compares the clinical correlates and treatment patterns of those with atypical depression with other depressives.

Methods: The Zurich cohort study is comprised of 591 subjects selected from a population-based cohort of young adults representative of the canton of Zurich in Switzerland, who were screened in 1978 with the Symptom Checklist 90-R [L.R.

Historical aspects of the dichotomy between manic-depressive disorders and schizophrenia.

The history of psychiatric classification is highly complex and this presentation must be restricted to a simplified overview. Guislain [Guislain, J., 1833.

[Cyclothymic obsessive-compulsive disorder. Clinical characteristics of a neglected and under-recognized entity].

Objective: Clinical research is largely focused on depressive comorbidity in obsessional compulsive disorder (OCD). However some recent publications have suggested that bipolar comorbidity occurs in authentic OCD and its presence has a differential impact on the clinical picture and course of OCD.

Method: Recent data from the collaborative survey conducted with AFTOC (French Association of patients suffering from OCD) have revealed a high rate of bipolar comorbidity in OCD: 30% for hypomania and 50% for cyclothymia.

[Temperament and affective disorders. The TEMPS-A Scale as a convergence of European and US-American concepts].

In temperament research, three traditions can be found: (1) in psychiatry or psychopathology, (2) in neurobiology, and (3) in developmental psychology. After giving an overview, we present results and theories concerning the relation between temperament and affective disorders. Based on Kraepelin's concept of the fundamental states ("Grundszustände"), we describe four types of temperament: hyperthymic (manic), depressive, irritable, and cyclothymic.

Bipolarity from ancient to modern times: conception, birth and rebirth.

We review the history of bipolar disorders from the classical Greek period to DSM-IV. Perhaps the first person who described mania and melancholia as two different phenomenological states of one and the same disease was the Greek physician of the 1st century AD, Aretaeus of Cappadocia. The modern concept of bipolar disorders was born in France, with the publications of and.

Concurrent psychiatric comorbidity and multimorbidity in a community study: gender differences and quality of life.

This study analysis of a community cohort at the age of 35 focused on the effects of gender and multimorbidity on quality of life and subjective distress. Consistent with an earlier analysis, quality of life decreased with increasing numbers of concurrent psychiatric diagnoses. Women generally reported lower quality of life and higher distress than men.

The spectrum of social phobia in the Zurich cohort study of young adults.

Background: The goals of the present study are to describe the prevalence, risk factors, course, and impact of social phobia in a 15-year prospective longitudinal community study; and to examine an expanded conceptualization of social phobia with respect to clinical indicators of severity, as well as gender differences, personality traits, and stability over 15 years.

Methods: The sample is a cohort of 591 young adults aged 18-19 from the general population of Zurich, Switzerland at study entry who have been followed to age 35.

Results: Six percent of participants met lifetime criteria for social phobia at the diagnostic level, 12% at the subthreshold level, and 24% had social phobia symptoms alone.