Les auteurs font la revue des études récentes concernant l’épidémiologie de la dépression. Les études épidémiologiques de la dépression dans la population générale sont difficiles à interpréter, du fait de différences dans l'identification des cas et de variations dans les procédures de diagnostic entre les études. Mais il y a eu un progrés considérable avec le récent développement des méthodes d’identifications de cas, fiables et valides, comme les RDC et le DSM-III. D’autres problémes méthodologiques concernent le choix de la population et le choix des différentes mesures du risque.

Des données examinées, on peut tirer les estimations suivantes : la prévalence sur six mois de la dépression majeure est de 1% à 3% chez l’homme, et 3% à 5% chez la femme; la prévalence sur la vie entiere (proportion des sujets qui ont déjà présenté le trouble) est de 3% à 6% chez l’homme et 5% à 10% chez la femme. L’estimation du risque morbide (ou risque sur la vie entiére) est plus difficile. Le principal probléme provient de l’effet de cohorte de naissance: il semble que les taux de troubles affectifs majeurs sont en train d’augmenter dans les cohortes nées apres la Seconde Guerre mondiale.

Aussi, les auteurs proposent une estimation des risques sur la vie entiére qui ne peut être que prudente: 6 à 10% chez l’homme, 12 à 20% chez la femme. Ils envisagent aussi l’épidemiologie de la dépression sous l’angle de la mortalité: les troubles affectifs sont associés non seulement à un haut risque de suicide mais aussi à une mortalité générale augmentée.

We performed a blind family interview study of 226 first-degree relatives of 63 probands meeting DSM-III criteria for schizophrenia, schizoaffective disorder, and bipolar disorder, as diagnosed by the National Institute ot Mental Health Diagnostic Interview Schedule (DIS). A small test-retest reliability study demonstrated good agreement between the proband interviewer and the principal family interviewer for the major diagnostic categories of psychotic disorders. Excellent compliance was obtained, with 85% of living relatives interviewed personally.

Three principal findings emerged front the study. First, as expected, bipolar disorder, as defined by DSM-III, displayed a strong familial comportent, comparable to that found by many studies using criteria other than those of DSM-III. Second, patients meeting DSM-III criteria for schizophrenia and schizoaffective disorder displayed a low familial prevalence of schizophrenia. Although initially suprising, this finding is in agreement with the results of several other recent lantily studies of schizophrenia. Upon comparing our results with those of other recent family studies of schizophrenia, it appears that the familial component in schizophrenia tnay be less than was estimated by earlier studies using older and “broader” definitions of schizophrenia.

Third, we found that patients meeting DSM-III criteria for schizophrenia appeared genetically heterogeneous. Those who had displayed a superimposed full affective syndrome at some tinte in the course of their illness, together with those probands meeting DSM-III criteria for schizoaffective disorder, displayed a high familial prevalence of major affective disorder, similar to that found in the families of the bipolar probands. On the other hand, “pure” DSM-III schizophrenie probands, who had never experienced a superimposed full affective syndrome, displayed a low familial prevalence of major affective disorder, similar to that found in the general population. These findings favor the possibility that probands meeting DSM-III criteria for schizophrenia, but displaying a superimposed full affective syndrome, may in sonie cases have a disorder genetically relatcd to major affective disorder.

Further prospective family interview studies, using DSM-III criteria and larger samples, will be necessary to test these preliminary impressions.

The present study was designed to evaluate the linguistic capacities of retarded adolescents. Four different settings of verbal interaction were suggested to seventeen retarded adolescents. The conversations of each dyad were recorded on audiotape and transcribed word for word, then analysed according to eighteen indices. The analyses focused on the differences between situations by measuring the indices as well as the relationships between the indices. The results indicate that although the discourse of retarded adolescents is repetitive, it is almost always informative and varies according to the status of the interlocutor. Moreover, regarding its developmental aspect, age appears to be a significant factor in the use of communicative strategies; such findings may have pedagogical applications.

Rushing (1968) offers two hypotheses for the possible structural connection between suicidal and chronic alcoholic case groups : the “processual cause theory” is based on the idea that alcoholism leads through its problematic nature to suicide attempts. In the “common cause theory” alcoholism and suicidai acts are due to mutually shared factors, e.g., social isolation and enforced social integration.

Data on suicide and suicide attempts were obtained as a separate aspect of a comprehensive follow-up investigation. All patients from one particular region in Austria, who had been admitted to hospital between 1976 and 1978 for treatment of chronic alcoholism took part in this study. Follow-up time was 4 to 7 years. 101 patients died during this period. 356 patients remained under close follow-up investigation. In addition to information about basic drinking habits, we attempted to identify predictive factors regarding the course of alcoholism and investigated familial circumstances, development and interactions.

In contradiction with both theories forwarded by Rushing, we were able to isolate a special subgroup of chronic alcoholics attempting or committing suicide. This group is characterized by a depressive symptomatology (endogeneous-depressive syndrome, according to the Viennese Diagnostic Criteria), as well as by the presence of other psychiatrie disturbances underlying chronic alcohol abuse. Family histories also uncovered evidence of psychiatric illnesses. Cases of negative alteration in social status and problematical partnerships could be found in this subgroup. Drinking habits themselves did not differ from non suicide-prone alcoholics.

Dexamethasone suppresson test (DST) was administered to 26 chronic schizophrenic inpatients who were on stable doses of neuroleptics for over 3 months. Clinical assessments were made on the Brief Psychiatric Rating Scale (BPRS), the Manchester Scale (KGV) and the Scale for the Assessment of Negative Symptoms (SANS). Patients’ neuroleptic treatment was then stopped for 4 weeks and the clinical assessements and the DST repeated. Thirty two percent of the patients showed DST non-suppression which was mostly stable over the 4-week period of the study and was unaffected by the neuroleptic treatment. Contrary to some reports in the literature, the clinical rating scores (including those for depression and negative symptoms), in our patients, showed no relationship with the DST status. We suggest that the DST abnormality in chronic schizophrenies may result from two quite different mechanisms: one due to stress assoeiated with transient psychopathology such as agitation, anxiety, depression or psychotic perturbation which is transient, the other resulting from structural abnormalities in the brain and which remains stable over time.

The dopaminergic agonist apomorphine hydrochloride (0.1, 0.2 and 0.4 mg s.c.) compared to placebo in a double-blind, latin square design induced yawing in population of 8 healthy volunteers. Yawning was the only behavioral effect observed and was not dose-related, as all the 3 doses were equipotent. Yawning was maximum between 10 and 20 min post-injection and did not last longer than 20 min. Compared to the data in the literature, 0.1 mg is the lowest dose described as inducing yawning in man. Further studies using doses lower than 0.1 mg would be required to determine the highest inactive dose in order to use apomorphine-induced yawning as an index of CNS dopaminergic receptor sensitivity.