Biomedical subjects
Publications and source records attributed to J Barsi.
Out of ten consecutive patients with DSM-III-R obsessive-compulsive disorder without any previous history of bipolarity, three patients showed antidepressant-induced hypomania (clomipramine, one patient; fluvoxamine, two patients) within the first 5 to 8 weeks of the drug treatment. These data support the previous results on a strong association between obsessive-compulsive disorder and bipolar affective illness.
Based on the well-known and strong relationship between suicide and depression, the authors investigated the regional distribution of the suicide rates, rates of diagnosed depressions and rates of working physicians in Hungary. It was found a strong significant positive correlation between the of working doctors and rate of diagnosed depressions, and both the mentioned parameters showed a strong significant negative correlation with the suicide rates. The more is the number of doctors/100,000 inhabitants, the better is the recognition of depression and the lower is the suicide rate in the given region. The rate of working doctors was significantly higher in the countries located in the western part of Hungary, which may have a role in the lower suicide mortality of this area of the country.
1. Moclobemide (Aurorix) is a newly developed, effective, short-acting well tolerable and safe antidepressant which belongs to the new class of reversible monoamine-oxidase-A inhibitors. 2. Aurorix was given per os in an open clinical trial for 6 weeks to 30 patients with DSM-III diagnoses of (nonpsychotic, nonmelancholic), major depression. 3. Out of the 25 patients who completed the study 14 (56%) were responders and 11 (44%) non-responders. 4. The patients tolerated the drug very well, and no serious side-effects were noted. 5. Pretreatment biological markers (dexamethasone suppression test, platelet-MAO-B activity, 3H-imipramine binding, thyroid function) did not have a predictive value regarding the drug response.
Based on the well-known relationship between depression and suicide, we investigated the regional distribution of the suicide rate, rate of diagnosed depression and prevalence of working physicians in Hungary. A strong significant positive correlation was found between the rate of working physicians and rate of diagnosed depression, and both parameters showed a strong significant negative correlation with the suicide rate. The more physicians per 100,000 inhabitants, the better is the recognition of depression and the lower is the suicide rate in the given region. The rate of working doctors was significantly higher in the counties located in western Hungary, which may have a role in the lower suicide mortality in this area of the country.
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Among 100 consecutive suicide victims with primary major depression at the time of their suicide, 46% were found to have had bipolar II depression, 1% bipolar I disorder and 53% non-bipolar major depression. Since the lifetime prevalence rates of bipolar II and bipolar I depressions are relatively low compared to primary major non-bipolar depression, the present findings suggest that bipolar II disorder gives a particularly high risk of suicide among the different subtypes of primary major affective illness. Fifty-nine percent of the patients had medical contact during the depressive episode, but the depression was frequently undiagnosed, untreated or undertreated. The implications of these findings for suicide prevention are discussed briefly.
Regional variations across Hungary in suicide rate and in rate of treated depression were examined. Regional differences in suicide rate as well as psychiatric morbidity were consistent over the 3 years examined (1985, 1986 and 1987). The suicide rate showed a significant negative correlation with the rate of treated depression in each of the 3 years, and weaker negative correlations with perinatal mortality and divorce rate. No correlation between suicide rate and rate of schizophrenia was found. The results suggest that underdiagnosis of depression may contribute to Hungary's very high suicide rate. The implications of this for medical education and psychiatric practice are discussed.
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