Context:It is unclear whether patients with asymptomatic primary hyperparathyroidism (PHPT) do better with parathyroidectomy (PTx) as compared with conservative medical management. Objective:The aim of the study was to evaluate the beneficial effect of PTx vs. conservative management in patients with mild asymptomatic PHPT. Design:We conducted a prospective, randomized study. Setting:The study took place at a referral center. Patients:We studied 50 patients who did not meet any guidelines for parathyroid surgery as recommended by the National Institutes of Health Consensus Development Conference on Asymptomatic PHPT.Intervention: Patients were randomly assigned to PTx or no PTx and were evaluated at 6 months and at 1 yr. Main Outcome Measures:We compared changes (percentage of basal) of lumbar spine bone mineral density (BMD) between the two groups at 1 yr. Results:The change in BMD at lumbar spine was greater after PTx (ϩ4.16 Ϯ 1.13 for PTx vs. Ϫ1.12 Ϯ 0.71 for no PTx; P ϭ 0.0002). The change in BMD at the total hip was also significantly greater in the PTx group (ϩ2.61 Ϯ 0.71 for PTx vs. Ϫ1.88 Ϯ 0.60 for no PTx; P ϭ 0.0001). There was no difference in BMD after 1 yr between both groups at the one-third radius site. In comparison with those who did not undergo surgery, the PTx subjects, after 1 yr, showed significant differences in four quality of life measures as determined by the 36-item short form health survey scale: bodily pain (P ϭ 0.001), general health (P ϭ 0.008), vitality (P ϭ 0.003), and mental health (P ϭ 0.017). Conclusions:In patients with mild asymptomatic PHPT, successful PTx is followed by an improvement in BMD and quality of life.

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The aims of this study were to identify the frequency of the risk factors for postpartum depression (PPD) listed in the Postpartum Depression Predictors Inventory-Revised (PDPI-R) during pregnancy and 1 month after delivery and to determine the predictive validity of the PDPI-R. The study used a prospective cohort design. Women completed the PDPI-R at the 3rd and the 8th months of pregnancy and at the 1st month after childbirth. Women were prospectively followed across three different time points during the postpartum using Structured Clinical Interview for DSM-IV Disorders to determine the presence of major or minor depression. The prenatal version of the PDPI-R administered at two different time points during pregnancy predicted accurately 72.6% and 78.2% of PPD and the full version administered at the 1st month after delivery predicted 83.4% of PPD. The cutoffs identified were 3.5 for the prenatal version and 5.5 for the full version. The PDPI-R is a useful and a valid screening tool for PPD.

The aim of this study was to assess suicidality in a non-clinical sample during the perinatal period and to report suicidality rates in women with major or minor depressive episode (MmD), assessed with the SCID, during the perinatal period. Women (1,066) were recruited at the third month of pregnancy and followed until the 12th month postpartum (N = 500). Suicidality was assessed with the MOODS-SR and with item 10 of the EPDS at different time-points during the perinatal period. The period prevalence of suicidality was 6.9% (95% CI: 6.0-7.8) during pregnancy and 4.3% (95% CI: 3.4-5.2) during postpartum, assessed with the MOODS-SR, and was 12.0% (95% CI: 10.8-13.2) during pregnancy and 8.6% (95% CI: 7.4-9.8) during the postpartum period, assessed with the EPDS. The prevalence of suicidality in women who had MmD during pregnancy was 26.4% and 34.1%, assessed with the MOODS-SR and the EPDS, respectively, while it was 18.4% (MOODS-SR) and 30.6% (EPDS) during the postpartum period. Clinicians should assess suicidality in women presenting with MmD during the whole perinatal period. Furthermore, suicidality should be assessed in women with a previous history of psychiatric disorder that reported a lifetime suicidal ideation.