Introduction: Depression frequently affects college and university students worldwide. The authors’ purpose was to estimate the positive rate of major depressive episodes (MDE) using a structured self‐report according to annual changes among Japanese university students. Data of freshmen were compared with those of students of other grades. Methods: During 9 years from 2001, 11,164 freshmen filled out the Diagnostic and Statistical Manual for Mental Disorders (DSM) scale for depression every April. During the 8 years from 2002, the same survey was administered to 31,454 students of other grades as a regular examination. Results: The positive rates of MDE were 1.2–2.0% among freshmen; they were 0.8–1.3% among students in other grades. Regarding data after 2005–2007 for female freshmen, the decrease from 2004 to 2007 was significant (P<0.05); from 2002 to 2007 (P<0.05). In 2001, and during 2005–2007, positive rates tended to be higher in male than in female students. Comparisons of MDE of freshmen and students of the other grades showed significant differences in 2005, 2006 (P<0.05), and 2009 (P<0.01). Male freshmen showed higher rates than males of the other grades in 2005, 2006 (P<0.05), 2007, and 2009 (P<0.01). Discussion: The MDE rates among university students were similar to those among the general population in Japan, and lower than those in Western countries. Among male freshmen, rates of MDE were particularly high. The reason for the recent decrease of MDE among female freshmen remains unclear. Sociocultural factors or selection bias should be considered.

Summary:Purpose: To examine a patient with valproic acid (VPA)-induced hyperammonemic encephalopathy accompanied by triphasic waves.Methods: A 61-year-old male patient with epilepsy experienced disturbance of consciousness after VPA dose was increased because of poor seizure control. The electroencephalogram (EEG) taken on admission revealed triphasic waves and high-amplitude &activity with frontal predominance. Although serum hepatic enzymes, such as AST and ALT, were normal, serum ammonium level was high at 96 pg/dl (normal range, 3-47 pg/dl). Serum amino acid analysis showed multiple minor abnormalities. Administration of VPA was discontinued immediately after admission, while other anticonvulsants were continued.Results: The patient's condition was improved on the fourth day of admission. An EEG, serum ammonium level, and amino acid profile were normal on the eighth day. Based on VPA administration, serum ammonium levels, and results of amino acid analysis, this patient had VPA-induced hyperammonemic encephalopathy .Conclusions: Our case indicates that caution is required if triphasic waves appear in VPA-induced hyperammonemic encephalopathy.

Using functional magnetic resonance imaging (fMRI) we were able to observe, in detail, ictal brain hemodynamics during epileptic seizure caused by a brain tumor. A 53-year-old man was experencing partial motor seizures of the left side of his face and neck. In a brain MR image a mass lesion was found in the subcortical area of the right frontal lobe. We found focal spikes in his right hemisphere, though dominantly in C4 and T4 regions. fMRI investigations were carried out at 1.5 T (GE Signa Horizon) using gradient-echo echo-planar neuroimaging. We were able to perform the ictal examination twice. The activated regions were focalized and clearly found only on the lateral side of the tumor base. The region was in agreement with the epileptic focus examined using an electrocorticogram (ECOG). The signal intensity in the seizure focus rapidly increased 30 seconds before the convulsion was observed. After the end of the convulsion it also took 30 seconds to restore the signal intensity to the baseline value. fMRI is a very useful tool for various studies such as the identification of the epileptic focus, the mechanism of epileptic seizure, and so on.

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Content and Cross Validity of the Todai Health Index Depression Scale in Relation to the Center for Epidemiologic Studies Depression Scale and the Zung Self-rating Depression Scale: Tomoyuki KAWADA, et al. Department of Public Health, Gunma University School of Medicine—The validity of the Todai Health Index (THI) depression scale was tested with outpatient data by comparing with a clinical diagnosis based on the DSM III-R criteria of major depression. The cross validity of the Japanese versions of the CES-D score and SDS index were also tested in comparison with the THI scale scores of survey data from Japanese female students. The main results obtained were as follows: 1) The sensitivity, specificity, positive predictive value and negative predictive value of the THI depression scale were 0.91, 0.84, 0.86 and 0.89, respectively, and were satisfactory for identifying clinical cases of depression. 2) The CES -D score and the SDS index showed a high correlation with the THI scale scores, especially with the depression scale of THI. The coefficients of correlation for the THI depression scale and the CES-D score or SDS index were 0.727 and 0.715, respectively. The partial coefficients of correlation for the THI depression scale and the CES-D score or SDS index, when the variances of all other scale scores of the THI were kept constant, were 0.528 and 0.536, respectively. 3) Factor analysis was used to compare SDS and CES-D with 12 THI scales.SDS was related mainly to the psychological complaints and partly related to the physical symptoms. The results indicate that the THI depression scale is valid for use not only in epidemiological surveys but also in monitoring the severity of the depressive state. (J Occup Health 1999; 41: 154-159)