No abstract

The efficacy of lithium prophylaxis in bipolar affective disorder in clinical practice was investigated. Comparison was made between 41 patients who were prescribed prophylactic lithium after two admissions in two years or three admissions in five years and a group of patients who did not receive lithium. The benefits conferred by the prescription of this drug were modest compared with the results from clinical trials.

A new scale for the evaluation of feelings of guilt is described. Two types of guilt feeling were of potential interest: 'delusional' guilt or shame (experienced in relation to one's actions), and 'affective' guilt (a more general feeling of unworthiness). Reliability and validity analyses for the first (15-item) version of the scale were performed in three separate and contrasting clinical samples. The second and final (seven-item) version was tested in another sample of major depressives and in normal controls. The HRSD was used as a measure of severity throughout. The BDI and Widlöcher psychomotor retardation scale were also used as external criteria for the seven-item scale. Exploratory factor analysis of this sample yielded two factors--'cognitive/attitudinal' and 'mood/feeling'--of which only the first correlated with scores for psychomotor retardation. It is suggested that these two factors represent two forms of guilt, but that only the former is related to a putative dopaminergic disorder. Guilt scores and measures of severity were not correlated. It is suggested that feelings of guilt should be considered as a behavioural marker for a subtype of depression.

The effects upon growth hormone (GH) secretion of oral baclofen were determined in 20 male volunteers. Doses of either 5 mg or 0.25 mg/ kg (approx. 20 mg) of baclofen were employed. No stimulation of growth hormone secretion could be discerned in the 90 min following ingestion, a result which is in contrast with the findings of a previous study. We conclude that stimulation of GH secretion by baclofen at low doses does not provide a ready assay of GABAB function in man. KEY wow-Baclofen, growth hormone, GABAB