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One of the diagnostic criteria for posttraumatic stress disorder (PTSD) is an exaggerated startle response; however, this phenomenon has not been verified empirically. The authors compared 20 Vietnam combat veterans with PTSD and 18 combat veterans without PTSD on the eyeblink reflex electromyographic response of the startle reaction. Subjects in both groups who failed to show an eyeblink response to the startle stimuli were eliminated from further analyses. Among the remaining subjects, the 13 with PTSD had a significantly greater startle response amplitude than the 12 control subjects at intermediate intensities of acoustic stimuli. The relationship between startle responsivity and both negative and positive symptoms was also investigated.

Background: Depression has been associated with a decrease in intracellular serotonin (5-HT) reuptake through its transporter, SERT. The 5-HT transporter long promoter region (5-HTTLPR) deletion in the SERT gene has also been associated with a decrease in 5-HT reuptake. Conversely, increases in extracellular 5-HT have been associated with increased temperature. It has not been established, however, whether body temperature in depressed patients is different from controls. Here, we hypothesized that temperature would be increased in depressed patients as well as in those with the 5-HTTLPR deletion. Methods: A strict oral temperature protocol employed single, cross-sectional, naturalistic time-of-day temperature measures in 125 subjects (46 normal controls, 79 outpatients with major depression). Controls and depressed patients were free of psychotropic medication and classified by the Structured Clinical Interview for Psychiatric Diagnoses. Eighty-one of the subjects (68 depressed, 13 normal) were additionally genotyped for 5-HTTLPR polymorphisms. Results: Depressed patients had a significantly higher uncorrected body temperature (mean ± SD 98.38 ± 0.61°F) than controls (mean ± SD 98.13 ± 0.59°F; F = 4.8, p = 0.03). An age (F = 14.09, p < 0.001) and time-of-day (11.4, p = 0.001) correction revealed a more robust (F = 14.02, p < 0.001) difference between depressed patients (mean ± SD 98.44 ± 0.55°F) and controls (mean ± SD 98.02 ± 0.56°F). When normalized for age and circadian differences between subjects, random, outpatient oral temperatures had a sensitivity of 63% and a specificity of 76% in identifying the depressed subjects from the controls. Independent of depression, subjects with the 5-HTTLPR deletion (short SERT allele) were warmer (mean ± SD 98.33 ± 0.65°F) than those lacking the short allele on either chromosome (mean ± SD 97.91 ± 0.69°F; F = 7.0, p = 0.01). However, the genotype did not explain the temperature differences between controls and depressed patients. Conclusion: This is the first demonstration of an increased daytime body temperature in cases with major depression. Subjects with a corrected temperature above 98.3°F were 2.6-fold more likely to be depressed. The results may strengthen the hypothesis of an inflammatory component of depression. In addition, the findings suggest a potential link between genetic differences in 5-HT transport and body temperature.

In order to determine whether baseline depression was related to initial success or failure in smoking cessation, we prospectively examined mood self-ratings in a pilot study of 43 unselected smokers attempting to quit smoking in an outpatient program. Mean pretreatment POMS depression scores in the subjects who were unable to quit were significantly higher compared to those successful in initially relinquishing smoking. These preliminary results suggest that a negative-affect group at high risk for failure in nicotine dependence treatment might be identified in advance by an assessment of mood done prior to treatment.

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