The present study confirms the high prevalence of mental disorders in a general practice setting, and their frequent association. Prevalence rates of our study are even higher than those obtained in previously conducted trials. Our study also demonstrates the utility of the PRIME-MD as a screening tool for mental disorders in primary care. In addition the use of the handheld computer software version of the PRIME-MD allowed us to screen for mental disorders in patients who are unable to attend the GP office and are seen during 'home' visits.

A previous Generalized Anxiety Disorder Impact Survey (GADIS I) performed on 15,399 Belgian patients consulting their primary care physicians, revealed high prevalences of generalized anxiety disorder (GAD) and major depression (MD) with important regional differences. The objective of this study (GADIS II) was to replicate previous findings and to evaluate the role of socioeconomic factors in the diagnoses of GAD and MD. A large-scale cross-sectional survey was conducted in a random sample of 377 general practitioners distributed geographically over Belgium and Luxemburg. Each physician was asked to screen 40 consecutive patients at predefined time periods for the presence of GAD and MD using sections of the Mini International Neuropsychiatric Interview (MINI). Socioeconomic parameters were collected. The level of impairment was assessed using the Sheehan Disability Scale. In a sample of 13,699 patients, point prevalences of GAD and of MD were found to be 13.4 and 11.0%, respectively. Overall, 17.8% of the population was positive for GAD and/or MD. Both disorders were significantly more frequent in women than in men. Marked regional differences were observed with prevalences for GAD and/or MD of 24.2% in Brussels, 22.7% in Wallonia, 13.6% in Luxemburg and 12.9% in Flanders. Several socioeconomic factors were significantly associated with positive diagnoses: living alone, a low level of education and unemployment. However, regional differences remained significant even after controlling for socioeconomic factors. The study confirms the high prevalence of GAD and MD in primary care and the role of several socioeconomic and regional factors in the illnesses.

Seahorses and pipehorses both possess a prehensile tail, a unique characteristic among teleost fishes, allowing them to grasp and hold onto substrates such as sea grasses. Although studies have focused on tail grasping, the pattern of evolutionary transformations that made this possible is poorly understood. Recent phylogenetic studies show that the prehensile tail evolved independently in different syngnathid lineages, including seahorses, Haliichthys taeniophorus and several types of so-called pipehorses. This study explores the pattern that characterizes this convergent evolution towards a prehensile tail, by comparing the caudal musculoskeletal organization, as well as passive bending capacities in pipefish (representing the ancestral state), pipehorse, seahorse and H. taeniophorus. To study the complex musculoskeletal morphology, histological sectioning, lCTscanning and phase contrast synchrotron scanning were combined with virtual 3D-reconstructions. Results suggest that the independent evolution towards tail grasping in syngnathids reflects at least two quite different strategies in which the ancestral condition of a heavy plated and rigid system became modified into a highly flexible one. Intermediate skeletal morphologies (between the ancestral condition and seahorses) could be found in the pygmy pipehorses and H. taeniophorus, which are phylogenetically closely affiliated with seahorses. This study suggests that the characteristic parallel myoseptal organization as already described in seahorse (compared with a conical organization in pipefish and pipehorse) may not be a necessity for grasping, but represents an apomorphy for seahorses, as this pattern is not found in other syngnathid species possessing a prehensile tail. One could suggest that the functionality of grasping evolved before the specialized, parallel myoseptal organization seen in seahorses. However, as the grasping system in pipehorses is a totally different one, this cannot be concluded from this study.

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