A 78-year-old female with a nine-year history of depression was hospitalized due to worsening depression and symptoms associated with Parkinson's disease (PD). Her motor abilities improved on levodopa and the depression improved after a trial of bupropion, following unsuccessful treatment with other antidepressants. We found four reports on successful treatment of depression in PD with bupropion. However, no controlled double-blind studies have been conducted so clinicians should be cautious when administering bupropion in depression in PD.

Erythrocyte COMT activity was determined in 31 healthy persons (16 men, 15 women) and in 34 persons with endogenous depressive syndrome (12 men, 22 women). It was found that enzyme activity is significantly higher in healthy men than in healthy women. In the group of women with endogenous depressive syndrome COMT activity is elevated as compared with the group of healthy women (P less than 0.05). This is true of all forms of affective disease: bipolar, unipolar, and undifferentiated. High COMT activity in women with depression is apparent mainly in patients whose first and second degree relatives revealed psychiatric disturbances, particularly affective disorders. This supports the significance of the sex factor in the genetic transmission of affective disorders, and a possible involvement of COMT activity changes in the pathogenesis of such disorders in women. No correlation was found between the changes in COMT activity and the psychopathological picture of depression or the severity of endogenous depressive syndrome.

IntroductionMothers after childbearing are vulnerable to many stress related disorders.Objectiveto emphasize the role of the past obstetric complications, as so present infant pathology as risk factors for the mother's post partum stress related disorders.MethodsThe case analysis.Case descriptionThe thirty-year-old, women left the maternity ward with her baby unnoticed on the fourth day after giving birth. She was referred to psychiatry ward, after finding her by the police. In the past history the patient had spontaneous miscarriage in the first pregnancy. She has waited with her husband 6 years long for the next baby. The second pregnancy was at risk, the labor was premature and the infant has palatoschisis. The mother had difficulties with feeding. She feared about baby's life, and had feeling of being neglected by the staff. In psychiatry ward she did not reveal any symptoms of mental illness. She was interested in her child, however the period of the flight was covered with memory gap. The predominance of immature defense mechanisms, as so mild cognitive dysfunctions were revealed in psychological testing. The dissociative fugue was diagnosed. The patient was discharged without any medication to ambulatory psychotherapy.CommentaryThe interaction of past and present traumatic experiences in the patient with cognitive dysfunctions and immature defense mechanisms could impair ability of post-partum coping with fear about the child and consequently led to the loss of conscious control over the memory. Early diagnosing and supporting problematic patients of the maternity ward is needed.

Parkinson's disease (PD) is a neurological disease with a heterogeneous pattern of neurological symptoms and concomitant psychiatric syndromes. These syndromes are triggered by alterations to neurotransmission that are likely common for both neurological and psychiatric symptoms. Syndromes such as depression, anxiety, or cognitive impairment can precede motor symptoms of PD and delay its diagnosis. Recently, questions related to aetiological factors and treatment strategies of depression in PD have become a growing concern of PD researchers. This article describes the main features of depression in PD and presents current hypotheses on its aetiology and recommended treatment modes.

Platelet MAO activity was determined in blood from 31 healthy persons and 43 persons with endogenous depressive syndrome. It was found that the enzyme activity is significantly higher in women than in men, both in healthy controls and in affective illness groups. Statistically significant lowering of the enzyme activity was found in the group of women with affective illness as compared with healthy women controls (P less than 0.05). Although the latter phenomenon is true of all three diagnostic subgroups of affective disorder (bipolar, unipolar, undifferentiated), it is most pronounced, and statistically significant only in the group of women with an undifferentiated course of disease. A small rise in the enzyme activity was noticed in some patients during remission, as compared with a period of depression, but this was not statistically significant. Analysis of the possible links between MAO activity and the clinical picture, or the severity of depression, revealed no significant correlations. No correlation was found between the level of MAO activity and a family history of psychiatric disturbances in general, and affective disorders in particular--in either women or in men.