Renal function in 32 patients treated with lithium for an average period of 10 years was reexamined 2 years after the first examination. A markedly influenced tubular function leading to increased urine volume (average 3 litres/24 h) and decreased renal concentrating capacity was still found, whereas glomerular function remained unimpaired in nearly all of the patients. No statistically significant changes in renal functions were observed at the follow-up examination. The results were compared with the same renal functional tests obtained from a control group consisting of 53 patients with affective disorders never treated with lithium. The control group had a significantly lower urine output (average 2 litres/24 h), but lithium-treated patients on a one-dose schedule had an average urine volume of only 500 ml/24 h more than the controls. In conclusion, this prospective study found no evidence of a progressive impairment of glomerular or tubular function in lithium-treated patients reexamined after 2 years. Patients with affective disorders never treated with lithium had normal renal concentrating capacity.

The reliability of the total scores on three rating scales (Melancholia Scale and the two Newcastle Scales) and the algorithms leading to the Feighner, Research Diagnostic Criteria, and the DSM-III subtypes of depression have been compared. The degree of inter-observer agreements for the various item-combinations was significantly higher than would be expected by chance. The average agreement for each assessment system ranged from 80 to 93 per cent. This 7 to 20 per cent lack of total agreement probably reflects the limitation of clinical assessments including the influence of halo effects.

Intravenous injection of radioactive phosphate and 300 to 900 Mmoles of LiCl was found (1) to increase radioactive phosphorus in muscle, liver, and brain, and (2) to decrease radioactive phosphorus in skull and decrease serum phosphate concentration. These findings may be secondary to the lithium action on carbohydrate metabolism.

Administration of lithium chloride to rats increased serum magnesium. The distribution of injected 28 Mg was also changed by lithium: radioactivity in serum was increased, radioactivity in bone was decreased. The results were similar to those which could be obtained with radioactive calcium. It is suggested that the results were secondary to lithium effects on carbohydrate metabolism.