The observational study design for estimating accuracy of diagnostic tests for suicide risk in clinical work is not ideal, due to the effects of directed suicide prevention to the high-risk group. This is an example of the confounding by indication and protopathic bias, which lead to misinterpretation of the accuracy terms sensitivity and specificity. The simple arithmetic mechanism presented here, forces the conclusion that the accuracy estimates sensitivity and specificity, applied in open prospective trials of surmised diagnostic tests for suicide risk, cannot be normally interpreted as accuracy estimators. Further, the related concept "prediction of suicide" is shown to be fundamentally illogical and should not be used in the present context. All these statements reveal a far-reaching problem within the suicide prevention research: Conclusions regarding the usefulness of diagnostic tests of suicide risk in the vast previous research since decades deserve reinterpretation. Diagnostic tests per se, can possess highly qualitative properties in estimating important suicidological aspects regarding a patient, but, when studied in an open design study, it cannot be demonstrated. This problem concerns rating scales and any biological and psychological tests in medicine, when confounding factors, for example, suicide prevention, influence the outcome because of the test result per se.

Background Irritable bowel syndrome (IBS) patients show evidence of altered central processing of visceral signals. One of the proposed alterations in sensory processing is an altered engagement of endogenous pain modulation mechanisms. The aim was to test the hypothesis that IBS patients with (IBS-S) and without visceral hypersensitivity (IBS-N) differ in their ability to engage endogenous pain modulation mechanism during habituation to repeated visceral stimuli.

Methods Brain blood oxygen level dependent (BOLD) response was measured during repeated rectal distension and its anticipation in 33 IBS patients with and without visceral hypersensitivity and 18 healthy controls (HCs). BOLD response to early and late phase of the distension series was compared within and between groups.

Key Results While BOLD response was similar during the early phase of the experiment, IBS-S showed greater BOLD response than IBS-N and HCs during the late phase of the distension series. IBS-S showed increasing BOLD response both to the anticipation and delivery of low intensity rectal distensions in brain regions including insula, anterior and mid cingulate cortex. IBS-N showed decreasing BOLD response to repeated rectal distensions in brain regions including insula, prefrontal cortex and amygdala.

Conclusions & Inferences These findings are consistent with compromised ability of IBS-S to respond to repeated delivery of rectal stimuli, both in terms of sensitization of sensory pathways and habituation of emotional arousal. The fact that both IBS subgroups met Rome criteria, and did not differ in terms of reported symptom severity demonstrates that similar symptom patterns can result from different underlying neurobiological mechanisms.

Background: A meta-analysis of studies investigating electrodermal activity in depressed patients, suggested that electrodermal hyporeactivity is sensitive and specific for suicide. less thanbrgreater than less thanbrgreater thanAims: To confirm this finding and to study electrodermal hyporeactivity relative to type and severity of depression, trait anxiety, its stability and independence of depressive state. Method: Depressed inpatients (n = 783) were tested for habituation of electrodermal responses and clinically assessed using the Beck Depression Inventory (BDI) and the STAI-Trait scale for trait anxiety. less thanbrgreater than less thanbrgreater thanResults: The high sensitivity and raw specificity of electrodermal hyporeactivity for suicide were confirmed. Its prevalence was highest in bipolar disorders and was independent of severity of depression, trait anxiety, gender and age. Hyporeactivity was stable, while reactivity changed into hyporeactivity in a later depressive episode. less thanbrgreater than less thanbrgreater thanConclusions: The findings support the hypothesis that electrodermal hyporeactivity is a trait marker for suicidal propensity in depression.

Calcitonin gene-related peptide (CGRP) seems to be involved in hot flushes in women and in castrated men. Therefore, we studied whether the plasma concentrations of CGRP changed during flushes in a group of healthy aging men. Twelve men (49-71 years) with no history of current or former prostate cancer or hormonal treatment reporting greater than= 20 flushes/week were investigated. Blood samples were drawn during and between flushes for analysis of CGRP and also androgen concentrations, that is, testosterone and bioavailable testosterone were analysed. Skin temperature and skin conductance were monitored. Thirty-five flushes were reported by 10 men. The plasma concentrations of CGRP did not increase during flushes. No significant change in skin temperature or conductance was found. CGRP is probably not involved in the mechanisms of flushes in healthy aging men. Therefore, flushes in aging healthy men seem to be different from flushes in men and women deprived of sex steroids where CGRP increases during flushes.

Purpose: The aims were to describe and analyze how people with experience of long term sick leave perceive that factors in their work environment support or interfere with work performance, satisfaction, and well-being. Method: The 53 participants were interviewed with the Work Environment Impact Scale (WEIS). The WEIS ratings and belonging notes were analyzed by descriptive statistics and qualitative analysis respectively. Differences in WEIS ratings between; women and men; participants with somatic and mental diseases; and participants working and on full-time sick leave were tested. Results: The most supportive factors concerned social interactions at work, and the value and meaning of work. The factors perceived as most interfering concerned work demands and rewards. The social relations at work were perceived as more supportive by the working group than by those on full-time sick leave. The participants with somatic diseases perceived physical work factors as more interfering than did participants with mental diseases, who in turn perceived the value and meaning of work as more interfering. Conclusion: Knowledge about the interaction between the worker and the work environment could reveal useful information about the complex phenomenon of reducing sick leave. The WEIS seems useful in providing information about how alterations and accommodations in the work environment could support individual workers.

Worker Role Interview (WRI) is an assessment tool designed to identify psychosocial and environmental factors which influence a persons ability to return to work. The purpose of this study was to investigate if the Worker Role Interview (WRI) can predict return to work over a period of two years. Fifty three long-term sick-listed people were interviewed and rated with the WRI. Differences in ratings and the ability of WRI to correctly predict whether these people would fall into the working or non-working groups at 6, 12 and 24 month follow-ups were tested by Mann-Whitney test and logistic regression respectively. Eight of 17 items in WRI were rated differently between the groups at one or more of the follow-ups. The regression models based on the WRI ratings had an overall correct prediction rate ranging from 81% to 96%. Expectation of job success which concerns the persons belief in abilities in relation to return to work emerged as an important predictive factor for return to work in all statistical analyses. The WRI assessment contains items that could predict return to work. This implies that the WRI could be a useful tool in vocational rehabilitation for identifying individual rehabilitation needs.

Studies from three independent laboratories report varying relationships between electrodermal hyporeactivity and suicidal behavior in depressed patients. The aims of this study were to explain that variation, to assess the discriminative validity of electrodermal hyporeactivity for suicide and suicide attempts and to suggest a tentative explanation model.

A meta-analysis was performed of 279 depressed patients and 59 healthy subjects.

The sensitivity was 96.6% and specificity 92.9% of electrodermal hyporeactivity for suicide and 83.3% and 92.7%, respectively, for suicide and/or violent attempts. The shares of hyporeactives were strongly significantly and greatly larger in high than in low suicidal propensity groups, P-value ranging from 4.7 x 10(-8) to 1.1 x 10(-14).

The high discriminative validity and the emerging links over a proposed interest-limiting precognitive set to cognitive theory of suicide encourage clinical application of tests of electrodermal reactivity. The study offers a series of testable hypotheses constituting a new platform for suicidological research in depression.

This study focused on interrelations between graphometric variables of the signature and measures of perception, cognitive function, and personality. Signatures from a sample of psychiatric and somatic outpatients (N=205) were analyzed into 23 graphometric variables and correlated with tests of IQ, cognitive and perceptual function, and personality. The results of a factor analysis of the graphometric, perceptual, and cognitive variables were very much like results from previous studies. Relationships with the graphometric variables can be described in five categories of intelligence, psychomotility, flexibility and speed of closure, and personality. Graphometric signs of Extraversion and Neuroticism were identified, and the two capitals in the signature indicated different psychological meanings. Measurements of the signature offered important personality information. © Perceptual and Motor Skills 2008.