Elvan Özalp

There is consistent evidence suggesting that genetic factors play an important role in predisposition to suicidal behavior. Family, twin, and adoption studies have demonstrated that there is a genetic dimension to suicide. Although there is some overlap between suicide and mood disorders, even among psychiatric groups with the highest risk, some patients never attempt suicide, indicating the importance of a diathesis or genetic link to suicide that is independent of the underlying psychiatric disorder. Over the last 3 decades research has shown that there is a relationship between suicide, aggressiveness, and impulsivity. It is possible that genetic factors may be related to personality traits such as impulsiveness and aggressiveness, which in turn may lead to suicide attempts. An increasing number of molecular genetic studies have been carried out among cases involving suicidal behavior and candidate genes thought to be related to suicide. The most important candidate genes include the serotonin transporters (SERTs), tryptophan hydroxylase (TPH), some serotonin receptors (5HT1A, 5HT1B, and 5HT2A), catechol-O-methyltransferase (COMT), monoamine oxidase-A (MAO-A), and tyrosine hydroxylase (TH). The aim of this review was to assess the genetic dimension of suicide behavior, both current and historical.

Objective: Adjustment disorders (ADs) and major depressive disorder (MDD) are often the most prevalent psychiatric disorders among cancer patients. This study's objective was to determine the overall performance of Hospital Anxiety and Depression Scale (HADS) as a screening instrument in identifying cases of psychiatric morbidity such as ADs and MDD.Methods: Two hundred and four consecutive patients completed a questionnaire including a demographic and clinical data form, HADS, and were examined with the Structured Clinical Interview for DSM‐IV (SCID). The screening performance of HADS was investigated by calculating the area under the receiver operating characteristics curves (AUC), rates of specificity, and sensitivity.Results: For MDD; the AUC was 0.77 on the HADS total, the AUC was 0.79 on the HADS depression subscale, and was 0.72 on the anxiety subscale. For ADs; the results were 0.74, 0.74, and 0.70 respectively. Findings indicated that a HADS total cut‐off score of ⩾17 to be optimal in identifying cases of MDD. This cut‐off score offered a sensitivity of 0.70 and a specificity of 0.80. Findings suggested that a HADS total cut‐off score of 10 was the optimal combination of sensitivity (0.84) and specificity (0.55) for ADs. When compared with SCID, the percentage of cases identified by HADS was 28% for MDD and 22% for ADs.Conclusions: Compared with SCID, HADS was found to have acceptable levels of sensitivity and specificity in detecting psychiatric morbidity especially for MDD and HADS can be recommended with reservations as a screening tool for breast cancer patients. Copyright © 2007 John Wiley & Sons, Ltd.

The distress thermometer (DT) is a useful measure of psychological distress in cancer patients. Our objective was to investigate distress impact on oncology patients in Turkey and determine the optimal cut‐off score on the DT for identifying clinically significant distress. One hundred and eighty two cancer patients completed the DT, Problem List (PL), and Hospital Anxiety and Depression scale (HADS), The European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ‐C30 version 3.0). The receiver operating characteristic (ROC) curve analyses of DT scores yielded an estimated area under the curve of 0.66 when compared to the HADS cut‐off score, suggesting the DT is an effective scale to discriminate between classified cancer patients both with and without clinically significant distress. The DT cut‐off score of 4 yielded the optimal combination of sensitivity and specificity. Scores on the DT were moderately correlated to the HADS (p<0.01) and EORTC QLQ‐C30. Based on the significant correlations, we conclude that the DT has acceptable criterion validity. Copyright © 2006 John Wiley & Sons, Ltd.