Alcohol use disorders and panic disorder co-occur at a rate that exceeds chance significantly. The underlying mechanism of alcoholism associated with anxiety has rarely been examined using experimental methodologies. The present study in healthy volunteers tested whether alcohol consumption reduces anxiety associated with a panic-challenge procedure (35% CO2 challenge).

The study design was placebo-controlled, double-blind, randomized. Eight healthy volunteers were enrolled; all subjects had an alcohol and a placebo oral intake according to a crossover design. After each consumption the subjects underwent the 35% CO2 challenge and a series of anxiety symptom assessments.

After the alcohol intake, the subjects presented a significant reduction in the anxiety state associated with the challenge procedure. The Panic Symptom List score is significantly lower after alcohol intake (P = 0.032), as compared with the placebo, and the Visual Analogue Anxiety Scale shows a trend to be lower after alcohol intake (P = 0.111).

Moderate doses of alcohol acutely decrease the response to a 35% CO2 challenge in healthy volunteers. These results lend support to the pharmacological anxiolytic effect of alcohol and suggest that this property may reinforce the drinking behaviour among those with high levels of anxiety.

The isoprenoid pathway produces three key metabolites: endogenous digoxin (membrane sodium-potassium ATPase inhibitor, immunomodulator and regulator of neurotransmitter/amino acid transport), dolichol (regulates N-glycosylation of proteins) and ubiquinone (free radical scavenger). The role of the isoprenoid pathway in the pathogenesis of sarcoidosis in relation to hemispheric dominance was studied.

The isoprenoid pathway-related cascade was assessed in patients with systemic sarcoidosis with pulmonary involvement. The pathway was also assessed in patients with right hemispheric, left hemispheric and bihemispheric dominance for comparison to find out the role of hemispheric dominance in the pathogenesis of sarcoidosis.

In patients with sarcoidosis there was elevated digoxin synthesis, increased dolichol and glycoconjugate levels and low ubiquinone and elevated free radical levels. There was also an increase in tryptophan catabolites and a reduction in tyrosine catabolites. There was an increase in the cholesterol:phospholipid ratio and a reduction in the glycoconjugate level of red blood cell (RBC) membrane in this group of patients. The same biochemical patterns were obtained in individuals with right hemispheric dominance. In individuals with left hemispheric dominance the patterns were reversed.

Endogenous digoxin, by activating the calcineurin signal transduction pathway of T cells, can contribute to immune activation in sarcoidosis. An altered glycoconjugate metabolism can lead to the generation of endogenous self-glycoprotein antigens in the lung as well as other tissues. Increased free radical generation can also lead to immune activation. The role of a dysfunctional isoprenoid pathway and endogenous digoxin in the pathogenesis of sarcoidosis in relation to right hemispheric chemical dominance is discussed. All the patients with sarcoidosis were right-handed/left hemispheric dominant according to the dichotic listening test, but their biochemical patterns were suggestive of right hemispheric chemical dominance. Hemispheric chemical dominance has no correlation with handedness or the dichotic listening test.

Female patients with anorexia nervosa differ significantly from the control women in various dimensions of personality.

To investigate the personality dimensions measured with the Temperament and Character Inventory (TCI) in adolescent patients with restrictive-type and bulimic/purging-type anorexia nervosa (ANR and ANB, respectively), and contrast them with the results of control females.

Sixty-one patients with anorexia nervosa (36 ANR and 25 ANB) and 60 controls were tested with the TCI. A concomitant assessment of depression, body mass index and age was made to evaluate the possible correlation with personality dimensions.

Adolescent ANR patients scored higher in persistence, harm avoidance and cooperativeness, and lower in novelty seeking and self-transcendence than control women. ANB patients scored in the middle between ANR and control females, but differences did not reach the significance level with either group, except for the self-transcendence dimension where they scored significantly higher than those with ANR.

The deviations in temperamental profile of adolescent ANR are similar to those reported in adult patients. The ANB adolescent patients with anorexia nervosa show less prominent deviations from the personality of control women. With regard to the character dimension of cooperativeness, adolescents with ANR scored higher than controls, in contrast to the observations in adult patients. This may reflect the effect of illness on the development of character.

Comorbid personality disorders have been shown to be a prominent factor affecting symptom severity and course in bipolar disorder (BD) patients. Bipolar patients with personality disorder had more relapses, poorer prognosis and worse treatment response than those without an axis II diagnosis.

We evaluated the prevalence rate of comorbid personality disorder in 74 bipolar I disorder cases who were in remission and tried to elucidate the possible relationship between comorbid axis II disorders and prognosis, severity and treatment features of BD cases.

Diagnosis of all personality disorder comorbidities was evaluated using the Structured Clinical Interview for DSM-III-R Axis-II Disorders (SCID-II), while the general psychopathology level was assessed using the Symptom Check List (SCL-90-R). A questionnaire for acquiring sociodemographic and clinical variables was also used.

Sixty-two per cent of bipolar I patients in this sample had at least one comorbid axis II disorder. The most common comorbid cluster of personality disorder was cluster C (48.6%), followed by cluster A (25.7%) and cluster B (20.3%) personality disorders. Assessment of demographic and clinical variables revealed that bipolar patients with comorbid personality disorder were mainly female, had multiple affective episodes, and had attempted suicide more often than patients without personality disorder.

The results of this study suggest that comorbid personality disorder might alter the course of BD and result in a poorer prognosis and more severe psychopathology. Further prospective controlled studies minimizing the bias of interviewers and other confounding factors would help us to understand the pure impact of personality disorder on the course of BD, its prognosis and response to treatment.