Appraisal of caregiving and its relationship to family burden and experienced mental health problems in the relatives were investigated as part of a multi-centre study of the quality of mental health services in Sweden performed in 1997. The sample was drawn from relatives of involuntarily and voluntarily admitted patients to acute psychiatric wards. The instrument used was a semi-structured questionnaire, interviewing relatives about the burden, experience of mental health problems and appraisal of the caregiving situation. The results showed a high proportion of relatives engaged in caregiving activities on a daily basis the month before the patient's admission to hospital and a high proportion of relatives appraising the caregiving activities negatively. The burden was more extensive if the relative and the patient were living together, had a longer duration of their relationship, if the relative was rendering caregiving on a daily basis and if the relative appraised caregiving negatively. The relatives' psychological distress was not related to their negative appraisal of caregiving, nor was patient characteristics, such as diagnosis and level of psychosocial functioning. The only factor found to influence the relatives' psychological distress was the duration of relationship to the patient. Interventions reducing psychological distress for relatives who have known the patients for more than 20 years, who live with the patient, who give care on a daily basis and who appraise their caregiving negatively are suggested.

This study examined the dimensions of burden perceived by key-relatives of patients suffering from schizophrenia spectrum disorder by the development of an instrument, the Family Burden Scale (FBS) and the underlying predictors. One hundred and seventy one primary caregivers, living with 158 patients suffering from chronic psychotic illness and maintained on community basis in Athens area, were interviewed by the use of FBS supplemented by the Family Atmosphere Scale and GHQ. Construction procedure and factor analysis of FBS produced a scale of 23 items in four factors, three of them measuring objective and the fourth one, subjective burden. The scale was also proved to be reliable and valid. Forty-five percent of primary caregivers reported high levels of burden. Psychological impairment (high GHQ scores) was related with high levels of burden and negative family atmosphere. Previous admissions and duration of illness were also found to predict burden. The results suggest that FBS differentiates objective from subjective burden. Psychological well being of carers is affected by the dimensions of perceived burden.

Neurological soft signs (NSS) are characterized by abnormalities in motor, sensory, and integrative functions. NSS have been regarded as a result of neurodevelopmental dysfunction, and as evidence of a central nervous system defect, resulting in considerable sociopsychological dysfunction. During the last decade there has been growing evidence of brain dysfunction in severe aggressive behavior. As a symptom, aggression overlaps a number of psychiatric disorders, but it is commonly associated with antisocial personality disorder. The aim of the present study was to examine NSS in an adult criminal population using the scale by Rossi et al. [29]. Subjects comprised 14 homicidal men with antisocial personality disorder recruited from a forensic psychiatric examination. Ten age- and gender-matched healthy volunteers as well as eight patients with schizophrenia, but no history of physical aggression, served as controls. The NSS scores of antisocial offenders were significantly increased compared with those of the healthy controls, whereas no significant differences were observed between the scores of offenders and those of patients with schizophrenia. It can be speculated that NSS indicate a nonspecific vulnerability factor in several psychiatric syndromes, which are further influenced by a variety of genetic and environmental components. One of these syndromes may be antisocial personality disorder with severe aggression.

The relationship between severity of subjective memory impairment and volume of the hippocampus/amygdala complex was investigated in non-demented depressed patients and it was found to correlate with decreasing volume in the right hippocampus.

A computerized version of the object alternation test (OAT) was employed in unmedicated obsessive–compulsive disorder (OCD) patients and matched healthy controls. OCD patients performed normally on the OAT but scored below controls on a task assessing visuo-spatial working memory. The results challenge the concept of the OAT as a sensitive instrument for orbitofrontal dysfunction in OCD.

Italian statistics on psychiatric bed availability, voluntary and compulsory admissions were examined from 1979 to 1997. Although the number of psychiatric beds dropped by 62.5%, the absolute number of compulsory admissions has remained substantially stable. The proportion of all admissions that were compulsory decreased from 17.1% to 11%. This study shows that a shift to community care was not associated with an increase in compulsory admissions in Italy.

The objective of the survey was to compare depressive symptoms in depression with and without a concomitant organic disease. The results based on the HAD and CES-D scales showed that, compared to those with an isolated depression, the patients with an associated chronic organic disease have a higher score on two items on the HAD. Three variables on the CES-D scale also helped to differentiate the two groups of depressed patients. No significant difference was found between the two groups in terms of anxiety or cognitive symptoms, fatigue or feelings of disability. Our results do not indicate any symptom that is specific to a combination of depression and somatic diseases. Guilt and hostility showed a lower level in depression associated with a concomitant somatic disease than in isolated depression.