Psychiatric comorbidity in alcoholics admitted to a rehabilitation center on either a voluntary or a coerced basis were studied. A group of 104 alcoholics (37 coerced and 35 voluntarily admitted men; and 21 coerced and ten voluntarily admitted women) with a mean age (SD) of 43 ± 8 years were assessed by means of a Structural Clinical Interview in accordance with the Diagnostic and Statistical Manual (DSM)-III-R (SCID). The interview took place a mean of 7 days after admission. The frequencies of lifetime/current axis I psychiatric comorbidity (substance use disorders excluded) were 66 and 61%, respectively. Drug dependence was present in 41 and 39%, respectively, of the cases. Thirty-seven percent had a lifetime diagnosis, and 33% a current diagnosis of affective disorders, 27 and 23%, respectively, of anxiety disorders and 20 and 13%, respectively, of non-organic psychotic disorders. In a subsample of 20 subjects, depressive symptoms were found to be stable during the course of treatment. No differences in frequency of psychiatric comorbidity were found between coerced and voluntarily admitted patients (67 and 56%, respectively) or between men and women (65 and 52%, respectively). The combination of psychiatric comorbidity and drug dependence was overrepresented among the coerced patients (50 vs 16%). It was concluded that the frequencies of psychiatric comorbidity were high in the present group. The co-occurrence of alcohol dependence, drug dependence and psychiatric comorbidity was more frequent among subjects who were coercively treated.

In recent years a two types classification of male alcoholism has been proposed by several authors. The study aimed at a testing of type I/type II classification of alcoholism in an independent sample. A total of 351 Research Diagnostic Criteria (RDC) male alcoholics consecutively admitted for an inpatient psychiatric treatment were studied. Type II characteristics were extracted from the pertinent literature; 19 available variables best representing these characteristics were selected. The data was collected using the method of a retrospective evaluation of clinical records. Cluster analysis yielded two clusters which were well separated from each other. Heterogeneity of the male inpatient population of alcoholics was demonstrated and the existence of broadly defined type I and type II alcoholism was confirmed.

In this study, we investigated the prevalence of full syndrome (FS), partial syndrome (PS) and subclinical syndrome (SCS) eating disorders in a sample of 356 high school girls. We identified two cases of anorexia nervosa (0.56%), 14 of bulimia nervosa (3.94%) and one of binge eating disorder (0.28%) according to Diagnostic and Statistical Manual (DSM)-IV. Moreover, 17 girls (4.77%) were recognized as PS cases and 49 (13.7%) as SCS cases. A follow-up is now ongoing to explore the clinical evolution of partial and subclinical syndromes.

Valid information on the early course of schizophrenia is necessary for clinical and research purposes, for example, to determine the onset of the disorder. Since reports given by psychotic patients are questionable, relatives are often asked about their observations. In order to test the quality of these reports, the recollections of emerging symptomatology were assessed systematically from 30 recent onset, postpsychotic schizophrenic patients and from 69 informants (mostly their close relatives) by means of the Interview for the Retrospective Assessment of the Onset of Schizophrenia (IRAOS). Patient-informant agreement rates like kappa were compared between the relatives of every single case. Multiple regression analyses demonstrated that personality and attributional factors, particularly causal attributions and the image the informant has about him/herself and about the patient, determine the quality of the informants' reports. Highest kappas over all symptoms, for instance, were reached by relatives who described the patient as “dominant” and themselves as “reserved”, and who attributed the disease to current psychosocial stress. Long and close contact to the patient tends to impair the quality of reports.

Taking up the Bleulerian view of a clinical description based on a pathogenic model, we propose a rating scale for the assessment of communication disorders in schizophrenic patients. The scale consists of clinical items that could be the direct expression of the three hypotheses of cognitive dysfunction which have been postulated to explain communication dysfunction in these patients. We assessed the frequency of the 16 items in the scale in a total of 80 subjects (43 schizophrenic subjects, ten manic subjects, 17 depressive subjects and ten normal control subjects). The results of this study showed that this item schedule was specific to schizophrenic patients and, in particular, could statistically significantly discriminate schizophrenic patients from psychotic patients with affective disorder. The methodological qualities of the scale were explored and proved accurate, except for the reliability which is too low for some items and the item-to-total correlation which is too low for one item of the scale.

The prolactin, cortisol and growth hormone (GH) responses to intravenous administration of 25 mg clomipramine (CMI) were studied in young male psychotic patients who had never received neuroleptics and suffered from schizophrenia (13 patients), delusional disorder (three patients) or schizoaffective disorder (one patient). The test was repeated after 1 month in 16 patients who were hospitalized and treated with haloperidol in doses appropriate for best clinical response (range: 7.5–40 mg daily). Symptomatology was assessed by the Brief Psychiatric Rating Scale (BPRS). There was no association of the side effects caused by the administration of CMI (nausea and emesis) to the GH responses. The side effects appeared significantly less in the after treatment trials. Treatment with haloperidol did not influence the response patterns of the three hormones. An indication that high haloperidol doses may inhibit the prolactin response to CMI was obtained when the data were compared between low (7.5–10 mg/day, mean 9.7) and high (15–40 mg/day, mean 22.0) dose subgroups. Significant positive correlations were found between the prolactin and cortisol responses to CMI in the drug-free state, and the scores in the positive symptoms subscale of the BPRS. The degree of improvement did not correlate to any of the hormonal data.

A case is described where phototherapy rapidly restored sleep-wake disturbances and concurrent symptoms of delirium in a patient who did not respond to conventional treatment with haloperidol. In this case, the delirious state may have been caused by a change in metabolism as a result of sepsis. Exposition of the patient to 8,000 Lux during 1.5 h for 5 consecutive days was sufficient to suppress all delirious symptoms and to normalize sleep. This result may encourage the setup of systematic studies towards the extent of desynchronization between various rhythmic cycles in delirium and towards the value of phototherapy for the restoration of normal circadian rhythmicity.

We report a cerebrovascular accident after Ecstasy (MDMA) intake which induced a frontal dementia in a young man.