The relationship between myocardial infarction (MI), depression and cardiac death is not well understood. There is evidence that poly unsaturated fatty acid (PUFA) metabolism and composition in phospholipids and cholesterylesters are involved in the pathophysiology of affective disorders and cardiac dysregulation. In this paper the relationship of PUFAs with 1) cardiac events 2) depressive disorder and 3) the inflammatory response system (IRS) will be reviewed. The underlying pathophysiologic mechanisms relate to the effects of dietary fatty acids on the IRS, the HPA-axis, serotonin metabolism and platelet reactivity. These effects are the result of the important effects of PUFAs on the structure and function of localized membrane domains, their involvement in eicosanoid synthesis and their influence on intra-cellular signalling pathways and gene expression. Antidepressive treatment has been shown to have immunosuppressive effects in healthy volunteers. In patients with bipolar disorder or schizophrenia, PUFA supplementation resulted in significant symptom reduction. In the ongoing substudy of the MIND-IT, the effects of antidepressive treatment on immune status, PUFA composition in serum phospholipids and cholesterylesters and whole blood serotonin in depressive post-MI patients will be investigated. More knowledge on the relationships between PUFAs in diet, IRS parameters and serotonin metabolism may alter treatment strategies in the prevention of both cardiac death and the occurrence of depressive disorder in cardiac patients.

A patient is presented showing an altered oddball response while suffering from auditory hallucinations. The nontarget stimulus evokes a compound negative potential encompassing a normal early N1 component and an additional negativity within the categorization N2 range. These findings are discussed in reference to impaired mismatch processes and the deranged monitoring of inner speech theory, proposed in schizophrenia.

The unrestricted use of the DSM as diagnostic instrument for psychiatric disorders results in an arbitary and over the time inconsistent application of labels whether or not accompanied by the adjective NOS. Moreover, the European psychiatric tradition is often regarded as irrelevant and the results from modern genetics, behavioural neurology and other neuroscience research are not considered. The neuropsychiatric paradigm and the need to focus on psychological dysfunctions and their putative neurobiological substrate are discussed on the basis of four case reports. This paper illustrates the pitfalls of a careless use of the DSM.