The author describes the development of a neurotoxicity syndrome in a 68 year old women treated for 1½ years with lithium for recurrent depressions. The syndrome developed after 10 mgr. haloperidol per day was added, during a manic episode, for 10 days. The lithium levels were 0.71 ± 0.19 MEq/L. After 19 days all medications were discontinued. The neurotoxicity consisted succes-sivily of confusion, somnolence, agitation, extrapyramidal symptoms, cerebellair ataxia and EEG abnormalities. After 10 weeks memory impairmments were still present. At four months, memory function was restored. After five months, the patient was discharged without residual symptoms. The patient reported amnesia for the first six weeks of the syndrome. The author points out that while patients may develop tolerance to lithium maintenance after several years, they still may develop a neurotoxicity syndrome when haloperidol is added to treat a manic episode.

Psychophysiological measures, such as late components of the event-related potentials (ERP's) may be applied in clinical nosological research in two different ways; as purely empirical or diagnostic markers and as markers of functional processes. The second application implies that ERP's may be used to increase the theoretical understanding of specific mental processes such as attention, memory and linguistic processes and the degree of impairment of these processes in psychiatric patients. Some examples derived from recent studies of dementia and aging are given of these two applications of ERP's.

With the introduction of major tranquillizers more than three decades ago symptom rating scales were soon accepted as the method of evaluating their clinical effects. The Mini-compendium is a collection of rating scales for measuring outcome of antianxiety drugs, antidepressants, antimanics, and anti-psychotics. The scales have been selected by their “cash values”, i.e. the scales most frequently used for the respective dimensions. These scales have been further developed in terms of strict item definitions. The simple sum of the individual scale items has been considered as a sufficient statistic if they fulfilled latent structure analysis of shared phenomenology.

Violent behaviour between inpatients and wardpersonnel is seen from a relational viewpoint. The reactions of the staff show a strong similarity with regressive transferences from the patients. Limit-setting as a method should be employed to contain the individuel behaviour of the patient as also so further the social climate on the ward. The method of limit-setting involves the reality testing of the patient, the transference reactions between patient and staff, clarity in decision-making and regulations, and architectural arrangements. These four levels of influence are separately discussed.

In deze rubriek zal worden ingegaan op recente observaties betreffende de psychofarmakologie in de breedst mogelijke zin. Vaak zullen zaken uit de Literatuur worden behandeld. De gekozen onderwerpen dienen altijd klinische relevantie te hebben. Ook zal deze rubriek gaan over gewoontes die in psychofarmakologische behandeling of in onderzoek zijn geslopen die volgens de auteur lang niet altijd logisch zijn. Soms zal deze rubriek een oproep bevatten om te reageren op een bijdrage gepubliceerd in dit of in een ander tijdschrift. Ook zal de lezer worden aangemoedigd hier zijn eigen ervaringen mee te delen. Het is niet de bedoeling in deze rubriek onderzoeken uitvoerig te rapporteren. Daarvoor staan andere pagina's van de Acta Neuropsychiatrica voor u open.