Like many phenomena which are located at the intersection between different disciplines, the complexity of alcoholism is difficult to comprehend, especially at an experimental level. In particular, pharmacological approaches towards alcoholism have emphasized the anxiety- and stress-reducing properties of ethanol, in spite of the limited clinical support for this hypothesis. In the same manner, the phenomenon of behavioral tolerance has mainly been approached from a pharmacological perspective, with little or no interest paid to the sensory stimuli possibly involved in the conditioning of drug effects. Comparative studies in animals selected for alcohol intake have concentrated on the biological responses to alcohol and have not investigated the possibility of genetic differences in sensitivity to environmental stimuli. Based on recent progress in the elucidation of the individual and environmental factors which play a key role in the development and stabilization of abnormal behavior in conflict situations, it is proposed that alcoholism is the result of a predisposition to react in a certain manner to environmental stimuli and social influences which is strengthened by the pharmacological effects of ethanol. The manner in which this hypothesis can be put to test has been discussed.

Benzodiazepines were first used in schizophrenia because of their anxiolytic properties. At high doses, or in association with neuroleptics, diazepam and estazolam also appears to exhibit an antihallucinatory effect, whereas alprazolam preferably acts on negative symptomatology due to its antidepressant properties.

In an empirical study on the classification of the psychoses, 302 patients were rated using the Longitudinal Psychopathology Schedule. The data were condensed by factor analysis, which yielded 10 factors - mania and schizomania, depression and suicidal activity, and 6 factors concerned with psychotic symptoms (verbal hallucinosis/passivity, delusion formation, defect symptoms, social decline, cycloid symptomatology and a factor loading depressive auditory hallucinations and visual hallucinations). Provisional diagnostic groups were obtained using DSM III. Discriminant function analyses showed that the only clearly distinct diagnostic group was bipolar disorder, and this was true for various definitions. Canonical variate analyses were performed using 3- and 4-criterion groups. These showed that a group corresponding approximately to cycloid psychosis also met criteria for being a distinct group. The most detailed examination pf the data, using 4-criterion groups and serial reclassification, suggested that the psychoses might fall into 5 groups - bipolar disorder, cycloid psychosis, depression, defect states and schizoaffective depression.

Nineteen different slides of food items and their effects on appetite and hunger as rated on visual analogue scales were investigated in 20 bulimics and 9 anorexics (DSM-III-R) at the onset and after 8 weeks of behavioral hospital treatment; 9 controls were examined at the maximum of weight loss during a diet and at normal weight. At the onset of treatment appetite ratings were significantly lower in patients than in dieting controls. In anorexics and bulimics appetite ratings increased significantly during treatment. The sight of food did not increase reported hunger in bulimics but did so in controls. Appetite ratings, however, were significantly increased by the sight of food in bulimics as well as in controls. Despite the small sample size, it may be concluded that dieting and weight loss have different psychological implications in healthy controls and in patients with eating disorders, that dieting rather than weight per se influences appetite and that differences in hunger responsiveness to the sight of food in anorexics and bulimics seem likely.

There has been continued interest in the nature of the association between affective disorders and alcoholism. This may be due to the fact that during the course of alcoholism 30-70% of the patients suffer from mood disturbances meeting the criteria for severe depression, especially in periods of excessive alcohol consumption or during withdrawal. In the course of a prospective multidimensional study, Tiibinger Alkoholismusprojekt (T-ALK Study), symptoms of depression in 31 male alcohol-dependent patients (RDC diagnosis) were assessed using the Beck Depression Inventory (BDI) and the Freiburger Personlichkeitsinventar (FPI-R) at the beginning and at the end of a 6-week inpatient treatment program. There was only a moderate degree of depression (BDI) in 20% of the patients which decreased significantly during the psychotherapeutic treatment under conditions of confirmed abstinence. No correlations between the degree of depression and neuropsychological impairment were found. Although the “satisfaction with life” (FPI-R factor) was still impaired in a third of the patients at the end of that short-term treatment period, our results do not indicate a general nosological overlap between alcoholism and affective disorders in males.

The aim of this study was to test whether a positive and a negative component could be found in broadly defined schizophrenic patients. Therefore, 70 patients either in an exacerbated or in a stabilized phase were selected according to the criteria of at least 1 of the 4 following diagnostic systems: DSM III-R, Schneider, Carpenter, Langfeldt; principal component analyses (PCA) were carried out with the 9 global ratings of the Scales for Assessment of Negative and Positive Symptoms (SANS and SAPS) and with the Positive and Negative Syndrome Scale (PANSS). The PCA of the SANS-SAPS global ratings yielded a 3-factor solution explaining 72.14% of the total variance, depicting a negative, a positive and a disorganization component. The PCA of the PANSS provided a 5-factor solution with a total explained variance of 55.98%. The first 3 factors were similar to those of the SANS-SAPS global rating analysis. The results showed that the positive and negative components described in a homogeneous schizophrenic population could be replicated in a larger and more heterogeneous group of schizophrenic patients. The question regarding the sufficiency of the positive-negative dichotomy was strengthened by the presence of a third disorganization component which explained as much of the variance as the positive component.

The Brief Psychiatric Rating Scale (BPRS) is expected to provide a valuable instrument for routine evaluation of the patient's status and correct interpretation of concentrations measured during therapeutic monitoring of antipsychotic drugs. Inpatient files were searched for information relative to acute episodes and BPRS items were scored every 10 days until discharge from the hospital according to a retrospective scheme. Eighty patients were included, who met DSM III criteria for schizophrenia and bipolar disorder. Clusters of symptoms that tend to appear together were identified through principal components analysis and are in keeping with factors described previously. Differences with respect to diagnosis further suggest that such clusters convey clinically relevant information. The time course of haloperidol action was also investigated: an average 51 % improvement was observed over the first 10 days, while the proportion of patients showing a 50% or larger BPRS decrease at the time of discharge reached 90%. The prominent contribution of changes in positive, florid symptoms to global improvement is also described. Finally, association of clinical improvement with a shorter period of hospitalization is shown. These results indicate that the BPRS represents a level of abstraction compatible with the way clinicians communicate and that its introduction into routine practice may allow for better description of the course of illness

The case of a woman presenting erotomania in the course of a loss-related depressive state is described. Clinical, biological and therapeutical characteristics highlight the role of mood in certain cases of erotomania and add support to previous accounts of the heterogeneity of this syndrome.