Forty-five cases of psychotic patients with admission urinalysis positive for cannabis were compared with psychotic controls without evidence of cannabis use. Cases and controls were matched for age, sex and year of admission, and were compared for socio-demographic data, circumstances of admission, diagnosis, and symptoms at admission. Three differences were found: cases were more likely to be Afro-Caribbean than white (P = 0.01), to manifest incoherence of speech (P= 0.02) and agitation (P= 0.01). In other respects the case and control groups were indistinguishable, and no pattern of symptoms characterised the “cannabis psychosis“group. These findings do not support the view that “cannabis psychosis” has a distinct psycho-phenomenological pattern Epidemiological studies are required to further clarify the association for psychotic patients between Afro-Caribbean ethnic groups and the likelihood of having a positive urine test for cannabis.

The sociodemographic and clinical characteristics of 62 patients, who were consecutively admitted to medical or surgical departments in a general hospital in Barcelona, as a result of attempting suicide by jumping from buildings were investigated. All patients met DSM III criteria for at least one psychiatric diagnosis. The most frequent diagnosis was schizophrenia (40%), followed by depression (24%). The attempts made by depressed patients tended to be more lethal. Most of the schizophrenics presented active psychotic symptoms at the time of attempting suicide.

To characterize the neurophysiological profile of patients with Subcortical Vascular Encephalopathy (SVE) we compared the quantified electroencephalogram (qEEG) of 15 consecutive patients, demented and non-demented, with leukoaraiosis and multiple lacunar infarcts on tomographic scan and magnetic resonance investigation, with those of 30 patients with Alzheimer’s disease (AD) and 30 controls. The investigation was carried out using an EEG fast Fourier transform program, and the data obtained were transformed into mean frequency (MF), calculated in the left occipital derivation, and in percent difference (PD), calculated in eight derivations. The data obtained were compared with the scores of the mini-mental state examination (MMS). The results demonstrate that the patients with SVE displayed a different qEEG pattern in comparison with AD patients and controls, with a prevalence of EEG slowing in frontal derivations, and with good correlation between PD values and MMS scores. The qEEG may detect subtle and/or early changes in patients with SVE. The use of adequate spectral parameters may give valuable data for a better classification of dementia syndromes.

Performance of patients with schizophrenia (n = 15) was compared to that of patients with vascular ischemic lesions of the dorsolateral prefrontal cortex (n= 10) and to age-matched controls (n= 15) in delayed reaction tasks known to be specific markers of the functions of the frontal lobe. The performance of patients with schizophrenia was similar to that of patients with prefrontal lesions in the delayed response task (DR) and the spatial discrimination-reversal task (SD and RV) but not in the delayed alternation task (DA) in which they performed as well as controls. The behavioural profile of responses in delayed reaction tasks for the schizophrenic patients was identical to that of patients with basal ganglia lesions reported in a previous study. These results suggest that in some patients with schizophrenia, a frontal lobe deficit could be indirectly induced by a dysfunction of the basal ganglia. This problem could be due either to the pathological process itself or to the effect of the neuroleptic treatment.

In an open multi-center study, 57 schizophrenic patients were treated with clozapine for indications of treatment-resistant psychosis or severe extrapyramidal side-effects caused by conventional neuroleptics. In 58% of the patients a clinical relevant improvement, expressed as percentage reduction of at least 50 from baseline BPRS scores was observed. With respect to extrapyramidal side-effects, a marked reduction was found upon treatment with clozapine. No major side-effects occurred, particularly agranulocytosis. It was concluded that clozapine is a potent antipsychotic agent that can be used safely when treatment is accompanied by frequent clinical and hematological monitoring.

This study presents the principal component analysis of Zuckerman’s Sensation Seeking Scale (SSS form IV - 72 items). The results of the analysis of the French form support the existence of the four distinct dimensions of sensation seeking identified by Zuckerman, and replicated in a large number of studies. On the basis of this structure, an abbreviated form of the scale (40 items) has been constructed. It ressembles Zuckerman’s SSS form V. Attention is drawn to items that do not load significantly on the expected factor. The shorter form should be more useful in following-up research on sensation seeking in psychopathology.

Although panic disorder has been ranked as an ‘anxiety disorder', its close relationship to depression has been suggested in pharmacological and clinical studies. Validation of this hypothesis of similarity between panic and depression requires that their common psychological characteristics be clearly evidenced, especially from the cognitive/emotional standpoint. We assessed 13 depressive themes from Beck's Cognition Checklist, to explore negative automatic thoughts in three groups of patients defined, according to DSM III-R criteria, as: major depression (n = 16), panic disorder (n = 19), social phobia (n = 11). We found a strong similarity in the ordering and regrouping of the depressive themes, between depressive and panic disorder patients, and no similarity with social phobics. These results suggest that panic disorder cognitions may be closer to depressive cognition than social phobia cognition.

The relationship between growth hormone (GH) response to clonidine and the Minnesota Multiphasic Personality Inventory (MMPI) was assessed in 20 major depressive inpatients. GH response to clonidine was negatively correlated with the depression, the psychasthenia as well as the social introversion MMPI scale scores, and positively correlated with the hypomania scale scores. In contrast, the Carroll depression scale did not exhibit any relationship with either GH response to clonidine or MMPI depression scale. These findings support the role of the clonidine test and several MMPI scales as trait markers for depressive illness.

Platelet 5-HT levels were determined by fluorescent orthophthaldehyde assay in 33 panic disorder patients with and without obsessive compulsive symptoms (PD + OCS: n = 16; PD-OCS: n = 17) according to DSM III-R criteria, and compared With those of 38 healthy controls. Mean platelet levels were significantly lower in PD + OCS than in PD-OCS patients. The results are discussed in relation to serotonergic dysfunction linked to PD and OCS comorbidity.

Nimodipine was administered at the daily dose of 90 mg po, for 30 days, to ten chronic undifferentiated schizophrenics, eight men and two women, aged 31-35 years, maintained on previously longlasting neuroleptic treatments. In five patients, a placebo period of 15 days preceded the administration of the drug. Monitoring of psychiatric symptomatology by the Brief Psychiatric Rating Scale (BPRS) revealed significant nimodipine-induced improvement. However, the Andreasen Rating Scale for Positive Symptoms (SAPS) showed favourable effects only in the five patients who had not received placebo, while in the others both SAPS and the Andreasen Rating Scale for Negative Symptoms (SANS) showed no significant effect of therapy. The Tardive Dyskinesia Scale revealed no improvements of neurological symptoms after either placebo or drug treatment. Measurement of plasma MHPG concentrations revealed no significant changes induced by either placebo or nimodipine, while HVA plasma levels showed a trend toward decrease, and prolactin a trend toward increase, after nimodipine.

Four patients are described whose presenting complaint - panic attacks associated with atypical chest-pain and varying degrees of avoidance; improved substantially following a simple paradoxical intervention. Three months’ follow-up suggested lasting benefits.

Psychiatric morbidity was measured in a prospective follow-up study of 51 patients admitted to hospital after minor head injury. By means of self report questionnaires (eg General Health Questionnaire (SHQ) and Impact of Event Scale), semistructured interviews and symptom-checklists, it was found that nearly half of the patients suffered considerable discomfort after 1 week. Improvement during the 3 months follow-up was generally poor. Both concussional symptoms and stress response contributed to the compromised well-being as measured by the GHQ, but outcome did not correlate to severity of injury. The GHQ-60 score of 1 week showed a strong positive correlation with outcome after 3 months. The incidence of post-traumatic stress disorder was low.

Recent studies have examined the effectiveness of the dexamethasone suppression test (DST) in the evaluation of bulimia. In a series of 18 female bulimic outpatients without major depression, 9 (50%) failed to suppress on the DST. No significant difference was found between suppressors and nonsuppressors in personal and family histories of affective disorder, levels of anxious and depressive symptoms, psychoactive substance abuse, and severity of abnormal eating-related behaviours. In contrast, non-suppression was significantly associated with low weight. There is a trend to differentiate non-suppressors from suppressors in the current diagnosis of anorexia nervosa and in past history of anorexia nervosa. Seven patients received fluvoxamine for 8 weeks. Five patients were suppressors and showed a significant decrease in the frequency of their binges while the 2 non-suppressors did not improve. These preliminary results suggest that DST non-suppression might be typical of bulimic patients with anorexia nervosa and that pretreatment DST results might predict the response of bulimic behaviour to treatment with fluvoxamine.

Nine raters applied ICD-10 diagnoses on 36 Danish child and adolescent psychiatric patients by screening their case records and using the DCR of ICD-10. The highest inter-rater agreement was obtained In the group of adolescent patients, the lowest was observed in emotional disorders in children. The comments on ICD-10 were generally positive but we support the creation of a category for the borderline children, and for the non-hyperactive children with attention deficit disorder.

Chronically stressed adult male Balb C mice were submitted to the tail suspension test. Chronic immobilization stress (6 h/d for 14 consecutive days) induced a significant reduction in immobility time when compared to non-stressed controls. Pretreatment with LY 53857, a serotonin 5HT2 antagonist, and IPS 339, a selective beta-2 adrenoceptor blocker, reversed immobility time to the levels of non-stressed controls. Chronic administration of corticosterone (100 mg/kg for 7 d) did not modify immobility time as compared to saline treated controls. It is suggested that both serotonergic and adrenergic pathways in the brain may participate in the stress-induced changes occurring in the tail suspension test response and that corticosterone does not appear to play a role in this process.

This study was designed to verify whether fluoxetine (FL), a serotonin (5-HT) re-uptake inhibitor, would interfere with nortriptyline (NT), a biphasic U-shaped curvilinear dose-response relationship recently described in our laboratory. We associated 10 mg/kg NT or vehicle to 0, 5, 10, 20 and 40 mg/kg FL, in one group, and 10 mg FL or vehicle to 0, 5, 10, 20 and 40 mg/kg NT, in another group, 30 min before the tail suspension test (TST) in mice. Although we were not able to confirm a synergistic effect between FL and NT, FL-NT association seems to require higher doses of NT to block its own anti-immobility effect at high doses, thus widening NT effective antidepressant-like dose range in mice submitted to TST.

A minimal brain damage examination was carried out in 73 schizophrenic patients divided into three groups according to their season of birth. Results showed no statistically significant difference among groups in the prevalence of neurological soft signs.

The usefulness of the dexamethasone suppression test (DST) in the prediction of treatment response to selective antidepressants was tested in 56 major depressive inpatients. Following DST, patients were randomly assigned to treatment by either nomifensine, a catecholaminergic antidepressant, or zimeldine, a serotonergic antidepressant during a 3-week period and assessed by means of the second part of the Clinical Global Impressions (CGI-2). No significant difference was present between the 27 DST suppressor and the 29 DST non-suppressor patients in their overall clinical outcome. Moreover, no preferential response to nomifensine or zimeldine was noted in any of the two groups defined according to DST status. Therefore, these results do not support the usefulness of the DST in the prediction of the treatment response to antidepressants in general and to selective antidepressants in particular.

Final conclusions and data comparisons from the thyrotropin-releasing hormone (TRH) test results are made difficult by differences in test implementation methods, ie, TRH different administration routes, dosages and blood sampling times. A number of statistical analyses are feasible, which may also influence test interpretation. The authors review some types of statistical analyses and suggest using the area under curve (AUC) method as a means of evaluation. The TRH test was performed before treatment and after a 5-day wash-out period, in 40 depressed patients hospitalized in the Psychiatric Unit of Besancon Teaching Hospital (Centre Hospitalier Universitaire de Besançon). Variation analyses performed by peak and threshold comparison (7.0 IµU/ml) and by the AUC method (386 IµU/ml) in positive and negative patients revealed some statistical differences.

Three cases of akathisia-induced impulsive suicide attempts are reported. In all three cases the patients admitted that the suicidal ideas occurred suddently. The suicidal attempts may be a result of neuroleptic – induced akathisia as they disappeared as soon as the akathisia was treated.