For many of the conditions with which psychiatry is concerned, there is still no anatomical or physiological abnormality that is reliably found in those affected with the conditions and not in other people. Some evidence exists that, for instance, severe and chronical psychopathological symptoms such as persistent auditory hallucinations, may be linked to structural brain abnormalities in certain subgroups of schizophrenic patients. However, such associations are not well-established as yet and the research in this field does not have practical implications for psychiatric assessment so far.

Because objective (physical) indices for measuring (the severity of) psychopathological states have hardly been available up to now, the rating scale is an essential instrument in clinical (psychopharmacological) research.

The association of eating disorders and bipolar disorders is less documented than the well-established association of eating disorders and unipolar depression. However, epidemiological studies have demonstrated an increased risk for bipolar disorders, especially bipolar II, in bulimic patients. We report the case of a patient displaying such a morbid association.

La loi française du 20 décembre 1988, dont le rapporteurétait le docteur Huriet, sénateur, a redéfini le cadre législatif des essais biomédicaux. Son objet, plus que de garantir la qualité scientifique d’un travail de recherche, vise à protéger les personnes - saines ou malades-qui seraient sollicitées pour participer à de tels essais. Venant se surajouter aux Bonnes Pratiques Cliniques et aux Directives Européennes qui encadrent la recherche clinique, l’application pratique de la loi Huriet, par certains de ses aspects - en particulier I’obtention du consentement et l’accès aux « documents sources » –, crée des difficultés importantes pour les cliniciens et de nouveaux dangers pour les malades. Des modifications pourraient y être apportées pour la mettre en harmonie avec le devoir de soins et l’éthique médicale.

Large multinational, multicenter trials are increasingly being performed during Phase III of the clinical development of a psychotropic drug to demonstrate the efficacy of the new therapeutic agent in the shortest possible time. The testing of the new drug therapy under a common protocol, foreseeing the combination of clinical data collected across countries for a joint evaluation, is becoming more frequent in drug development. Usually, Sponsors use the services of Contract Research Organisations (CROs) to undertake and manage such large multinational, multicenter trials.

The Sponsor who is setting up large definitive CRO-managed studies with psychotropics may anticipate to encounter issues along the following lines: Psychiatric Practice, Organization and Logistics, Data Integration and Manpower.