In one of his Cahiers, Paul Valéry has the note. Somatism (heresy of the end of time),

Adoration, cult of the machine for living.† Have we come to the end of time? The heresy anticipated by Valéry has almost become the official religion. Everything is related to the body, as if it had just been rediscovered after being long forgotten; body image, body language, body consciousness, liberation of the body are the passwords. Historians, prey to the same infection, have begun inquiring into what previous cultures have done with the body, in way of tattooing, mutilation, celebration all the rituals related to the various bodily functions.2 Past writers from Rabelais to Flaubert are ransacked for evidence, and immediately it becomes apparent that we are far from being the first discoverers of bodily reality. That reality was the first knowledge to enter human understanding: ‘They knew that they were naked’ (Genesis 3.7). From then on, it has impossible to ignore the body.

Background. It has been argued recently that the attentional dysfunction in schizophrenia occurs as a result of an inability to inhibit automatic attentional shifts to compelling external stimuli. However, this hypothesis is based on performance on paradigms that require overt or covert shifts of spatial attention.

Method. We investigated responses to foveally presented stimuli in patients with schizophrenia and healthy controls as they performed unidimensional and bidimensional versions of the flanker task. In both tasks, centrally presented target stimuli were flanked by peripheral stimuli that were either congruent or incongruent with the behavioural goal of the subject. In the bidimensional task, the flanking stimuli could be congruent and incongruent on multiple stimulus characteristics.

Results. On the unidimensional flanker task, the behavioural goal modulated the responses of the schizophrenia group such that response times (RTs) to target stimuli that were flanked by congruent stimuli were faster than RTs to target stimuli flanked by incongruent stimuli. However, on the bidimensional flanker task, the responses of schizophrenia patients were no longer constrained by the behavioural goal and RTs to both congruent and incongruent stimuli were equivalent.

Conclusions. It appears that the attentional dysfunction in schizophrenia may reflect difficulty in resolving multiple and simultaneous response conflicts. These findings suggest a possible role for the anterior cingulate cortex in the attentional impairments associated with schizophrenia.

Background. Research on risk factors for burnout has mainly focused on circumstances at work and on personal characteristics. The aim of this study was to investigate whether burnout clusters within families and, if so, whether this is due to genetic influences or to environmental factors shared by family members. Finally, we tried to identify specific risk factors for burnout.

Method. In 2707 twins, 736 of their siblings and 575 of their spouses from a population-based twin-family sample, burnout was measured using a self-report questionnaire. Correlations in burnout scores were obtained for monozygotic and dizygotic twin pairs and sibling pairs conditional on the pairs' sex. Correlations for twins and their spouses were derived conditional on the length of the relationship.

Results. In the final model, correlations of the monozygotic and dizygotic twin pairs and sibling pairs were significantly different from zero, but not significantly different from each other. The correlation was estimated at 0·22. The correlation between spouses was also significant. This was mainly due to the group with a relationship longer than 5 years in which the correlation was 0·24. Burnout scores were higher in subjects whose parents had a high level of education.

Conclusions. There is familial clustering for burnout due to environmental factors shared by family members, explaining 22% of the variance. Genetic factors do not seem to be of importance. The significant correlation between spouses supports the conclusion that common environment plays a role in burnout. A high parental education is one of the familial risk factors.

Background. In order to improve care for people with depressive disorders and to reduce the increasing burden of depression, the American Regional Office of the World Health Organization has launched a major region-wide initiative. A central part of this effort was directed to the primary care system where the diagnosis and treatment of depression are deficient in many countries. This study evaluated the materials developed by the World Psychiatric Association in a training program on depression among primary care physicians by measuring changes in their knowledge, attitudes, and practice (KAP).

Method. One hundred and seven physicians and 6174 patients from five Latin American countries participated in the trial. KAP were assessed 1 month before and 1 month following the training program. In addition, the presence of depressive symptoms was measured in patients who visited the clinic during a typical week at both times using the Zung Depression Scale and a DSM-IV/ICD-10 major depression checklist.

Results. The program slightly improved knowledge about depression and modified some attitudes, but had limited impact on actual practice. There was no evidence that the diagnosis of depression was made more frequently, nor was there an improvement in psychopharmacological management. The post-training agreement between physician diagnosis and that based on patient self-report remained low. The physicians, however, seemed more confident in treating depressed patients after training, and referred fewer patients to psychiatrists.

Conclusions. Traditional means of training primary care physicians in depression have little impact on clinical practice regardless of the quality of the teaching materials.

Background. The use of cannabis and other illicit drugs (OIDs) and their co-morbid misuse are frequently reported in the literature. Correlated vulnerabilities and causal or gateway influences have been implicated in this association. We investigated the source of this co-morbidity between cannabis use (experimentation, early and repeated use, and problems) and OID experimentation and problems using genetic models proposed by Neale and Kendler (American Journal of Human Genetics 1995, 57, 935–953).

Method. In a sample of 4152 same-sex male and female adult Australian twin individuals, we fit 13 genetically informative models of co-morbidity to data on experimentation, early use, repeated use of cannabis and co-morbid OID experimentation, and to abuse/dependence (A/D) problems with cannabis and OIDs.

Results. Model-fitting results suggest that common genetic, shared and unique environmental factors are responsible for the association between cannabis experimentation, early use, repeated use and A/D problems and OID experimentation or problems. The liability causation model, which is a reduced form of the correlated vulnerabilities model, also fit very well. In women, we found evidence for high-risk cannabis experimenters and repeated users to be at increased risk for OID experimentation, despite being below the risk threshold on the liability distribution for OID experimentation (extreme multiformity).

Conclusions. Co-morbid cannabis and OID use and misuse are due partly to a common predisposition to substance use disorders. Putative causal effects could not be ruled out. These models warrant further research, so that features of the correlated vulnerabilities model and the gateway models can be studied jointly in a single series of adaptive nested models.

The general relationship between alcohol and crime is reviewed, and five central methodological problems are identified relevant to prison population ‘alcoholism prevalence surveys’ as a prelude to a report of an investigation of 500 recidivist prisoners. The prevalence rate is shown to be highly dependent on the particular definition of ‘alcoholism’ which is employed. Long-term and short-term prisoner subgroups are compared, and similarities with a population of non-prisoner homeless men discussed. A ‘dependence score’ derived from an operant conditioning model of alcoholism correlates significantly with various measures of social instability.

Clinical, neuropsychological and psychopharmacological characteristics were investigated for their ability to distinguish individuals with and without involuntary movements (tardive dyskinesia), among a population of 40 out-patients with bipolar affective disorder and a history of exposure to neuroleptics and lithium. Impaired performance on a test of cognitive flexibility bore the primary association with both the presence and the severity of involuntary movements. The additional relationships identified emphasized further that individual vulnerability to involuntary movements appeared to be associated not with greater duration or dosage of treatment, but with features of the bipolar illness, including number and type of affective episodes, for which that treatment was prescribed.

Background. The study aimed to assess the current and lifetime rates of post-traumatic stress disorder (PTSD) and major depression (MDD) among Nazi concentration camps survivors.

Methods. We investigated 51 Italian political deportees and 47 Resistance Movement veterans who reported traumatic experiences during active service. The Structured Clinical Interview for DSM-IV was used to assess the presence of PTSD and MDD. The Dissociative Experiences Scale and the shorter version of the Hopkins Symptoms Checklist were also administered.

Results. The lifetime rates of PTSD and MDD were 35·3% and 45·1% respectively among deportees and 4·3% and 6·4% among former partisans. The current rates for PTSD and MDD were 25·5% and 33·3% among deportees and 4·3% and 4·3% among former partisans. Dissociative symptoms were more severe among deportees than among Resistance movement veterans.

Conclusions. Concentration camp internment, even for political reasons, appears to have severe long-term psychiatric consequences.

Background. Previously it was shown that during a series of out-patient consultations dysfunctional complaint-related cognitions and anxiety diminished significantly in patients with functional abdominal complaints (IBS). The aim of the present study was to assess the maintenance of positive changes initiated during medical consultations in the patients' complaint-related cognitions and anxiety, as well as the influence of these cognitions on the severity of the complaints, 6 months after the first visit to the out-patient clinic.

Methods. One hundred and five consecutive patients with IBS referred by their general practitioners to the out-patient clinic for internal medicine completed questionaires about their complaints and their complaint-related cognitions and anxiety before the first and after the last out-patient visit and again at follow-up, 6 months after the first out-patient consultation.

Results. Positive changes in the patients' complaint-related cognitions during the consulting period were found to persist during the follow-up period. Improvement in abdominal complaints at follow-up was found to be related to the level of the patients' state anxiety, fear of cancer, and catastrophizing cognitions at the last out-patient visit.

Conclusions. Medical consultations can bring about long-lasting positive changes in prognostically unfavourable cognitions and anxiety. These changes appear to be related to a better outcome of IBS.

One hundred and thirty out-patients with depression were studied by grade of membership multivariate (GOM) analysis. Five depressive types were generated. Pure Type I represented a mild form of melancholia in older, stable males, who showed a modest drug response. Pure Type II included obsessive-anxious symptoms in older patients who responded well to an MAOI drug, but poorly to placebo. Pure Type III was a mildly symptomatic form of depression which responded well to placebo. Pure Type IV included features of agitation, mood worsening later in the day, anorexia and depersonalization; it was commonly precipitated by external stress and MAOI treatment was more effective than placebo. In Pure Type V depression, patients were mostly younger females with high levels of symptomatology, atypical vegetative symptoms, unstable life-styles, disadvantaged backgrounds and a poor response to MAOI and placebo. These results resemble in many ways our earlier GOM study of depression, as well as other multivariate studies of depression in the literature.

In a matched controlled clinical study of 300 neurotic depressives collected over 6 years, 13% had experienced parental death before 17 years of age compared with 10·7% of the controls; this difference was not significant. There were no significant differences between the two groups when maternal or paternal death was examined separately either before 11 or 17 years of age. Thus the experience of parental death as a child is not in itself a risk factor for neurotic depression as seen in psychiatric patients.

Census data from the Danish island of Samsø have provided information on all but 20% of the population. Fifty per cent of the population with past or present mental illness had been referred to the psychiatric service during the 18-year-period 1957–74; the proportion varied from 85 % for patients with psychoses (100 % for schizophrenic patients, and 90% for manic-depressive patients) to 43 % with non-psychotic disorders. The frequency of past and present mental illness was 24 %, higher for women with manic-depressive disorders, psychogenic (reactive) psychoses, and neuroses. The possible reasons for these and other findings are discussed.