As depression is a considerable risk factor for an unfavourable course of myocardial infarction (MI), antidepressant treatment of post-MI depression and, inherent to MI status, polypharmacy has become an important issue.

The present study is the first to evaluate cognitive side effects of fluoxetine, as part of a placebo-controlled double-blind trial, in patients with post-first MI depression.

Cognitive performance of 54 depressed patients post first-MI, treated with fluoxetine or placebo was compared. Cognitive performance was tested before and after 9 weeks of treatment using the Visual Verbal Learning Test, Concept Shifting Task, Stroop Colour-Word Test and Letter-Digit-Substitution Test.

The median number of cardiovascular drugs taken by MI patients was 4.9. There were no differences between the fluoxetine and the placebo group on cognitive performance.

In sum, there were no negative side effects of fluoxetine compared with placebo on cognition in depressed MI patients, simultaneously treated with cardiac drugs.

The aim of this study was to search for morphological and hemodynamic changes in hepatic and splanchnic vasculature in alcoholic patients without the signs of hepatic damage and subtyped by Cloninger classification by means of sonography, and compare the subtypes among themselves and with nonalcoholic healthy subjects.

Thirty alcohol dependent patients and 30 healthy subjects with no alcohol problem or hepatic impairment were included in the study. Patients were subtyped by Cloninger classification and all patients were evaluated by gray-scale and spectral Doppler ultrasound. The diameter of the portal vein, portal venous velocity, peak systolic and end diastolic velocities of hepatic and superior mesenteric arteries were assessed. RI, PI and systolic/diastolic velocity ratios were also calculated.

Portal vein diameter (PV diameter), portal vein cross sectional area (PV area), portal vein velocity (PV PSV), hepatic artery peak systolic velocity (HA PSV), hepatic artery end diastolic velocity (HA EDV), hepatic artery resistive index (HA RI), hepatic artery pulsatility index (HA PI), and systolic/diastolic velocity ratios (HA S/D), superior mesenteric artery peak systolic velocity (SMA PSV), superior mesenteric artery end diastolic velocity (SMA EDV), superior mesenteric artery resistive indices (SMA RI), pulsatility index (SMA PI), and systolic/diastolic velocity rates (SMA S/D) showed no significant difference among the groups (P > 0.01). Although there is no significant difference in PV PSV, HA PSV, SMA PSV, SMA EDV values between the groups, mean values of Type II alcoholics is greater than other groups. Portal vein cross-sectional area was greater in alcoholic patients (Type I, II and III) compared to the control group (P = 0.000). Portal vein velocity, hepatic artery peak systolic and end diastolic velocity, superior mesenteric artery peak systolic and end diastolic velocity were significantly greater in alcoholic patients than in the control group (P < 0.001). No statistical difference was detected between other parameters evaluated.

In alcohol dependent patients, some hemodynamic and morphologic changes occur in hepatic and splanchnic circulation, even before the signs of hepatic damage develop, which can be detected by means of Doppler and gray-scale sonography. But as there is no significant difference between the Doppler ultrasonographic findings among alcoholics subtyped by a Cloninger classification, which is a clinical classification, it suggests that psychiatric classification doesn't show any correlation with biological parameters, and because of this Cloninger classification a psychiatric classification cannot be considered as a characteristic determinative factor in the prognosis of hepatic disorder due to alcohol use. However, higher values of Type II alcoholics can be attributed to the longer alcohol intake of this subtype.

The enlarged cava septi pellucidi (CSP = 6 mm in length) have been reported as a reliable marker of an underlying neuropsychiatric disease or disorder. Differences in the dimensions of cava longer than 6 mm associated with a neuropsychiatric impairment could be of possible clinical and forensic significance.

We obtained 479 brains from autopsied persons (310 males and 169 females, aged 22–89 years) and observed that 110 brains (75 males and 35 females) had CSP, of which the length of CSP was equal to or longer than 6 mm on 69 (49 males and 20 females) of them. These cava were classified into four groups depending on the past medical histories of the autopsied person: five without neuropsychiatric history (asymptomatic CSP), 25 schizophrenic patients, 22 alcoholics, and 17 with a past head trauma (symptomatic CSP).

The linear parameters of CSP (i.e. length, width) of the symptomatic and asymptomatic groups were measured and were statistically analyzed. Analysis revealed that the cava in the group of schizophrenic patients were significantly longer and wider.

Discriminant function analysis was used to derive a mathematical formula to classify CSP into one of the groups obtained based on width measurements of the cavum.

In this flexible-dose, open-label trial, we examined the efficacy of omega-3 fatty acids for the treatment of depression during pregnancy.

Fifteen pregnant women with major depressive episodes participated. Subjects initially received two capsules per day [0.93 g of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA)]; the dose could be increased by one capsule per day every 2 weeks to a maximal dose of 2.8 g. Subjects were assessed with the Edinburgh Postnatal Depression Scale (EPDS) and Hamilton Rating Scale for Depression (HRSD).

Average duration of participation in this treatment trial was 8.3 weeks (SD ± 7.1). Average final dose of EPA + DHA in this flexible dose trial was 1.9 g per day (±0.5). The mean reduction in EPDS scores was 40.9% (SD ± 21.9); the mean decrease in HRSD score was 34.1% (SD ± 27.1).

This open trial provides data to support the need for randomized controlled dose-finding trials of omega-3 fatty acids in major depressive episodes during pregnancy.

The aim of this study was to evaluate whether risk factors for depression in the general population are also markers for depression in Alzheimer's disease (AD) and to identify additional disease-specific markers for depression in AD.

A logistic model of five risk factors for depression in the general population was constructed using the data of 217 patients with AD, of whom 63 (29%) suffered from major depressive disorder. In a next step, five potential disease-specific markers were individually added to this model to see whether the strength and predictive power of the model would improve.

The multivariate model of five risk factors for depression in the general population was not a good model to predict depression in AD. In this multivariate approach, only ‘a history of depression’ was an independent marker for depression. The only disease-specific variable that improved the logistic model was ‘disability due to AD’. An interaction between these two markers became apparent.

Of the established risk factors for depression in the general population, only ‘a history of depression’ was found to be an independent marker for depression in AD. ‘Disability due to AD’ was the only disease-related marker for depression in AD, although this marker cannot be considered specific for AD. The importance of controlling for general risk factors for depression in the search for disease-specific markers for depression in AD is stressed.

Physical hyperactivity has often been described in anorexia nervosa (AN) patients but up until now in-depth research has been scarce. Experience sampling methodology (ESM), a structured diary technique assessing momentary mental state at random times during the day, may be useful in studying hyperactivity in AN.

In two single case reports, ESM was used to investigate the variation across time of the urge to move in relation to potentially relevant eliciting conditions such as positive and negative emotions, weight preoccupation and attractiveness.

Frequency distribution of the involved variables indicated substantial individual differences between patients. While both patients' tendency to be hyperactive was positively related to their weight preoccupation and negative emotions, in only one patient, the urge to move turned out to be significantly related to (the absence of) positive emotions.

ESM can be useful to test whether general theories of psychopathology apply to specific patients, and it may be conceived as an individually tailored approach to self-monitoring. As such, it may guide the clinician to devise therapeutic interventions in particular patients.

Patients suffering from Parkinson's disease (PD) are often reported to have an impaired performance on tests measuring executive functioning, such as fluency tasks.

To investigate whether verbal fluency is impaired in PD patients (n = 25) compared with healthy controls (n = 15) using a 2-min semantic and phonemic verbal fluency test. A 2-min version of the fluency task was used to allow for more switches between clusters to study retrieval strategies more adequately.

No differences in performance on both semantic and phonemic fluency tasks between the PD patients and the control persons were found. Moreover, both groups appeared to use the same retrieval strategies.

Patients suffering from PD appear to use the same strategies for producing words as healthy controls do. Different pathways may be involved in switching clusters during the fluency task than in other types of switching that may be impaired in PD, such as motor switching and concept-shifting.

Many studies have evaluated patients with idiopathic hypogonadothropic hypogonadotropism (IHH), but few of these studies utilize event-related potentials (P300).

To assess the cognitive functions of hypergonadotropic vs. hypogonadotropic patients.

The study group consisted of 41 untreated IHH patients, 32 untreated Klinefelter syndrome (KS) patients, and 30 healthy control subjects.

In this study, the latency and amplitude of P300 was evaluated in 41 untreated IHH and 32 untreated KS patients and compared to healthy control subjects (average age: 30 years). Also evaluated were the patients' hormone levels.

In this study, the amplitude of P300 was found to be reduced, and the latency prolonged in IHH patients in comparison to KS patients and control subjects. In KS patients, there was no difference in latency of P300, but the amplitude was reduced when compared with the control group. Cognitive dysfunction in patients with hypogonadotropism is related to androgen hormone levels. This deficiency can affect development of the central nervous system (CNS), causing defects of CNS to varying degrees during the perinatal period. Androgen deficiency is considered to exert its effects during the period of cognitive ability development, manifest in IHH patients but not KS patients.

Wilson's disease commonly presents with neurological or hepatic manifestations. When it presents with only psychiatric symptoms, or with extrapyramidal symptoms secondary to neuroleptic exposure, the diagnosis of underlying Wilson's disease may be missed.

An 18-year-old boy presented to the psychiatric clinic with a manic syndrome and high propensity for extrapyramidal symptoms to neuroleptic. Initial examination revealed splenomegaly and pancytopenia. Subsequent detection of Kayser–Fleischer ring and typical biochemical findings confirmed the diagnosis of Wilson's disease.

While the psychiatric symptoms came under control with lithium carbonate, extrapyramidal symptoms continue to persist even after neuroleptic withdrawal. Pancytopenia thought to be due to hypersplenism persists, and patient has developed features of liver cirrhosis. Treatment with zinc and folic acid has been started, and the patient is under evaluation for treatment with penicillamine.

The psychiatrist needs to recognize that Wilson's disease can uncommonly present with isolated psychiatric symptoms, including mania. Early and severe extrapyramidal symptoms secondary to neuroleptic exposure in an adolescent age group warrants a detailed evaluation to rule out underlying neuropsychiatric conditions.

Capgras syndrome is the most common type of delusional misidentification syndromes. In this phenomenon, the patient believes the delusional conviction that a familiar person has been replaced by imposters. Capgras syndrome was thought to occur in psychotic and organic contexts. It has some rare variants. In one of these rare variants, the patient has the delusion of inanimate doubles. There are reports which regard the relationship between Capgras syndrome and epilepsy as a contributing factor. We present a case of grandmal epilepsy with psychotic features including delusion of inanimate doubles.

A single case is reported.

A 55-year-old woman with long-time history of grandmal epilepsy developed psychosis 3 months prior to her psychiatric referral. She believed that her sons replaced her possessions and furniture continuously. There was no history of previous psychiatric illness, and also there was no evidence of any other organic disorder.

Previous reports showed Capgras phenomenon as a clinical presentation in epileptic patients. We show that the delusion of doubles of inanimate objects as a variant of Capgras syndrome could also be a clinical presentation in epileptic patients.

Subacute sclerosing panencephalitis (SSPE) is rare in adult patients. Clinical presentation in intial phases of SSPE may be non-specific leading to diagnostic delay. We present a 24-year-old patient with depressive syndrome of five months' duration prior to the onset of typical features of SSPE, which is a rare presentation. This patient had responded partially to Sertraline, for a brief period, before he was diagnosed to have SSPE. This case illustrates affective symptoms can be the presenting features of SSPE in adults.