Depression is a common psychiatric problem in patients with type 2 diabetes (DM2). A common view is that the burden of having DM2 contributes to the development of depression in DM2. Aim of the present study was to compare the levels of diabetes-specific emotional problems of DM2 patients with diagnosed depression with those with a subclinical form of depression and those without depression.

A cross-sectional study was conducted in 101 DM2 patients (51 men and 50 women, mean age = 63,17; SD = 10,74) who completed a standardized, structured psychiatric diagnostic interview (MINI), the Beck Depression Inventory, the Hamilton Depression Rating Scale as well as the Problem Areas in Diabetes (PAID) scale (a 20-item measure, with an overall scale measuring diabetes-related emotional distress and four subscales [negative emotions, treatment-related problems, food-related problems, lack of social support]).

A depression diagnosis was made in 35% (n = 35) of the participants, 24% (n = 24) had a subclinical form of depression, 42% (n = 42) were not diagnosed with any kind of depressive disorder. Diabetes-specific emotional problems were most common in DM2 patients with a depressive disorder (significantly highest PAID score: 39) compared to patients with subclinical depression or no depression. In the group of non-depressed patients, only 14% agreed to have four or more (somewhat) serious diabetes-specific problems. In those with subclinical depression, this percentage was 42% and in those with a depressive disorder 49% (P < 0.001).

Diabetes-related emotional problems are particularly common among DM2 patients with comorbid clinical depression and to a lesser extent in patients with subclinical depression, compared to non-depressed DM2 patients. Male diabetes patients with a depressive disorder are particularly vulnerable to develop high levels of diabetes-specific emotional distress. Major differences between the three groups mainly concern the diabetes-specific problems connected with the illness.

Prevalence of cardiovascular disease is high in schizophrenia. Our aim is to estimate the prevalence of cardiovascular risk factors (CVRF) among schizophrenia patients.

National cross-sectional study in patients diagnosed with schizophrenia under treatment with second generation antipsychotics and admitted to short-stay hospitalisation units.

A sample of 733 consecutively admitted patients was enrolled; the most prevalent CVRFs were smoking 71% (95% CI: 67–74%) and hypercholesterolemia 66% (61–70%) followed by hypertriglyceridemia 26% (26–32%), hypertension 18% (15–21%) and diabetes 5% (4–7%). Metabolic syndrome showed 19% (95% CI: 16–23%) prevalence or, according to updated definitions (Clin Cornerstone 7 [2005] 36–45), 24% (95% CI: 20–28%). The rate of patients within the high-risk range of a 10-year fatal cardiovascular event was 6.5%. CVRFs under routine management were diabetes (60%), hypertension (28%) and, to a lesser extent, dyslipemia (14%). Treatment for CVRFs was associated to gender, men for hypertension OR = 25.34, p < 0.03 and women for diabetes OR = 0.02, p < 0.03.

We found that CVRFs in schizophrenia were prevalent and under-diagnosed, and thus with insufficient therapeutic management.

To explore the associations between the presence of personality problems and somatic morbidity and health care utilisation.

The Iowa Personality Disorder Screen was administered in order to identify persons with personality problems in a Norwegian population survey (the Oslo Health Study – HUBRO). Cases consisted of 369 individuals, 30, 40 and 45 years of age with personality problems matched on age and gender with five controls each. Data on somatic morbidity and health care utilisation were collected by questionnaires.

The cases more frequently reported persistent muscular pain, asthma, fibromyalgia and alcohol problems than the controls. They also more often used nonprescribed analgesics and antidepressants. The cases more frequently had consulted a general practitioner (GP) in the last 12 months, less frequently got referral to somatic specialist care and were less satisfied with their last visit to a GP.

In this population based study, personality problems in young adults based on DSM-IV personality disorder criteria were associated with increased occurrence of somatic morbidity and primary health care utilisation. The relevance for GP to take personality problems into account during consultations is underlined and a method for doing so is suggested.

To evaluate the efficacy and safety of amisulpride in medical inpatients who present with delirium.

Open label prospective study with 7-day follow-up. Forty hospital inpatients with delirium were recruited, seven of whom died and two of whom refused medication. The average dose of amisulpride for delirium treatment was 200–300 mg/day. Daily assessments were performed with Delirium Rating Scale (DRS), Positive Subscale of the Positive and Negative Syndrome Scale (PANSS-P), Mini Mental State Examination (MMSE), Neurological Subscale of the UKU side effect rating scale. Variance analysis was performed through repeated measurements, with the general linear model with paired comparisons and Bonferroni correction for each measured variable.

Patients showed significant improvement on the DRS from the first day of treatment DRS = 17.55 until day 7 DRS = 7.26 (F = 92.485; p < 0.001), psychotic symptoms improved from first day PANSS-P = 18.26 to last day PANSS-P = 9.35 (F = 144.83; p < 0.001). Cognitive status showed a significant improvement from day 2 MMSE = 18.71 until day 7 MMSE = 24.06 (F = 96.56; p < 0.001), and the neurological subscale of the UKU side effect rating scale showed a significant improvement the last day with respect to baseline pretreatment level (F = 7.539; p = 0.01).

These results suggest a good response to amisulpride in the acute phase of delirium, although further randomized controlled studies must be performed.

Increased impulsivity is a diagnostic feature of mania in bipolar disorder (BD). However it is unclear whether increased impulsivity is also a trait feature of BD and therefore present in remission. Trait impulsivity can also be construed as a personality dimension but the relationship between personality and impulsivity in BD has not been explored. The aim of this study was to examine the relationship of impulsivity to clinical status and personality characteristics in patients with BD.

We measured impulsivity using the Barratt Impulsiveness Scale (BIS-11) and personality dimensions using Eysenck Personality Questionnaire in 106 BD patients and demographically matched healthy volunteers. Clinical symptoms were assessed in all participants using the Clinical Global Impressions Scale, the Montgomery-Asberg Depression Rating Scale and the Young Mania Rating Scale. Based on their clinical status patients were divided in remitted (n = 36), subsyndromal (n = 25) and syndromal (n = 45).

There was no difference in BIS-11 and EPQ scores between remitted patients and healthy subjects. Impulsivity, Neuroticism and Psychoticism scores were increased in subsyndromal and syndromal patients. Within the BD group, total BIS-11 score was predicted mainly by symptoms severity followed by Psychoticism and Neuroticism scores.

Increased impulsivity may not be a trait feature of BD. Symptom severity is the most significant determinant of impulsivity measures even in subsyndromal patients.

Adolescents in residential care are a high-risk population for psychiatric disorders. Due to limited access to outpatient treatment, crises often result in psychiatric hospitalizations. These crises are often accompanied by termination of supportive relationships, which increases the risk for further problems. To minimize hospitalizations and to stabilize the psychological state of these adolescents, we developed and evaluated a home-treatment intervention program based on psychiatric liaison-services and compared it to standard medical care (SMC).

The intervention was applied in 11 German residential group homes (N = 288, M = 14.1 years, SD = 2.7), while adolescents from 15 institutions (N = 336, M = 13.6 years, SD = 3.0) served as a comparison group (CG) (SMC). The frequency and duration of psychiatric inpatient treatment episodes were documented and caregiver-reported behavioural symptoms were assessed at baseline and at 6 and 12 months postintervention.

In both groups, less than 10% of the adolescents were admitted to psychiatric wards. Compared to SMC, hospitalizations were of shorter duration in the intervention group (IG) (1.30 vs 2.47 days per head within 12 months, p < .001). In both groups, behavioural problems decreased overtime.

Applying a home-treatment intervention program to children in residential care helps to stabilize the developmental course of this high-risk population by shortening psychiatric inpatient treatment.