A 56 year-old man who presented with symptoms and signs of dementia was later diagnosed as having nasopharyngeal carcinoma.

This study is part of a more extensive research conducted by a group of scientists from different countries, who have joined forces to conduct an international study on the development of the therapist, and to develop a novel instrument for therapists, the “Development of Psychotherapists’ Common Core Questionnaire” (CCQ). We report here the results based on the answers of a French-speaking sample to this questionnaire. Data were analyzed using univariate (non parametric tests) and multivariate analyses (Principal Component Analysis and Multiple Correspondence Analysis). The perceived effects of psychoanalytical training were examined. The therapists’ own perception on their current skills and the type of difficulties they experienced were very similar, whether or not they had received psychoanalytical training. However, striking and significant differences in coping strategies were observed between the two groups.

In vivo NMR 31p spectroscopy is a non invasive, non ionizing method of exploration of energy and phospholipid metabolism in the brain. This study consisted of comparing 31p spectra in five patients with Senile Dementia of Alzheimer Type (SDAT) with those of four controls of similar ages. Abnormal phosphonionocsters (PME) concentrations, either high or low, were found in the patients, but statistical analysis did not elicit any significant difference relative to controls.

Suicide rates were found to decline during the major world wars of this century in both men and women and in both participating and non-participating nations. The increase in suicide rates after the conclusion of the wars, however, was not as pronounced.

There have been many contradictory reports on the effectiveness of antidepressant drug treatments in autistic syndromes with sell-injurious behavior (SIB). We report a retrospective case study in which norepinephrinergic antidepressants (inhibitors of the re-uptake of norepinephrine) increased SIB each time they were administered.

To approve a drug means to release it for use in a specific patient population which should be characterized as clearly as possible in the labelled indications in the Summary of Product Characteristics (eg patients with major depression according to DSM III-R).

Ideally, the patient samples in various clinical trials should be representative of this specific patient population, and the crucial question is whether the study data allow an extrapolation to the wider patient population which we intend to treat.

Basically, what is valid for preclinical data and animal exposure, should also be valid for humans: more or less all regulatory authorities agree that they should accept valid data and information from all regions and all clinical studies available in order to minimize unnecessary human exposures and needless duplication. This is especially important in therapeutic fields where there is an urgent need for treatment due to the lack of suitable alternatives.

In May 1992 the German Council of Physicians decided that in the future there will no longer be a specialist in psychiatry, but, only a specialist in psychiatry and psychotherapy. This decision has enormous consequences for the psychiatric training of residents specializing in the field in Germany. Psychotherapy is now an integral part of psychiatry and must be completely included in training programs. The period of advanced training in the future will encompass five years instead of four years. The future curriculum for psychiatrists is far more structured and includes many more regulations than was formerly the case. The specialist in the field must acquire equal competence on the somatic, social-psychiatric, psychopathological and psychotherapeutic levels, followed by their subsequent integration into diagnosis and therapy. Practical experience in psychotherapy must be acquired in both a primary and secondary method. The only methods capable of recognition as the primary method are psychodynamic psychotherapy and behaviour-cognitive therapy. The secondary method will be restricted to psychodynamic psychotherapy, behaviour-cognitive therapy and client-centered therapy. The principle aim of the new specialist physician regulations in Germany is to achieve a multi-dimensional approach to the diagnoses and treatment of psychiatric disorders corresponding to the complex nature of psychiatric illness.

Already at the end of the 19th century, Hughlings-Jackson suggested that positive symptoms such as hallucinations and delusions should be kept apart from negative symptoms such as anhedonia and reduced energy in all psychoses. Both Kreapelin and Bleuler regarded the negative symptoms as fundamental in schizophrenia while the positive symptoms were regarded as being accessory, accompanying the disorder. This view was maintained for 60 years (table 1) until Schneider (1959) introduced the “first rank symptoms”, all of them positive. Schneider never advocated that these symptoms should be a sufficient basis for a diagnosis of schizophrenia. In any case, the “first rank Symptoms” have been included in most later diagnostic systems (table 1).

La loi du 27 juin 1990 relative aux droits et á la protection des personnes hospitalisées en raison de troubles mentaux et á leurs conditions d'hospitalisation a maintenant remplacé en France, I'ancienne loi de 1838 sur les « aliénés ». Elle précise les droits des malades et veut instaurer un meilleur contrôle des conditions d'hospitalisation. L'hospitalisation á la demande d'un tiers nécessite maintenant, en plus de la demande d'admission, deux certificats médicaux attestant que le consentement du malade est impossible, que son état nécessite des soins immédiats et une surveillance médicale constante. L'hospitalisation d'office exige un certificat médical circonstancie portant sur l'état actuel du malade. Elle est prononcée par le préfet du département. La levée de l’ hospitalisation d'office est décidée par deux psychiatres experts qui doivent établir que l'intéressé n'est plus dangereux. Ces nouvelles dispositions visent essentiellement à protéger le sujet sain contre I'arbitraire, plutôt que le malade contre son entourage et lui-même. La notion de consentement impossible est en particulier ambiguë et peut aboutir à exclure de l'hospitalisation des malades dont l'état va s'aggraver. La notion de dangerosité (article 348) sur les conditions d'entrée et de sortie des malades hospitalisés d'office fait appel à des prérequis contradictoires et devrait être clarifiée.

We report the case of a patient with major depression and obsessive-compulsive disorder who had simultaneously high serum citalopram, clomipramine, and alprazolam concentrations probably due to the reciprocal competitive inhibition of the cytochrome P450-catalyzed oxidative metabolism.