This study was designed to evaluate the effect of semantic priming with a lexical decision task in 22 depressed patients (DSM-III-R, 1987) and 30 control subjects. These patients were evaluated twice: first when they arrived at the hospital, and secondly, after clinical improvement. Clinical improvement was evaluated using standard depression rating scales. A lexical decision task involving semantic relations (related vs. unrelated, e.g., apple-pear) was used to evaluate the processing of semantic information. The results showed that, for the first evaluation, the depressives presented similar semantic priming to control subjects. When we compared semantic priming in the first and the second passes, we observed that its amplitude was identical. The sole difference between the two passes concerns the global reaction time in the depressive group. This last result suggested that, with clinical improvement, the characteristic psychomotor retardation declines. One of the major results concerns the fact that severe depressive patients (first pass) exhibit normal semantic priming in a lexical decision task. These results indicate, in this clinical population, the preservation of controlled processes implicated in this lexical decision task.

Progress in identifying the genetic vulnerability factors in autism requires correct identification of the inherited phenotype(s). This can be achieved not only by the accurate description of the affected subject but also by the identification of vulnerability traits in non-affected relatives of autistic probands. This review will focus on this last strategy and principally on clinical, biochemical and cognitive traits.

For the first time, the present study explores pre-episodic disturbances, i.e. self-experienced vulnerability and prodromal symptoms, and related coping strategies preceding schizophrenic and depressive relapses. After complete recovery from the acute episode, 27 patients with recurrent schizophrenic and 24 patients with recurrent depressive episodes were assessed retrospectively for pre-episodic disturbances and related coping strategies with the “Bonn scale for the assessment of basic symptoms—BSABS”. All (100%) of the schizophrenic and 23 (96%) of the depressive patients showed pre-episodic disturbances. Patients with schizophrenia showed significantly more often an increased emotional reactivity and certain perception and thought disturbances. Depressive patients reported significantly more often an impaired tolerance to certain stress and disorders of emotion and affect. Sixty-three percent of the schizophrenics and 87% of the depressives reacted to pre-episodic disturbances with coping strategies. The pre-episodic disturbances in patients with schizophrenia could be described in terms of mild psychotic productivity, those in depressives in terms of mild depressive syndrome. Future studies will have to show if these findings can be replicated in first episode or initial prodromal state samples and if the assessment of mild psychotic productivity and mild depressive syndrome can be used for early diagnosis and early intervention in schizophrenia and depression.

The A1 allele of the D2 dopamine receptor (DRD2) gene has been associated with alcohol dependence. However, the expression of this allele risk on the severity of drinking behavior in patients with alcohol dependence has not been systematically explored. The present study examines the association between DRD2 A1+(A1/A1 and A1/A2 genotypes) and A1– (A2/A2 genotype) allele status and key drinking parameters in alcohol-dependent patients. A sample of Caucasian adults was recruited from an alcohol detoxification unit. A clinical interview and the Alcohol Dependence Scale (ADS) questionnaire provided data on consumption, dependence, chronology of drinking and prior detoxification. A1+ allele compared to A1– allele patients consumed higher quantities of alcohol, commenced problem drinking at an earlier age, experienced a shorter latency between first introduction to alcohol to the onset of problem drinking and had higher ADS scores. Moreover, A1+ allele patients had more detoxification attempts than their A1– allele counterparts. In sum, alcohol-dependent patients with the DRD2 A1 allele compared to patients without this allele are characterized by greater severity of their disorder across a range of problem drinking indices. The implications of these findings are discussed.

We examined the differences in the suicide characteristics between areas directly and indirectly affected by war activities and in war and post-war periods according to the following variables: suicide rate, sex, age and method of suicide. Analysis was done on 5349 suicides committed in the period 1993–1998 (war and post-war years). The suicide rates in the Republic of Croatia oscillated in the pre-war, war and post-war periods (1985–2000) but without significant differences. In the areas directly affected by war, the suicide rate was significantly lower than in other areas during the study period 1993–1998 (chi-square = 10.3245; P = 0.0017). The number of suicides in both sexes declined in the areas directly affected by war—more in men than in women; the difference between sexes was statistically significant (chi-square = 3.6697; P = 0.055). Middle- and old-aged people were the population with high suicide risk in both areas (t = 1.76; P = 0.078). There were significant differences in the methods of suicides between war and non-war areas (chi-square = 108.8473; P = 0.001). Firearms or explosive devices were the methods used more significantly for suicides in the areas directly affected by war than in other areas, whereas hanging was more frequently used in the areas indirectly affected by war.

Information-processing in the prefrontal cortex is abnormal in patients with schizophrenia. From functional neuroimaging and other studies, it appears that neurons of the dorsolateral prefrontal cortex are effectors of core clinical and biological phenomena associated with the illness. Cognitive deficits qualitatively similar to those in patients with schizophrenia are also found in their healthy siblings and other relatives. The evidence for abnormal prefrontal function in healthy siblings suggests that the deficit in information-processing is part of the biology of genetic susceptibility. Therefore, genetic variations in human DNA that affect this kind of information-processing may contribute part of the genetic risk for the illness. COMT is an enzyme that is distributed widely throughout the brain, but seems to be uniquely relevant to how dopamine affects information-processing in the prefrontal cortex. There is a common variation in the genetic sequence of the COMT gene, which causes a dramatic change in its enzyme activity. In people with schizophrenia, in their healthy siblings, and also in normal controls, the COMT genotype predicts 4% of the variation in human executive cognition and working memory. We have thus identified a genetic mechanism in the human species that affects the efficiency and efficacy of information-processing in the prefrontal cortex. It is, also, a weak genetic risk factor for schizophrenia: in family studies, it increases the risk of schizophrenia by 50-80%. Prefrontal neuronal tuning may be a target for new drug development in the future.

Abstinent alcoholics often denycraving for alcohol but still show a high level of relapse. The eyeblink response to startling noise was used as an indicator of the emotional response to alcohol-related, positive, negative and neutral visual stimuli in abstinent alcoholics, social drinkers and rarelydrinking controls. The cognitive evaluation of the stimuli was assessed byratings of subjective craving, valence and arousal. The startle response of the alcoholics to alcohol-related stimuli was significantlyinhibited despite an aversive overt stimulus-evaluation. These findings indicate that alcohol-related stimuli mayhave appetitive incentive salience for alcoholics in spite of verbal reports of craving and valence to the opposite.

The effect of depression on the hippocampus has become the focus of a number of structural and functional neuroimaging studies. In the past two decades, advances in neuroimaging techniques now allow the examination of subtle changes in both regional structure and function that are associated with the pathophysiology of depression. Many studies using 3-dimensional magnetic resonance imaging (MRI) volumetric measurement have reported decreases in hippocampal volume among depressed subjects compared with controls, whereas other studies have not found any volume loss. Differences among studies have been discussed. In some studies, the volume loss appears to have functional significance including an association with memory loss. Furthermore, we have found a trend towards loss of 5-HT2A receptors in the hippocampus using positron emission tomography (PET) to detect regional changes in [18F]altanserin binding. Functional imaging extends the sensitivity and specificity of structural imaging and will lead to a better understanding of affective disorders.

Currently, tardive dyskinesia (TD) remains an important clinical problem. The average prevalence is estimated at 30%. The appearance of antipsychotics has opened new paths. The extrapyramidal profile of these molecules is more favorable than that of conventional neuroleptics. In order to assess their prophylactic as well as curative potential, we reviewed the literature concerning four of these atypical antipsychotics: clozapine, risperidone olanzapine and amisulpride. Clozapine seems to induce fewer cases of TD than the conventional neuroleptics, and has a specific therapeutic effect. However, the risk of agranulocytosis reduces the possibility of utilisation. Risperidone appears to be an effective therapy, but several authors report cases of TD during treatment. Furthermore, larger studies and longer follow-ups are necessary to confirm the efficiency of olanzapine and amisulpride. Further studies and observations are still necessary before drawing any conclusion for these new atypical antipsychotic actions. They are doubtlessly promising, but we cannot ignore the notion of risk–benefit; regular monitoring and listening to the subjective experience of the patients must remain uppermost in the choice of therapy.

Studies suggest a greater reliance on visual information for maintaining balance in anxious subjects. Nevertheless, links between this supposed preferred visual processing and spatial orientation have not yet been evaluated. Two groups of subjects differing in their level of trait anxiety were formed. Equipped with a head-mounted visual display, they learned a virtual corridor using passive translation but active rotation, both with normal and with two different conflicting sensory conditions. After two visual navigation trials in the corridor, they were blindfolded and asked to reproduce the same trajectory from memory. In addition, subjects drew a map of the remembered corridor. Anxious subjects were comparable to non-anxious subjects when asked to reproduce the trajectory from memory, but exhibited a deficit when drawing a map of the corridor they were in. The results do not support the hypothesis that anxious subjects use preferentially one type of sensory cue over another for spatial orientation, but instead manifest difficulties in constructing more global representations of space.

Self-esteem (SE) and social adjustment (SA) are often impaired during the course of affective disorders; this impairment is associated with suicidal behaviour. The aim of the present study was to investigate SE and SA in unipolar or bipolar patients in relation to demographic and clinical characteristics, especially the presence of suicidality (ideation and/or attempt). Forty-four patients, 28 bipolar and 16 unipolar, in remission for at least 3 months, and 50 healthy individuals were examined through a structured clinical interview. SE and SA were assessed by the Rosenberg self-esteem scale and the social adjustment scale, respectively. The results have shown that bipolar patients did not differ from controls in terms of SE, while unipolar patients had lower SE than bipolars and controls. No significant differences in the mean SA scores were found between the three groups. Suicidality during depression was associated only in bipolar patients with lower SE at remission; similar but not as pronounced was the association of suicidality with SA. It is concluded that low SE lasting into remission seems to be related to the expression of suicidality during depressive episodes of bipolar patients, while no similar pattern is evident in unipolar patients.