The pattern of family burden was compared in 32 relatives of schizophrenic patients and 32 relatives of people with mental retardation, using a standardised semistructured interview named “Accertamento della Disabilità e del Carico Familiare” (Assessment of Disability and Family Burden). There were few quantitative differences between the two samples of relatives, although relatives of schizophrenics presented a tendency for a higher degree of both objective and subjective burden in some areas. Problems frequently reported were the presence of emotional distress, poor social relationships and lack of holidays or free time activities. Relatives of schizophrenics specifically claimed the presence of financial difficulties, while those of people with mental retardation were concerned by problems with neighbours.

Individuals with schizophrenia who participated in a psychosocial and educative rehabilitation programme showed a 46% improvement in quality of life in the absence of any significant change in symptom severity. In contrast, there was no significant change in quality of life for individuals who continued with supportive rehabilitation. Our preliminary findings highlight the ‘quality of life’ benefits of psychosocial and educative rehabilitation for individuals with schizophrenia who are clinically stable and living in the community.

This study investigates mood congruence effect in explicit and implicit memory tasks in 23 inpatients fulfilling DSM-III-R criteria for major depressive disorder. Performances were compared to those of 15 in- or outpatients fulfilling DSM-III-R criteria for schizophrenia, and 37 normal subjects serving as euthymics controls. All subjects were submitted to a standard cued recall test and to a word stem completion test devised to assess the effect of the initial presentation without the explicit retrieval of the words being necessary. The material used for these two tasks consisted of emotionally negative and positive words. The results show a mood congruence effect in the implicit memory task (and not in the explicit memory task) only in patients who had recovered from their major depressive episode (and not in depressed patients, schizophrenic patients, or controls). These results suggest that implicit and explicit emotional information processing differ from one another in certain respects.

The authors investigated the historical and clinical variables of 159 inpatients affected by mood disorders in order to identify variables which might differentiate psychotic from non-psychotic forms. The results showed that 32% of the patients had psychotic symptoms. Although no significant difference was detected with regard to the severity of depression, psychotic depressives were younger and had a lower age at onset, as well as a shorter episode length. These features suggest that depression may express itself with or without psychotic symptoms, according to the different individual and, perhaps, biological substrate. Taken together, our findings seem to indicate that psychotic depression should not be considered a separate clinical entity, but a subtype of mood disorders.

Recently, much effort has been directed towards reaching a consensus on the use of antipsychotic medication in the United Kingdom (UK) and in France. Anecdotal evidence suggests, however, that any differences that may exist between practitioners in the UK are only minor in comparison to those between practitioners in the various countries in the European Union. A comparison was conducted of the number of prescribed antipsychotic compounds, as well as their way of administration, in two samples of schizophrenic patients in the UK and France. French patients were much more likely to have been prescribed two or more antipsychotic compounds, either alone (relative risk: RR = 26.3; 95% CI: 3.8-190.6), or in combination with a depot preparation (RR = ∞; Fisher's exact test P = 0.04). British patients were more likely to have been prescribed a single depot preparation (RR = 4.7; 95% CI: 2.3-9.9). These disparities are related to contrasting views on the properties and indications of antipsychotics in the two countries. Given these disparities, working towards a European consensus appears essential.

The first breakthrough in the treatment of obsessive-compulsive disorder (OCD) came in 1967, when Fernandez and Lopez-Ibor reported on the efficacy of clomipramine (CMI) in the treatment of 16 patients with OCD (Fernandez and Lopez-Ibor, 1967). However, controlled studies with CMI were not published until 1980 (Montgomery, 1980; Thoren et al, 1980), and only in the last 5 years have large well-controlled studies been published (Clomipramine Collaborative Study, 1991). Several studies demonstrated that among the tricyclics (TCA), only CMI is effective in OCD, while effective antidepressants with a noradrenergic profile, such as desipramine (DMI), appear to be totally ineffective (Zohar and Insel, 1987; Goodman et al, 1990; Leonard et al, 1989). This selective response to TCA with a serotonergic profile led to the formulation of the serotonergic hypothesis of OCD and to the development and use of other serotonergic agents in the treatment of this disorder. Several drugs, possessing a serotonergic profile are currently being studied worldwide, among them CMI, fluoxetine, fluvoxamine, sertraline, paroxetine and citalopram. Currently, as the knowledge regarding the pharmacological approach to OCD is only beginning to accumulate, very little is known regarding treatment duration in OCD. In this review we shall attempt to examine the existing data regarding treatment duration in OCD.

This study investigated the attitudes of medical students towards psychiatry, both as a subject on the medical curriculum and as a career choice. Three separate questionnaires previously validated on medical student populations were administered prior to and immediately following an 8-week clinical training programme. The results indicate that the perception of psychiatry was positive prior to clerkship and became even more so on completion of training. On completion of the clerkship, there was a rise in the proportion of students who indicated that they might choose a career in psychiatry. Attitudes toward psychiatry correlated positively with the psychiatry examination results. Those that intended to specialise in psychiatry achieved significantly higher examination scores in the psychiatry examination.

A meta-analysis of the published literature was performed in order to quantify the efficacy of low-dose neuroleptic therapy in reducing extrapyramidal side effects in schizophrenic patients. A low-dose regimen between 50–100 mg equivalents of chlorpromazine, in comparison to a standard-dose regimen between 200–500 mg reduced extrapyramidal side effects by a 0.30 (±0.12) standard deviation, which is only a limited effect.

We report the case of a 68-year-old depressive patient who developed severe thrombocytopenia during hospitalization. EDTA-associated thrombocytopenia and psychodrug-induced thrombocytopenia are illustrated as potential causes of low platelet counts, particularly in regard to psychiatric patients.