The descriptive diagnostics constitute the first step, the base and the prerequisite for the psychodiagnostic process and the treatment of depression. Within the descriptive diagnostics, two approaches are distinguished, namely (1) the differentiation between dimensional and categorical levels of measurement and (2) the consideration of the influence of the applied method: questionnaire versus interview. Departing from these approaches, a review of the most widely used instruments on depression is given, with a focus on the reliability and validity of the dimensional depression instruments, based on the findings of our research group. The importance of the differentiation between dimensional and categorical levels of measurement can also be recognised within the discussion on quantitative/dimensional versus qualitative/categorical taxonomic views on depression. The Integrated Threshold Model, which integrates both the quantitative and the qualitative view on the classification of depressive disorders, is considered. By way of conclusion, a diagnostic multi level/modality/method strategy is discussed and a specific test battery, which can be particularly useful within a research context, is presented.

Klinefelter syndrome is a genetically determined disorder characterized by an additional X-chromosome. Apart from the phenotypical features, the literature about this disorder mentiones a psychopathological phenotype comprising mainly psychoses, depressive diseases and personality disorders. A substantial number of patients presents with mild to moderate mental retardation.

In this paper, two case reports are described and their psychopathology is compared with the data from the existing literature.

Chronic pain is a phenomenon with important psychiatric aspects from a diagnostic as well as a therapeutic point of view. The place of chronic pain in the different versions of the Diagnostic and Statistical Manual of Mental Disorders, and the differential-diagnosis are critically discussed. The comorbidity with depression, anxiety disorders, substance abuse and personality disorders is extensively treated. Finally, the essential role of the psychiatrist in the multidisciplinary therapeutic approach of these patients is emphasised.

Drug-induced psychiatric conditions are a common and severe problem in the treatment of patients with Parkinson's disease. Psychotic symptoms are the most frequent reason for nursing home placement of patients with Parkinson's disease. The psychotic symptoms seem to present themselves in a continuum where alterations in dreaming patterns often precede visual hallucinations, which often progress into delusional syndromes and, finally, into confusional organic syndromes. When evaluating a patient on dopaminergic treatment, it is important to inquire systematically about abnormal sleep related phenomena, for these are important clues in the early detection of psychotic symptoms. The pathogenesis of the psychotic symptoms is not yet fully understood but complex adaptations of various neurotransmitter systems seem to be involved. In the treatment of these drug-induced psychotic symptoms, the atypical antipsychotic drug clozapine plays an important role. Drug-induced mania, hypersexuality and anxiety, although less frequent than the psychotic symptoms, also occur as a complication of dopaminergic treatment. Depressive symptoms, although common in Parkinson's disease, are less likely to occur as a side effect of the drug treatment.