This study aimed to investigate the psychological disorders following rape as well as the course of Post-Traumatic Stress Disorder (PTSD), and to determine clinical factors predictive of chronic PTSD. Seventy-three rape victims were observed in a systematic follow-up study over 1 year following rape using structured interview schedules. The frequency of PTSD was massive. The early disorders predicting PTSD 1 year after rape included somatoform and dissociative disorders, agoraphobia and specific phobias as well as depressive and gender identity disorders and alcohol abuse. Through stepwise logistic regressions, the following were found to be good models of prediction of chronic PTSD 1 year after rape: for the characteristics of the traumas, intrafamily rape, being physically assaulted outside rape, and added physical violence during rape; for the early psychological and behavioural attitudes, low self-esteem, permanent feelings of emptiness and running away; and for early mental disorders, agoraphobia and depressive disorders. Finally, among all these predictive factors, added physical violence during rape, low self-esteem, permanent feelings of emptiness and agoraphobia were shown to constitute a strong model of predictors. People presenting features such as the predictive factors of chronic PTSD found in the study should be asked about a history of rape and symptoms of PTSD.

The question of whether hypocholesterolemic treatment is associated with increased mortality due to suicide, violence and car accidents is controversial and of great importance. We investigated the effect of hypocholesterolemic dietary and drug therapy on dysphoric emotions. Twenty-five hypocholesterolemic men were started on a 3-month dietary modification plan; those who showed unsatisfactory cholesterol reduction were given, in addition, a hypocholesterolemic drug for up to 1 year. Lipid profile and change in dysphoric emotions were measured. During the whole period, a negative correlation was found between cholesterol level and depression. During the dietary period, a significant improvement in depression and guilt with no change in lipid profile was noted. Drug therapy significantly reduced cholesterol levels, with a trend toward increased depression (after 3 months) and a significant increase in aggression and guilt (after 1 year). We conclude that changes in dysphoric emotions occurring during hypocholesterolemic therapy cannot be completely explained by the changes in cholesterol levels.

The frequency of anxiety and depressive disorders was examined in 69 insulin-dependent diabetic mellitus (IDDM) outpatients and in two control group. Based on self-report measures, these disorders were similar in IDDM sample and in the control groups. In diabetic outpatients, according to DSM-III-R criteria, there was a high lifetime prevalence of not otherwise specified anxiety and depressive disorders (44% and 41.5%), of simple phobia (26.8%), social phobia (24.6%), and agoraphobia — with and without panic disorder (14.6%). Current social phobia, dysthymia and not otherwise specified depressive disorders were associated with impaired glycaemic control. Glycosylated haemoglobin was associated with compliance but psychiatric disorders were not, except for social phobia which was significantly associated with more frequent consultations and a bad compliance for dietary regimen (more snacking). Somatic complications were not associated with anxious and depressive disorders (current or lifetime) or compliance and were best explained by the duration of the illness and impaired glycaemic control.

Anhedonia may be considered as a transnosological feature of depression and schizophrenia. The aim of the present study was to assess hedonic responses to sucrose solutions and sweet taste perception threshold in patients with major depression and in schizophrenic patients in comparison with healthy subjects (matched for age and gender with depressive patients), and to compare these responses to evaluations by the Physical and Social Anhedonia scale of Chapman and the Pleasure Scale of Fawcett, generally used to quantify anhedonia. Hedonic responses to sucrose solutions were similar in patients with major depression (n = 20), schizophrenia (n = 20), and healthy controls (n = 20). Sweet taste perception threshold was significantly higher in depressive patients than in controls. Hedonic response to sucrose was inversely correlated with physical Anhedonia Scores and sweet taste perception threshold with Pleasure Scale scores. Measures of hedonia/anhedonia were not related with the intensity of depression or anxiety as measured by the Montgomery-Asberg Depression Rating Scale (MADRS) and Hamilton Anxiety Scale, respectively. In 11 depressed patients hospitalised for 17 to 33 days, neither hedonic ratings to sucrose solutions, sweet taste perception threshold, Physical, Social Anhedonia scores nor Pleasure Scale scores were modified in spite of substantial decrease in MADRS or Hamilton Anxiety scores. Hedonic responses to sucrose solutions and sweet taste perception threshold may be used as complementary evaluation to quantify anhedonia.

Data from six randomised, controlled, comparative studies of risperidone and conventional neuroleptics (haloperidol, zuclopenthixol and perphenazine) in the treatment of 911 patients with chronic schizophrenia were analysed to estimate the benefits and risks of treatment. Efficacy and risk of treatment were assessed by means of the Positive and Negative Syndrome Scale (PANSS) and the Extrapyramidal Symptom Rating Scale (ESRS). An effect size (difference between treatments) was calculated from the PANSS and ESRS scores. The effect size of antipsychotic effect favoured risperidone (sizes ranged from 0.22 to 0.37 on the PANSS subscales), and the effect size of safety also favoured risperidone (sizes ranged from 0.18 to 0.36 on the ESRS). An analysis of the proportions of patients requiring antiparkinsonian medication produced an effect size of 0.37 (20% of risperidone patients and 38% of patients receiving a conventional neuroleptic required antiparkinsonian medication). These data indicate that risperidone is a more effective antipsychotic than the conventional agents and causes less severe extrapyramidal symptoms.

A 40-year-old woman initially considered as suffering from anorexia nervosa was later diagnosed as having achalasia and megaesophagus.

Clozapine was administered to 28 resistant schizophrenics at psychiatric services in Bologna. At 26 weeks 62% responded. Positive and negative symptoms improved, but decrease of negative symptoms partially depended upon improvement of positive and EPS. No cases of agranulocytosis were seen. Some drop-outs were related to difficulties with psychopathological improvement.

Prevalence of psychotic depression, and comparison between psychotic and nonpsychotic depression, were studied in 203 consecutive unipolar and bipolar outpatients presenting for treatment of depression in a private practice. Prevalence was 14%. Of the variables investigated (unipolar/bipolar diagnosis, age at baseline/onset, gender, recurrences, atypical features, comorbidity, chronicity, duration of illness, baseline severity) bipolar I diagnosis was significantly more common, and severity of depression was significantly greater in psychotic vs nonpsychotic depression. Discordant findings in the literature may be related to the different samples studied.

An inquiry among the 150 participating trainees and trainers from 24 European countries (mainly from Western European countries), at the Annual EFPT Symposium revealed that in most countries live supervision and observation are not used in training. To make matters even worse, psychiatry trainees hardly get any supervision at all. About one third of the participants never observed a senior psychiatrist in interaction with a patient during the course of their training. Half of the participants were never observed while interacting with a patient during the course of their training. The author elaborates on five of the reasons why live supervision and observation are indispensable tools for training psychiatrists. He concludes that it is unethical to permit trainees to become psychiatrists without this kind of training. For psychiatry to become a profession earning more respect from the other medical professionals and the general public, it is necessary that senior psychiatrists pay more respect to their own profession by giving trainees an adequate training in the craftsmanship of psychiatry.