One of the theories on the biology of panic disorder which received much attention is the locus coeruleus hypothesis. This hypothesis states that there exists an episodic overactivity of noradrenergic systems in panic disorder. Experiments with yohimbine form the cornerstone of this theory, and additional supporting evidence is provided by challenge studies with isoproterenol and treatment studies with clonidine. These studies are critically reviewed and it is argued that based upon the studies with yohimbine one cannot conclude that there is a specific noradrenergic abnormality in panic disorder, since yohimbine also affects dopaminergic and serotoninergic neurons in the brain.

In an alternative theory on the relationship between noradrenaline and anxiety it is postulated that increases in anxiety, irrespective of the diagnostic category, are related to increases in locus coeruleus activity.

Indications for lithium in the treatment of bipolar disorders are acute mania, depression and preventive treatment. In the case of insufficient efficacy or adverse effects the first alternative for lithium in acute mania is carbamazepine. However, the role of carbamazepine in preventive treatment is still uncertain. Well designed prospective research is hardly done. Clearly positive reports on the efficacy of carbamazepine concern specific lithium-resistant groups such as the ‘rapid-cyclers’. Valproic acid has been found effective in a few studies in bipolar disorders, especially in acute mania. Clonazepam is sometimes mentioned as a possible alternative, however recent research seriously questions the efficacy of clonazepam in bipolar disorders. Calcium-antagonists, especially verapamil, may have some efficacy in the treatment of acute mania, their role is still very uncertain.

Recently, some investigators have reported blunted natural killer cell activity (NKCA) in patients with major depression. In addition, there were some reports on negative relationships between NKCA and the occurence of negative life events. In order to replicate the above findings, the present study investigates NKCA and negative life events in 11 normal and 35 unipolar (minor, simple major, melancholic) depressed subjects. NKCA has been determined by all subjects. They completed the Questionnaire on Recently Experienced Events with scores on number and impact factor of events related to a) illness, b) working conditions, c) social relationships, d) housing problems, e) loss of possession. Depressed subjects reported higher scores on number and/or impact factor of events related to illness, social relationships and housing problems. In our investigation NKCA was significantly blunted in depressed subjects and, particularly in melancholies. So NKCA is negative correlated to the severity of depression. We were unable to detect any significant relationship between NKCA, and life events ( number of impact factors ), Our results do not corroborate the thesis that life events may affect immune function, as assessed by NKCA.

Slowly progressive aphasia is an uncommon presenting symptom of a degenerative neurological disorder which in most cases eventually leads to a global dementia. The early recognition of this syndrome is sometimes hampered by the presence of accompanying or pre-existing psychiatric symptomatology. This is illustrated by two case reports. After a brief reflection on the nosological status of the disorder, the clinical picture and diagnosis are discussed.