In order to assess the accuracy of schizophrenia diagnoses for genetic studies, we identified all schizophrenia patients (n = 492) in an isolated community with a diagnosis of schizophrenia in the Finnish Hospital Discharge Register (HDR) between 1969-1991. For the accuracy study we identified a sample of 73 patients from registers with Diagnostic and Statistical Manual (DSM)-III-R for schizophrenia (codes 295.10, 295.30, 295.60, 295.90) (n = 62) or “schizophrenia spectrum” diagnoses (295.40, 295.70, 297.10, 301.20, 301.22) (n = 11). When the operational criteria (DSM-III-R) were applied by two senior researchers using information from the original mental hospital records, 93% (68/73) of the cases fulfilled criteria for schizophrenia or schizophrenia spectrum. The results demonstrate that the schizophrenia diagnoses of the registers are accurate when a broad concept of schizophrenia is applied. When using operational DSM-III-R schizophrenia criteria, eight false positive cases were found among the 62 mental hospital schizophrenia diagnoses. Consequently, there may be a need to reassess schizophrenia diagnoses depending on the purpose of the study. We also found good agreement between DSM-III-R (kappa 0.93) and operational criteria (OPCRIT) diagnostic system (kappa 0.89) diagnoses, made by one researcher, compared with operational diagnoses. This indicates the possibility for the reliable use of one of these methods alone for diagnostic reassessment. The information in the HDR on primary diagnoses and on the dates of admission and discharge was accurately transferred from the hospital records.

In a three phase sequential treatment strategy study involving 119 depressed outpatients, a total of 31 patients (26.7%) stopped treatment prematurely due to side-effects (21/31), aggravation of symptoms (3/31), non-compliance (4/31), and non-treatment related events (3/31). At baseline, no significant differences were found on sociodemographic and psychiatric data between patients who did or did not drop out. As predictors of dropout eight domains of data concerning psychiatric history, premorbid history, symptomatology, personality, and social adjustment were used. Using a logistic linear regression analysis, only three variables were related to dropout. Patients with a history of alcohol use or poor social functioning according to axis V of the Diagnostic and Statistical Manual (DSM)-III-R had a higher chance to drop out, while patients with a sleep disturbance according to the Symptom Checklist (SCL)-90 had a smaller chance to drop out.

A review of the literature showed that there is no good systematic study of a series of rigorously diagnosed “kleptomaniac” persons, other than those referred by the courts for expert opinions. This applies in particular to German-speaking and other European countries. We therefore report here on the phenomenology, demographics, psychopathology, family histories, treatment histories, behaviour therapy oriented analyses, and treatment results of 12 individuals meeting Diagnostic and Statistical Manual (DSM)-III-R criteria for kleptomania. All patients described an uncontrollable impulse to steal and a reduction in anxiety or tension during or after the act. All had at least one further psychiatric diagnosis. Although the kleptomaniac symptomatology did not seem to be part of these other disorders, the extent of stealing corresponded (positively or negatively) to other psychiatric symptoms such as depressive feelings, excessive urges to eat or migraine attacks. Microanalysis of the act of theft, as well as the preceding and following events (explored by applying behaviour therapy oriented analysis) showed intraindividually consistent, but inter-individually differing triggering factors. There was no evidence of correlation with obsessive-compulsive disorders, but some indications that kleptomania may be associated with affective disorders in terms of an “affective spectrum disorder”. According to a broader definition of “multi-impulsive-disorder” (analogous to Lacey and Evans or Fichter et al), one third of the patients might be diagnosed as “bi-impulsive disorder”. Eight of the 12 patients could be investigated at a mean follow-up time of 2 years after discharge showing favourable results. In conclusion, kleptomaniac behaviour seems to be multiconditionally caused and sustained.

A representative sample of teachers working at the primary or secondary grade level in both public and private schools answered an anonymous questionnaire on sociodemographic information and completed the Center for Epidemiologic Studies Rating Scale for Depression (CES-D). The teachers were classified as depressed when they scored ≥ 16 on the CES-D; 27.5% of the subjects were above this cut-off score. Logistic regression was used to calculate a multivariate model with the variables school ownership, grade level and teaching experience. Working in a public school, teaching at the primary level and longer teaching experience all increased the risk of depressive symptomatology.

The validation of the French version of the Edinburgh Postnatal Depression Scale (EPDS), conducted on a sample of 87 women in the first 4 months of post-partum, is presented. The study of the sensitivity, specificity and predictive values versus research diagnosis criteria provide the cut-off score of 10.5 as the best (sensitivity: 0.80; specificity: 0.92). The EPDS as an index of severity of postnatal depression (PND) also had good criterion validity compared to the psychiatrist's assessment. Factor analysis shows that the internal structure of the EPDS is composed of two subscales which underline a more accurate description of PND. The reliability study confirms the good internal consistency of the global scale (Cronbach's alpha: 0.76) and its good short term test-retest reliability (0.98).

In previous reports, we have observed that blood magnesium was significantly higher in drug-free patients with major depression when compared to healthy controls. This was especially true for erythrocyte magnesium. Furthermore, the most severely depressed patients had the highest intracellular magnesium content, showing that intracellular magnesium rate was related to the intensity of symptoms. We report here the results of blood magnesium measured in 88 major depressed patients as compared to 61 controls. We show that the mean erythrocyte and also plasma magnesium contents are both increased in these patients. We observe that about 40% of male and female patients have a very significant increase (25%) in intracellular magnesium content as compared to controls. However, about 60% of the hospitalised depressed patients have normal values. None of the controls has high erythrocyte magnesium. This is less evident concerning the plasma magnesium. No differences are observed between patients when classified according to the intensity of moral pain or anxiety. In contrast, the patients with mild to high psychomotor retardation score, which is an index of hypoexcitability, have significant higher erythrocyte magnesium values compared with other patients. The results of male patients without psychomotor retardation do not differ from control values. Our study suggests that central hypoexcitability might be related to an increase in intracellular magnesium observed at the peripheral level, keeping in mind that hyperexcitability, as observed in various conditions such as stress and cardiovascular disorders, is frequently associated, in contrast, with a decrease in blood magnesium.

Both suicide and homicide rates rose in nations formed after the formal break-up of the Soviet Union in 1991. Homicide rates, but not suicide rates rose in Eastern European nations after the fall of their communist regimes in 1989.

The relationships between the Tridimensional Personality Questionnaire (TPQ) and depression were examined in a sample of 53 major depressive patients and 33 healthy controls. Depressed patients exhibit higher harm avoidance scores as well as lower novelty seeking sub-scale exploratory excitability (NSI) scores as compared to healthy controls. However, the other dimensions and their sub-scales do not differ between depressive patients and controls. In the depressive group, the harm avoidance dimension is related to the severity of depression as assessed by the Hamilton scale. This study confirms the state dependence of the harm avoidance dimension and suggests a relationship between the novelty seeking sub-scale NSI and depression.

Three adolescent and two adult patients suffering from chronic excited psychoses (either schizophrenia or schizoaffective disorder) resistant to traditional neuroleptics and clozapine were treated with combined clozapine-lithium. Improvement was assessed with the Positive and Negative Symptoms Scale, the Brief Psychiatric Rating Scale and the Clinical Global Impressions, administered before and during combined clozapine-lithium treatment. All patients demonstrated a significant improvement with this combination. There was no occurrence of agranulocytosis, neuroleptic malignant syndrome or other clinically significant adverse effects.