The incidence of severe anorexia nervosa in the canton of Zurich rose significantly during the 1960s and 1970s. Since then, the incidence appears to have reached a plateau.

Objective: The perimenopause is associated with increased hormone fluctuations and an elevated risk of depression. A number of predictors of depressive symptoms in the menopausal transition have previously been suggested. The purpose of this study was to investigate a set of biopsychosocial predictors of depressive symptoms in perimenopausal women. Methods: This cross-sectional study, investigating 114 perimenopausal women (according to the STRAW criteria) aged 40-56 years, was conducted within the scope of the Swiss Perimenopause Study. Multiple regression analyses were performed to identify the most accurate model predicting perimenopausal depressive symptoms. Depressive symptoms were assessed with the German version of the Center of Epidemiologic Studies Depression Scale (CES-D). Validated questionnaires were used to examine psychophysiological complaints, stress, self-esteem, self-compassion, body image, and social support. Estradiol (E2) and progesterone (P4) were assessed through saliva samples, and follicle-stimulating hormone and luteinizing hormone were determined through dried blood spot samples. Seven saliva samples per participant were used to investigate absolute levels and fluctuations of sex steroids. All other variables were measured once. Results: Multiple regression analyses revealed that E2 fluctuations (β=0.15, P = 0.015), history of depression (β=0.14, P = 0.033), menopausal symptoms (β=0.47, P < 0.0001), perceived stress (β=0.17, P = 0.014), body image (β= −0.25, P = 0.014) and self-esteem (β=−0.35, P < 0.0001) were predictive of perimenopausal depressive symptoms (R 2 = 0.60). P4 fluctuations and absolute levels of hypothalamic-pituitary-gonadal hormone were not statistically significant. Conclusions: E2 fluctuations were shown to be predictive of depressive symptoms in the perimenopause. Moreover, the presence of burdensome complaints and chronic stress as well as a poor self-evaluation seem to promote depressive symptoms in perimenopausal women.

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The author presents some new theoretical aspects and therapeutic implications of the concept of Couples in Collusion, (22), first published in 1975. According to this concept, the emotional attraction in the selection of a mate is based on a fascinating, mutual, and alarming theme, shared by both partners in order to be mastered together. The partners unavowedly start colluding to compensate for former frustrations and to repress fears of intimacy. After some time of living together and in defense of repressed feelings, they may enter into an escalation of the dysfunctional interactional pattern. Experience shows that severely neurotic personalities don't necessarily start colluding, provided that their partners don't gratify regressive needs or reinforce their defenses but help to cope with the frustrations of these unfulfilled regressive wishes. Therapies based on the concept of collusion aim at the improvement of intradyadic and extradyadic boundaries and the depolarization of extreme progressive-regressive behavior. These goals can be reached by both systemic and psychodynamic techniques. The concept of collusion may serve as a guide for this therapeutic process.

How do men and women describe and assess their relationship? What themes are decisive for its quality and stability? To answer such questions, we investigated a random sample of 204 married couples (reference sample), and 31 married couples undergoing psychotherapy (clinical sample) using a newly developed questionnaire. The participating couples were asked to evaluate a total of 19 themes with respect to their importance for the couple's connectedness. Although only rarely directly addressed in couple therapy and investigated in couple research, the theme "Love" proved to be the decisive factor for quality and stability. The results of the present study, therefore, indicate that "Love" should be investigated more thoroughly in couple research and included more actively in diagnostic and therapeutic procedures.