Background: Childhood stress and trauma have been related to adult psychopathology in different psychiatric disorders. The present study aimed at verifying this relationship for stressful experiences during developmental periods by screening stress load across life in adult psychiatric inpatients with different diagnoses compared to healthy subjects. In addition, a relationship between the amount of adverse experiences and the severity of pathology, which has been described as a 'building block' effect in posttraumatic stress disorder (PTSD), was explored for nontraumatic events in psychiatric disorders other than PTSD.

Failure to respond to adequate pharmacological treatment for major depression is now the most common indication for the use of electroconvulsive therapy (ECT). The advantages of ECT with respect to both speed and quality of response are clinically important issues, but surprisingly few studies have examined the efficacy of ECT in relation to newer antidepressant agents such as selective serotonin reuptake inhibitors (SSRIs). A total of 39 subjects with major depression and with at least two failed antidepressant trials (mean 4.9 trials) were randomized to either paroxetine treatment (n=18) or right unilateral (RUL) ECT (n=21). Up to the end of the study treatment we found a reduction in the HAMD score of 59% for the ECT group and of 29% for the paroxetine group (P<0.001 paired t-test). In the ECT group, 71% of subjects fulfilled the response criteria (at least a 50% decrease in total HAMD score). The present study found ECT to be superior to paroxetine in medication-resistant major depression, in terms of both degree and speed of response.

Zusammenfassung. An einer demographisch heterogenen Gelegenheitsstichprobe (n = 200) und drei klinischen Stichproben (Major Depressive Disorder, n = 60; Angst- und Essstörungen, n = 11; Schizophrenie, n = 40) wurden Messeigenschaften des vereinfachten Beck-Depressions-Inventars (BDI-V) ermittelt. Homogenität und Reliabilität des BDI-V übersteigen jene des Original-BDI (BDI-O) und jene weiterer vier Depressionsskalen. BDI-V und BDI-O konvergieren auf der Ebene einzelner Symptome (durchschnittliche Korrelation in der Gesamtstichprobe = .70) und auf der Ebene des Summenwertes (r = .91 in der Gesamtstichprobe). Beide BDI-Versionen korrelieren in ähnlicher Höhe mit anderen Selbstbeschreibungsmaßen der Depression (durchschnittliche Korrelation = .70) und einem Expertenrating (Hamilton-Skala, r = .50). BDI-V und BDI-O differenzieren ähnlich gut zwischen klinisch unauffälligen Personen und Patienten mit einer depressiven Primär- oder Sekundärsymptomatik. Vergleichbar gut gelingt mit beiden Versionen auch die Differenzierung klinischer Gruppen. Eine konfirmatorische Faktorenanalyse ergab in der klinisch unauffälligen Stichprobe eine geringfügige Abweichung von perfekter Messäquivalenz (1.00 ≥ r ≥ .95). Diese Abweichung ist für die diagnostische Praxis unbedeutend. Mit dem vereinfachten BDI steht ein Instrument zur Verfügung, das gleich gute Messeigenschaften aufweist wie das Original, diesem in seiner Messökonomie aber deutlich überlegen ist und sich deshalb insbesondere für epidemiologische Screenings an großen Stichproben eignet.

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Within a controlled prospective intervention study, schizophrenic outpatients randomly assigned to four treatment groups and one control group were assessed with regard to collaboration with drug treatment. In total, 39.3% of 84 regular attenders of the psychoeducational training programme and 26.6% of 64 control patients reported having persuaded their psychiatrists to modify their medication prescriptions. A total of 8.3% and 7.8%, respectively, modified their medication on their own initiative, although with subsequent approval by the psychiatrist, and 20.2% and 15.6%, respectively, modified their medication after consulting their psychiatrist. With regard to medication management, the groups did not differ either at post-treatment or at follow-up. At follow-up, regular attenders showed a reduced fear of side-effects, increased confidence in their medication and stable confidence in their physician. Among the control subjects, confidence in the medication and in their physician declined, and fear of side-effects increased. Psychoeducational training therefore led to an optimization of patients' attitudes toward treatment, but not to changes in medication management.