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A preference for shared decision making may reduce health care costs by reducing inpatient admissions. Patient satisfaction with decisions was a predictor of costs, and clinicians should maximize patient satisfaction with CDM.

Intellectual function was studied in 28 boys with Duchenne dystrophy, 12 patients with facioscapulohumeral-type and 10 patients with limb-girdle-type muscular dystrophy. A definite relationship between intelligence level and the type of muscle disease was found. The more severe the genetic damage manifested by the rapidity of progression of muscular dystrophy the more definite the affection of the CNS manifesting as mental deficit. The factors influencing the level and structure of intelligence seem to exert their effect before the manifestation of muscle lesions.

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A 30-year-old male patient with paranoid schizophrenia was on clozapine therapy for more than five years. Discontinuation of clozapine and an attempt to change his medication to sertindole has led to serious psychotic and somatic symptoms. After readministration of clozapine the psychotic symptoms rapidly disappeared. The patient was monitored by BPRS and PANSS positive and negative scale. Also clinical and labor parameters of the patient were monitored. The change of his medication from clozapine to sertindole was unsuccessful. This case report suggests that although atypical antipsychotics may be generally different from the classical neuroleptic drugs, there are also significant differences among the atypical antipsychotic drugs in their effects on the receptors of the central nervous system. Therefore the change of clozapine to another atypical antipsychotic medication in the clinical practice should be cross-tapered and the symptoms of withdrawal closely monitored.

A 130&m pilot-version of the QoL instrument in schizophrenia (QLIS) was analysed in 203 schizophrenics. Items were selected according to psychometric properties and content. In a validation study the resulting questionnaire was completed by n=l36 schizophrenic patients along with the WHOQOL-Bref, SWN-K and the German Version of the LQLR and by n=49 in a test-retest design. Reliability coefficients for the 10 subscales were satisfactory to good (median of retest-coefficients: 1=.80, median of internal consistencies: a =.75). Validity coefficients show that QLIS-scales differ empirically from present QoL instruments. QLIS, therefore, offers an opportunity for specific, comprehensive and reliable self-reported evaluation of QoL in schizophrenia.

decreased rCBF in superior frontal gyrus, right mesial (posterior hippocampus) and lateral temporal regions. Classic rCBF abnormalities seen in depressed patients appear to resolve following 10 weeks of VNS. Conclusion: These early data suggest that response to VNS therapy is associated with normalization of resting rCBF patterns.

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