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Treatment satisfaction of different mental disorders is still poorly understood, but of high clinical interest. Inpatients of a general psychiatric care hospital were asked to fill out questionnaires on satisfaction and clinical variables at admission and discharge. On the basis of an exploratory approach, differences in treatment satisfaction among diagnostic groups were examined by means of one-way analysis of variance. Potential associated clinical and socio-demographic variables were studied using multi/univariate tests. Patients with personality disorders (n=18) showed a significantly lower treatment satisfaction (ZUF-8, Zurich Satisfaction Questionnaire) and a slightly lower improvement of symptoms (CGI, Clinical Global Impression) and global functioning (GAF, Global Assessment of Functioning scale) than that of other diagnostic groups (n=95). Satisfaction in patients with personality disorders correlated much stronger with the symptom improvement and slightly with the functioning level than in patients without personality disorders. Interestingly, in patients with personality disorders psychopharmacological treatment in general (present versus not present) was independent from satisfaction. This exploratory investigation suggests that a lower satisfaction of patients with personality disorders in a general psychiatric hospital is mainly based on a reduced improvement of the symptoms and of the global functioning level.

The use of long-term anti-psychotic medication for borderline personality disorder contravenes prescribing guidelines in the UK. There is evidence to suggest clozapine can be beneficial yet anecdotally it is prescribed almost exclusively in locked settings. A single study suggests a substantial proportion of psychiatrists disapprove of this practice. The purpose of this paper is to articulate concerns about the use of clozapine for “BPD” that are absent from current literature.

This paper summarises the reflections and experiences of the authors lived experience, academic and clinical backgrounds.

The published literature is uniformly positive when describing the prescription of clozapine for those diagnosed with BPD; however, this in no way reflects the experience of the authors. There is no body of material reflecting a study showing that a substantial number of psychiatrists have issues with this practice.

While it is a fact that there is a discrepancy between psychiatrists attitudes towards clozapine prescription for “BPD” and the published literature, the described concerns in this paper are based solely on the authors’ experiences and observations.

Those seeking literature to articulate concerns about the use of clozapine with this population will likely be disheartened by the paucity of published literature.

To the best of the authors’ knowledge, this paper is the first to raise substantial concerns about the use of clozapine for those diagnosed with “BPD” and the circumstances in which it is prescribed.

Prediction of increased risk of suicide is difficult. We had the opportunity to follow up 20 patients receiving electroconvulsive therapy (ECT) because of severe depression. They filled in the Antonovsky sense of coherence test (SOC) and Beck depression inventory (BDI) before and after a series of ECT treatments. Seventeen surviving patients had a mean observation time of 20.6 months, whereas the three deceased patients had 11.3 months. There was a lower mean age at onset of illness and a longer mean duration of disease in the deceased. Other clinical parameters did not differ. The surviving patients had a significant decrease on the BDI from 35 to 18 (P<0.001) and an increase on the SOC test after ECT from 2.45 to 3.19 (P<0.001), indicating both less depression and better functioning in life. The deceased had a larger change on the BDI from 32 to 13, not attaining significance because of the low number of deceased. The SOC test, however, did not increase to a purported normal level; that is, from 2.43 to 2.87. Although the SOC scale has been shown to predict mortality in substance abusers, the SOC test has not been part of earlier reviews of predictive power. Tentatively, a low pathological score on the SOC test may indicate low sense of coherence in life that might increase the propensity for suicide. These preliminary results need replication in larger studies.

In the course of group analytic psychotherapy, where we discovered the power of the therapeutic effects, there occurred the need of group analytic psychotherapy researches. Psychotherapeutic work in general, and group psychotherapy in particular, are hard to measure and put into some objective frames. Researches, i. e. measuring of changes in psychotherapy is a complex task, and there are large disagreements. For a long time, the empirical-descriptive method was the only way of research in the field of group psychotherapy. Problems of researches in group psychotherapy in general, and particularly in group analytic psychotherapy can be reviewed as methodology problems at first, especially due to unrepeatability of the therapeutic process.

The basic polemics about measuring of changes in psychotherapy is based on the question whether a change is to be measured by means of open measuring of behaviour or whether it should be evaluated more finely by monitoring inner psychological dimensions. Following the therapy results up, besides providing additional information on the patient's improvement, strengthens the psychotherapist's self-respect, as well as his respectability and credibility as a scientist.

Impairment of intelligence in Duchenne muscular dystrophy (DMD) patients was described by Duchenne de Boulogne himself in 1868. Further studies report intelligence disorders with mayor impairment of memory. The aim of the present study was to assess the presence of affective and personality disorders in a group of children affected by DMD. Twenty six male DMD patients, mean age eleven and four months years old, were assessed for their affective and personality disorder. Only eight subjects had a total IQ below average with major difficulties in verbal and visual-spatial memory, comprehension, arithmetic and vocabulary. All the subjects presented some disorders: tendency to marginalization and isolation, self-depreciation, sense of insecurity, hypochondriac thoughts and marked state of anxiety. These disorders are often a dynamic prolongation of a psychological process which starts when the diagnosis is made and continues, in a slow and latent fashion, throughout the evolution of the disease.

A parent who continuously physically abuses her/his child doesn't aim to kill the child but commits an accidental filicide in a more violent outburst of anger. Fatal abuse deaths are prevented by recognition of signs of battering in time. Out of 200 examined intra-familial filicides, 23 (12%) were caused by child battering and 13 (7%) by continuous battering. The medical and court records of the victim and the perpetrator were examined. The perpetrator was the biological mother and the victim was male in 69 per cent of the cases. The abused children were either younger than one year or from two-and-a-half to four years old. Risk factors of the victim (being unwanted, premature birth, separation from the parent caused by hospitalization or custodial care, being ill and crying a lot) and the perpetrator (personality disorder, low socioeconomic status, chaotic family conditions, domestic violence, isolation, alcohol abuse) were common. The injuries caused by previous battering were mostly soft tissue injuries in head and limbs and head traumas and the battering lasted for days or even an year. The final assault was more violent and occurred when the parent was more anxious, frustrated or left alone with the child. The perpetrating parent was diagnosed as having a personality disorder (borderline, narcissistic or dependent) and often substance dependence (31%). None of them were psychotic. Authorities and community members should pay attention to the change in child's behavior and inexplicable injuries or absence from daycare. Furthermore if the parent is immature, alcohol dependent, have a personality disorder and is unable to cope with the demands the small child entails in the parent's life, the child may be in danger.

Violence is elevated in older adolescents and adults with schizophrenia; however, little is known about younger children. This report focuses on rates of violence in younger children with schizophrenic-spectrum illnesses. A retrospective review of structured diagnostic interviews from a case series of 81 children, ages 4-15 years of age, with childhood onset of schizophrenic-spectrum illness is reported. Seventy-two percent of children had a history of violent behavior, including 25 children (31%) with a history of severe violence. Of those with a history of violence, 60% had a least one episode of violence that did not appear to be in response to an external stimulus (internally driven violence). There was no significant impact of age or gender. For many children, these internally driven violent episodes were rare and unpredictable, but severe. Similar to what is found in adolescents and adults, violence is common in children with schizophrenic-spectrum illnesses. General violence prevention strategies combined with early identification and treatment of childhood psychotic illnesses may decrease the morbidity associated with childhood psychotic violence.