Background. The human serotonin transporter gene (5-HTT) is a strong candidate for involvement in the pathogenesis of mood disorders. Two common polymorphisms have been identified in the gene: a VNTR in intron 2 and a functional deletion/insertion in the promoter region. In previous studies we proposed that allele 12 of the VNTR might increase susceptibility for bipolar disorder.

Methods. We have genotyped 122 parent–offspring trios of British Caucasian origin where the proband had DSM-IV Bipolar I disorder (BPI). The results were analysed with the transmission/disequilibrium test (TDT), which examines whether particular alleles are preferentially transmitted from heterozygous parents to affected offspring.

Results. The 12 repeat in the VNTR in intron 2 was transmitted 72 times and not transmitted 56 times (χ2 = 2·0, 1 df, P=0·16). If we exclude 24 families in which the proband was a case in our published case–control studies (Collier et al. 1996a; Rees et al. 1997), the excess transmission of allele 12 reaches conventional levels of statistical significance: χ2 = 3·85, 1 df, P<0·05. The deletion/insertion polymorphism in the promoter region was not associated with BPI: 66 parents transmitted the inserted (L) allele and 59 parents transmitted the deleted (S) allele (χ2 = 0·39, 1 df, P=0·53).

Conclusions. The 12 repeat of the VNTR in intron 2 of the serotonin transporter gene might be a susceptibility factor in bipolar affective disorder. The genetic effect, if true, is likely to be small, and requires confirmation in further studies using parental controls.

Background. The evolutionary consequences of love are so important that there must be some long-established biological process regulating it. Recent findings suggest that the serotonin (5-HT) transporter might be linked to both neuroticism and sexual behaviour as well as to obsessive–compulsive disorder (OCD). The similarities between an overvalued idea, such as that typical of subjects in the early phase of a love relationship, and obsession, prompted us to explore the possibility that the two conditions might share alterations at the level of the 5-HT transporter.

Methods. Twenty subjects who had recently (within the previous 6 months) fallen in love, 20 unmedicated OCD patients and 20 normal controls, were included in the study. The 5-HT transporter was evaluated with the specific binding of 3H-paroxetine (3H-Par) to platelet membranes.

Results. The results showed that the density of 3H-Par binding sites was significantly lower in subjects who had recently fallen in love and in OCD patients than in controls.

Discussion. The main finding of the present study is that subjects who were in the early romantic phase of a love relationship were not different from OCD patients in terms of the density of the platelet 5-HT transporter, which proved to be significantly lower than in the normal controls. This would suggest common neurochemical changes involving the 5-HT system, linked to psychological dimensions shared by the two conditions, perhaps at an ideational level.

Background. Benzodiazepines (BZs) can impair explicit memory after a single dose and also when taken repeatedly for treatment of anxiety disorders. A previous study with agoraphobia/panic patients found that the BZ alprazolam impaired memory during an 8-week treatment and residual impairments were still manifest several weeks after drug withdrawal (Curran et al. 1994). The present study followed up the same group of patients 3·5 years after treatment to determine whether those memory impairments persisted.

Method. Thirty-one patients, 15 who had originally been treated with alprazolam and 16 with placebo, were assessed on a battery of psychometric tests and self-rating scales.

Results. Ex-alprazolam patients performed at the same levels as ex-placebo patients on the memory task and on other objective tests. Performance levels of both groups were similar to pre-treatment baselines, however there were differences in subjective ratings whereby ex-alprazolam patients rated themselves as less attentive and clear headed and more incompetent and clumsy than ex-placebo patients.

Conclusions. Explicit memory impairments found while patients were taking alprazolam and weeks after drug withdrawal did not persist 3·5 years later. We suggest that the memory impairments observed in our previous study weeks after withdrawal of alprazolam were not residual effects of alprazolam but rather were due to the drug's interference with practice effects on the tests and habituation of anxiety over repeated exposure to the test situation.

Background. The International Personality Disorder Examination (IPDE) has been developed as a standardized interview for personality disorders. While it has good psychometric properties, its length makes it difficult to use in the community in population research, particularly outside psychiatric settings. The informant-based Standard Assessment of Personality (SAP), which has been in use since 1981, could serve as a valid screen to detect likely personality disordered individuals who would then receive a definitive diagnosis by IPDE. This study aimed to compare the two instruments in their capacity to detect personality disorder according to ICD-10 taxonomy and to estimate the efficiency of the use of the two together in a case-finding exercise.

Method. Ninety psychiatric out-patients in Bangalore, India, were assessed for personality disorder using the two methods. Assessment was conducted by a pair of trained interviewers in random order and by random allocation to interviewer.

Results. Overall agreement between the two instruments in the detection of ICD-10 personality disorder was modest (kappa = 0·4). The level of agreement varied according to personality category, ranging from kappa 07·66 (dependent) to kappa 0·09 (dyssocial). The SAP proved to have a high negative predictive value (97%) for IPDE as the gold standard, suggesting its potential as a screen in samples where the expected prevalence of personality disorder is low.

Conclusion. A two-stage approach to epidemiological studies of personality disorder may be practicable.

Background. Psychiatric mother and baby units are increasingly asked to assess parenting in people with severe mental illness, particularly schizophrenia, but little research evidence exists on which to base assessments.

Method. Mother–infant interaction was assessed in 26 women who had recovered from the acute phase of severe post-partum mental disorder, a validated rating scale based on direct observation was used.

Results. Women with schizophrenia showed greater interaction deficits than those with affective disorders, being more remote, insensitive, intrusive and self-absorbed. The 4-month-old infants of women with schizophrenia were more avoidant, and the overall quality of mother–infant interaction in schizophrenia was poorer.

Conclusion. The long-term significance of these preliminary findings is not known but they raise concerns about the parenting capacity of women with schizophrenia and suggest the need for an intervention to improve parenting skills in this group.

Background. We studied whether heterogeneous profiles of cognitive function are relevant to survival in patients with early Alzheimer's disease.

Methods. CAMCOG subscales of cognitive function were used as predictors of survival, together with gender in 157 consecutively referred patients with early Alzheimer's disease. Statistical analysis was performed with Cox proportional hazards analysis and Kaplan–Meier survival curves. Survival rates were compared with those in the general population.

Results. Eighty patients (51%) died during the follow-up that extended to 5·7 years, with a median survival of 4·4 years after entry. Only the praxis subscore was statistically significant related to survival (P<0·0001). Its predictive power was based on only two items, including copying ability for a spiral and a three-dimensional house, independent of age, sex, education, overall CAMCOG score, dementia severity and symptom duration. Kaplan–Meier curves for the combined score of these items (0, 1, or 2) showed three groups with significantly different survival rates for both men and women. Comparison of gender specific survival rates with data from the general population showed that excess mortality was statistically significant (P<0·01) higher in men (51%) than in women (21%) after follow-up extending to 5 years.

Conclusions. A simple test of copying ability defines subgroups of AD patients with large differences in survival rates. This suggests that parietal lobe impairment is an important predictor of mortality in AD. Also, the course of AD may be more benign in women than in men.

Background. We previously reported that in panic disorder a history of near-suffocation is associated with predominantly respiratory panic attacks. It might be hypothesized that the near-suffocation experienced in certain kinds of torture is also associated with the development of predominantly respiratory panic attacks.

Methods. A sample of patients who had experienced torture (N=14) was drawn from an Anxiety Disorders Clinic in South Africa. Subjects were questioned about symptoms of panic disorder, post-traumatic stress disorder and depression.

Results. Patients with a history of torture by suffocation were more likely than other patients to complain of predominantly respiratory symptoms during panic attacks. These patients also demonstrated higher levels of depressive symptoms.

Conclusions. While various interpretations of the data can be made, it is possible that torture by suffocation is associated with a specific symptomatic profile. Were such an association to be replicated, this would perhaps support the suffocation alarm hypothesis of panic disorder and provide evidence that specific environmental factors play a role in the development of this alarm.

Background. Systematic reviews should identify all relevant trials in order to minimize the potential for bias and the play of chance in their results. Other specialities have shown that conference proceedings are a rich source of trials, but many of these trials are never fully published.

Methods. All clinical trials presented at a single conference (Vth World Congress of Psychiatry, Mexico, 1971) were identified by hand searching. Full publications of these abstracts were then sought on five databases by searching for the authors or relevant key words.

Results. Full publications were found for 46% of the abstracts. The odds of publication decreased for abstracts that were from a non-Anglophone country or that failed to mention randomization.

Conclusions. Anyone wishing to undertake a systematic review of a mental-health care topic should search relevant conference proceedings for trials.

Background. Catatonia, a symptom complex with motor, affective and cognitive symptoms seen in a variety of psychotic conditions and with organic disease, was examined using a motor task using functional magnetic resonance imaging (fMRI).

Methods. Two acute catatonic patients and two age- and sex-matched healthy controls performed sequential finger opposition (SFO) after being medicated with 2 mg of lorazepam (i.v.). Functional magnetic resonance images were collected using a gradient echo pulse sequence (EPI).

Results. Patients with catatonia showed reduced motor activation of the contralateral motor cortex during SFO of the right hand, ipsilateral activation was similar for patients and controls. There were no differences in the activation of the SMA. During left hand activation the right-handed catatonic patients showed more activation in the ipsilateral cortex, a reversal from the normal pattern of activation in which the contralateral side shows four to five times more activation than the ipsilateral side.

Conclusions. In catatonic patients there is a decreased activation in motor cortex during a motor task compared to matched medicated healthy controls. In addition activation of the non-dominant side, left-handed activity in right-handed patients, results in a total reversal of the normal pattern of lateral activation suggesting a disturbance in hemispheric localization of activity during a catatonic state.

This Congress will be held in Berlin, Germany, from 27 to 31 March 2001. For further information, please contact Dr Mario Lanczik, Congress President, Department of Psychiatry, University of Erlangen, Schwabachanlage 6, D-91054 Erlangen, Germany. Fax: +49 9131 853 6592. E-mail: lanczik@psych.med.uni-erlangen.de