Medical students’ attitudes towards suicide and suicidal patients were studied. The aim was also to determine whether attitudes differ between students in the beginning and end of studies. A questionnaire including own attitudes on death and suicide and psychosocial circumstances was filled in by 63% of first and final year students (306 of 485). The calculation included a factor analysis on items describing the attitudes to suicidal patients. Attitudes towards patients became influenced by the knowledge of mental disorders and by biological aspects of behaviour during the education. Final year students more often consider suicide to be an expression of psychiatric disease and thought that people trying to commit suicide were not responsible for their own actions. Thirty-four percent and 44% (ns) in the first and last years, respectively, reported suicidal ideas some time in their lives. Students with such a history of suicide thoughts were less optimistic about the possibility to help. Ongoing depressive/anxious symptoms were prevalent in 36/305 (12%) of students, but did not seem to affect their attitudes to patients. Female students had sought psychological/psychiatric help more often than males (26% and 10%, P < 0.01).

Personality deviations and deficits in cognitive executive function are common among forensic populations. The present study on incarcerated offenders explored whether there are links between the two domains. Personality was assessed using the Temperament and Character Inventory (TCI). Neuropsychological performance, including visual working memory, attentional set-shifting and planning, were tested with the Cambridge Neuropsychological Test Automated Battery (CANTAB). Subjects with personality disorders scored high on harm avoidance, and low on self-directedness and cooperativeness. Personality disordered offenders did not differ from the comparison groups (offenders without personality disorder, and non-criminal controls) with regard to CANTAB measures of visual working memory (delayed matching to sample, spatial working memory) and planning (Stockings of Cambridge), but they made a larger number of errors on the attentional set-shifting task. Dimensional analysis of the personality and neuropsychological variables revealed significant associations between self-directedness and cooperativeness on the one hand, and attentional set-shifting on the other. Intellectually disabled, non-criminal individuals (marginal mental retardation) who performed poorly on attentional set-shifting also scored low on self-directedness and cooperativeness. The results indicate that poor development of certain personality traits may be associated with deficits in neuropsychological functioning.

The objective of the present study was to conduct a systematic inquiry into the frequency and impact of patients’ suicide on psychiatric trainees, and the availability and usefulness of training courses. Data were collected from 114 psychiatric trainees of the Dutch-speaking part of Belgium, representing a 70% response rate. A self-report questionnaire developed in the UK was adapted to the Flemish situation. A Dutch version of the Impact of Event Scale (IES) inquiring about post-traumatic stress symptoms was also used. The frequency of suicide experience was considerably higher in the present study than in similar studies in the USA and the UK. Thirty percent of first year trainees had been confronted with patient suicide. Personal and professional impact of patient suicide, as well as post-traumatic stress scores were considerably lower in Flemish psychiatric trainees. They considered informal support to be of more value than formal support to come to terms with the event. Finally, postgraduate training in post-suicide management was found to be largely insufficient. The results of the present study show that psychiatric trainees in the Dutch-speaking part of Belgium are at a high risk of experiencing patient suicide, whereas the impact of this experience appears to be relatively low. Only a small minority of trainees has received adequate training on procedures to follow after patient suicide.

Previous research on hypothalamic-pituitary adrenal (HPA) axis-activity in suicide attempter research has shown conflicting outcomes. The design of the present study was to test the influence of personality disorders and concominant axis I diagnoses on the dexamethasone suppression diagnostic test by use of multiple regression analyses. The sample consisted of 184 patients with a recent suicide attempt and 42 healthy controls. As expected, the lowest pre- and postdexamethasone cortisol levels were found in patients with personality disorders axis II, cluster B as compared to the other patients. The results remained significant when analysed for covariance with DSM-III-R axis I diagnoses, age or sex. Whether these low cortisol levels are due to previous experience of extreme stressful events or long-lasting burden, or whether they may be a consequence of biogenetic or psychological predisposal of interest, remains to be elucidated. Axis I comorbidity needs to be further examined.

Body dysmorphic disorder (B.D.D.) consists of a preoccupation with an imagined or slight physical defect. This study is the first European report on prevalence and several clinical and functional characteristics of patients with B.D.D. in a cosmetic surgery setting. Comparisons with defect- and severity-matched subjects without B.D.D. were also performed.

A single case of a patient suffering from a first psychotic episode and the differential diagnoses between affective and psychosis is performed throughout the combined use of peripheral serotonergic markers and clinical psychopathological scales during a 6-months follow-up. The results suggest the need of performing further studies combining biological and clinical markers of psychiatric disorders.

In the present open prospective study the effects of quetiapine were investigated in two elderly patients with parkinsonism and psychosis. Treatment induced a marked antipsychotic effect that coincided with an improvement of general motor functioning. These findings support the idea that quetiapine may be preferentially of use in the elderly with parkinson’s disease and psychotic symptoms.