Definition and quantification of six immune- and neuroregulatory serum proteins in healthy and demented elderly.

Aim: Blood-based biomarkers related to immune- and neuroregulatory processes may be indicative of dementia but lack standardization and proof-of-principle studies. Materials & methods: The blood serum collection protocol as well as the analytic procedure to quantify the markers BDNF, IGF-1, VEGF, TGF-ß 1, MCP-1 and IL-18 in blood serum were standardized and their concentrations were compared between groups of 81 Alzheimer's disease patients and 79 healthy controls. Results: Applying standardized methods, results for the quantification of the six markers in blood serum are stable and their concentrations significantly differ for all analytes except VEGF between patients diagnosed with Alzheimer's disease and healthy controls. Conclusion: Analyzing a panel of six markers in blood serum under standardized conditions may serve as a diagnostic tool in primary dementia care in the future.

[The "Psychiatrie-Enquete" - the German Report on the State of Psychiatry in 1975]. / Auf dem Wege zur Reform - die Psychiatrie-Enquete wird 40.

Forty years ago an expert-commission submitted a report on the deplorable state of German psychiatric care, called the "Psychiatrie-Enquete" to the Bundestag, the German parliament. The Report initiated a substantial change of Psychiatric services in the country. Inhuman treatment and living conditions were superseded. Mental hospitals were not completely abolished. But they lost their importance in favour of decentralized psychiatric services including departments at general hospitals, day hospitals and outpatient services. Custodial care was largely successfully developed into therapeutic and rehabilitative care. This article attempts a mildly critical evaluation of the Enquête 40 years after.

The Werther effect and assisted suicide.

In the course of a large epidemiological study in the region of Basle, Switzerland, from 1992 to 1996, a considerable rise in suicides assisted by the right-to-die society EXIT was uncovered after wide press coverage of an assisted double suicide of a prominent couple in that region in March 1995. Further investigation revealed that the rise of assisted suicides for a period of 2 years after the critical event was statistically significant compared to the 2 years previous to the double suicide. This was especially true for women older than 65 years. Hence, the almost enthusiastic kind of reporting about this event was apt to induce imitation suicides or a "Werther-effect."

[Decisions of the psychiatric court of appeal of basle-city in the year 2000--procedure on appeal against compulsory admission in a Swiss canton]. / Entscheide der Psychiatrierekurskommission des Kantons Basel-Stadt im Jahr 2000--Rekursverfahren bei fürsorgerischen Freiheitsentziehungen in einem Schweizer Kanton.

We present the legislation of the compulsory admission and treatment of mentally ill persons in the Swiss canton of Basle-City. We inquired retrospectively the requests of the clinic and the appointed time given by the psychiatric court of appeal in the year 2000. With 320 compulsory admissions there were 118 appeals. The patients with organic mental disorders are older and we exclude them for further examination because of the completely different psychosocial background. In the remaining 107 cases the schizophrenic disorders are clearly over-represented (75 % vs. 27 % of all admissions). Women are approx. 9 years older, are discharged three times more frequently at the negotiation and retained against their will for a shorter time than men. Men are more frequently isolated and compulsorily treated. The regression analysis can explain between 10 % and 16 % of the variance of the duration of the compulsory hospitalisation by the days of hospitalisation in the last two years and by sex.

[Schizophrenia in the German national paper Frankfurter Allgemeine Zeitung -- a didactic play]. / Die Schizophrenie in der Frankfurter Allgemeinen Zeitung - ein Lehrstück.

The Basel Project on Psychiatry and the Printed Media has focussed on the role of the media in the development and enhancement of prejudice and stigma against the mentally ill. Analyzing the reporting of the German national paper Frankfurter Allgemeine Zeitung on schizophrenia we show a gap between the competent reporting on the illness schizophrenia and a devaluating use of schizophrenia as a metaphor. This is of special importance since almost three fifth of the identified articles (48 of 83) use schizophrenia as a metaphor.

Suicide after discharge from psychiatric hospital.

56 of 287 persons committing suicide between 1992 and 1995 in the region of the city of Basel were identified to have been inpatients in the region in psychiatric hospitals between 1986 and 1995. Fifty of these committed suicide after discharge from hospital - eight times as many as during their time as inpatients. A quarter of these patients killed themselves within the first four weeks after discharge.