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Unlabelled: In the literature, no review concerning the family comorbidity of mood and anxiety disorders of anorexic subjects exists. However, this data can be important for the comprehension of this disorder and for the assumption of responsibility., Objective: We conducted a critical literature review on studies assessing the prevalence of anxiety disorders (AD) and mood disorders in relatives of anorexia nervosa (AN) subjects. In the first part, we discuss methodological issues relevant to these comorbidity studies. In the second part, taking into account the methodological considerations raised, we summarise the findings of these studies., Method: We performed a manual and computerised search (Medline) for all published studies on the frequency of MD and AD in AN relatives and MD or AD, limiting our search to the 1980-2002 period, in order to get sufficiently homogeneous diagnostic criteria for both categories of disorders (most often RDC, DSM III, DSM III-R, or DSM IV criteria)., Results: We review methodological issues regarding population sources, general methodological procedures, diagnostic criteria for AN, MD and AD, diagnostic instruments, age of subjects and course of the eating disorder., Discussion: We discuss the results taking into account the methodological problems observed. We give implications for reviewing the results of published studies and planning future research.

Obsessive-compulsive symptoms (OCSs) frequently occur in schizophrenia and seem to worsen prognosis. Many case studies suggest that OCSs appear or worsen with an atypical antipsychotic agent treatment (that is, with risperidone, olanzapine, and clozapine). Therefore, family or personal history of OCS should be investigated before initiating such treatment, and OCS onset should be monitored during treatment. Clozapine is involved in most such cases. When OCSs appear with clozapine, dosage can be reduced and a serotonin reuptake inhibitor treatment added. Current studies suggest that patients with schizophrenia and OCSs should benefit from treatment with an antipsychotic and an antiobsessive medication. Two controlled trials deal with OCS treatment in schizophrenia: the first, with clomipramine; and the second, with fluvoxamine. Both have proven their efficacy, but these trials include a small number of patients with heterogeneous characteristics.

The cyclic vomiting syndrome is defined by episodes of vomiting lasting from hours to days with free intervals between episodes. Various symptoms can be associated with vomiting: nausea, abdominal pain, photophobia, fever, pallor, dehydratation, excess salivation, social withdrawal. Some factors often precipitate the crisis: infection, psychological stresses, menstruation. Excluding a medical condition, especially a gastro-intestinal or a neurological disease is compulsory for the diagnostic of cyclic vomiting syndrome. The cyclic vomiting syndrome shares many common features with migraine including treatment. Due to negative paraclinical testing, a psychiatric disease is often suspected in these children. Pathophysiology of cyclic vomiting syndrome is unknown. As for migraine, mitochondrial and ionic channels abnormalities are thought to play a role. Overactivation of hypothalamic-pituitary-adrenal axis and autonomic dysfunction seem to be involved too. Three clinical vignets will illustrate these aspects.