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The presence of pain as a symptom has been studied in a series of 51 depressed elderly inpatients and in a control group of 71 subjects. The frequency of patients with moderate to severe pain was significantly higher in the experimental group (72%) than in the controls (33.8%). Of the various categories diagnosed according to the DSM III degree criteria, the highest scores for pain were gained by the subjects suffering from dysthymic disorder and atypical depression, while those obtained by the patients with major depression and adjustment disorder with depressive mood were lower. The difference does not seem to depend on the quantity of anxiety present.

A case is described of a patient with a history of several years of diazepam abuse (in the last 24 months at dosages of 120 mg/d). A tapering schedule was carried out during a 12-day stay in the hospital in which the diazepam dosage was reduced by a fixed quantity every day, corresponding to about ten percent of the initial dosage. Five days after discharge from the hospital the patient experienced panic attacks, for the first time, which continued until 13 days after discharge. By the 40th day, the patient was experiencing a major depressive episode, which improved after administration of clomipramine therapy. We suggest that a relatively quick withdrawal schedule (ten percent per day) is probably inadequate in preventing withdrawal reactions to long-acting benzodiazepines taken in high doses for an extended period of time.

A longitudinal evaluation of the degree and type of psychological distress was carried out in 50 geriatric medical in-patients, using the Symptom Distress Checklist. They were tested within three days of admission, after 12-15 days of hospital stay, and 20-30 days after discharge. The first two evaluations showed significantly higher distress than the third for almost all the subscales. Scores indicating a significant depressive distress decreased from 70 per cent (first evaluation) and 76 per cent (second evaluation) to 34 per cent at the third one. The number of patients with significant distress for the other SCL-90 subscales was, at the third evaluation, rather low. Our data hence seem to show that the phenomenon of psychological distress in the hospital setting is transitory, and mainly arises from the factors of 'disease' and 'hospitalization'. However, in the case of some particular aspects of psychological distress, such as depression, whilst most patients overcome it, one out of three still presents a significant degree of suffering after returning home.