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Fourty in-patients suffering from depressive illness were treated with a new antidepressant drug, viloxazine. Apart from the already well-established antidepressant action, the authors emphasize the lack of anticholinergic effects; this illnesses with organic damage where usual antidepressant therapy is contraindicated

The rate of traumatic early life events in 31 agoraphobic subjects with panic attacks was significantly higher than that in matched control subjects. Experience of maternal separation, parental divorce, and events occurring after the age of 4 years was significantly more common.

The efficacy of captopril in the treatment of Raynaud's phenomenon was observed in an open study in 53 patients with primitive Raynaud's disease and in 18 patients with Raynaud's associated with scleroderma. Each patient was given captopril 25 mg three times a day for three months. The drug significantly decreased the frequency and the severity of ischaemic attacks in patients with Raynaud's disease, but did not affect the attacks in patients with scleroderma. These subjective ratings were supported by the results of digital strain gauge plethysmography during cold challenge. The therapy was discontinued in six patients (one because of an allergic skin reaction and five owing to orthostatic hypotension), but no serious side-effects were noticed.

Although more than twenty-five years of clinical use and several placebo-controlled studies have demonstrated the clinical effectiveness of anti-depressant drugs, the mechanism through which these drugs function and how they relate to the pathological mechanisms that underlie depressive disorders are still not clear. The present article briefly reviews the literature available on the subject. In chronological order, it examines studies on the clinical effectiveness of antidepressants, their effects on biogenic amine metabolism and on known receptor systems. The existence of possible specific receptor systems for tricyclic anti-depressants, their modifications during depressive illness, the effect of treatment with psychotropic drugs and the role which these systems may play in depression are then illustrated.

The possibility of a close relationship between depression and headache has been investigated by many authors; and supported by clinical, biochemical and pharmacological findings. In the present study the features of headaches were investigated in a sample of 58 depressed inpatients, selected according to Feighner's diagnostic criteria. Head pain was found in over 50% of the depressed, with a greater incidence within the psychogenic group. On the other hand headache did not correlate with the nuclear symptoms of depression (depressed mood, guilt, retardation, inadequacy); it correlated with tension and somatic anxiety. The authors conclude that headache, as a symptom of depressive syndrome, must be considered only an accessory component of depression, but not a central feature of the syndrome.

The authors assessed life events during the 12 months before the onset of panic disorder in 64 patients. Compared with a control group of 78 healthy subjects, patients with panic disorder had higher scores however life events were assessed, i.e., number of events, weighted normative scores, contextual scores, and number of subjects with major events. Independent life events (those beyond the subject's control) were also more numerous and more severe among the patients. The larger number of events experienced by the patients was due to the more frequent occurrence of life stress in the month before the onset of panic disorder. Loss events had the strongest relationship to panic disorder.

Viqualine dihydrochloride is a new molecule, which possesses strong serotonin reuptake inhibition properties and, at the same time, diazepam-like actions, such as [3H]-diazepam-binding inhibition and antipunishment effect. The drug was administered double-blindly to 10 patients suffering from major depression resistant to previous treatments with tricyclics. The comparison group (10 patients) received placebo. Lorazepam (10 mg/day) was also given to both groups. Viqualine proved to be significantly superior to placebo in the 4th week of treatment on all the three rating scales which were used. Tolerability of viqualine was good both objectively and on subjective grounds.

The new italian law regulating psychiatric treatments (number 180/78) does away with hospitalization for mental diseases in Psychiatric Hospitals. When required, hospitalization occurs only in Psychiatric Care Units attached to General Hospitals. Compulsory Health Treatments (T.S.O from italian "Trattamenti Sanitari Obbligatori") may be enforced whenever the patient refuses to be hospitalized although he needs hospitalization for treatment and there are no alternatives to it. The Authors report on the first seven months of experience in a Psychiatric Care Unit of a General Hospital in Florence where T.S.O. had been made available. The characteristics, places of origin, profession of the 42 patients admitted for T.S.O. have been investigated. Organizational and emotional issues arising from the enforcement of the new regulations and involving the staff are examined; the main issue being the significance of not having participated in the decision for hospitalization although having the responsibility for the patient's staying in the hospital. All these seem to have made more difficult, at least at first, to achieve a thorough psychiatric treatment, whereas it is easier to resort to a mere drug treatment. Possible solutions to ease the situation are put forward.

Six depression rating scales (RS) (Beck Depression Inventory, BDI; Zung Self-Rating Scale, SDS; Visual Analogue Scale, VAS; Hamilton Depression Rating Scale, HRSD; Wechsler Depression Rating Scale; Bunney and Hamburg Rating Scale, BHRS) were administered to the same 100 depressed patients and compared as regards ease of use, reliability, distribution, and validity. Separate factor analyses carried out on the items of the single scales showed considerably different factorial structures, thus revealing that different concepts of depression are at the basis of the various scales. These differences suggest that comparison of results derived by the use of different scales must be regarded with caution.