Epidemiological data on a wide range of mental disorders from community studies conducted in European countries are presented to determine the availability and consistency of prevalence, disability and treatment findings for the EU. Using a stepwise multimethod approach, 27 eligible studies with quite variable designs and methods including over 150,000 subjects from 16 European countries were identified. Prevalence: On the basis of meta-analytic techniques as well as on reanalyses of selected data sets, it is estimated that about 27% (equals 82.7 million; 95% CI: 78.5–87.1) of the adult EU population, 18–65 of age, is or has been affected by at least one mental disorder in the past 12 months. Taking into account the considerable degree of comorbidity (about one third had more than one disorder), the most frequent disorders are anxiety disorders, depressive, somatoform and substance dependence disorders. When taking into account design, sampling and other methodological differences between studies, little evidence seems to exist for considerable cultural or country variation. Disability and treatment: despite very divergent and fairly crude assessment strategies, the available data consistently demonstrate (a) an association of all mental disorders with a considerable disability burden in terms of number of work days lost (WLD) and (b) generally low utilization and treatment rates. Only 26% of all cases had any consultation with professional health care services, a finding suggesting a considerable degree of unmet need. The paper highlights considerable future research needs for coordinated EU studies across all disorders and age groups. As prevalence estimates could not simply be equated with defined treatment needs, such studies should determine the degree of met and unmet needs for services by taking into account severity, disability and comorbidity. These needs are most pronounced for the new EU member states as well as more generally for adolescent and older populations.

This study was conducted in order to test the hypothesis derived from the International Pilot Study of Schizophrenia (IPSS) that the existence of extended families in developing countries contributes to the more favorable course and outcome of schizophrenia in these countries in comparison with industrial countries. For this purpose, we compared data from the 5- and 10-year follow-up obtained within the IPSS at Cali, Colombia with data from two 5 to 8-year follow-up studies of former schizophrenic inpatients of the Max Planck Institute of Psychiatry (MPIP) in Munich, FRG. Although, in Cali, schizophrenics are hospitalized and treated with drugs only during acute episodes of the psychosis and no facilities exist for long-term treatment, the psychopathological outcome was, on the whole, not worse than in Munich. Furthermore, the duration of hospitalization during the follow-up period was much lower at Cali and a significantly lower number of Colombian than of German patients was not separated from their families. However, contrary to the hypothesis, family size did not predict course and outcome at both centers.

Growing up in an urban area has been shown to be associated with an increased risk of psychotic disorder in later life. While it is commonly held that a only a tiny fraction of exposed individuals will develop schizophrenia, recent evidence suggests that expression of psychosis in exposed individuals may be much more common, albeit at attenuated levels. Findings are based on a population sample of 2548 adolescents and young adults aged originally 14–24 years, and followed up over almost 5 years up to ages 17–28 years. Trained psychologists assessed all these subjects with the core psychosis sections on delusions and hallucinations of the Munich-Composite International Diagnostic Interview. Growing up in an urban area was associated with an increased risk of expression of psychosis in the adolescents and young adults (adjusted OR 1.31, 95% CI 1.03–1.66). The proxy environmental risk factor that urbanicity represents may shift a relatively large section of the adolescent population along a continuum of expression of psychosis. Other causal influences may be required to make the transition to schizophrenia in adult life.

La physiopathologie de la schizophrénie reste encore aujourd'hui incomprise même si l'existence de facteurs génétiques, environnementaux et neurodéveloppementaux est connue. Les anomalies neurodéveloppementales hippocampiques ont des répercussions fonctionnelles sur les mémoires spatiale et contextuelle. Le but premier de ce travail de thèse était d'évaluer, chez les patients schizophrènes, par utilisation d'une tâche visuo-spatiale (navigation en condition écologique), un possible déficit du « binding » contextuel. Le second but était de tester la construction de cartes cognitives de l'environnement par les patients. Une tâche de navigation en condition écologique a été effectuée par 20 patients schizophrènes et 28 sujets contrôles sains. L'exploration des mémoires spatiale et contextuelle consistait en un rappel libre (description verbale et plan libre de l'itinéraire), rappel indicé (retracer le trajet sur un plan donné), reconnaissances de vues sans effet d'ordre et reconnaissance de vues avec effet d'ordre. Les patients schizophrènes étaient moins performants. Ils prescrivaient moins d'actions, incluaient moins de repères et faisaient plus d'erreurs de changements d'orientation et dans la reconnaissance avec effet d'ordre. En revanche, il n'y avait pas de différence significative pour la tâche de reconnaissance sans effet d'ordre entre les deux populations. Ainsi, les patients schizophrènes étaient déficitaires dans la construction de cartes cognitives de l'environnement ainsi que dans reconnaissance de l'ordre chronologique des repères. Ces résultats sont compatibles avec l'hypothèse d'anomalies hippocampiques et du cortex préfrontal dans la schizophrénie.

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Diplomarbeit Hochschule für Angewandte Psychologie Zürich, 2007.

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This paper aims to investigate how far it is possible to analyze Hermann Hesse’s The Steppenwolf regarding two perspectives. The first one concerns the text’s social criticism and the other one concerns if it is possible to analyze the protagonist’s debaucherous way of life psychoanalytically. The answer to the first question is inconclusive and the answer to the second question is positive. / Diese Arbeit versucht zwei Fragestellungen in Hinsicht auf Hermann Hesses Buch Der Steppenwolf zu beantworten, nämlich inwiefern der Text die gesellschaftliche Unruhe der Zeit spiegelt und ob die Ausschweifungen des Protagonisten Material für Psychoanalyse sind. Die erste Frage konnte unschlüssig beantwortet werden und die andere Frage ist mit einem positiven Ergebnis beantwortet worden.