[Medical disciplinary law in Belgium].

Background: Disciplinary law is regulated differently in Belgium than in the Netherlands. The Belgian Order of Physicians is responsible for the disciplinary supervision of physicians. The order is an institution with legal personality and has a three-tiered structure, two of which have judicial authority, namely the ten provincial councils and the two appeal councils.

The World Federation of Societies of Biological Psychiatry (WFSBP) 2020 guidelines for the pharmacological treatment of paraphilic disorders.

The primary aim of these guidelines is to evaluate the role of pharmacological agents in the treatment and management of patients with paraphilic disorders, with a focus on the treatment of adult males. Because such treatments are not delivered in isolation, the role of specific psychotherapeutic interventions is also briefly covered. These guidelines are intended for use in clinical practice by clinicians who diagnose and treat patients, including sexual offenders, with paraphilic disorders.

Validation of the Change or Stop Testosterone-Lowering Medication (COSTLow) Scale Using the Delphi Method Among Clinical Experts.

Guidelines for pharmacological treatment of patients with paraphilic disorders have been developed by a working group of the World Federation of Societies of Biological Psychiatry (Thibaut et al., 2010 ). With an increasing duration of experience and number of treated patients as well as aging patients, change of or withdrawal from testosterone-lowering medications (TLM) has become an important issue.

The World Federation of Societies of Biological Psychiatry (WFSBP) guidelines for the treatment of adolescent sexual offenders with paraphilic disorders.

The primary aim of these guidelines was to evaluate the role of pharmacological agents in the treatment of adolescents with paraphilic disorders who are also sexual offenders or at-risk of sexual offending. Psychotherapeutic and psychosocial treatments were also reviewed. Adolescents with paraphilic disorders specifically present a different therapeutic challenge as compared to adults.

[Sexual disorders in the DSM-5].

Background: In DSM-IV-TR, the subject of 'sexual and gender identity disorders' was dealt with in one chapter; in DSM-5, however, the subject is divided into three chapters, namely sexual dysfunctions , gender dysphoria, and paraphilic disorders.

Aim: To discuss the above-mentioned changes.

Method: The one-chapter version in DSM-IV is compared with the three-chapter contribution in DSM-5 and the differing criteria are tested for their clinical utility.

Consensus on guidelines for stereotactic neurosurgery for psychiatric disorders.

Background: For patients with psychiatric illnesses remaining refractory to 'standard' therapies, neurosurgical procedures may be considered. Guidelines for safe and ethical conduct of such procedures have previously and independently been proposed by various local and regional expert groups.

Methods: To expand on these earlier documents, representative members of continental and international psychiatric and neurosurgical societies, joined efforts to further elaborate and adopt a pragmatic worldwide set of guidelines.

Psychomotor function and response inhibition in chronic fatigue syndrome.

Most research points to cognitive slowing in chronic fatigue syndrome (CFS), although there have been negative reports. The present study is one of few that examines fine motor processing and the inhibition of automatic responses in a well-characterised CFS population. A total of 35 female CFS patients without current major depression and 25 female controls performed two computerised figure-copying tasks.

The World Federation of Societies of Biological Psychiatry (WFSBP) guidelines for the biological treatment of paraphilias.

Objectives: The primary aim of these guidelines was to evaluate the role of pharmacological agents in the treatment and management of paraphilia, with a focus on the treatment of adults males. Because such treatments are not delivered in isolation, the role of specific psychosocial and psychotherapeutic interventions was also briefly covered. These guidelines are intended for use in clinical practice by clinicians who diagnose and treat patients with paraphilia.

Use of the Temperament and Character Inventory (TCI) for assessment of personality in chronic fatigue syndrome.

Background: Chronic fatigue syndrome (CFS) is characterized by severe and prolonged fatigue, along with a set of nonspecific symptoms and signs, such as sore throat, muscle pain, headaches, and difficulties with concentration or memory.

Objective: The study examined whether CFS is associated with specific dimensions of Cloninger's psychobiological model of personality.

Method: Personality profiles were compared between 38 CFS patients and 42 control subjects by means of the Temperament and Character Inventory (TCI).

[Fitting proof].

Randomised controled trials (RCT's) and meta analyses of RCT's are known as the best research designs to evaluate if interventions are doing more good than bad. Some interventions can not be evaluated by RCT's because of the heterogeneity of the problems, the cost of the evaluation study or ethical arguments against the study. This is often the case with population based interventions.

Chronic fatigue syndrome and DSM-IV personality disorders.

Objective: Personality is an important factor in the research of the chronic fatigue syndrome (CFS). Although some studies report a high rate of personality disorders--around the 40% level--in samples of patients with CFS, the generalizability of these findings can be questioned. The present study evaluates the prevalence of Diagnostic and Statistical Manual for Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR) personality disorders in a sample of female CFS patients and in two control groups.

[Mentally disturbed offenders in Flanders].

In the course of the past 25 years in Flanders there has been a real breakthrough as far as forensic psychiatry is concerned. New types of treatment have become available for mentally disturbed offenders, whether they are in prison or in the community. A new Belgian law on mentally disturbed offenders with diminished responsibility confirms that 'internment' is still regarded as a protective measure and an alternative to punishment.

Psychomotor functioning in chronic fatigue syndrome and major depressive disorder: a comparative study.

Background: Studies comparing chronic fatigue syndrome (CFS) and major depressive disorder (MDD) reported similarities as well as differences between the two disorders. However, whereas psychomotor symptoms have been studied extensively in MDD, such research in CFS is more limited. Moreover, the few studies that compared cognitive and motor performance in MDD and CFS yielded inconsistent results.

Long-term electrical capsular stimulation in patients with obsessive-compulsive disorder.

Objective: Because of the irreversibility of lesioning procedures and their possible side effects, we studied the efficacy of replacing bilateral anterior capsulotomy with chronic electrical capsular stimulation in patients with severe, long-standing, treatment-resistant obsessive-compulsive disorder.

Methods: We stereotactically implanted quadripolar electrodes in both anterior limbs of the internal capsules into six patients with severe obsessive-compulsive disorder. Psychiatrists and psychologists performed a double-blind clinical assessment.

Deep brain stimulation of the ventral internal capsule/ventral striatum for obsessive-compulsive disorder: worldwide experience.

Psychiatric neurosurgery teams in the United States and Europe have studied deep brain stimulation (DBS) of the ventral anterior limb of the internal capsule and adjacent ventral striatum (VC/VS) for severe and highly treatment-resistant obsessive-compulsive disorder. Four groups have collaborated most closely, in small-scale studies, over the past 8 years. First to begin was Leuven/Antwerp, followed by Butler Hospital/Brown Medical School, the Cleveland Clinic and most recently the University of Florida.

Applicants for stereotactic neurosurgery for psychiatric disorders: role of the Flemish advisory board.

Objective: Research on stereotactic neurosurgery for psychiatric disorders (SNPD) is rapidly evolving. Knowledge on patients undergoing SNPD is of crucial importance. We describe applicants for SNPD and examine the necessity for a multidisciplinary advisory board.

Electrical stimulation of the brain for psychiatric disorders.

Despite advances in therapies, there remain psychiatric patients who are extremely ill and cannot be helped by classic psychiatric treatments, including psychotherapy and drug therapy. Certain of these patients may be helped by use of bilateral brain lesioning. The complication rate of standard stereotactic psychosurgery techniques is very low.

Combined dexamethasone/corticotropin-releasing factor test in chronic fatigue syndrome.

Background: Studies of hypothalamic-pituitary-adrenal (HPA) axis function in chronic fatigue syndrome (CFS) point to hypofunction, although there are negative reports. Suggested mechanisms include a reduced hypothalamic or supra-hypothalamic stimulus to the HPA axis and enhanced sensitivity to the negative feedback of glucocorticoids. The aim of the current study was to investigate HPA axis function in CFS with the dexamethasone/corticotropin-releasing factor (Dex/CRF) test, in analogy with research in affective disorders.

Behavioural and physiological effects of electrical stimulation in the nucleus accumbens: a review.

Electrical stimulation (ES) in the brain is becoming a new treatment option in patients with treatment-resistant obsessive-compulsive disorder (OCD). A possible brain target might be the nucleus accumbens (NACC). This review aims to summarise the behavioural and physiological effects of ES in the NACC in humans and in animals and to discuss these findings with regard to neuroanatomical, electrophysiological and behavioural insights.

Single nucleotide polymorphism analysis of corticotropin-releasing factor-binding protein gene in recurrent major depressive disorder.

Corticotropin-releasing factor-binding protein (CRF-BP) regulates the availability of free CRF and is a functional candidate gene for affective disorders. Previous research showed an association between polymorphisms in the CRF-BP gene and recurrent major depression (MDD) in a Swedish sample. The purpose of the current study was to re-evaluate the previous findings in an extended Swedish sample and in an independent Belgian sample of patients with recurrent MDD and in control samples.

Hypothalamic-pituitary-adrenal axis function in chronic fatigue syndrome.

There is evidence for a hypofunction of the hypothalamic-pituitary-adrenal (HPA) axis in a proportion of the patients with chronic fatigue syndrome (CFS), despite the negative studies and methodological difficulties. In this review, we focus on challenge studies and on the role of the HPA axis in the pathogenesis of CFS. Mild hypocortisolism, blunted adrenocorticotropin response to stressors and enhanced negative feedback sensitivity to glucocorticoids are the main findings.

Lower omega-3 polyunsaturated fatty acids and lower docosahexaenoic acid in men with pedophilia.

Background: Previous studies have suggested that abnormalities in plasma phospholipid fatty acids may play a role in aggressive behavior. Recently, it was suggested that a dysfunctional serotonergic turnover in the brain may be involved in the etiopathology of pedophilia. Depletion of n-3 polyunsaturated fatty acids (PUFA) may cause alterations in the serotonergic system that may be related to pedophilia and aggression.

A biopsychosocial model as a guide for psychoeducation and treatment of depression.

Effective treatment of severe or chronic unipolar depression requires the combination of pharmacological and psychotherapeutic interventions, and demands a theoretical paradigm integrating biological and psychosocial aspects of depression. Supported by recent research, we propose in our article a biopsychosocial diathesis-stress model of depression. Its basic aim is psychoeducational: to provide therapists, patients, and their environment a constructive conceptual framework to understand depressive complaints, vulnerability, and stress.