The birth of modern psychiatry - Hans Jacob Schou and the Dianalund Sanatorium.

Hans Jacob Schou (1887-1952) was a well-educated Danish specialist in nervous diseases. He was persuaded in 1922 to take over the leadership of the only large scale private institution in Denmark for patients with nervous diseases, The Colony of Philadelphia, near Dianalund, on the island of Zealand. He pioneered a development of this conservative institution into a modern charity hospital for patients with all kinds of nervous and mental disorders.

[Harald Selmer - the father of Danish psychiatry].

Harald Selmer is rightly called the father of Danish psychiatry. He was born in 1814, and received in 1831 his degree in medicine from the University of Copenhagen. At the age of 32 he published his famous book on the "general rules .

[Danish pioneers of psychopharmacology].

Although a small country, Denmark has played an important role in the development of modern psychopharmacology due to an active and ambitious pharmacological industry, excellent researchers and last but not least, far-sighted clinicians. The most prominent among these clinicians are portrayed here. Mogens Schou advocated throughout his long life for the benefits of lithium treatment for bipolar patients, Lars Gram for the use of drug monitoring in the pharmacological treatment of depressed patients, Erik Jacobsen invented Antabus for treatment of alcohol dependence and later became one of the first presidents of the Collegium Internationale Neuropsychopharmacologicum (CINP) and finally, Claus Braestrup was the first to describe the benzodiazepine receptor.

[The physician's role elucidated through literature and philosophy].

The primary aim of the described course at the Faculty of Health Sciences, Aarhus University, is to provide the medical student with an opportunity to reflect on the preconditions to being a "good physician" through the reading of literature and philosophy. The course gives the student a number of analytical, methodological and practical tools for understanding and handling the demands of his or her future career as a health professional.

Lamotrigine versus lithium as maintenance treatment in bipolar I disorder: an open, randomized effectiveness study mimicking clinical practice. The 6th trial of the Danish University Antidepressant Group (DUAG-6).

Objectives: In industry-generated pivotal studies, lamotrigine has been found to be superior to placebo and comparable to lithium in the maintenance treatment of bipolar I disorder. Here, we directly compared lamotrigine to lithium under conditions similar to clinical routine conditions.

Methods: Adult bipolar I disorder patients with at least two episodes within the last five years and an index episode requiring treatment were randomized to lithium (n = 78; doses adjusted to obtain serum levels of 0.

Low-frequency repetitive transcranial magnetic stimulation inferior to electroconvulsive therapy in treating depression.

Objectives: Repetitive transcranial magnetic stimulation (rTMS) is a potential new antidepressant method and alternative to electroconvulsive therapy (ECT). The efficacy of right prefrontal low-frequency rTMS was shown in a previous placebo-controlled, randomized study but has never been compared with ECT. The aim of this study was to compare the antidepressant efficacy and adverse effects of right prefrontal low-frequency rTMS with that of ECT.

[Melancholia and depression--from madness to illness].

In present time depression affects 3-5% of the population in the western countries. Has this illness always existed? Can it be traced backwards in historical periods? The answer is a reluctant yes. The term "depression" has been in use in psychiatry for only 150 years and the very term "psychiatry" for 200 years.

Long-term outcome of patients with bipolar disorder commenced on lithium prophylaxis during hospitalization: a complete 15-year register-based follow-up.

Objectives: From placebo-controlled studies of up to two years duration, it has been established that lithium has preventive efficacy in bipolar disorder (BD). However, the effectiveness of lithium under routine conditions seems less pronounced. In the present study, the overall 15.

[Lithium intoxication: assessment, treatment and prevention].

A 64-year-old woman with bipolar disorder had received treatment with lithium for 33 years when she was admitted to the Department of Neurology with clinical signs and symptoms of an apoplectic insult. Her serum lithium level was 2.42 mmol/l.

Repetitive transcranial magnetic stimulation as add-on antidepressant treatment. The applicability of the method in a clinical setting.

Recent research indicates that repetitive transcranial magnetic stimulation (rTMS) over the frontal cortex has an antidepressant effect. The aim of the present pilot study was to assess the antidepressant effect, side-effects and the applicability in daily clinical practice of left prefrontal high-frequency rTMS. Fifteen inpatients with major depression (ICD-10 and DSM-IV) were randomized to receive 15 days of real left prefrontal high-frequency rTMS (20 trains of 10 s, 60-s interval, 10 Hz, 90% of motor threshold) or sham rTMS as add on to conventional antidepressant treatment.

Guidelines for maintenance treatment of bipolar disorder: are there discrepancies between European and North American recommendations?

Practice policies and guidelines for the long-term management of bipolar patients have appeared in many parts of Europe and North America. Although recommendations in most areas do concur remarkable differences are apparent both regarding diagnostic practice and pharmacological management. Differences among recommendations point towards professional and cultural differences between Europe and North America but also towards areas with unresolved research questions and lack of scientific evidence.

Pain thresholds during and after treatment of severe depression with electroconvulsive therapy.

Pain and depression are often associated suggesting that both conditions share a common neurobiological mechanism, which modulate emotional function and processing of noxious information. Pain thresholds are hypothesized to be altered in depressed patients and normalized with the amelioration of depression. The purpose of this study was therefore to determine pain thresholds in patients during and after treatment with electroconvulsive therapy (ECT) of severe depression and in healthy controls.

[Preventive drug therapy of depressions].

At least 5-10 per cent of the Danish population will during their lifetime experience more than one episode of major depression but only a minority of this group will receive the necessary and sufficient prophylactic treatment against their illness. Randomised controlled studies have shown that the majority of commonly used antidepressant drugs, new as well as old ones, possess prophylactic efficacy. Thus, treatment efficacy is not a major problem but the treatment efficiency in everyday clinical practice is unsatisfactory.

[Psychopharmacological treatment of bipolar disease].

This paper gives an update on the psychopharmacological treatment of bipolar disorder. The antimanic efficacy of lithium is well documented. The same applies to valproate, which is also efficacious in mixed mania.