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Depression and Violence: A Contradiction? Abstract. Depression is one of the leading diseases worldwide. Its symptoms are of great importance for a variety of areas within internal medicine, as patients often pay a visit to their general practitioners first. Although symptoms of depression are observed in both genders, existing peculiarities of the symptoms in men are only insufficiently known or acknowledged. Therefore, we dedicate this article to the concept of male depression, which can be characterized by social withdrawal, irritability or substance abuse. Here, we present practice-related associations between depression and violent behavior, which will be illustrated by two case studies. Of particular relevance is the so-called suicidal-homicidal syndrome, which should make further psychiatric, if not forensic-psychiatric evaluation mandatory.

The Swiss Criminal Code provides measures for mentally-ill offenders focusing on their need for treatment. This may lead to the deprivation of the patient's liberty up to several years. Under certain circumstances the mentally-ill offender can be sentenced to an indefinite incarceration. This case presentation we will describe a forensic psychiatric patient diagnosed with schizophrenia who was ordered an indefinite incarceration in Switzerland after he had been sentenced to 8 years of imprisonment for a deliberate killing. Initial presentation of symptomatology included formal thought disorders and negative symptoms such as affective flattening and alogia. Due to a scarcity of adequate treatment sites in the 90s and lack of scope for risk assessment and management, the patient could only be treated within highly regiment prison environments in the past. There, the patient's treatment concept primarily focused on short-term psychiatric care instead of providing an adequate treatment plan that would have been essential for the patient's improvement of chronic symptoms. This case description aims to present some of the fundamental issues observed in the forensic mental health system, where strong efforts are made to balance risk management and the treatment of severe mental health disorders. We will put the patient's own course of treatment and his progress within the penal system into context with ethical challenges in the forensic and correctional services and will provide potential recommendations for future research in the field of forensic psychiatry.

Psychomotor retardation and reduced daily activities are core features of the depressive syndrome including bipolar disorder (BD). It was the aim of this study to investigate white matter microstructure of the motor system in BD during depression and its association with motor activity. We hypothesized reduced physical activity, microstructural alterations of motor tracts and different associations between activity levels and motor tract microstructure in BD. Nineteen bipolar patients with a current depressive episode (BD) and 19 healthy controls (HC) underwent diffusion weighted magnetic resonance imaging (DW-MRI)-scans. Quantitative motor activity was assessed with 24 h actigraphy recordings. Bilateral corticospinal tracts (CST), interhemispheric connections between the primary motor cortices (M1) and between the pre-supplementary motor areas (pre-SMA) were reconstructed individually based on anatomical landmarks using Diffusion Tensor Imaging (DTI) based tractography. Mean fractional anisotropy (FA) was sampled along the tracts. To enhance specificity of putative findings a segment of the optic radiation was reconstructed as comparison tract. Analyses were complemented with Tract Based Spatial Statistics (TBSS) analyses. BD had lower activity levels (AL). There was a sole increase of fractional anisotropy (FA) in BD in the left CST. Further, there was a significant group x AL interaction for FA of the left CST pointing to a selective positive association between FA and AL in BD. The comparison tract and TBSS analyses did not detect significant group differences. Our results point to white matter microstructure alterations of the left CST in BD. The positive association between motor activity and white matter microstructure suggests a compensatory role of the left CST for psychomotor retardation in BD., (Copyright © 2018 The Authors. Published by Elsevier Inc. All rights reserved.)

This case report describes a patient with a dysembryogenic neuroepithelial tumor localized in the posterior thalamus and internal capsule, which presented with psychosis including religiously determined severe self-mutilation, auditory hallucinations, and rituals. The patient's history includes periodic religiousness over decades of her life suggesting that spirituality in this case might be a symptom of tumor progression. Our case reports on the topology-related effect of lesions on different brain networks involved in the phenomenology of the patient's psychotic symptoms.

This study tested whether patients with major depressive disorder (MDD) and schizophrenia spectrum disorders would differ in three dimensions of psychopathology (language, affectivity and motor behavior) as assessed by the Bern Psychopathology Scale (BPS) in a cohort of 58 patients with MDD and 146 patients with schizophrenia spectrum disorders. The overall estimation of severity of each of the three dimensions was rated on a seven-point Likert scale from severely inhibited to severely disinhibited. Here, more than half of the patients endorsed ratings that showed normal or mildly (dis-)inhibited behavior. At group level more pronounced negative ratings of affect were seen in MDD. Group comparisons of the severity ratings on language or motor behavior yielded no differences between schizophrenia spectrum disorders and MDD. At the individuals' levels, extreme ratings in the language and motor dimensions were more frequent in schizophrenia spectrum disorders and in the affectivity dimension more frequent in MDD. Shared psychopathological features could be seen across diagnoses, supporting a dimensional approach to psychopathology in endogenous psychoses. However, the groups differ in the severity of affect ratings as well as in the distribution of language, affectivity and motor ratings with more variance among the group of schizophrenia spectrum disorders., (Copyright © 2017 Elsevier Ireland Ltd. All rights reserved.)

Background: Several therapy optimization studies (TOSs) for the treatment of hematologic and oncologic disorders in children and adolescents have been conducted in Germany. The publication of research results is necessary to ensure that future studies are well designed and based on relevant and unanswered questions. This retrospective cohort study was conducted to analyze the study- and publication practice in this field., Methods: All study protocols in the field of the pediatric oncology and hematology in Germany were collected. Relevant data from study protocols were extracted, beginning with 1) general information about the study protocol, and 2) information about each methodological trial. In a second step, the publication practice was characterized by searching in electronic databases and by contacting principal investigators. Relevant Data of each publication was extracted., Results: The research activity has increased significantly in the past few years. The found publication rate of 85% represents an outstanding publication practice. Additionally, German, as being the main publication language a few decades ago, has been almost completely replaced with English. An acceptable methodological conduct was observed in the analyzed study protocols., Discussion and Conclusion: Studies have been principally based on the concept of TOS, without considering a detailed breakdown into each methodological trial. A markedly subdivision of studies into methodologically identifiable trials would allow a clear definition of their parameters, while increasing transparency of the study conduct and its results., (© Georg Thieme Verlag KG Stuttgart · New York.)

Purpose: The new classification of malignant fibrous histiocytoma leaves only a small group of tumors without further line of differentiation, so-called pleomorphic sarcomas, not otherwise specified (NOS) as a pseudo-entity. This study focused on these tumors and analyzed the association of gene expression profiles to clinical outcome., Materials and Methods: Ten fresh samples of pleomorphic NOS sarcomas were evaluated histopathologically and by means of microarray analysis. Analysis of expression profiles was performed by clustering methods as well as by statistical analysis of primary vs recurrent tumors, irradiated vs nonirradiated tumors, tumors of patients above and below 60 years of age, male and female, and of tumors that developed metastatic or recurrent disease during the clinical course and those that did not., Results: Tumor clustering did not correlate to any histopathological or clinical finding. Detailed gene expression analysis showed a variety of genes whose upregulation (platelet-derived growth factor receptor alpha polypeptide, solute carrier family 39 member 14, solute carrier family 2 member 3, pleiotrophin, trophinin, pleckstrin and Sec7 domain containing 3, enolase 2, biglycan, SH3 and cysteine-rich domain, matrix metalloproteinases 16) and whose downregulation (tissue inhibitor of metalloproteinase 4, hairy/enhancer of split related with YRPW motif 2, protein tyrosine phosphatase receptor-type Z polypeptide 1, SH3 domain GRB2-like 2, microtubule-associated protein 7, potassium voltage-gated channel shaker-related subfamily member 1, RUN and FYVE domain containing 3, Sin3A-associated protein 18 kDa, proline-rich 4, calcium/calmodulin-dependent protein kinase ID, myeloid/lymphoid or mixed-lineage leukemia translocated to 3, insulin-like growth factor binding protein 5, nucleoside diphosphate-linked moiety X-type motif 9, NudC domain containing 3, imprinted in Prader-Willi syndrome, TAF6-like RNA polymerase II p300/CBP-associated factor 65 kDa, WD repeat and SOCS box-containing 2, adenosine diphosphate ribosylation factor 3, KRR1, proliferation-associated 2G4; CD36, complement component (3b/4b) receptor 1, solute carrier family 4 sodium bicarbonate cotransporter member 4, lipoprotein lipase (LPL), GATA binding protein 3, LPL, glutathione peroxidase 3, D: -aspartate oxidase, apolipoprotein E, sphingomyelin phosphodiesterase acid-like 3A) were associated with poor clinical outcome in terms of development of metastatic or recurrent disease., Conclusions: The classification of these tumors may undergo further changes in the future. Gene expression profiling can provide additional information to categorize pleomorphic sarcoma (NOS) and reveal potential prognostic factors in this "entity."