In May 1981 a new disease caused by widespread food-poisoning (probably with adulterated rape-seed oil) appeared in Spain. More than 20000 people were affected, and about 350 patients have died. The clinical syndrome consisted of pulmonary, neuromuscular and systemic symptoms, which evolved to produce mild or severe physical disabilities. Although the disease is not primarily a psychiatric condition, more than 6000 TOS patients have been referred to a psychiatrist: these patients show a well-defined 'reactive disaster syndrome', vulnerability being associated with female sex, low income and class, and a personal history of 'nervous' disorders. The enormous public repercussions of the disease and the specific administrative measures it provoked are discussed and evaluated. This unique experience of a specific disaster can contribute to our knowledge of the psychological and psychiatric aspects of disasters in general; and it suggests that teams of psychologists and psychiatrists should play a significant role in managing the effects of major catastrophes.

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In order to investigate the role of serotonergic mechanisms in depressive disorders, the fenfluramine challenge test was performed in 31 patients suffering from different types of depression. The strategy was to select a simple method (i.e., easier to perform than CSF studies for instance) to be applied to a wide range of patients, as close as possible to everyday cases in a clinical setting (Le., not only to such severe or highly selected groups as is normally the case in biological research in psychiatry). The neuroendocrine test (which consisted of the measurement of variations in the secretion of prolactin, growth hormone and Cortisol after the administration of 60 mg dl-fenfluramine p. 0.) did not correlate with symptoms of behavior patterns previously identified with a 'serotonin deficit· (i. e., suicidal behavior or attempts, lowering of the control of impulses, sleep disturbanees) but only with the severity of the diagnosis (in the DSM-III hierarchical scale) or with indexes of endogeneity (Newcastle scale). This fact could be explained by methodological artifacts (L e., dlfenfluramine is not a clean probe, showing influence in the dopamine and noradrenaline metabolism; the absorption of fenfluramine was not controlled) or by the fact that the involvement of serotonin in affective disorders is not a selective, isolated dysfunction, but is integrated in more complex interrelationships. Nevertheless, our preliminary findings (even without the results of the comparison with a control group and the evaluation of a few more data and cases) do coincide with the absence of predictors or the lack of specific patterns of response of symptoms with new selective re-uptake blockers of serotonin antidepressants. Der Fenfluremlnte.t al. möglicher Marker der Endogenltit und des Schweregred. affektiver Störungen Zur Untersuchung der Rolle der serotonergischen Mechanismen bei depressiven Erkrankungen wurde an 31 Patienten, die an verschiedenartigen Depressionen erkrankt waren, ein Fenfluramintest durchgeführt. Dazu wurde eine möglichst einfache Methode gewählt (die leichter auszuführen war als z. B. Liquoruntersuchungen) und bei einer breiten Skala von Patienten angewandt, d. h. nicht nur bei einer so schwer erkrankten oder äußerst selektiv ausgewählten Gruppe, wie dies in der biologischen Forschung in der Psychiatrie üblich ist. Der neuro-endokrine Test bestand aus einer Messung der Schwankungen der Sekretion von Prolaktin, Wachstumshormon und Kortisol (Hydrocortison) nach der Verabreichung von 60 mg dlFenfluramin p. o. Das Ergebnis zeigte keine Korrelation mit den Anzeichen von Verhaltensmustern, wie sie früher als Ausdruck eines .Serotonindefizits· angesehen worden waren (d. h. Selbstmordtendenzen oder -versuche, Herabsetzung der Kontrolle über die Impulse, Schlafstörungen) ; eine Korrelation ergab sich jedoch mit dem Schweregrad der Diagnose (nach der DSM-1I1 hierarchischen Skala) oder mit Endogenitätsindizes (Newcastle-Skala). Dieser Befund ließ sich aufgrund methodologischer Artefakte erklären (d. h.: dl-Fenfluramin...

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