With the exception of aggression - our subjects did not have high aggression scale scores - the 'frontal lobe hypothesis', according to which alcoholic patients are impaired on function tests related to the frontal lobe, was therefore confirmed in our sample.

The aim of this study was twofold: 1 - to identify a psychological profile of patients with psychogenic nonepileptic seizures (PNESs) that is possibly distinct from that of subjects affected by epileptic seizures (ESs) alone; 2 - to detect the possible differences between the clinical features and psychological profile of patients affected by PNESs alone and those of subjects in whom PNESs are associated with epileptic seizures (ES/PNES patients). We assessed the psychological profiles of 2 different groups of subjects. The first group was of 38 patients who had all developed PNESs after epileptic seizures (ES\PNES, group 1). The second group was of 31 patients with PNESs alone (PNES, group 2). We compared the psychological findings of each of these 2 groups with those of 2 control groups, composed of patients who matched groups 1 and 2 for sex, age, and educational level, but who were affected only by ESs (groups 1C and 2C). Finally, we considered possible differences between the ictal symptoms and signs of PNESs occurring in ES/PNES and in PNES patients. Both the ES/PNES group and the PNES group revealed higher percentages of Somatoform Disorders and Cluster B Personality Disorders (DSM-III-R diagnoses) than the ES patients in the control groups. The scores obtained on the Psychophysiological Distress Scale of the Cognitive Behavioural Assessment Battery (CBA) followed the same pattern. Among PNES ictal phenomena, autonomic symptoms and signs were significantly more frequent in the PNES than in the ES/PNES group. The occurrence of PNESs mimicking generalised tonic-clonic ESs (GTC-PNESs) was significantly associated with a low academic level. The results of this study suggest that the patients with PNESs alone and those affected by PNESs and ESs share the same psychological profile, which is different from that of patients with ESs alone. However, some differences between ES/PNES and PNES patients were found in the clinical semiology of their PNESs. Our findings could have implications for the diagnosis and for the treatment of patients with PNESs.

SUMMARY Subjective sleep quality and its related factors were investigated in 869 (530 F, 339 M) 17-year-old adolescents, who were selected from the pupils of state-run secondary schools in the city of Pavia in the north west of Italy. The study was conducted cross sectionally, and it consisted of a questionnaire based survey. One hundred and fortytwo subjects (16.5% of the whole sample, 19% of the females and 11.7% of the males) met the criteria chosen for definition as poor sleepers (namely, a complaint of 'non restorative nocturnal sleep', 'often' or 'always' over the previous 12 mo). A significant association was found between chronic poor sleep and (1) gender (female) (2) emotional factors, such as worries, anxiety and depression (3) poor sleep hygiene (4) arousal related parasomnia. Only 4% of poor sleepers took sleep promoting drugs (including benzodiazepines, homeopathic products and other medications), generally without seeking medical advice. adolescence, poor sleep INTRODUCTION schools in the city of Pavia, which is a medium sized city of 80000 inhabitants in the north west of Italy. To date, most large community based studies have determined insomnia-like complaints and the use of hypnotic medication MATERIAL AND METHODS as primarily affecting older people (Bixler et al. 1979; Karacan et al. 1983;Lugaresi et al. 1983; Partinen et al. 1983; Hohagen The study was conducted in February and March 1992 in et al. 1993).Pavia and consisted of a cross-sectional, questionnaire based However, various epidemiological surveys indicate that survey involving subjects chosen at random from the 1226 sleeping difficulties are experienced by a remarkable number students (60% females, 40% males) attending the 4th year of of children and adolescents (Prince et al. 1978 (ISTAT 1994). Furthermore in Pavia some kinds of hygiene and parasomnia, are likely to affect sleep quality at secondary schools, traditionally, namely attended by females, pre-adult ages. A greater awareness and appreciation of sleep are overrepresented: these data account for the high proportion problems in young people, of the underlying factors and of of females in our students population. The sample consisted the type of remedy administered, could assist physicians to of subjects chosen at random from the 1226 4th year secondary plan programmes of preventive sleep medicine.school students. The randomization was carried out as follows: This study aims to assess subjective self-reported sleep quality the names of the 1226 students were listed in alphabetical and usage of sleep-promoting medications in a sample of 17-order. The randomized choice started by the 8th name of the year-old students selected from pupils of state-run secondary list. Every successive 4th name of the list was chosen for a pretest group, while the others were used for the sample group. Of the 920 subjects chosen for the sample, 32 were not presentCorrespondence: Professor A. Tartara, Neurological Institute 'C.at school during the questionnaire administration. Of th...

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Pathologic nocturnal eating can be associated with a heterogeneous group of medical and psychiatric disorders. The current study was designed to evaluate the prevalence and clinical features of nocturnal eating syndrome (NES), a major subtype of pathological nocturnal eating. Conducted prospectively over an 18-month period (January 1994-June 1995), the study consisted of clinical, psychological, and polysomnographic assessments of 120 adult subjects (51 males, 69 females; mean age 42.6 years, range 18-86 years) who were either self-referrals (58%) or physician referrals (42%) to our Sleep Disorders Center for insomnia complaints. Nocturnal eating with features that are typical of NES, namely compulsive feeding shortly after a mid-non-rapid eye movement (NREM) sleep awakening, in the absence of daytime eating disorders, occurred in seven subjects (five females, two males; mean age 50.8 +/- 9.5 years; mean age at onset of NES 42 years, range 18-61 years), or 5.8% of the sample. NES accounted for 44.4% of all the nocturnal eating cases observed. The data suggest that an adult, late-onset variety of NES is not infrequent. Several of the clinical features of our NES patient series correspond closely to most of those observed in other descriptions of NES in the literature. Overall, the data reinforce the idea that NES is a distinct syndrome, even though some of its features overlap with sleep-related eating disorders (e.g. associated with sleepwalking, restless legs syndrome, obstructive sleep apnea, etc.) and with eating disorders such as daytime binge eating.