Steck Andreas

Neurology and psychiatry share common historical origins. From this perspective the articles of this issue of the “Swiss Archives of Neurology, Psychiatry and Psychotherapy” reflect well the continuing relationship between neurology and psychiatry.

This issue starts with a review “Confounded by the sun: multiple sclerosis and vitamin D” by Daniel Eschle. Numerous observational studies have suggested that there is a correlation between the level of serum vitamin D and MS risk and disease activity. To explore this hypothesis the author analysed randomised controlled trials that might provide evidence of a beneficial effect of the use of vitamin D in MS. Though there is evidence indicating that lower vitamin D levels are associated with increased risk of MS, it is concluded that the hypothesis of vitamin D possibly decreasing MS incidence, may just be a bystander effect.

A timely topic is the review by Mark Hallett, on “Clinical effects of non-invasive brain stimulation”. It will interest psychiatrists and neurologists since non-invasive brain stimulation has been used in the treatment of depression, also in the form of electroconvulsive therapy, or for adjunctive treatment of movement disorders. One important aspect that is discussed by Mark Hallet is the realisation that repetitive non-invasive brain stimulation leads to plastic changes of the brain that can be enduring long after the stimulation has ended. Based on these findings, non-invasive brain stimulation techniques are being increasingly used to improve neurorehabilitation and also find application in the field of cognitive neuroscience.

The development of the psychiatric assessment of children and adolescents in the context of the divorce proceedings of their parents is outlined by Wilhelm Felder. Legislation and case law, divorce research and social changes are taken into account equally and presented along the time axis from 1907 until today..

In their report “Sustain and reinforce transition from child to adult mental health care in Switzerland”, Deniz Kilicel et al. present the protocol of a randomised controlled study to investigate the transition boundary between child/adolescent and adult mental health services in the canton of Geneva. Transitional care is problematic worldwide and may not be restricted only to mental health services. The current study will determine the effectiveness of an experimental model of managed transition in improving outcomes, as compared with usual care. This is a particularly important project, aiming to ameliorate the overall mental health care of young people.

The case report by Jakob Spyth et al. describes an unusual and rare neurological complication of long-term lithium therapy in a patient with schizoaffective disorder. The authors describe how a 70-year-old lady under long term lithium therapy suddenly developed a confusional state with dysarthria and ataxia. The cranial magnetic resonance imaging scan showed the pathognomonic picture associated with a posterior reversible encephalopathy syndrome (PRES). PRES is a rare and potentially life-threatening entity occurring after chemotherapy and immunosuppressive therapy, and also with other conditions. It is important to recognise this syndrome as it is potentially reversible, as exemplified by this case.

Daniele Zullino and Silke Bachmann present the comedy-drama film 8½ directed by Federico Fellini. The narrative of the movie is analysed in terms of psychoanalytical concepts such as Freud’s interpretation of dreams as wish-fulfilment. This film study demonstrates vividly how art deeply transcends our lives. It is an occasion to watch or rewatch this iconic movie.

Following the First person account on constraints in psychiatry, Karl Studer discusses the concept of ambivalence in an interview with Kurt Lüscher, who intensively investigated this topic in his sociological work.. Five book reviews round up the last issue of 2020.

We wish pleasant reading.

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