[25 years of forensic psychiatry in the Netherlands, a concise review]. / 25 jaar forensische psychiatrie in Nederland, een beknopt overzicht.

In the past 25 years of forensic psychiatry in the Netherlands, there have been improvements in the quality of information made available for pre-trial assessments, changes in the psychopathological characteristics of the patient population, shifts in the treatment paradigm and an increase in scientific research.

Diffuse CNS involvement in systemic lupus erythematosus: intrathecal synthesis of the 4th component of complement.

In extracerebral systemic lupus erythematosus (SLE), the complement system plays a prominent pathogenic role, and decreased serum concentration of the 4th component (C4) is a reliable indicator of systemic disease activity. In diffuse CNS-SLE, however, the pathogenic role of complement is less clear. In 12 patients with active diffuse CNS-SLE presenting with delirium (4), organic personality syndrome (3), or generalized seizures (5), we determined the CSF indexes of the complement components C3, C4, and factor B, and of IgG, IgA, and IgM. There was a significant increase of the C4 index in these patients compared with controls and a significantly higher CSF C4 index in patients with an increased IgM index. We conclude that intrathecal C4 is being produced in diffuse CNS-SLE.

Hypomanic behaviour associated with familial spastic paraplegia.

Psychiatric manifestations of familial spastic paraplegia are rare and have been described only infrequently. A 35-year-old male is reported, who presented both hypomanic behaviour and gait disturbances as features of a previously undiagnosed familial spastic paraplegia. This association implies that the CNS manifestations of familial spastic paraplegia may overlap with the neurochemical or neuroanatomic substrata regulating mood.