[Perspectives of the 3d Basel Psychiatry Rounds]

This work discusses the papers of the third symposium on psychiatry held in Basle. Herzka interprets substance abuse from a historical and cultural point of view as an escape from external tensions into an internal fight with the drug. The increase of tolerance of the many controversies and discrepancies in our culture could help to prevent drug abuse. The doctor is also in a clash between different cultures and social systems, where most values have become relative. In this situation the doctor will be tempted to only take some of the aspects of the bio-psychosociological model of psychiatric illnesses into account and to become highly specialized as to evade the conflict himself. The development of new benzodiazepines is progressing and the isolation of partial effect components, such as pure antianxiety and antiaggressive effects, is an important goal which has been partly reached. Benzodiazepines today belong to the most important medication for insomnia, restlessness, tension, anxiety present in different functional disorders, which not only concern psychiatry but medicine in general. A lot of patients need longterm treatment with benzodiazepines. This fact is contrary to the common recommendation to avoid benzodiazepine dependence. The one year prevalence of dependence is estimated to be, according to Ladewig, 0.1% of the population, which is, with regard to frequency and toxicity, compared to other substances, socially and medically relatively low. The therapeutic benefit is worth the risk of dependence. The prophylaxis for the reduction of drug dependence in the population is effective.(ABSTRACT TRUNCATED AT 250 WORDS)