The first case in which lithium toxicity and leucocytosis with hypomania appear to have been induced by the selective serotonin reuptake blocking antidepressant, fluoxetine, is described. The possible pathophysiology of this interaction is discussed.

Different authors have used markedly different definitions of bingeing. Probably the most widely used of the current definitions is the DSM III R definition which states that a large amount of food must be consumed over a short period of time. Three case histories and a case vignette are used to illustrate the different clinical syndromes which may include bingeing, when bingeing is defined in this way. The authors argue that cognitive constructs are a more precise way of defining bingeing within the context of eating disorders.

Medical audit was carried out to evaluate drug therapy in a cohort of depressed patients admitted to a functional ward for the elderly. A retrospective case note study was carried out in 61 consecutive admissions with a diagnosis of depression. Seventeen of the 41 patients (41%) with a diagnosis of Manic Depressive Psychosis were not taking antidepressant medication on admission. Of the 11 patients who received Electroconvulsive Therapy seven (64%) did so under Section 3 of the Mental Health Act. Four of the 41 patients (10%) with a diagnosis of Manic Depressive Psychosis were not on prophylactic antidepressants or lithium on discharge. Seventeen of the patients (28%) were taking benzodiazepine hypnotics on admission, and 14 of these were discharged on the same type and dosage. There were no patients on more than one type of antidepressant or antipsychotic at any one time. These findings reflect deficiencies in the general practice and specialist treatment of depressive illness in an elderly cohort. The need for on-going audit in this at risk group is emphasized.

A self-administered questionnaire assessing general knowledge about AIDS, including modes of transmission, methods of prevention and attitudes to the disease, was completed by staff in a psychiatric hospital after an AIDS education seminar. The data were used to assess staff knowledge of and attitudes to AIDS, and to assess the usefulness of the seminar in changing these. Responses to individual questionnaire items were examined for associations with age, sex, job description and attendance at the seminar.

Eighty-six staff members returned questionnaires, a response rate of 39%. The results showed that levels of knowledge concerning AIDS transmission and prevention were high. A significantly greater proportion of seminar attenders were aware that needles should not be recapped after taking blood samples, but when this and other knowledge and attitude responses were corrected to allow for the higher proportion of non-medical staff among the non-attenders, there were no significant differences between attenders and non-attenders.

These results suggest that an omnibus AIDS education seminar may not produce a worthwhile improvement in staff knowledge of or attitudes to AIDS.

Alcoholic polyneuritis with characteristic mental symptoms was described by Sergei Korsakov in 1887; Wernicke confirmed and extended his observations, and modern high-resolution magnetic resonance imaging techniques make it possible to relate the confabulatory amnesia with abnormally small mammillary nuclei.