A rare case of Charles Bonnet syndrome, which presented in a 38-year-old man, responded to carbamazepine.

Doctors and mental healthcare professionals are at greater risk of being stalked than the general population, particularly by their patients. Despite causing significant psychological distress, stalking remains underrecognised and poorly managed. Healthcare organisations should ensure appropriate policies are in place to aid awareness and minimise risk, including the provision of formal educational programmes.

We are all of us familiar with the expression “to run amuck,” but perhaps comparatively few of us are familiar with the significance of the term in the Eastern Archipelago. Amuck, or, as it is properly spelt Amok, is a Malay word, and means a furious assault, its derivatives, Mengamok and Pengamok respectively, meaning to commit a furious assault and the person who runs Amok.

There have been relatively few studies concerning the occurrence of depersonalization phenomena in normal subjects. Roberts (1960) and Dixon (1963) studied college students and reported a high incidence of brief depersonalization experiences in their samples. The aim of the present study is to investigate the relationship between depersonalization, the conditions under which it occurred and a measure of extraversion/ introversion in a group of normal subjects.

This paper reports a study of maternal psychiatric illness in school-phobic adolescents admitted to a psychiatric in-patient unit. These cases have been previously described and studied in various ways (Berg, Nichols and Pritchard, 1969; Berg, 1970; Berg and McGuire, 1971; Berg, Butler and McGuire, 1972; Berg and McGuire, 1974).

We present the first report of the use of cyproheptadine to treat fluvoxamine-induced anorgasmia, in a 63-year-old man suffering from recurrent severe unipolar depression.

Since human electroencephalography was first introduced by Berger in 1929, there have been many attempts to correlate the alpha rhythm with various aspects of personality. Lemere (1936) first reported a relationship between “good” and “poor” alpha rhythms and cyclothymic and schizoid personalities respectively. Gottlober (1938) found a correlation between a high alpha index (per cent. time alpha) and extraversion. However, Henry and Knott (1941) pointed out that the group studied by Gottlober was loaded both with high alpha indices and extraverts, and with additional data were unable to find a significant relationship between extraversion-introversion and alpha index.

This study examined the effects of desensitization, flooding and social skills training on social fears. The patients were 30 social phobics. All three treatments were associated with useful therapeutic gains during the period of treatment that were maintained over a six-month follow-up period. No differences were found between treatments.

A number of recent studies (Leff & Vaughn, 1985; Nuechterlein et al, 1986; Jenkins et al, 1986; Mintz et al, 1987) have indicated that attitudes of family members towards a relative with schizophrenia (termed High Epressed Emotion (EE)), are predictive of the short-term course of the patient's disorder. The measure used to define EE status of a relative is a semi-structured interview, the Camberwell Family Interview (CFI) (Vaughn & Leff, 1976), which is usually administered shortly after the patient is admitted to hospital for an index episode of the disorder.

After more than thirty years the operation of leucotomy still remains a controversial treatment, and its value is questioned by many. This scepticism, and the advent of new surgical techniques, have emphasized the need for careful appraisal of the results of psychosurgery. In a previous prospective study 40 patients were assessed six weeks after modified leucotomy, and 75 per cent of these patients were found to be clinically improved (Kelly, Walter and Sargant, 1966). They were less neurotic on the M.P.I., had lower Taylor Manifest Anxiety scores and rated themselves as less anxious; a good clinical outcome was associated with diminution of physiological arousal as measured by forearm blood flow and heart rate. This group has now been followed-up and reassessed 18 months after operation, and a further group of 38 patients has been examined before, and again six weeks after, leucotomy. The data from the two groups have been combined to determine the immediate outcome for various diagnostic categories, and a multiple regression has been performed to elicit which of the pre-operative factors predict a favourable post-operative result.

The tricyclic antidepressant drugs are established therapeutic agents, yet their mode of action has remained obscure. The usual delay of some 10 or more days before they produce beneficial effects has never been satisfactorily explained. Many months are usually necessary for lasting cure, for often symptoms recur when the drugs are stopped. If they are then reinstated for several months, and then stopped, the patient commonly remains free of symptoms. There is thus uncertainty as to whether the drugs might simply be masking the depression in a manner comparable to anxiety-relieving agents, and uncertainty whether patients should be regarded as temporarily dependent upon tricyclic drugs. Slow brain processes have to be inferred, of a duration often met in psychiatry (Oswald, 1967). The observations we now report have features in common with many other slow brain recovery processes Oswald, 1969) and may cast light upon the mode of action of antidepressant drugs, as well as providing further insight into the chemical mechanisms of sleep. The latter are currently believed to be governed in part by cerebral mono-amines, which the tricyclic drugs are thought to affect.

“I think you ought to leave your head to the College of Surgeons to ascertain what wonderful impressionable substance it contains instead of brains” (G. B. Shaw to a correspondent, 1926).

In view of recent findings in Japan, and in England and Wales, data on schizophrenic births in the United States were reexamined to see if seasonal shifts had occurred. In Missouri a progressive shift from February to April and May was noted between 1921 and 1930 and between 1941 and 1950. In five New England states there was no shift over the same period. Data were then obtained to compare the Missouri shift with two hypotheses previously put forward to explain schizophrenic birth seasonality: (1) that it is related to the seasonality of general births, and (2) that it is related to seasonal temperature variation. Neither hypothesis was supported by the data.

Diminished sexual activity among individuals dependent upon the opiate drugs (heroin, morphine, methadone, etc.) has been noted by Freedman (1967) and by Jurgensen (1966). A study of four populations of male patients (controls, abstainers, heroin addicts and patients maintained on methadone), suggested that although factors other than the specific drug effects may be important determinants of sexual difficulties, that the drug itself may act as a specific determinant (Cushman, 1972). This was supported by the fact that all patients claimed to have been normal before narcotic use, that heroin reduced sexual performance and desire, and that a reversal to normal sexual function rapidly occurred during enforced withdrawal. Other observations by Ding (1972), and Scher (1967) support these findings. Berzins et al. (1971), and Mott (1972) have noted that drug-dependent subjects tend to have problems of sexual identity, and Hobi (1972) suggests that psychosexual immaturity is frequently seen in drug-dependent subjects.

When the length of stay of restricted patients admitted to Broadmoor under the legal category of psychopathic disorder was examined, the factor found to be of primary importance was the gravity of the admission offence. If the men's offences did not cause personal injury, they had a good chance of early release. Patients convicted of violent or sexual offences, and particularly those who attacked strangers, made up the great majority of the long-term group. For the mentally ill there was no relationship between length of stay and admission offence: instead the data suggested that severity and chronicity of illness were the main relevant factors.

Cognitive functions were investigated in seven manic-depressive patients while on lithium, after two weeks off lithium, and after a subcutaneous injection of physostigmine while on lithium. Test performance was unaffected by lithium, but after physostigmine the I.Q. score of a shortened version of the WAIS was significantly increased.

The outcome in clinical and social terms of a psychiatric illness arising within 1 year of confinement or termination of pregnancy and requiring on-going care was studied after a period of 1–6 years in 47 women. The outcome was related to the earlier features of the illness and to personal and historical features. Social impairment and continuing psychopathology occurred in many cases. The only factor which significantly related to poor outcome was an initial diagnosis of schizophrenia.