A 48-hour rapid-cycling disorder in a patient with pre-existing cerebral sarcoidosis, not described previously, was similar to that of others in the literature in that the mood switching occurred during sleep. Although the condition is rare, its existence raises important questions regarding the neurophysiology of affective disorders in general.

Camptocormia is a rare conversion syndrome found mainly in soldiers from World War I and II. No case has been reported since, but this paper reports the syndrome in a former soldier of the Nicaraguan army. It is characterised by severe frontal flexion of the spinal cord and knees, with passive dropping of both arms, and sometimes behavioural abnormalities.

Of 20 patients attending a clinic for maintenance therapy of schizophrenia, seven had regular panic attacks, and these were often associated with agoraphobia and social phobia. Similar fears and avoidance in other cases were associated with paranoid ideas and negative symptoms. The relationship of panic to psychotic symptoms varied greatly. In two patients neuroleptics were associated with an increase in panic attacks.

The presentation of inappropriate penile erections calls for great caution in making a diagnosis. Two patients who had unwanted erections also had obsessive-compulsive disorder – a previously unreported association. Obsessive-compulsive disorder is not inconsistent with unwanted erections and should be considered in assessment.

In two cases of folie à trois, affecting two Soviet-Jewish families who emigrated to Israel, both elderly parents in both cases shared the paranoid delusional beliefs of an only child. Severe trauma in the past and social maladjustment in the present may be among the precipitating factors for the development of the shared paranoid disorder.

Over 14 years a patient was admitted at least 91 times to at least 25 general and four psychiatric hospitals and treated for a wide range of conditions that she did not have. She appears to have recovered. The medical and psychiatric care she received probably contributed to the onset of this disorder in a person already vulnerable, and to its maintenance.

A case of dependency on prescribed pressurised aerosols in a patient with asthma and mild mental handicap is reported. The majority of reported cases involve young asthmatics, abuse being reported mainly using salbutamol inhalers although other inhalers have also given cause for concern. The agent of addiction is uncertain although it may be the fluorinated hydrocarbons used as propellents, rather than the active substance itself.

A rare case of infantile behaviour of a fetishistic nature in an 80–year-old man was possibly related to a head injury at the age of six, when his regression first began. Treatment was deemed unwarranted.

A case of rabbit syndrome, a complication of long-term neuroleptic medication, is reported. It is important to differentiate it from tardive dyskinesia and continuous therapy with an antiparkinsonian agent may be required for control of symptoms of rabbit syndrome.

Five index patients and three of their first-degree relatives were affected both by schizophrenia and Marfan syndrome. Since the association appears statistically significant, the possibility of linkage disequilibrium between adjacent genes or a cytogenetic abnormality causing both disorders is suggested. These hypotheses are testable and hold promise in attempting to map the ‘schizophrenia susceptibility gene’ by the candidate-gene approach.

Of 54 patients aged 30–60 years with a diagnosis of Down's syndrome, 38 had evidence of orofacial dyskinesia, assessed using the AIMS. There was a strong relationship between the presence of such movements and the severity of mental handicap. No relationship was found between abnormal movements and age. None of the patients had previously taken neuroleptic medication.

A 13–year-old boy developed severe kleptomania after a depressive illness. This was a response to psychological trauma, and appeared in the context of a probable ‘lethargic’ encephalitic process.

Thirty obsessive-compulsive patients were randomly allocated to two treatment conditions. In group A a significant family member was trained to act as cotherapist at home, whereas in group B, only the patient was seen and given home assignments. All 30 patients received a similar treatment regime of systematic desensitisation, exposure, and response prevention. The family-based approach resulted in greater improvement in anxiety, depression, obsessive symptoms, and in social adjustment in occupational and household responsibilities. The personality pattern of the family members also appeared to influence outcome.

An unusual case of pseudocyesis of almost ten-year duration, characterised by a monosymptomatic hypochondriacal delusion and a selective response to pimozide is reported. The nosological status of the diagnosis, delusional (paranoid) disorder, is suggested to be a variety of the Kraepelinian concept of paranoia. The therapeutic pitfalls of relying on a phenomenological distinction between overvalued ideas and delusional beliefs are discussed.

A woman developed rigidity, autonomic instability and altered consciousness after taking an overdose of trifluoperazine and carbamazepine. A diagnosis of NMS was made despite the absence of fever, as carbamazepine might modify the presentation of NMS.

A 52-year-old woman, whose initial psychiatric presentation at the age of 15 was with a disorder resembling schizophrenia, developed symptoms of Klüver–Bucy syndrome, and is now thought to suffer from an organic psychotic disorder. Klüver–Bucy syndrome must be distinguished from symptoms of schizophrenia or affective disorder; its presence suggests an organic process.