Links have been established between eating disorders and abnormal patterns of interaction between members of the sufferer's family. Faced with often contradictory information, the clinician needs to know which member of the family will give the most valid description of that family's interaction. This study demonstrated the value of the Family Assessment Device (FAD) as a measure of ‘pathology’ in the families of anorectic and bulimic women. Using the ability to predict the eating disorder as an index of concurrent validity, the sufferers themselves had the most realistic perceptions of their families' interactional styles.

Thirty-one patients dependent on benzodiazepines were randomly assigned to either slow withdrawal (SW) or abrupt withdrawal under propranolol cover (PW). Of 16 patients in the SW group, 11 successfully withdrew from their drugs, while only 4 out of 15 in the PW group did so. Patients in the SW group had only mild withdrawal symptoms, while those in the PW group suffered more severe symptoms, which lasted around four weeks. In all, 81 % of the whole group suffered withdrawal symptoms of some kind. Patients in both groups were significantly less anxious at the end of the study than at baseline. Younger subjects and those who were more severely anxious at the start of the trial had more difficulty in withdrawing than older and less anxious patients.

The prevalence of Schneiderian first-rank symptoms in 75 schizophrenic in-patients was found to be 67%. The commonest were somatic passivity, thought broadcast, and thought insertion. This suggests a considerable variation in the prevalence of first-rank symptoms and their individual frequencies in different cultures. First-rank symptoms thus have inherent weaknesses.

In a one-year prevalence study of conspicuous psychiatric morbidity in two group general practices, one urban and the other rural, personality disorder was diagnosed in 5.3% by the GP and in 5.6% by the psychiatrist, but this increased to 28% when personality disorder was assessed using a structured interview. The prevalence of personality disorder was higher in the urban practice than in the rural one but there was no consistent association between personality disorder and mental state disorder, with the exception of alcohol abuse and dependence. The high rate of personality disorder found using the interview schedule is likely to be a true finding, and failure to recognise this hidden morbidity is important in both general and psychiatric practice.

The heads of centres collaborating with the WHO in biological research on mental disorders decided to develop a series of consensus statements on key issues in biological research and treatment of psychiatric problems. The statement on prophylactic use of anticholinergics in patients on neuroleptic treatment is the second of the proposed series.

Nuclear magnetic resonance images of the non-dominant cerebral hemisphere were obtained in 20 unipolar depressed patients immediately before and 25 minutes after electroconvulsive therapy (ECT). T1 values rose about 1 %. Repeated scanning up to 24 hours after ECT was carried out in 13 of these patients. The greatest change in magnetic resonance images was two hours after ECT, and thereafter images gradually returned to baseline values. There was no correlation between magnetic resonance changes and the time taken to become re-orientated after ECT.

A manic-depressive young woman received mild brain damage from anoxia after attempting suicide by hanging. The case conference was held to elucidate whether her subsequent symptoms were functional or organic, and what courses of treatment should be tried in this very refractory case.

Diagnosis of mental illness in mentally-handicapped people is often difficult and complex, because of atypical presentation and lack of clear diagnostic criteria. A patient in whom seasonal variation in behaviour and mood gave a clue to the diagnosis of manic–depressive psychosis is reported.

This is a report of the treatment of four patients suffering from a syndrome consisting of a single delusion in association with depression. The tendency of monodelusional syndromes to respond to a pimozide provides a rationale for nosological organisation.

A case of depressive disorder in which treatment resistance was associated with the calcium-channel blocker nifedipine is described.

Acute non-anaphylactic reactions to procaine penicillin include fear of death, sensations of disintegration, perceived changes of body shape, and visual and auditory hallucinations. Fragments of the original reaction experience, or elaborations of it, feature prominently in a chronic syndrome which persists if the initial reaction is not supported emotionally or professionally. The cultural acceptance of the reality of ‘mysterious' forces played a role in the syndrome. Compatible diagnostic labels were panic disorder, post-traumatic disorder, mixed phobic disorder, and depressive illness. The observed period prevalence rate is 5.9 per 1000.

The stage theories of personality development, such as those of Piaget, Freud, and Erikson, are not currently popular, in part because of misunderstandings about the supposed restrictions of timing and of confines of developmental stages. But the stage theorists did draw attention to newly appearing, qualitatively different cognitive, emotional, and behavioural systems of interaction, which come into being sequentially as children grow up.

A 35-year-old woman with persistent affective and phobic symptoms responded dramatically to a combination of isocarboxazid and amitriptyline, and this improvement was maintained over the next three-and-a-half years. Isocarboxazid was replaced by placebo, using double-blind procedure. The change to placebo was accompanied by a marked increase in anxiety and depressive symptoms, which resolved when active isocarboxazid was reintroduced. It is suggested that combined antidepressant therapy still has a place in the treatment of resistant neurotic disorder.

A fatal case of water intoxication in a schizophrenic female Chinese patient is described, including post-mortem findings.

We have reservations about accepting the conclusions made by Crow et al (1989), namely that there is evidence that susceptibility to schizophrenia may be transmitted by a pseudoautosomal locus. In our view the methodology of the study is unsound. Additionally the data presented by the authors, when analysed correctly, do not support their hypothesis.

A 66-year-old farmer's wife had been admitted 31 times over eight years, suffering from manic depression. A variety of treatments for depressive episodes led to hypomania, and a case conference was held to discuss treatment.

The main task of vocational rehabilitation facilities is to help people to return to work or, if they have never worked, to find a job for the first time. In the past seven years controversy has surfaced with regard to the role vocational rehabilitation plays in the economy. Some authors have claimed that it implicitly supports an ideology of individualism which actually acts against the interests of people with mental health problems looking for work. While accepting the need to offer a work adjustment service, these writers make a case for further socio-political intervention to help clients. The purpose of this article is to explore some of these ideas and examine their practical implications.