A 24-year-old male schizophrenic had a delusion that he was female and had lived his life as a woman for almost two years. Unlike the only other reported case, his ‘symptomatic transsexualism’ responded to the effective treatment of his schizophrenia.

Curtis & Gurling quote with approval Sturt & Shur's (1985) critique of same-sex concordance with the implication that the phenomenon has been explained as ascertainment bias. While some of Sturt & Shur's points are valid, we note that these are not relevant to those series of dizygotic (DZ) twins that, by including both concordant and discordant pairs, controlled for sampling bias. In these series a same-sex excess in concordant pairs is present and substantial (Table II of our paper (Crow et al, 1989)).

Case reports of anorexia nervosa in subjects of Asian (Indian subcontinental) extraction have been rare. Three Asian adolescents with anorexia nervosa are described, one of whom is male. The impact of the Muslim festival of Ramadan is described in the two Muslim cases. There is a need for better understanding of attitudes towards body shape and food within the subculture.

Using the HAD scale, anxiety and depression were assessed in 18 mothers of mentally retarded psychotic children and a comparative group of 18 mothers of children with motor handicaps. Anxiety and depression scores were significantly higher among the mothers of the psychotic children, although no definite signs of depression were recorded.

“To determine the effect of job loss on health an investigation was made of admissions to hospitals in 887 men five years before and three years after the closure of a Danish shipyard. The control group comprised 441 men from another shipyard. The information on hospital admissions was obtained from the Danish national register of patients. The relative risk of admission in the control group dropped significantly in terms of the number of men admitted from the study group from 1.29 four to five years before closure to 0.74 in the three years after closure. This was especially true of admissions due to accidents (1.33 to 0.46) and diseases of the digestive system (4.53 to 1.03). For diseases of the circulatory system, particularly cardiovascular diseases, the relative risk increased from 0.8 to 1.60, and from 1.0 to 2.6 respectively.

These changes in risk of illness after redundancy are probably a consequence of a change from the effects of a high risk work environment to the effects of psychosocial stresses such as job insecurity and unemployment.”

A case of erotomania in relation to childbirth is reported. There was a good response to treatment and no evidence of relapse at 18-month follow-up.

A case of an unusual pica in a patient with anorexia nervosa is described. The patient was also found to have iron-deficiency anaemia. The relationship of mineral deficiency to pica and anorexia nervosa is discussed.

A case illustrating the association between neonaticide and denial of pregnancy is reported. Neonaticide may be a relatively common form of homicide. In some cases it could be preventable, providing the physician responsible for antenatal care is alert.

SPECT studies were carried out on three occasions in a woman with schizophrenia. Marked ‘hypofrontality’ was demonstrated during an acute phase of illness. A study during remission was within normal limits, but some return of the original defect was noted in a subsequent relapse. These findings parallel those found in PET studies of schizophrenia.

The uncommon behaviour of baby gazing is described in a patient who had also suffered three episodes of anorexia nervosa. The baby gazing responded to joint therapeutic interviews leading to the patient and her husband resolving their different views about having a family and the patient becoming pregnant. Even then there was a minor recurrence of anorexic behaviour which yielded to treatment.

A 25-year-old man with a variety of unusual ocular symptoms was fully investigated and no abnormality discovered. The suspicion of self-medication with a mydriatic was confirmed when homatropine was isolated in his tears. We describe a method for collecting tears which allowed biochemical confirmation at leisure.

In the search for neurobiological factors in the aetiology of autism, interest has focused on the temporal lobes. We present a case of Asperger's syndrome in an otherwise healthy adult with direct evidence of left temporal lobe damage on computerised tomography.

A patient experienced an organic affective psychosis on three separate occasions after taking recommended doses of non-prescription cold/sinus preparations. The possible underlying pharmacological mechanisms of this clinical reaction lend support to the cholinergic-adrenergic balance hypothesis of affective disorders. Recognition of this acute drug-induced state can lead to appropriate short-term pharmacotherapy and can prevent misdiagnosis of a major affective disorder or schizophrenia.