Apart from well known areas of overlap between endocrinology and psychiatry (e.g. studies, in psychiatric disorders, of neurohormones and of the response to manipulations of hypothalamic-pituitary-target gland axis, and analysis of behavioural and psychological disturbances in endocrinological disorders) there is a more intimate intrinsic relationship between the brain and the endocrine system which is less well known or studied. Many of the extracranial endocrine glands have autonomic innervation. Like the pituitary gland which is under direct neural (as well as humoral) diencephalic control, the extracranial endocrine glands are under direct neural control, integrated by the hypothalamus and “head ganglion of the autonomic nervous system”. Yet it is only in the case of the pancreatic islets that this integration has been clearly defined. It is postulated that by this innervation the somatic endocrine glands can respond to homeostatic needs with a rapid initial secretion before the more sustained outpouring of humoral agents typically regulated by blood-borne constituents including pituitary hormones. This is a vast area awaiting further investigation.

Interest in the monoamine oxidase (MAO) inhibitors has been revived over the past fifteen years since the publication of studies and reviews which argue their relative safety and efficacy in certain patient subgroups. The authors conclude that there is a continuing role for the MAO inhibitors in treating atypical depressive illness and panic disorders. Careful selection of patients to be commenced on MAO inhibitor treatment is advised. When prescribed alone or in combination with lithium there is evidence to support a usefulness for MAO inhibitors in depression resistant to the tricyclic antidepressants. Their efficacy in the depressed phase of bipolar affective disorder or in combination with the tricyclic antidepressants remains unproven. The risk of anaesthesia while a patient is receiving MAO inhibitor treatment may be less than heretofore believed. There is realistic hope of finding among the short-acting selective MAO inhibitors an effective antidepressant which is also free from tyramine related effects. With the increasing difficulties of evaluating new drugs on account of ethical and governmental constraints, it may however be some time before the preliminary hopeful findings can be substantiated in larger groups of patients.

The paper makes a chronological review of the literature in the area of psychological intervention with cancer patients, focussing particularly on breast cancer as this is the disease which has attracted most attention from mental health profesionals. Initially, surveys which identify psychological distress in cancer patients are reviewed, as it is felt that these may have contributed the impetus for intervention. In the second half of the paper, interventions are classified and reviewed.

Electroconvulsive therapy was introduced in 1938 by Ugo Cerletti (1877-1963) of Rome in association with “young Dr. Bini”. Cerletti's training and his development of the electrical technique as an alternative to chemically-induced convulsions are briefly outlined.