The 1970s horror film Asylum∗ is new out on the video store shelves. On the cover, above a severed head wrapped in brown paper, it warns, “you'll find more than cuckoos in this nest”. This anthology of popular perceptions of madness and mad-doctors

I have been treating a 55-year-old man suffering from a 21 year history of agoraphobia. The treatment has been cognitive-behavioural, primarily based around a systematised graded exposure to different transport systems and increasing distances from home. An accident recently occurred which serves to remind us that no matter how controlled an exposure programme is intended, we cannot protect either our patients, or ourselves, from the occasional chance encounter with unmitigated disaster.

The President of the World Psychiatric Association (WPA), Dr Jorge Costa de Silva, being Brazilian, this congress was the first to be held south of the equator and in a local winter. The choice of venue caused more then usual anticipatory anxiety because Rio, the largest of all tropical cities, accommodating ten million people who unify by calling themselves Cariocas but whose economic welfare is widely disparate, has a reputation for mugging rather than begging. In the event delegates were made so security conscious and the city administrators allocated so many hundreds of police to prevent trouble that there were only three or four materially untoward incidents. One story is that a delegate ventured to the beach wearing bathing trunks and sun glasses and returned with neither.

The value of mental illness is not obvious. It is a subtle matter.