Prader-Willi syndrome (PWS) is associated with an insatiable appetite and (often) other maladaptive behaviours (self-injury, sleep disorders, insistence on routines, and temper tantrums). Psychoses are not a recognised feature. Most affected people have a chromosome 15 abnormality (deletion, disomy, structural rearrangement, etc.). Three people with PWS who developed psychotic disorders in early adult life are described. The nature of the psychoses and the significance of the association are discussed.

A 45-year-old man was admitted with a hair growth delusion and depressive symptoms. The delusion persisted for three years and disappeared after a manic episode. This odd delusion has some similarities with lycanthropy.

A patient who had experienced most of the standard methods of managing alcohol abuse found that during 11 years of treatment, the most consistently effective intervention has been the taking of disulfiram under family supervision. He has received 600 mg daily almost continuously for over six years without side-effects. Smaller doses do not have an adequate deterrent effect.

British Journal of Psychiatry (1993), 163, 687–689