Generalized and partial seizures induced by antipsychotic agents are well documented in the medical literature, but these patients generally do not present a management problem. The incidence of this phenomenon is less than 1% in both psychiatric and general medical population (Malcolm, 1972); we came upon only one report of a psychomotor status-like episode due to iatrogenic drug effect in the relevant literature (Kuschke, 1972). According to Gastaut's (1970) classification of epileptic seizures, the general term for psychomotor status is partial seizures with complex symptoms.

It has been suggested that schizophrenic patients have a lower risk of cancer than the general population. We therefore investigated the smoking patterns of 100 current chronic schizophrenic in-patients, and the causes of death in 122 recently deceased schizophrenics. We found that schizophrenics are heavy smokers, and that schizophrenics do die from carcinoma of the bronchus. Proportional mortality rates for all malignancies were not significantly lower in schizophrenics than in the general population but there was a significant absence of cancer of the gastro-intestinal tract. Proportional mortality rates for female mammary carcinoma, pneumonia, and suicide were raised, and that for cerebrovascular disease was low. These differences between schizophrenics and the general population warrant further investigation.

A marked elevation in human growth hormone (GH) following intravenous infusion of thyrotropin releasing hormone (TRH) was seen in three of seven adolescent male schizophrenic patients receiving neuroleptic drugs, and in one of five controls matched for age, sex, and developmental stage, receiving the same drugs. A positive family history for schizophrenia was noted in all three schizophrenic ‘responders' but in only one of the remaining patients. The response patterns of thyroid stimulating hormone (TSH), triiodothyronine (T3), and thyroxine (T4 following TRH infusion were not significantly different in the two groups. No significant correlations were found between T3, T4, TSH, or GH response patterns and age of patient, duration of illness, medication dose or duration, weight change, or hours of sleep preceding testing.

Thirty-six patients with obstructive coronary artery disease were interviewed before by-pass graft surgery, and again a mean period of 12.3 months (n = 34) after the operation. The operation was successful in providing relief from chest pain in 31 patients. Psychiatric outcome was related to preoperative mental state, social maladjustment, neuroticism, Bortner Type A score, and previous psychiatric history. One quarter of those employed preoperatively failed to return to work after operation, even though they were improved in terms of symptoms and functional capacity. No association was found between measures of either psychiatric morbidity, or employment status at follow-up, and pre-operative physical variables.

A survey of police and medical records in a province of Fiji indicated high rates of suicide for Indian women under 30 and for Indian men over that age, especially amongst families engaged in sugar-cane farming. Indian suicide rates were high during the Indenture period (1879–1920), and are still higher amongst Indians than amongst native Fijians: almost 90% of all suicides are Indian, though this group comprises only 50% of Fiji's total population. Age/sex/ethnic distribution, methods, and precipitating factors of recorded suicides were examined for one province of Vanua Levu during the period 1979–82. The increasing use of toxic herbicides, especially paraquat, as a vehicle for suicide is discussed.

The dexamethasone suppression test (DST) was carried out on 143 patients with a major depressive disorder, who were classified into those with a history of weight loss (n = 89) and those without (n = 54). Seventy-three per cent of patients with weight loss and 61% of patients without had an abnormal DST; this difference was not statistically significant. Of the patients receiving prophylactic lithium therapy, 13 were found to have changed their DST status on retesting after a period of 14 months, but there was no significant difference in their weight. It is concluded that weight loss is not a necessary condition for an abnormal DST in depressive illness.

Two psychiatric day hospitals were evaluated in terms of the outcomes after three months' attendance by patients. Multiple measures were made using questionnaires, naturalistic observation, and ratings at the start and end of this period, for a total of 83 patients. The results indicated that although both day hospitals were serving similar patient samples, only one was achieving significant clinical improvements; one plausible explanation for the findings was the differences between their respective programmes. The major implication of the result is the need for evaluation of both the outcome obtained by patients following attendance and the therapeutic process by which these outcomes are achieved.

The possible value of event-related potentials (ERPs) in the differential diagnosis of dementia was investigated in a group of 42 demented elderly patients, 29 non-demented elderly patients, and 10 healthy young controls. The auditory evoked potentials were elicited by using target and non-target auditory stimuli. There was no significant difference in N100 and P200 latency between these groups. Our results indicate an age-related increase of P300 latency of 0.3 msec/year in the non-demented subjects. There was no significant difference in P300 latency between demented and non-demented patients, and the latencies vary widely within the groups of elderly patients.

Medical journals are enlivened by case reports of bizarre and unusual syndromes. Although somatic delusions are relatively common in schizophrenia, reports of hallucinations and delusions of bicephaly are rare. For a patient to attempt to remove a perceived second head by shooting and to survive the experience for more than two years may well be unique, and merits presentation.

Twenty-seven consecutive male patients suffering from anorexia nervosa were fol lowed-up 2–20 years after presentation; 20 had been treated with an in-patient refeeding/psychotherapy regime. The outcome of the series compared very closely with a similar group of female anorectics: 12 (44%) had a good outcome, stable weight restoration and normal sexual functioning; seven (26%) had an intermediate outcome, and eight (30%) poor (weight more than 15% below normal, and poor or no sexual activity). No patient had died. Good outcome in terms of weight was associated with good psychological and social functioning, while poor outcome was clearly associated with a longer duration of illness, previous treatment, and greater weight-loss during illness, although not with any specific dietary behaviour. Poor relationship with parents during childhood and the absence of normal adolescent sexual behaviour premorbidly were also strongly predictive of poor outcome.

In spite of the comparative rarity of anorexia nervosa in African patients, the case of a young black Zimbabwean woman which fulfils Feighner's diagnostic criteria is presented. Special reference is made to several unusual features which include the social and psychological conflicts engendered by changes of culture, the clinical symptoms, and the role of a traditional healer in her recovery. A speculative hypothesis concerning aetiology is suggested.

A case is described of anorexia nervosa arising in a mentally-handicapped 35-year old person with Down's syndrome. The late onset is accounted for on the grounds that adolescent challenges had only recently arisen in this instance. Removal of the patient from the provocative situation, coupled with some effective psychotherapeutic ‘grief work’ with the family, was associated with restoration of normal body weight and menstrual function, following the patient's acceptance of the usual re-feeding treatment programme.

The aim of the study was to discover the relative effectiveness of four methods of treating patients suffering from hyperventilation attacks. The methods used were: breathing and relaxation therapy, hyperventilation provocation training, treatment based on influencing the factors which lead to the development of the syndrome, and drug treatment. The first three methods were demonstrated to be effective, whilst the fourth showed no signs of effectiveness. The condition of patients in the control group remained the same or deteriorated.

The hypothalamic - pituitary - gonadal axis was evaluated in men with paedophilia and non-paedophilic paraphilia, and in normal male controls, by infusion of 100 meg. of synthetic luteinising hormone-releasing hormone (LHRH). There were no significant differences among groups in age, height, weight, testosterone, baseline luteinising hormone (LH) and follicle stimulating hormone (FSH), and FSH response to LHRH. However, there was a significant difference between the paedophilic group and the other two groups in the LH response to LHRH. The paedophiles responded with a marked elevation of LH, when compared with the non-paedophilic paraphiliacs and controls. These data indicate a hypothalamic - pituitary - gonadal dysfunction in paedophiles.

A case is described in which a diagnosis of paranoid schizophrenia was made using the criteria of Schneiderian first-rank symptoms. The patient showed the Capgras syndrome, with delusional misidentification of her son and other people in her environment, and also Ekbom's syndrome, with the delusion that she was infested with parasitic worms which migrated between various parts of her body. In this case, the two syndromes are descriptions of a specific delusional content, and occur as part of the psychopathology within a schizophrenic disorder, rather than as distinct disease entities.

Previous research has demonstrated a different psychophysiological response of schizophrenic patients depending on whether their key relative was rated high or low on Expressed Emotion (EE). A case assessment is described in which a young man suffering from schizophrenia, who lived with both a high EE and a low EE parent, was tested psychophysiologically in their presence using an ABAC design. The patient demonstrated a significantly higher amount of spontaneous activity in skin conductance level when the high EE parent was present. The high EE parent also demonstrated a greater perceived inability to cope, and a higher level of personal distress.

Serum immunoglobulins were quantified in 85 consecutively admitted patients from an acute-care psychiatric in-patient unit. The patients were diagnosed as: major depressive disorder, 53; chronic schizophrenia, 12; schizophreniform psychosis, 4; substance abuse disorder, 12; and miscellaneous other diagnoses, 4. A small sub-group of these patients, which included six with major depression, one with chronic schizophrenia, and one with a personality disorder, were found to have low IgM concentrations. Immunoglobulin levels were not associated with use of medication or length of illness prior to this hospital admission. This study provides further evidence for suppression of humoral immunity in some psychiatric patients (approximately 10%).

The definition and clinical aspects of rapid cycling affective illness are reviewed and various factors associated with the onset and maintenance of rapid cycling enumerated. On the basis of this information and of reports of the response of rapid cycling patients to various treatment interventions, an approach is suggested to the evaluation and treatment of rapid cycling affective illness.