‘KORO’ (head of turtle) or ‘suk-yeong’ (shrinking penis) names a symptom characterized by the belief that: 1. the penis is shrinking; 2. it will disappear into the abdomen; 3. it will cause death. It is usually accompanied by intense fear and by preventive manoeuvres such as tying or clamping or grasping the penis. It tends to be short-lived and may affect single individuals or groups.

A questionnaire was sent to 274 doctors and nurses. The first section was to see if certain symptoms and signs elicited the description of patients as ‘confused’, and the second to discover the respondents' definitions. The results showed a marked discordance in health workers' understanding of this word ‘confused’ in reference to patients, and it is suggested that it should only be used if it is clearly defined.

A retrospective study was carried out of 79 patients with subacute or chronic subdural haematomata. Forty-six (58.2%) had mental changes at admission which were categorised using DSM-III criteria. Delirium was the most frequent mental change, followed by dementia and coma. Three cases of organic affective syndrome were found. In those with mental changes, delirium was significant in older patients (P <.05) and coma in young patients (P <.001). Dementia was more common in the elderly. These findings confirm the presence of common mental syndromes in patients with subdural and haematomata and substantiate time-honoured clinical stereotypes.

Headache sufferers (n = 30) reported significantly more immediate family members with headache, compared to controls (n = 22). Sensitivity, specificity, and efficiency analyses revealed that knowledge of family headache history has predictive value. The results are consistent with findings with other pain disorders.

A successful preliminary trial of an inexpensive non-invasive method for detecting successfully administered electroconvulsive therapy is described.

‘Koro’ has been described as a culture-bound syndrome with localised depersonalisation confined to the penis, occurring in the context of a panic state with fear of impending disaster (Yap 1965,1969). Because ghosts are not thought to possess genitals, penile shrinkage is believed to be potentially fatal, with the risk that the victim will himself turn into a ghost. Until recently the syndrome was thought to be restricted to Southern Chinese emigres in Hong Kong and South East Asia. We wish to report two such cases, one in a West Indian and the other in a Greek Cypriot, admitted to Friern Hospital.

There is currently a great deal of interest in whether or not circadian rhythms are capable of explaining certain psychiatric phenomena. This short review will briefly explain the concept of endogenous circadian rhythms and then go on to describe some of the attempts to relate this to psychiatry. It is not possible to give a complete discussion in the space available and interested readers are referred to two recent texts on circadian rhythms (Wever 1979, Minors and Waterhouse, 1981). The psychiatric aspects have been reviewed by Sampson and Jenner (1975).

It has often been said—though sometimes tongue-in-cheek—that there is as much to be learnt from great works of literature about the malfunctioning of human thoughts and feelings as from the standard textbooks of psychiatry. This obviously over-simplifies the situation; very much more of psychiatric interest will be found in classic writings by one who knows what he is looking for, through knowledge of the discipline's basic texts. But it is true enough to make the ever-increasing emphasis on scientific and technical information in psychiatric training a matter of some regret. What shall it profit us, in trying to help patients, if we know more and more biochemistry and pharmacology, but at the same time lose the insight that artists and writers have recorded over centuries about the human condition?

Jerome Frank, notable psychotherapy researcher, emeritus Professor of Psychiatry at Johns Hopkins and persistent campaigner for nuclear disarmament published the first edition of Persuasion and Healing in 1961. The revised edition, extensively re-written, and the focus of this appraisal, came out in 1973.