A man presenting with factitious alcohol abuse and its alleged complications is described. It is argued that chronic factitious disorders are more logically viewed as part of that spectrum of conditions where there is abnormal illness behaviour, including somatoform disorders and other related conditions, than as separate nosological or diagnostic entities.

The literature on Werner's syndrome is scarce, and to our knowledge, no documented evidence is available to substantiate central nervous system involvement in this multisystem disease. We present a case of Werner's syndrome associated with recurrent delusional psychosis in the presence of cognitive impairment and computerised tomography (CT) radiological changes in the posterior cerebral cortex.

A case of colloid cyst of the third ventricle in a patient presenting with delusional depressive syndrome, in clear consciousness and with minimal cognitive impairment, is reported. The possible pathogenesis of the syndrome is discussed in the light of the reported association between aqueduct stenosis, diencephalic dysfunction, hydrocephalus, and psychotic symptoms.

A 38-year-old patient, who can give the day of the week of any day this century, is described. He is believed to have been autistic in early childhood. The relationship of the autistic child and the adolescent idiot savant is discussed and brief reference made to the patient's method.

The mortality of 99 long-stay psychiatric patients did not significantly increase after interhospital relocation. Preparation for the transfer, and the type of environmental change, seem to be important determinants of outcome in this and other studies.

Seventy-three out of a hundred Malaysians on phenothiazines for more than 24 months had ocular pigmentation. Seventy-one had conjunctiva pigmentation. No pigmentary retinopathy or visual impairment was detected. Frequency of pigmentation increased with age and with higher total dosage prescribed, but there was no critical level below which pigmentation was not detected.

A case of benign hereditary chorea is reported, along with a brief review of the condition. It is a rare and little known autosomal dominant disorder which may be confused with Huntington's chorea, which has a more serious prognosis. The case described shows some characteristic features. It is difficult to decide how many of the patient's psychiatric difficulties are a reaction to his disabilities and how many have an organic substrate.

A total of 328 patients were admitted for deliberate self harm (DSH) to the General Hospital Jaffna, Sri Lanka, during the year 1984. Twenty-two of these patients succumbed to their injuries. Information about these patients collected before death, and their methods of suicide, are reported.

Of 30 Saudi patients with social phobia, eight had echocardiogram evidence of mitral valve prolapse. Only two out of 30 controls had echocardiogram evidence of mitral valve prolapse. The clinical and research implications of this finding are discussed.

A retrospective case-note study of young women admitted for appendicectomy showed that in those patients who had a normal appendix removed, there was a significantly higher rate of admission for parasuicide, before and after the index admission; 27/184 (∼15%) compared with 17/368 (∼5%) for patients who had an inflamed appendix removed.

A case is reported of a severely depressed patient in whom treatment with electroconvulsive therapy was abandoned because of repeated failure to induce a convulsion. Reasons for the failure to convulse and alternative treatment approaches are discussed.

A case is described of a 21-year-old man who, after extensive investigations by the general physicians and neurologists, was transferred to a psychiatric hospital with a diagnosis of functional illness. The clinical picture at that stage simulated schizophrenia with prominent dysmorphophobic features. A diagnosis of subacute sclerosing panencephalitis was then made 9 months after the onset.

Recent work has demonstrated the coexistence of depressive illness in some patients with dementing disorders. Two cases of mixed depression and dementia showed behavioural and mood improvement after treatment with ECT, but without improvement in cognition. The role of ECT in the treatment of affective symptoms in dementia is discussed.