Five consecutive cases of the NMS are presented, in all of which a catatonic state preceded the onset of the condition. Catatonia would appear to represent a highly significant risk factor for the NMS and a possible causal link between the two disorders is suggested.

This case-note survey compares a group of Asian children referred to child psychiatry and guidance clinics in Bolton with a control group of white children referred to the same clinics. The proportion of Asian children was less than the proportion of Asian people in the general population. The proportion of Asian children coming from a broken home or a single-parent family was significantly lower than in the control group. Conduct disorders were more common in the control group and somatoform disorders were more common in the Asian group.

HLA status was asessed in matched groups of schizophrenics, 20 with and 20 without tardive dyskinesia. The antigen frequencies were also compared with that in a control sample. The anticipated excess of HLA-B44 was not confirmed. Pooled data displayed a shortfall of HLA-Cw7 and an excess of HLA-B44 in schizophrenics relative to population controls.

To our knowledge Pisa syndrome in childhood or adolescence has not previously been described. The syndrome developed in an adolescent girl following administration of neuroleptic medication for psychotic features, and was transiently thought to be abnormal illness behaviour. This case emphasises the need for early diagnosis and rapid effective treatment.

Mania secondary to advanced uraemia caused by polycystic disease of the kidneys in a 62–year-old woman involved a complex interplay of physical, psychological and social factors. Psychotherapy and thioridazine led to full recovery.

British Journal of Psychiatry (1991), 158, 119–121

The neuropsychiatric changes in a Chinese patient suffering from progressive supranuclear palsy led to a difficult diagnosis. Polysomnography revealed sleep fragmentation and central apnoea.

A case of psychogenic amnesia in a 58-year-old man supports the view that complete loss of personal identity can follow a traumatic experience. He regained his memory by being helped to develop an affective link with the painful event.

The association of a puerperal psychosis with the removal of a trophoblastic tumour supports the hormonal hypothesis for the aetiology of puerperal psychosis and suggests new lines of investigation into this disorder.

British Journal of Psychiatry (1991), 158, 122–123

A woman with pituitary microadenoma presented with panic attacks. This case illustrates the need both for routine medical screening of psychiatric patients and for psychiatrists to remain aware of the clinical features of medical syndromes.

Dramatic response of major (psychotic) depression to verapamil in an 82–year-old woman suggests that further study of the use of the drug in affective disorders is required, particularly in the light of a possible aetiological role for calcium.

British Journal of Psychiatry (1991), 158, 124–125