Only around 300 cases of the Capgras syndrome have been reported in the medical literature. We report a widely read but scientifically neglected case of a mad scientist who showed this misidentification syndrome with classical and potentially dangerous features. The current literature on the psychopathology and neuropsychology of the Capgras-syndrome is briefly reviewed and discussed in the light of this new case.

In the psycho-geriatric field there is great concern that as the number of elderly people in the population rises so the number of those suffering from dementia will increase. Services are already stretched and innovatory changes are needed to ensure that this large group of people receive adequate care.

Community support teams are an important component of services for the chronically mentally ill who do not need to remain in hospital. In the autumn of 1989 the Department of Psychiatry in Central Manchester established a small team with a remit to develop such a service. The team is made up of four nursing staff (a charge nurse, staff nurse, SEN and a nursing auxiliary) with additional support provided by two occupational therapists, a clinical psychologist, consultant psychiatrist and senior registrar in rehabilitation psychiatry. This paper will briefly describe some of the experiences and problems that the service has encountered so far and some of the solutions that have been explored.

Regional secure units are a relatively new facility for the treatment of mentally disordered offenders and difficult to manage patients. Their role is still evolving. Previous studies have described details of referrals and admissions to such secure units (Higgins, 1981; Gudjonsson & Mackeith, 1983; Offen & Taylor, 1985; Faulk & Taylor, 1986; Bullard & Bond, 1988). To date, however, no studies have examined changes of practice in RSUs over time. The purpose of the present study is to examine changes in the admission characteristics of patients admitted to the Butler Clinic, regional secure unit for Devon and Cornwall since it opened in 1983 to the present time.

Experience of being resident on-call is common to all practitioners who have worked through the training grades. Other professions have their lean years while in training, for example the apprentice years in the law profession or the junior financial executive's commitment to his company, but being resident on-call in a place of work, ready to deal with any emergency for a significant fraction of one's waking and sleeping life, is peculiar to the junior grades in the medical profession. Judging by the opinions expressed by my colleagues, all registered practitioners are united in having experience of being on-call and finding it to some extent irksome. Part of the problem lies in having to do long periods of overtime for reduced rates of pay, often in delapidated surroundings when one could be more enjoyably occupied elsewhere. Most people decide that the benefits of serving the prescribed training period in the junior grades to become vocationally trained general practitioners or members of one of the Royal Colleges outweighs the short-term discomfort. In this paper I examine the experience of ‘being on-call’, working through the different aspects. I argue that the irksomeness of the experience may derive in part from the echoing of unconscious conflicts.

Mental hospital closure and the resultant discharge of patients with chronic psychiatric disabilities into the community has led to public concern (Wallace, 1989). Currently it would seem important to collect as much pertinent data as possible on all aspects of mental hospital closure and the resultant effects on patients and communities. This study focuses on a relatively neglected area in the research literature on community psychiatry and mental health planning, i.e. the opinions of the consumers.

Trainees beginning their careers in psychiatry sometimes view research as an additional hurdle that they have to surmount in order to gain senior registrar or consultant status. Conversely, research enthusiasts may see research as an exciting and rewarding activity which enriches and informs clinical practice. The aim of this article is to strike a balance between these two divergent views to help trainees in their selection of the research option most suited to their temperament and aspirations. As a result of our own experiences of full-time and part-time research, in addition to research conducted during full-time clinical posts, we intend this article to be practically rather than theoretically orientated.

A month's residence in an elegant stately home, situated among the manicured lawns and gardens of 150 acres of parkland, sounds ideal; when allied with comfortable accommodation, delicious food and thoroughly professional service, it sounds idyllic. When it is being paid for by Kenneth Clarke, it becomes irresistible.

During registrar training I had the privilege of working in the interim secure unit at Friern Hospital in London. To gain further experience in the field of forensic psychiatry, I secured (if that is an appropriate term), a post as trainee psychiatrist at James Nash House, centre for forensic psychiatry, Adelaide, South Australia. This article compares the legal and health care frameworks in England and South Australia relevant to mentally abnormal offenders. The two units are described and differences in facilities, patient populations and working practices are discussed.

This speciality is concerned with the psychiatry of patients whose development of intelligence has been impaired.

The practice of out-patient psychiatry has undergone a number of significant developments in recent years: the number of patients referred by general practitioners has steadily increased: a large number of psychiatrists are now seeing patients in the primary care setting and more patients are being seen on one occasion only.

Health and social care in Britain is undergoing the most profound changes in its structure and organisation since its inception (Griffiths, 1988); indeed, some would argue that it is about to change beyond recognition. The purpose of this article is to describe contemporary developments in the delivery of such services in the USA. Given that many of the political changes here have been directly influenced by thinking and practice in that country, it is argued that there are two important lessons to be learnt. The first concerns the coordination of service delivery between different agencies, the second involves an emphasis on the delivery of acute and rehabilitation services in the community. In short the traditional distinctions between the two would be blurred.

Mark Jones continues this occasional series by examining Verdi's Macbeth of 1847 in the light of David Pountney's new production for the English National Opera premiered at the London Coliseum in April.

The ten year period 1840–1850 saw the appearance of ten operas by the young Giuseppe Verdi which now constitute his ‘early’ musical output. Not all the operas were equally successful and Verdi later acknowledged their inconsistencies; but here was the work of a genius who was to become the greatest composer in the Italian tradition, and at this time was thought of as a worthy successor to Rossini, Donizetti and Bellini.