In 1978, William Alwyn Lishman's Organic Psychiatry: The Psychological Consequences of Cerebral Disorder was published, fostering the development of neuropsychiatry and leading to the recognition of Lishman as the father of neuropsychiatry. This article is a narrative account of his personal struggles, as well as conceptual dilemmas he dealt with while writing this book, and how through its four editions it has evolved to become an anchor for psychiatrists as they seek to develop understanding of the workings of the brain, and a beacon for them when they discuss clinical implications of diagnosis with patients and families.

Lunatic Asylums, published 130 years ago, is a fascinating insight into how these institutions were managed in the late Victorian era. This brief article considers what it reveals about the zeitgeist of the time and the book's author, the remarkable Charles Mercier.

Personality disorders can worsen with age or emerge after a relatively dormant phase in earlier life when roles and relationships ensured that maladaptive personality traits were contained. They can also be first diagnosed in late life, if personality traits become maladaptive as the person reacts to losses, transitions and stresses of old age. Despite studies focusing on late-life personality disorders in recent years, the amount of research on their identification and treatment remains deficient. This article endeavours to provide an understanding of how personality disorders present in old age and how they can be best managed. It is also hoped that this article will stimulate further research into this relatively new field in old age psychiatry. An awareness of late-life personality disorders is desperately needed in view of the risky and challenging behaviours they can give rise to. With rapidly growing numbers of older adults in the population, the absolute number of people with a personality disorder in older adulthood is expected to rise.

Clinical guidelines recommend avoiding the use of medications to manage personality disorder. In clinical practice, however, substantial amounts of medication are used. In this article, we summarise the recommendations of guidelines published in various countries in the past 15 years. We review the evidence from randomised controlled trials and recent reviews, discuss the discordance between guidance and clinical practice and give recommendations on what a clinician should consider if they choose to prescribe in cases of severe disturbances in mood or behaviour despite the lack of evidence.

The large volume of seemingly conflicting guidance on the management of borderline personality disorder (BPD), combined with the ongoing shortage of specialised resources, can make the task feel like an exclusive undertaking that the general psychiatrist is underprepared for. In this article, we distil current evidence to submit that sound psychiatric management principles used to treat all serious and enduring mental disorders (diagnostics, comorbidity management, rational pharmacotherapy and dynamic risk management) are readily applicable and particularly therapeutic for BPD. We offer actionable practice guidance that we hope will render the clinical management experience a more lucid and rewarding one for both practitioner and patient.

John Thomas Perceval (1803–1876) was confined first to Dr Fox's private madhouse (asylum) in 1830 and transferred to Mr Newington's madhouse at Ticehurst, Sussex, in 1832 until his release in 1834. His account of his incarceration and treatment was published in two versions, the first in 1838 and the second in 1840. In this article I describe Perceval's psychosis, his treatment and management at Dr Fox's madhouse and his reforming and advocating contributions to psychiatry in the period following his release.

The Bell Jar (1963) is a semi-autobiographical novel written by the confessional poet, novelist and short-story writer Sylvia Plath (1932–1963). It has been often cited as a recommended reading within the medical humanities, because of its powerful description of depression and the understanding-by-experience of the related psychiatric treatments. This brief article, primarily directed at the clinically oriented reader, presents a selection of excerpts from The Bell Jar to illustrate the main diagnostic features of clinical depression and the vital role of therapeutic relationship quality in hindering or facilitating treatment outcomes and recovery.