Objectives: The objectives of this paper are to review the presentation of hyponatraemia and diagnose its cause in psychiatric inpatients.

Method: Episodes of significant hyponatraemia (sodium <130mmol/L) were identified from computerised biochemical data and a retrospective review of patients' notes was carried out.

Result. The diagnoses of hyponatraemia reached were different for the two groups of patients studied, adults of over 65 years and under 65 years. Carbamazepine, polydipsia and medical conditions were found as causes in the below 65 age group. Diuretics, medical conditions and lofepramine were identified as causes in the over 65 age group. Inpatients with polydipsia below the age of 65 had lower sodium (p = 0.013) and urea levels (p = 0.00059) than other groups and patients with carbamazepine induced hyponatraemia tended to have episodic hypocalcaemia (p = 0.056). These groups were compared using Fisher's exact test. This study also showed the overall frequency of serum sodium of less than 135mmol/L to be 9.5% in psychiatric inpatients.

Conclusion: Hyponatraemia is a not uncommon finding in psychiatric inpatients. Attention to drug therapy and biochemical findings are helpful in its diagnosis. Accurate diagnosis is usually possible and may vary according to age-group.

Objective: This study aims to determine if there is a relationship between antenatal depression and maternal depression in the following three to four years. Secondly, to establish if there is a relationship between maternal depression and behavioural problems with the pre-school child. Thirdly, to investigate if social parameters are correlated with maternal health and childhood behaviour.

Method: In a longitudinal study, a sample of women were screened for depression at the antenatal stage and followed up four years later. Mothers were screened for depressive illness on both occasions. Children's behaviour was assessed at four years. Social parameters were also measured at the pre-school stage.

Result: Depression at the antenatal stage was not found to be significantly related to depression at the pre-school stage. The existence of a behaviour problem was not significantly related to the depressive state of the mother antenatally, however a currently depressed mother is approximately six times more likely to have a child with behaviour problems than a mother who is not depressed. Social factors were also assessed and found to correlate with maternal depression.

Conclusion: In managing a child with behavioural problems the child psychiatrist should consider the mental state of the mother. The social world of the individual would appear to be important and should not be ignored when treating either a child with behavioural problems or an adult with depression.

Objective: To clarify the effect of age on behaviour disorders in adults with learning disabilities, and the differentiation of behaviour disorders from other psychiatric disorders.

Method: Detailed assessments, measuring maladaptive behaviours, psychiatric disorders and demographic factors were completed on 93.7% of all people with learning disabilities aged 65 years and over, living in Leicestershire, UK (n = 134), and also a random sample of adults with learning disabilities aged 20-64 years (n = 73). Behaviour disorders were distinguished from other psychiatric disorders. Descriptive and inferential statistics were calculated.

Result: Equal rates (15%) and types of behaviour disorder were found in the two groups. The presence of behaviour disorder was associated with the severity of learning disabilities, but age was not associated, and nor was presence of epilepsy or gender. In many cases, positive scores on the behavioural assessment, which carers attributed to challenging behaviour/ behaviour disorder, were actually symptoms of psychiatric illness.

Conclusion: Behaviour disorders persist into old age, and therefore require management from the appropriate services. This need will increase, due to increasing lifespan. The accurate interpretation of behaviour scales requires that a comprehensive psychiatric assessment is also undertaken, particularly in elderly people where rates of psychiatric disorders are higher than for younger adults.

Objective: To explore the relationship between social skills and depressive symptoms in a normal young adolescent population.

Method: An all male group of 85 schoolchildren, in the first year of secondary school, completed self-report instruments to measure the constructs of depression and of social skills. The Depression Self-Rating Scale (DSRS) and the Matson Evaluation of Social Skills with Youngsters (MESSY) were the instruments used.

Result. Regression analysis of the factor scores on the MESSY and the total score on the DSRS revealed a significant, negative relationship. This was particularly so for the jealousy/withdrawal factor (Factor V) on the MESSY (f = 27.323; p < 0.001)

Conclusion: The data provide support for the social skills deficit model of depression and indicate the possible role of fostering pro-social behaviours and promoting social skills enhancement in the vulnerable young adolescent.

Objective: To examine the phenomenology of erotomania and to discuss the relevance of its classification into primary and secondary forms.

Method: Two case reports are presented. Both were female, non-Irish nationals who travelled to Ireland expressly to pursue their objects, who were both members of an internationally famous rock band. Case 1 and Case 2 are presented as primary and secondary erotomania, respectfully.

Result: The difficulty in distinguishing primary from secondary erotomania is discussed; the modern literature is referred to, which appears to be divided about the status of the primary form of this disorder as a distinct entity.

Conclusion: Until further advances are made in elucidating mental disorders, diagnosis will remain symptom-based, leaving diagnostic formulations somewhat over-crowded with syndromes of undetermined aetiology. Such is the case with erotomania.

The social, personal, occupational and domestic deficits of schizophrenia are well known. Perhaps it has not been emphasised sufficiently that people suffering from schizophrenia also have an increased mortality. It is important to recognise that suicide is the commonest form of death among both male and female schizophrenics and occurs in 10%-15% of cases.

Interest in the psychiatric aspects of old age predated the institution of geriatrics as a clinical discipline, but the systematic study of the ageing brain only began in the second half of this century when an ageing population presented a global numerical challenge to society. In the senescent cerebral cortex, though the number of neurons is not reduced, cell shrinkage results in synaptic impoverishment with consequent cognitive impairment. Recent advances in imaging techniques, combined with burgeoning knowledge of neurobiological structure and function, have increased our understanding of the ageing processes in the human brain and permit an optimistic approach in the application of the newer insights into neuropsychology and geriatric psychiatry.

Clozapine has become a widely used drug in therapyresistant schizophrenia and, increasingly, in the levodopa-induced dyskinesias and the psychoses of chronic Parkinson's disease. We report the case of a 43 year old male patient who developed a reversible encephalopathy associated with clozapine therapy.

We report the case of a patient with unilateral left-sided auditory hallucinations in association with a left middle ear infection, who in addition demonstrated a symptom of passivity, attributing the infection to the actions of a voice. The case demonstrates the potential for complex interplay between physical and mental pathology.

Prader-Willi syndrome is a genetic illness associated with a defect on chromosome 15. It presents with hypotonicity in infancy followed by voracious appetite and gross obesity from early childhood and with a range of other clinical and behavioural sequelae. This case report is of an adolescent boy who was admitted to a psychiatric unit for an intensive behavioural programme to control his weight gain and deal with associated behavioural problems, and demonstrates that an inpatient programme can lead to sustainable improvements in weight control and other indicators of well-being in PWS patients.

A case of alcoholic hallucinosis with vivid visual hallucinations is presented. The relevant literature is briefly reviewed with reference to the aetiology of this condition.