The 1 mg dexamethasone suppression test (DST) was carried out in patients with a major depressive illness in order to establish whether the results of this test, given before antidepressant or ECT treatment, could predict eventual therapeutic outcome. No significant difference could be detected in overall therapeutic improvement between those patients with a normal or abnormal DST response respectively, based on the 50 ng/ml cortisol cut-off point. However, using 100 ng/ml as a cut-off point it was found that patients with an abnormal DST response (i.e. a post-DST plasma cortisol concentration ⩾ 100 ng/ml) responded significantly better than those who had a normal DST response. These observations were statistically significant for those patients receiving antidepressants and in the combined treatment groups of those patients receiving either antidepressants or ECT.

This 18 month prospective study assessed the time course of sleep disturbances in 85 male psychiatric out-patients and 103 male non-patients. Over one-third of the patients and 5 per cent of the non-patients reported frequent symptoms of insomnia during at least 14 of the 18 months. Frequency and chronicity of insomnia were strongly associated with intensity of psychiatric symptomatology, but not with diagnosis. Minor tranquillizers and hypnotics were used frequently by patients and occasionally by non-patients, but there was little indication that they altered the course of insomnia.

Sleep-walking, which is a fairly frequent symptom in children, is less common in adults, and, though fascinating, this subject has not yet received as much attention as its importance deserves. In the Text-Book of Medicine edited by Price there is no mention of this symptom. In the medical and legal literature one often comes across the same case-histories quoted by successive writers, some of whom consider somnambulism a hysterical dissociated state, while others maintain that it is an epileptic phenomenon. A correct diagnosis is essential not only for the purpose of treatment, but also for assessing criminal responsibility. Unfortunately, the features stated to be characteristic of somnambulism would seem really to be due to more than one condition.

Oxygen saturation was measured during anaesthesia and electroconvulsive therapy (ECT) using ear oximetry. Significant hypoxia occurred during some treatments; desaturation related to the number of ventilations performed after muscle relaxation and prior to the shock. Desaturation did not correlate significantly with seizure duration. These findings highlight the need for adequate oxygenation during ECT.

The study tested Bowlby's hypothesis that experiencing the poor relating of parents in childhood predisposes the individual to poor relating in adult life. Data were drawn from two community samples: a younger sample of 25–34-year-old married women, and an older one of 40–49-year-old women. Data were also drawn from the husbands of the women in the younger sample. It focused on the single childhood variable of the recollection of poor maternal care. To avoid the effect of this on depression or other psychopathology, groups who were depressed and not depressed, or who were at different levels of psychopathology, were examined separately. Recollection of poor early care was associated with poor relating, lower age at marriage, poor-quality marriage and divorce from first marriage. There was a suggestion that the effects of the recollection of poor early care of marital partners summate.

Our aim was to investigate whether there is a season-of-birth effect in anorexia nervosa. In a meta-analysis, we compared the distribution of anorexia births (n = 1293) from four independent UK cohorts to that of the general UK population (n = 21 914 037), using both the Walter & Elwood seasonality and chi-squared tests. We found an excess of anorexia births from March to June (odds ratio (OR) = 1.15, 95% CI 1.03–1.29, P = 0.012) and a deficit from September to October (OR = 0.8, 95% CI 0.68–0.94, P = 0.007). These results indicate that environmental risk factor(s) are operative during gestation or immediately after birth and their identification will be important for disease prevention strategies.

Positron emission tomography (PET) differs fundamentally from computerised tomography (CT) and magnetic resonance imaging (MRI) in that it is a method for measuring function as opposed to structure. It is the most powerful tool available for the measurement of in-vivo brain function. This review describes the basic principles of the technique and its application to the study of brain metabolism in neurological and psychiatric disorder. The development of resting-state metabolic studies by the application of specific activation paradigms, a major current focus of the technique, is discussed.

Diet has been associated with behavioural problems, including aggression, but the long-term effects of childhood diet on adult violence have not been studied. We tested the hypothesis that excessive consumption of confectionery at age 10 years predicts convictions for violence in adulthood (age 34 years). Data from age 5, 10 and 34 years were used. Children who ate confectionery daily at age 10 years were significantly more likely to have been convicted for violence at age 34 years, a relationship that was robust when controlling for ecological and individual factors.

Proposals by psychiatrists to reclassify conversion disorder in DSM-5 and ICD-11 are proving difficult and controversial. Patients with conversion disorder usually present initially to neurologists, who often use different concepts and terminology. History and clinical practice suggest that the way forward is to seek agreed principles and a common understanding between the two disciplines, preferably in a single universal classification.

How to respond optimally following traumatic events remains a Holy Grail. A number of early interventions lack evidence of effect. Practical, pragmatic support provided in an empathic manner is likely to be an appropriate initial response and complement the high levels of resilience shown by individuals exposed to traumatic events.

The only papers dealing with latah, with which I am acquainted, are a brochure by Mr. H. O. O'Brien, of the Straits Settlements Civil Service, published some years ago in the Asiatic Journal, and a short notice by Dr. A. M. Browne, of Sydney, published in the Provincial Medical Journal, 1887; though the Miryachit of the Siberians and Lapps, the jumping disease of America, and the Bah-tschi of the Siamese, diseases allied to, if not identical with, that which forms the subject of this essay, have been all fully described. Quite recently, and since I had begun to put these notes together, Dr. Van Brero has written a paper on the subject; and Mr. F. A. Swettenham, the British Resident of Perak, has published a book called “Malay Sketches” in which there is a chapter on latah, dwelling principally on the humorous side of the question as it appears to bystanders. Mr. Swettenham likens latah to cases of hypnotism shown him in one of the Paris hospitals.