A Western psychiatrist visiting a ward, out-patient department, or sheltered workshop in China would find much that was familiar, not only in terms of clinical syndromes and medication usage but also in the paucity of resources, problems with administrative hierarchies, and lack of status accorded by medical colleagues to psychiatry. Chinese psychiatric patients able to converse with their Western counterparts would discover that they shared much of the experience in common: stigma, problems with employment, and difficulties in finding a marital partner. Patients' relatives from East and West, likewise, would be able to recite a litany of similar concerns and complaints: the need for guidance and advice in handling disturbed behaviour at home, the gossip of neighbours, and the fear of another relapse.

The majority of men convicted of manslaughter by reason of diminished responsibility used to receive hospital orders, but are now receiving prison sentences. A sample of offenders convicted between 1966 and 1977 was studied to see the reasons for the change. It was found that the make-up of the offender population did not change materially over the period, nor did the willingness of judges to make hospital orders. What changed was the pattern of treatment recommendations made by the examining doctors in their court reports.

Multiple tics appear in the population with a frequency estimated at from 1 in 1,000 child psychiatric out-patients (Lucas et al., 1967) to 1 in 12,500 out-patients (Ascher, 1948). The incidence of XYY karyotype is about 1.24 per thousand males (Nielsen and Christensen, 1974). The occurrence of multiple tics with vocalization in a patient with the XYY chromosome constitution strongly suggests that the extra chromosome promotes neurological abnormality.

Six cases are reported in which the bereaved kept the deceased's body for periods ranging from one week to ten years.

Some relevant anthropological and psychoanalytical observations are discussed. This phenomenon does not appear to have been reported in the literature of Western psychiatry.

Ketamine therapy for treatment-resistant depression in European national health systems may only be considered after attempting all evidence-based antidepressant strategies outlined in clinical guidelines. This paper seeks to explain the ethical, regulatory and procedural framework for the off-label use of ketamine for treatment-resistant depression within a public healthcare system.

The time course of clinical improvement was studied in 41 schizophrenic and schizoaffective acute in-patients treated for 28 days with 10, 20 or 30 mg/day of oral fluphenazine hydrochloride in a double-blind, randomised study. Significant improvement was seen in the four BPRS factors: thinking disturbance, hostile-suspiciousness, withdrawal–retardation and anxious depression. The first two of these factors were improved by day 5. Significant improvement was seen up to day 22 for three of the four factors, but without significant improvement during the last week (although scores continued to drop). The half of the sample showing greater overall improvement did not improve faster than the sample as a whole. These more improved subjects did not differ significantly from the less improved subjects in the thinking disturbance factor until day 15, suggesting that at least a two-week neuroleptic trial would be necessary to begin to differentiate more and less responsive patients. The longer-term course of improvement cannot be determined from these data. The withdrawal–retardation and anxious depression factors showed their greatest improvement later than the ‘positive’ symptom factors, suggesting that the former may improve as a result of change in the latter.

The differential diagnosis of a presenting symptom is usually to be found as a section of an article on a disorder in which the particular symptom is common. Thus one learns a great deal about the widely different pathological processes responsible for epigastric pain in a description of peptic ulcer, and much about headache in descriptions of cerebral tumour or migraine. Amnesia is peculiar in this respect in that succinct expressions of its differential diagnosis are rarely found in the description of individual disorders.

Electronic monitoring has been used in criminal justice and some health settings for three decades. Technological interventions are becoming more common in psychiatry, but may be a cause for ethical concerns and controversy. We discuss electronic monitoring as an aid to security and public safety in a forensic setting.

Forty depressed in-patients for whom electro-convulsive therapy had been prescribed were rated before treatment on depression and anxiety scales. Side effects, post-operative agitation and retrograde memory impairment were assessed in each patient after each of several treatments. Results were compared when no tranquillizer was given and when either diazepam or haloperidol was administered intravenously immediately before the anaesthetic. It was found than when ECT was given without tranquillization, the incidence and severity of post-operative agitation and of side effects were significantly greater in those patients with a high level of anxiety before treatment. Both diazepam and haloperidol were found to be effective in subduing agitation and side effects in anxious, depressed patients, but with diazepam recovery time was longer.

This notice describes a correction to the above mentioned paper.

Attempts to define selective serotonin reuptake inhibitor (SSRI) withdrawal with the term ‘discontinuation syndrome’ are not supported by evidence. Acknowledging that SSRI use can result in dependence and withdrawal allows patients to be better informed around decisions related to these drugs, and helps inform strategies for safe tapering as appropriate.

Obsessional symptoms and depression often co-exist. There are obsessional neurotics who are subject to recurrent depressions, and there are patients with marked obsessional personality features, but not suffering from an obsessional neurosis, who develop severe obsessional symptoms in the course of their depressions only. I do not agree with those writers who maintain that the typical features of the obsessional character can be found in every case of manic-depressive illness.

In earlier articles from 1939, the results of treatment with amphetamine preparations have been discussed. In this paper, a comparison of the results of treatment by means of electric convulsive therapy with those from methyl-amphetamine will be made.

The concept of “orality” as used in this paper indicates a certain constellation of traits or habitual reactions which are, or are assumed to be, derivatives, whether direct or modified, of behaviour patterns characteristic of early childhood. The importance of the mouth as the first erotogenic zone and as the organ generating fundamental attitudes of giving or receiving, waiting or being impatient, and hoping or despairing, has been stressed by psychoanalysis. According to psycho-analytic theory, the oral phase, that is, the first period of libidinal development, plays a most important part for later character development in as far as gratification, or frustration, of the oral impulses is assumed to have a determining influence on character-formation in later life.

It is extremely befitting that this Association should be interested in the relation of chronic sepsis to mental disorders, principally for the reason that this idea had its origin in England. As early as 1875, Savage, the English alienist, reported the recovery of cases of mental disorder following the extraction of infected teeth. The full significance of this report, of course, was not realised at the time, for if it had been recognised, an entirely different history of the care and treatment of mental disorders during the last century would have been written.

This paper describes the phenomenology of depersonalisation and focuses upon the relationship between depersonalisation, self-perception and body image. In discussing this relationship, the influence of certain phenomenological philosophers will be considered. Theoretical discussion of depersonalisation will be limited to those theories that are relevant to the purpose of this paper. Comprehensive reviews of the wide range of theories held to explain depersonalisation have been provided by Sedman (1970) and Oberst (1983).

The recognition of a well-established psychosis due to arteriosclerotic or senile brain changes rarely presents any difficulty. However, increasing numbers of elderly people are seen with affective, paranoid, or neurotic manifestations, and it is sometimes very difficult to decide whether their symptoms present prodromata of an organic psychosis, or whether in the absence of degenerative brain disease they are occasioned by a variety of endogenous and environmental causes leading to a “functional” psychiatric illness.