A field study of 14 treatment centres found broad agreement between clinical practice and the Royal College of Psychiatrists' Memorandum on the use of ECT. Differences in electrode placement and anaesthetic agents and a poor standard of safety and reliability in the electrical equipment was noted.

Clozapine-induced agranulocytosis is usually reversible after discontinuation of the drug. A patient who developed agranulocytosis after termination of clozapine therapy responded to treatment with granulocyte macrophage colony stimulating factor.

The nature of causal explanation remains a conceptual difficulty for psychiatric research. Most research workers and clinicians can describe their processes of causal inference with reference to some empirical example close at hand. Yet such demonstrations are themselves based on more fundamental abstract models that are themselves left unstated. Psychiatric classificatory schemata presently used in research possess unwritten, underlying assumptions regarding causality, and these assumptions need examination.

‘As for the bodily temper of man and his Brain… a very little distemper of the brain… is enough to represent Spirits, Angels and Devils, Sights and Stories of Heaven and Hell to the Fancy… which sober kind of madnesses and delineation (is) little understood vulgarly’.

The object of this paper is to consider the proposition that some kinds of critical change in a person's life experience bring about a change in his sense of identity which is not subjectively recognized and acknowledged until between one and two years after the critical event or initiation of the critical change.

This study concerns the scores on a questionnaire measure of ‘Psychoticism’ of patients with a diagnosed psychotic illness.

Eysenck (1952) postulated the existence of three main dimensions of personality—Extra-version, Neuroticism and Psychoticism. The label ‘Psychoticism’ as used to suggest the hypothesis: ‘that there exists a set of correlated behaviour variables indicative of predisposition to psychoticbreakdown, demonstrableas a continuous variable in the normal population and independent of E and N (Eysenck and Eysenck, 1968a). Psychotically ill patients are held to mark the extreme end of this dimension.

The psychiatric community seems determined to ground its medical legitimacy on principles that confuse diagnoses with disease. If mental illnesses are diseases of the CNS, they are diseases of the brain, not the mind. If mental illnesses are the names of (mis)behaviour, they are forms of behaviour, not diseases. Psychiatric metaphors have the same role in medicine as religious metaphors have in theology. Religion is, among other things, the institutionalised denial of a finite life. Psychiatry is, among other things, the institutionalised denial of the tragic nature of life: individuals who want to reject the reality of free will and responsibility can medicalise life, and entrust its management to health professionals. Psychiatrists have succeeded in persuading the scientific community, the courts, the media, and the general public that the conditions they call mental disorders are diseases, that is, phenomena independent of motivation or will. The more firmly psychiatrically based ideas take hold of the collective American mind, the more foolishness and injustice they generate. Long ago, the law makers agreed to let psychiatrists literalise the metaphor of mental illnesses. Thus, the Americans With Disabilities Act (AWDA), scheduled to be fully implemented by July 1992, covers claustrophobia, personality problems, and mental retardation, though unlike DSM–III–R it excludes kleptomania, pyromania, compulsive gambling, and transvestism. The literal language of psychiatry allows motivated actions to be called ‘diseases'. Other examples of behaviour for which psychiatrists have disease names, and which AWDA implicitly accepts as genuine diseases, include dysmorphophobia, multiple personality disorder, frotteurism, hypoactive sexual desire disorder, and factitious disorder with physical symptoms. However, it remains an open question whether premenstrual syndrome will achieve similar recognition in DSM–IV. Diseases occur naturally, whereas diagnoses are artefacts; why do psychiatrists make diagnoses?

We report cognitive performance of a group of individuals who are likely to have transmitted liability to psychosis to their offspring. Out of 230 relatives of patients with psychosis, 27 met our criteria for a presumed obligate carrier, that is a non-psychotic individual who had a parent or a sibling as well as an offspring with psychosis. The presumed obligate carriers showed impairments in verbal memory and in visuospatial manipulations, suggesting that these individuals transmit vulnerability for psychosis to their offspring in terms of a disability to recall verbal information and an impaired capacity to perceive spatial relations.

Today, even long-retired psychiatrists are unlikely to recall having seen more than some occasional cases of syphilis-induced paralytic dementia. But not many generations earlier, ‘general paresis of the insane’ accounted for some 10% – even as much as a third – of the admissions to mental hospitals in Europe and the USA. All that began to change on the day in August of 1909 when Paul Ehrlich fired the first ‘magic bullet’.

Administration of moclobemide – a relatively short-acting, reversible inhibitor of monoamine oxidase-A (MAO-A) – to experimental animals potentiates the pressor responses to intravenously injected tyramine, but such effects are moderate, short-lived, and much less apparent when the tyramine is given orally. The ability of moclobemide to potentiate the pharmacological actions of amine substrates for MAO-A in in vitro preparations is very weak, unless the drug is ‘activated’ by prior incubation with the tissues. However, animal experiments, both in vitro and in vivo, can give realistic indications not only of the mode of action of inhibitors of MAO and any toxicity, but also, in the case of MAO inhibitors, of the chance of potentially life-threatening hypertensive crises following inadvertent ingestion of amine-containing food or medicaments. Animal tests may also reveal any influence MAOIs have on amines released from non-neuronal stores.

Until recently, it was considered that Down's syndrome precluded a diagnosis of mania, or gave rise to an atypical presentation. There have been seven case reports of mania in people with Down's syndrome and all these cases are reviewed. The clinical features of mania are noted to be similar to those previously described in individuals with learning disabilities due to other causes. However, all reported cases are male and none has a family history of affective disorder. In two of the seven men reported, the illness followed a rapid cycling pattern. Hypothyroidism and monoamine biochemistry in people with Down's syndrome are discussed in the context of these atypical features.

On Tuesday 10 June 1975 G.M.B. was convicted at Bristol Crown Court of the murder of a young woman and sentenced to imprisonment for life.

A masked analysis of videotaped assessments of people at high genetic risk of schizophrenia revealed that those who subsequently went on to develop schizophrenia used significantly more second-person pronouns. This was evident before diagnosis, at two separate assessments approximately 18 months apart. This supports the view that people who go on to develop schizophrenia may have an abnormality in the deictic frame of interpersonal communication – that is, the distinction between concepts being self-generated or from elsewhere may be blurred prior to the onset of a diagnosis of schizophrenia.