Plasma renin activity (PRA), aldosterone (aldo) levels, electrolyte levels, and blood pressures were measured in 16 patients with affective disorders taking lithium prophylactically, and in 16 age and sex-matched control subjects. PRA and aldo levels were significantly elevated in the lithium-treated group. There was no difference between the groups in plasma electrolytes or erect and supine blood pressures, arguing against secondary aldosteronism. In the lithium-treated group, there was a significant positive correlation between both PRA and plasma aldo vs serum lithium. We postulate that lithium inhibits the action of aldosterone on the distal tubule in the kidney. Activation of the renin angiotensin system maintains normal blood pressure and plasma electrolytes.

Neurophysiological studies of experimental pain were carried out on two severely depressed patients who complained of an inability to experience emotion. They had normal thresholds for stimulus appreciation but markedly increased thresholds for pain. These abnormal pain thresholds normalized with clinical recovery.

A variant of the Capgras syndrome is described in a 43-year-old woman who had vitiligo and multinodular goitre. The unusual feature of the case was that the patient not only misidentified members of her own family but also claimed that she herself had been replaced by a double.

A patient who had experienced most of the standard methods of managing alcohol abuse found that during 11 years of treatment, the most consistently effective intervention has been the taking of disulfiram under family supervision. He has received 600 mg daily almost continuously for over six years without side-effects. Smaller doses do not have an adequate deterrent effect.

British Journal of Psychiatry (1993), 163, 687–689

Psychiatric disorders in a sample of spouses of probands with recurrent Primary Affective Disorders (PAD) and in their first degree relatives were evaluated and compared with those in the spouses of control subjects without psychiatric illnesses. No differences were found in the risk for PAD, but spouses of PAD patients and their respective first degree relatives manifested a greater incidence of affective spectrum disorders.

Eighty opiate takers attending a Scottish drug dependence clinic were studied on a number of characteristics. The more recent attenders since 1981 were younger but otherwise not different from longer-term attenders. Recent young heroin abusers may not be seeking treatment from the drug clinic.

Using a classical click/flash paradigm, the CNV was recorded from the following three groups of subjects at Broadmoor Hospital: (1) 14 ‘psychopathic’ patients selected by use of the 4/9 MMPI profile and confirmed by independent clinical diagnosis; (2) 15 ‘non psychopathic’ patients, all psychotic and mainly schizophrenic; (3) 14 healthy staff control subjects. All three groups were matched for age and sex; the two patients groups were also matched for length of stay. Two series of 32 paired stimuli were used, separated by an interval of 30 minutes. The mean CNV voltage was significantly lower in the ‘non-psychopathic’ patients. The amplitude of the ‘psychopath's' CNV response did not differ significantly from that of the staff controls, but the response variability between the first and second series of trials was much greater in the ‘psychopathic’ patients than in the other two subject groups. The ‘psychopathic’ subjects tended to show more rapid initial development of the CNV.

A 19-year-old woman, blind since birth, lost 26 kg over a 7-month period. This was achieved by restriction of food intake, excessive exercise, laxative abuse, and self-induced vomiting. Although the visual experience is often believed to be an integral component of body-shape perception and the overvaluation of thinness in contemporary society, it does not preclude the development of anorexia nervosa.

The Ganda are the most numerous tribe in Uganda. They live around the capital, Kampala, along the north-west shore of Lake Victoria and up to 50 to 100 miles inland. They are a Bantu-speaking people, surrounded by other Bantu to the east, west and south, with Nilotic people to the north.

Seven out of twelve patients with malignancy and hypercalcaemia had associated psychiatric symptoms. The mental aberrations disappeared when the calcium levels returned to normal after treatment.

Meclofenoxate (Lucidril), a synthetic substance related to plant auxins, is claimed to cause an increase in the glucose uptake of the mouse brain, and to influence the EEG tracings of rats deprived of oxygen (Nickel, et al., 1963). Other animal experiments show Meclofenoxate to protect rabbit brains against experimental anoxia induced with nitrogen (Dereymaeker et al., 1962), and against histoxic anoxia induced by potassium cyanide (Nakajima et al., 1964).

An analysis of the temporal distribution of 115 in-patient suicides that occurred in two Swiss psychiatric hospitals in the years 1977–86 failed to reveal any statistically significant clustering of suicides. Thus, the modelling effect does not generally play a decisive role in psychiatric in-patient suicide.

This paper describes the development of community mental health services in Nanjing and reports on a retrospective study that compared the two-year outcome for 78 schizophrenic patients who attended four enterprise-based sheltered workshops (experimental group) with that of 78 schizophrenic patients who attended an out-patient clinic (control group). Despite having a longer course of illness and more prior hospital admissions than patients in the control group, at the end of the two years patients treated in enterprise-based sheltered workshops had significantly less psychosocial dysfunction (mean Social Dysfunction Screening Schedule score 3.4 (s.d. 0.2) v. 7.4 (s.d. 0.7), t = 49.2, d.f. 154, P<0.001) and less severe psychiatric symptomatology (mean Brief Psychiatric Rating Scale score 33.1 (s.d. 2.7) v. 54.1 (s.d. 2.9), t = 47.0, d.f. 1 54, P<0.001). Moreover, compared with the control group, over the two year period a smaller proportion of the experimental group experienced a clinical relapse (14.1% v. 38.5%, χ2 = 5.10, d.f. 1, P<0.05) or hospital readmission (7.7% v. 21.8%, χ2= 10.7, d.f. 1, P<0.01). We conclude that the organisation of on-site sheltered workshops for mentally ill factory workers is an effective model for promoting community mental health that merits widespread application in China.

A range of memory and perceptual tests not previously used in the assessment of the effects of ECT has shown no impairment in 38 depressed patients after six unilateral (one dominant and five non-dominant) ECT.

The impressive successes of early Behaviour Therapy are now being subjected to critical revaluation, whilst current work in the field employs more sophisticated methodology (Marks et al., 1965; Eysenck, 1964; Lazarus, 1961; Lang et al., 1963). The treatment is entirely symptom-centred and so its effects should be more easily assessable than those of other forms of psychotherapy. Yet results are still controversial, in spite of efforts to apply all the normal control measures.

Current theories suggest that there is a relatively frequent association of self-mutilative behaviour with eating disorders, particularly with the modern binge-purge syndrome, bulimia nervosa. In order to consider this association on a historical dimension. 25 bulimic cases, reported from the late 17th to the late 19th century, were investigated. These were found to include four examples of self-mutilative behaviour, in three males and one female: these cases are described and discussed. The historical evidence lends some support for the suggested connection between eating pathology and self-mutilation.

Rates of involuntary admission are increasing in England. Personality disorder should be excluded as a criterion for involuntary admission; stronger restraint reduction programmes should be instigated; and involuntary care should be based on treating illness (something we can do) and not on predicting violence (something we cannot).

Persons living with HIV report experiencing disproportionally severe and chronic pain and worry. However, no objective biomarkers of these subjective experiences have been developed. To address the lack of objective measures and assist in treatment planning, this study examined whether digital biomarkers of pain severity, pain chronicity and worry could be developed, using passive wearable sensors that continuously monitor movement. Results suggest that digital biomarkers can predict pain severity (r[35] = 0.690), pain chronicity (74.63% accuracy) and worry severity (r[65] = 0.642) with high precision, suggesting that objective digital biomarkers alone accurately capture internal symptom experiences in persons living with HIV.