The post-war development of psychiatric services in Nottingham, with their reduction in the number of beds and marked increase in in-patient turnover and day patient and out-patient attendances, represents a close approximation to the proposals of the 1962 Hospital Plan. These changes were achieved by redeployment of existing resources.

A fifteen-year attrition study of 1960 long-stay in-patients shows a high rate of discharge, especially for males.

The reasons for these findings and some implications are discussed.

While the beneficial effect of lysergic acid diethylamide (LSD) in the treatment of carefully selected patients as an adjunct to psychotherapy has been amply reported (Robinson et al., 1963), concern has been expressed regarding the damage to chromosomes in those taking the drug.

A priority for psychiatric rehabilitation workers in China is to develop less-restrictive methods for managing the estimated 2500 chronically institutionalised patients who are symptomatically stable and have adequate psychosocial functioning but have no family members who are able or willing to take them home. We transferred 45 chronic schizophrenic male in-patients to an open-door rehabilitation ward where they were given as much freedom as possible and encouraged to take part in occupational, social, and recreational activities. The Nurses Observation Scale for Inpatient Evaluation (NOSIE) was used to compare the psychosocial functioning of the 43 patients who completed the year-long trial with that of 43 similar patients who received standard in-patient treatment on a locked ward. Over the year, the experimental group showed a significant improvement in overall functioning, whereas the control group showed no improvement. These findings suggest that open-door rehabilitation wards situated within the hospital can mobilise latent psychosocial functioning and may be a good method for re-introducing chronic schizophrenic patients in China back into the community.

Four men with HIV infection who were referred to liaison psychiatry for assessment of eating disorders are described. In all four cases the eating disorder had implications for the clinical management of their HIV infection. Investigations of weight loss, dietary intervention, and compliance may all be affected by the presence of an eating disorder. The development of HIV disease may exacerbate the symptoms of an eating disorder.

“Much doubt persists about the different benefits from, and indications for, all the many drugs proposed for the relief of anxiety” (Lancet, 1965). Chlordiazepoxide is one of the most popular minor tranquillizers used by psychiatrists, physicians and general practitioners. Its efficacy has been advocated in the “Today's Drugs” column of the British Medical Journal (1967, 1968a and b). Others, however, have been “impressed by the number of patients who claim great benefit but show little evidence of this” (Jenner, 1965).

Pericyazine (“Neulactil”), introduced in 1961, is a phenothiazine with tranquillizing and stimulating properties.

Cohen (1960) defined risk-taking as ‘embarking on a task without being certain of success', and he agreed with Stengel (1958) that it is possible to gain a better understanding of attempted suicide if we regard it as conveying a degree of uncertainty that the attempt will succeed or fail. Investigation after a suicide attempt usually reveals that the patient was at the time uncertain about the toxic effects and lethality of the overdose, and uncertain of whether others would intervene before the poison could take effect. Taking the widely held view that in most cases of so-called attempted suicide the prevailing motives are directed towards survival with all the advantages of having risked self-destruction, it might be argued that the attempt succeeds by avoiding rather than causing death. The alternative term ‘parasuicide’ suggested by Kreitman et al. (1969) is less paradoxical.

A 32-year-old man presented with koro-like symptoms in association with a depressive illness and HIV infection.

The diagnosis of personality disorder is sometimes tolerated but often reviled as a label to attach to people we do not like. This is hardly surprising when we consider that problems in interpersonal relationships constitute the main feature of the disorder. But we cannot escape the fact that personality problems are extremely common and rejection on grounds of perceived undesirability is doltish. Both the DSM-5 (2013) alternative model and new ICD-11 classification of personality may help understanding as they are more in tune with science. Most of the previous classifications have failed to help practitioners or patients.

COVID-19 presents new challenges for psychiatry as clinical management, ethical dilemmas and administrative complications need to be addressed. The psychiatrist should protect the needs and rights of the mentally ill while maximising population health and ensuring solidarity, reciprocity and community well-being for all.

A fatal case of water intoxication in a schizophrenic female Chinese patient is described, including post-mortem findings.