Five cases of Gilles de la Tourette's syndrome occurring in the Chinese are described. The onset, course, symptomatology and family psychopathology are similar to those reported in Caucasians. On the parameters of APGAR score, psychological testing, EEG and psychiatric examination all had at least one abnormality. The response to haloperidol was uniformly good. Follow-up results showed that all were able to lead a fairly normal life after treatment. Though the cases are few in number, the findings seem to support the hypothesis that the syndrome has an organic substratum subject to psychological influences.

It has been suggested that cerebral noradrenaline turnover in patients can be assessed from the excretion in urine of 3-methoxy-4-hydroxyphenylethylene glycol (MOPEG). Studies were therefore made on the effects of mild exercise on the excretion of the conjugates of MOPEG as this might complicate interpretation. Changes are produced, but there are individual differences between subjects.

Physical fitness was also studied and, although it could not be shown to be the factor explaining differences between different patients, nevertheless it is probably a factor influencing the levels of MOPEG excreted.

The study of the distribution of free MOPEG and its sulphate conjugate in a human brain also raised doubts about the proportions which could have a cerebral origin.

The observations suggest the need for caution in using MOPEG excretion to detect abnormal amine changes in brain. They do not, however, conclusively refute the hypothesis that MOPEG sulphate in urine significantly reflects cerebral noradrenaline activity.

Following the method of Brown and Harris 30 Kenyan patients suffering from depression and 40 community non-psychiatrically-disturbed controls were studied for contextual and reported threat due to short-term and long-term life events. It was found that the patients did not over-rate threat due to events (in ‘search for the meaning’) nor did the controls under-rate the threat of life events. Some theoretical issues on the ‘contextual threat’ of life events are raised.

In psychiatry, lithium has been used mainly in the treatment of manic states and other forms of affective psychoses (Cade, 1949; Schou, 1956; Maggs, 1963; Baastrup, 1964). Strömgren (1965) puts forward the view that the usefulness of lithium is very questionable in the treatment of other psychiatric disturbances than affective disorders. Even earlier, Teulie et al. (1955) had found lithium to have a relatively weak therapeutic effect in schizophrenic, hallucinatory and epileptic psychoses. The Russian investigators, Mosketi et al. (1963), treated different kinds of psychotic disturbances by administering lithium iodide (0·5–1·0 g/die) intravenously. They found the effect of the drug to be highly favourable within 7 to 15 days, in some cases in 30 to 60 minutes. They obtained the best results in cases of paranoid-hallucinatory, confusional and depressive-paranoid psychoses. Compared with earlier observations, these results indicate a surprisingly favourable effect of lithium in non-affective psychoses.

The experience of visual images appearing as well-described persons and objects, either familiar or unfamiliar to the patient, has frequently prompted psychiatric evaluation for apparent psychotic or schizophrenic disorders. A case of apparent psychotic depression is reported, in which the symptoms were due to the patient's experience of palinoptic images. Answers to particular questions in the initial interview can obviate the need for psychiatric consultation, as various consistencies have been reported in the non-psychiatric symptom of palinopsia.

A case of paranoid psychosis in an elderly female is reported in which recurrent episodes were apparently induced by the staff of the institution where the patient was a resident. The issues raised by this case are discussed.

We describe the limitations on studying the interactions of drugs of abuse in humans. Two ‘acute’ studies were carried out. In the first study, the administration of alcohol/placebo with cocaine showed the possibility of identifying the euphoric effect of the drugs by the EEG power spectra analysis in terms of enhancement of alpha- and beta-wave activity. The results of the second study, in which cocaine and buprenorphine were administered, show the existence of low-dose interactions and the influence of buprenorphine on craving for cocaine.

Psychodrama, a method of human relations training and psychotherapy, is traced from its creation by Moreno fifty years ago to its present resurgence with the growth of ‘humanistic’ psychology. The basic techniques are described, together with Moreno's concepts of social interaction, e.g. encounter, spontaneity, the moment, catharsis and role playing. Its uses and limitations are discussed briefly.

Olanzapine possesses a broad pharmacological profile, interacting with a range of different neurotransmitter receptors. Although its affinity for muscarinic receptors is relatively greater than for dopamine receptors, on schedule-controlled behaviour olanzapine displays a profile resembling a dopamine antagonist. Likewise, in a test of cognitive function, olanzapine does not produce anticholinergic-like deficits. In drug discrimination assays, olanzapine substitutes for clozapine in clozapine-trained animals and clozapine generalises to olanzapine in olanzapine-trained animals. Olanzapine also reverses the behavioural deficits produced by inhibiting N-methyl-D-aspartate receptor glutamatergic transmission. This profile suggests that olanzapine will be effective against both positive and negative symptoms of schizophrenia while producing minimal extrapyramidal side-effects.

Pseudocyesis is an uncommon condition in which the psychological and somatic phenomena are usually thought to arise with neurotic rather than psychotic illness. We report a patient whose pseudocyesis took a course not previously described, culminating in an acute schizophrenic episode. Despite this she demonstrated many similarities with neurotic patients previously described in the literature. A phenomenological explanation, the belief of pregnancy as an overvalued idea, is discussed.

Eighteen long-stay patients from an old county asylum moved into hospital hostels. After 12–24 months, there were significant reductions in overall symptoms, as rated by the CPRS and the Krawiecka scale, as well as in deviant but not general behaviour, rated by the REHAB scale. Six later moved to live in supported accommodation. All relatives and patients who expressed an opinion to an independent assessor were satisfied with their present accommodation or wished to move to more independent living.

This study is an investigation of the social class background of a randomly selected sample of young people appearing in the London Juvenile Courts; and of the relationships between their social class and sex and the number and types of offences with which they were charged.

A double-blind, cross-over, placebo-controlled study of dydrogesterone (10 mg b.d.) in the treatment of premenstrual syndrome is described. Two groups of women were studied: secondarily referred hospital clinic patients, and self-referred patients. Only one-third of patients screened completed the study. All patients showed significant improvements in symptom scores during the course of the study, the only significant difference between placebo- and dydrogesterone-treated patients being an increase in frequency of breast tenderness and a decrease in pain with menstrual bleeding in the latter.

Thought disorder has always been regarded as an important symptom of schizophrenia. Attempts have been made to measure it by means of psychological tests: patients who manifest thought disorder clinically have been found to perform idiosyncratically on tests of concept-formation (1). The purpose of the first part of this investigation was to confirm the already established finding that schizophrenics, as a whole, are more thought disordered than controls. Not only were patients tested, but also their first-degree relatives; this aspect of the investigation, however, will be dealt with in the second part of the paper.