A 40-year-old woman suffering from major depression with psychotic features was unresponsive to conventional therapy. After the administration of a wide range of drug treatments and ECT, she received clozapine. Depressive symptoms improved and psychotic features disappeared. It is suggested that clozapine could be efficient in psychotic refractory depression.

Psychotic symptoms are not included under accepted definitions of premenstrual syndrome (PMS). We present a 14-year-old girl with PMS, who developed a late luteal cyclic psychosis during two consecutive premenstrual periods, which resolved completely after the onset of menses. She was treated with dehydroxyprogesterone for two cycles, and later with placebo for the next three consecutive cycles. Psychotic symptoms did not reappear following two psychotic cycles, and the PMS resolved within the next menstrual cycle. We suggest that cyclic psychoses associated with the menstrual cycle may be a specific benign entity, not included under the recognised functional psychoses. In some cases these psychoses could be classified as a subgroup of PMS.

A 45-year-old man was admitted with a hair growth delusion and depressive symptoms. The delusion persisted for three years and disappeared after a manic episode. This odd delusion has some similarities with lycanthropy.

Poor performances of patients with Tourette's syndrome (TS) on tests requiring visual-perceptual abilities had led previous authors to the suggestion of right hemisphere involvement. We have compared the results of neuropsychological examination of 16 children with TS, with those of 16 children with a lesion of the right hemisphere. No evidence was found of a dysfunction of the right hemisphere in TS.

British Journal of Psychiatry (1993), 163, 116–118

A case of post-traumatic stress disorder (PTSD) following a road traffic accident in which the onset of symptoms was delayed for 18 months until a widely reported major disaster occurred is described. A severe major depressive episode was precipitated, requiring treatment in its own right. During psychotherapy sessions, extreme emotions, heightened sensations, and ‘organic memories’ relating to the original accident were experienced.

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