The Psychopathology Instrument for Mentally Retarded Adults, a recently developed, empirically derived measure of psychiatric disturbance for the mentally handicapped, gives a total of eight scales which correspond to DSM–III diagnostic categories. This paper reports its psychometric properties in a British population and the psychometric properties of three scales derived by factor analysis. The internal consistencies of the scales were only barely acceptable in this sample and less acceptable than in previous studies.

A non-psychotic adult attempted surgically to reconstruct a foreskin for himself. The patient's membership of an organisation which lobbies against circumcision was contributory.

An eight-year-old boy with Asperger's syndrome was given haloperidol to control agitation and aggressive outbursts. Withdrawal of the drug after two years was followed by Tourette-like symptoms. Subsequently neither haloperidol nor a second antipsychotic drug altered the core features of Asperger's syndrome, despite suppressing the movement disorder. His first exposure to neuroleptics was in utero.

A patient with a paranoid schizophrenic illness showed features of two rare syndromes, Capgras and de Clérambault's.

An improvement in tardive dystonia in a patient who had received ECT for a schizophrenic psychosis is reported. The improvement suggests that the pathophysiology of tardive dystonia may involve neurotransmitter receptor changes similar to those seen in schizophrenia.

Dhat syndrome is a culture-bound sex neurosis of the Indian subcontinent. Fifty-two patients with a presenting complaint of passage of ‘Dhat’ in urine were studied. Diagnosis of neurotic depression, anxiety neurosis, hypochondriacal neurosis, and psychogenic impotence were made in 21, 19, 3, and 1 cases respectively. Seven patients received the diagnosis of pure Dhat syndrome, and one of gonorrhoea.

A mirror-image pair of monozygotic twins concordant for obsessional–compulsive disorder had remarkably similar clinical symptoms, and brain electrical activity mapping showed slower alpha and more theta activity than normal for their age.