The consistency of de Clérambault's syndrome and its relationship to other diagnostic labels is examined in terms of operational criteria derived from the original description of the syndrome. Five new cases of erotic delusions are examined, and 53 cases reported in the recent literature are reviewed; none of these completely satisfies the diagnostic criteria, while the majority of patients actually suffered from another disorder, most commonly schizophrenia. The justification for the retention of the syndrome as a nosological entity is discussed, and it is argued that the term should be seen as principally of historical interest.

40 new neurotic patients who lapsed from out-patient treatment were compared with 40 new neurotic patients who remained in treatment. The lapsed patients more often reported marital disharmony and 40% of them no longer felt ill at follow-up.

We describe psychotic illness in a Nigerian and a Togoese woman respectively. Although the clinical presentation was familiar to the clinical team, neither responded to conventional methods of treatment. Detailed ethnic enquiry revealed cultural beliefs which had a profound impact on each illness. Swift recovery occurred after repatriation. Eisenbruch (1983) has reported a case of ‘wind illness' in a paper described as a 'study of psychiatric anthropology’, which stresses the importance of understanding the patient's own view of his illness and it causes, in arriving at the correct diagnosis and intervening effectively. We describe here two cases of atypical psychosis in West African women, which lead us to endorse this view; as in his case, Western medicine proved useless, although complete recovery occurred once both had been repatriated.

Ekbom et al (1972) described dystonic syndromes that appeared as a side-effect to treatment with the butyrophenone group of neuroleptic drugs. These symptoms consisted of tonic flexion of the trunk to one side, accompanied by its slight rotation, in the absence of other concomitant dystonic symptoms. They called this the ‘Pisa syndrome’. A literature survey of neuroleptic-included extrapyramidal side-effects gave little reference to this syndrome (Sovner & DiMascio, 1978; Berger & Rexworth, 1980), but two cases that fit the description of this side-effect are presented here.

The case is presented of a twelve-year-old boy suffering simultaneously from Tourette Syndrome (TS) and a manic episode. The problems of this unique clinical association are discussed from the point of view of differential diagnosis, treatment, and possible biochemical basis. The case also illustrates the usefulness of the expanded concept of TS as a neuropsychiatric disorder with dys-regulation of perceptual, motor, and cognitive functioning.

A unique case of a homicide committed by a young male psychotic inpatient on a fellow-patient is reported and discussed with regard to the special victim-offender relationship, the relationship between suicide and homicide, the phenomenon of aggression and the question of the management of a highly suicidal psychotic patient, including the issue of continuous observation.

The case of a 17 year-old female with psychogenic polydipsia is reported; 13 out of 18 members of her maternal family were known to have had polydipsia and polyuria, but only two had undergone endocrine investigations—one had diabetes insipidus and one also had psychogenic polydipsia. There are probable contributions of non-genetic family factors including imitation and identification to the development of this patient's condition. Detailed family and developmental histories may be of particular assistance in the understanding of the psychogenesis of the disorder in some patients.

In 1952 Eysenck threw down the gauntlet, when he claimed that psychoanalytical forms of psychotherapy were no more effective than spontaneous remission. As we trudge through the fourth decade of this debate, its quality remains as divisive and acrimonious as ever. Professor Michael Shepherd (1979, 1980) has latterly taken on Eysenck's mantle, averring that psychotherapy is not only ineffective but may actually harm patients. In an editorial in the British Medical Journal (1984), he launched yet a further attack, arguing on this occasion that the psychotherapist is little more than a ‘placebologist’ exerting his effects through nonspecific means. Why bother with highly trained therapists when an inert pill will produce the same result?

A cohort of 83 British addicts from one clinic was followed-up after 11 years; Home Office records and medical notes were personally searched to trace current status. Twenty-nine were still using drugs, 37 were not known to be using drugs, and 17 had died. The group still using drugs had become markedly more stable on parameters of drug use, criminality, and social stability over the follow-up period.

An unusual case of Huntington's Chorea, without dementia, is described. The diagnostic issues are discussed with particular reference to the problems of psychiatric assessment and management of the disease.

The phenomenon of the vampire is ancient, ubiquitous, and fascinating; moreover, it can only be understood adequately within the context of more general blood reliefs and rituals. (See Prins, 1984 for a review). References to vampires and associated phenomena may be found in the world's great literature long before Bram Stoker created his notorious and evil Count (Summers, 1960, 1980). Belief in the vampire's actual physical existence was probably encouraged by the prevalent practice of premature burial during times of plague, by the large numbers of itinerants and beggars that abound at such times, and by the fact that many of them took refuge in vaults and graveyards. In addition, the myth was probably given more tangible reality by such physical explanations as Erythropoietic Protoporphyria or its variants. This disorder is said to induce the body to produce an excess of porphyria, which results not only in excess redness of the eyes, skin and teeth, but also a receding of the upper lip and cracking of the skin, which bleeds when exposed to light. It has been suggested that physicians of the day could only treat sufferers by secluding them during the day and by persuading them to drink blood to replace that lost by bleeding (Illis, 1964; Milgrom, 1984; Prins, 1984). In more modern times, there have been accounts of people seeking to protect themselves from vampiric attentions (Farson & Hall, 1978).

We report two cases showing psychiatric symptoms associated with a fear of Acquired Immune Deficiency Syndrome (AIDS). There have now been over 42 cases of AIDS in the United Kingdom (Communicable Disease Surveillance Centre, 1984) since the first case appeared in December 1981, a year after the syndrome was first identified in the United States of America. It was the BBC television programme “Death in the Village” which brought the risks home to many UK homosexual men in mid-1983. Following the programme, the London Gay Switchboard received a high level of telephone calls from men who were afraid that they had AIDS (London Gay Switchboard, 1984).