False allegations of victimisation although uncommon are important to recognise. This paper examines those who falsely claim to have been the victims of stalking.

To highlight the phenomenon of false victims of stalking.

Twelve individuals who falsely claimed to be victims of stalking were compared with a group of 100 true stalking victims.

False stalking victims presented for help earlier than real victims and were less likely to claim harassment via letters. They reported equivalent levels of violence directed at themselves but seldom claimed others were attacked. Five types of false claimants were recognisable. False victims consumed more medical services than genuine stalking victims and they were more likely to be embroiled in legal action. They reported similar levels of distress with suicidal ruminations in over 40%.

The current interest in stalking is promoting false claims of being stalked. Early identification of these cases and appropriate intervention are essential to both minimising abuses of resources available to true victims and equally to ensure appropriate care for those who express their own disordered state in false claims of victimisation.

Systematic clinical investigations of consecutive suicides have found psychiatric disorders in 90–95% of subjects (depressive disorder 30–87%).

To investigate use of psychotropics in men and women of different ages who commit suicide.

Results of toxicological screening in 5281 suicides in Sweden 1992–94 were studied.

Psychotropics were detected in 45.3% of the suicides. Antidepressants were detected in 12.4% of the men and 26.2% of the women (7.2% and 14.2%, respectively, of those under 30 years of age). Neuroleptics or antiepileptics (in the absence of antidepressants) were detected in 8.3%, and anxiolytics/hypnotics alone in 20.5% of the subjects. Overdose by an antidepressant was the probable cause of death in 2.1% of the men and 7.9% of the women.

The pattern of psychotropics detected in toxicology was incongruent with the pattern of diagnoses found in the clinical investigations of suicides mentioned above. Depression appears to be undertreated in individuals committing suicide, especially in men and in subjects under 30 years of age.

Case management, particularly in intensive form, has been widely introduced for the treatment of severe mental illness. However, the optimal intensity of case management has not been determined.

We aimed to assess whether intensive case management (small case load) reduces hospitalisation and costs compared with standard case management.

Development and rationale of a large randomised controlled trial comparing intensive case management (case load per worker? 15 patients) with standard case management (case load 30–35 patients)

Two-year outcome data will be obtained on patients representative of the seriously mentally ill in inner-city mental health services.

The study planned with 700 patients should be sufficient to detect small differences in the readmission of patients to hospital (10%), the number of days spent in hospital over a two-year period (10 days) and the average weekly cost of care per patient. The sample is large enough to compare the cost-effectiveness of intensive and standard case management in mild and severe disability and in people of African–Caribbean origin and White Caucasians.

Neurobehavioural symptoms are common immediately after a minor head injury but have not been studied one year after the injury.

To estimate the rate and pattern of neurobehavioural symptoms one year after a head injury of varying severity.

Adults who had been hospitalised after a head injury (n=196, 164 of whom had a face-to-face interview) and showed indirect evidence of brain assault were assessed for the presence of neurobehavioural symptoms with the help of a behaviour rating scale.

About 40% had three or more symptoms. Individual symptoms varied among 3% (social disinhibition), 15% (lack of initiative) and 35% (irritability) of the cohort. Premorbid factors such as lower social class and lower educational achievement, head-injury-related factors such a low Glasgow coma score, and outcome-related factors such as the presence of a disability according to the Edinburgh Rehabilitation Status Scale and psychiatric caseness according to the Clinical Interview Schedule–Revised, significantly influenced the rate and the pattern of behavioural symptoms. The pattern of symptoms varied between age groups and according to the severity of the head injury.

A significant proportion of patients with varying degrees of severity of head injury showed behavioural symptoms after one-year of head injury.

Regular assessment of mood is often important for treatment but traditional measures can be time-consuming. A quick ‘litmus test’ is needed.

To test the reliability and validity of a single-item scale for mood.

Mood was measured repeatedly in 812 patients (258 in-patients, 554 out-patients) being treated in an anxiety disorders unit. Patients had self- and clinician ratings of a single-item depression scale and also rated the 21-item Beck Depression Inventory (BDI–21). Their single-item scores were compared with BDI–21 scores and with outcome measures.

The single-item depression scores correlated 0.71 to 0.78 with the BDI–21 scores. Clinically useful cut-off points were identified. Depression scores at discharge, but not pre-treatment, correlated significantly with improvement in the main problem.

The quick single-item depression scale, whether rated by patient or by clinician, is a reasonable rough guide to mood in anxiety disorders and saves time for the patient and the clinician compared to longer measures.

Family history data suggest the possibility of an association between childhood shyness and parental social phobia.

To examine the prevalence of maternal affective disorder in a community sample of four-year-old shy and non-shy children.

By screening 867 children, 43 shy children, 59 children with another form of disturbance (i.e. fearfulness, feeding problem or conduct problem) and 26 children with no disturbance were identified. Interviewers who were unaware of child status used a standardised mental state assessment to determine the rate of affective disorder in the mothers of these children.

Compared with the mothers of the children in both comparison groups, the mothers of the children who were purely shy (i.e. shy children with no comorbid condition) had a significantly raised lifetime rate of anxiety disorder in general, and social phobia in particular. The odds ratio of a social phobia in the mothers of the purely shy children was raised over the normal control group by a factor of more than seven.

These findings suggest a specific association between childhood shyness and maternal social phobia.

A past history of major depression or alcoholism has been associated with poorer smoking treatment outcomes.

To evaluate the efficacy of bupropion for smoking cessation in smokers with a former history of major depression or alcoholism, and changes in depressive symptoms during smoking abstinence.

Data were drawn from a multicentre trial of bupropion for smoking cessation. Smokers (n=615) received placebo or bupropion sustained-release at 100, 150, or 300 mg/day for six weeks after target quit date (TQD). The primary outcome was the point prevalence smoking abstinence at the end of treatment and at one year. The Beck Depression Inventory (BDI) was used to assess depressive symptoms.

A significant dose – response effect of bupropion for smoking cessation was found. This was independent of history of major depression or alcoholism. Among those continuously abstinent from smoking for two weeks following TQD, an increase in BDI score was associated with a return to smoking at end of treatment.

Bupropion is efficacious for smoking cessation independently of a former history of major depression or alcoholism. Increases in depressive symptoms during an initial period of abstinence are associated with a return to smoking.

Recent studies indicate that selective serotonin re-uptake inhibitors (SSRIs) reduce the symptoms accompanying personality disorders and modulate a normal personality.

To examine the effect of two SSRIs, sertraline and Citalopram, on personality traits in major depressed patients.

Personality traits were evaluated at baseline and after six months using the Karolinska Scales of Personality (KSP).

After treatment, significant changes in the direction of normalisation were seen in all scales. To determine whether the observed changes could be explained by improved depressive symptoms, multiple stepwise regressions with the separate KSP as dependent variables were performed. Improvements in depressive symptoms only accounted for 0–8.4% of the observed variance.

In depressed patients treated with SSRIs significant effects are seen on personality traits measured by the KSP.

The occurrence of a seizure during electroconvulsive therapy (ECT) should be confirmed. Most clinicians use motor seizure monitoring alone and recent guidelines have not considered electroencephalogram (EEG) monitoring mandatory.

To examine the potential pitfalls of motor seizure monitoring.

Consenting consecutive patients (n=232) were prospectively studied at the first ECT session using both motor and EEG seizure monitoring. It was ensured (by titration) that all the patients had an adequate EEG seizure. Adequate and prolonged seizures were defined according to the latest recommendations of the Royal College of Psychiatrists.

Motor seizure was inadequate in 15 (7%) of patients. EEG seizure was prolonged in 38 (16%) of patients. Fifteen patients (39%) did not have a prolonged motor seizure. Motor seizure correlated well (r=0.8, P < 0.001) with EEG seizure when the latter was adequate, but not when prolonged (r=0.12, P > 0.5).

Motor seizure monitoring without EEG is undependable. The study provides a rational basis for the Royal College of Psychiatrists' definition of prolonged EEG seizure.