Under the proposed English Health Act regulations most mental health units will have to be smoke-free, although patients will be able to smoke outside. Implementing the regulations will be challenging but may also be an opportunity for a more holistic approach focusing on the physical and psychological health of patients.

The year 2006 marks 20 years from the first identified bovine spongiform encephalitis in cows and 10 years from the first description of variant Creutzfeldt-Jakob disease in humans. The threatened epidemic in humans now appears unlikely, but psychiatrists need to be aware of recent developments in prion diseases.

Most people with schizophrenia live in low- and middle-income countries in which clinicians/policy makers are not the first targets of marketing. Because it is years after a drug is first launched that the full effects become known with confidence, the evidence upon which to base practice in low- and middle-income countries may be less biased than that in richer nations.

The concept of acute and transient psychoses is, together with that of schizoaffective disorders, a challenge by the Kraepelinian dichotomy. Although these conditions have some similarities to schizophrenia, they differ significantly from schizophrenia regarding onset, duration, prognosis, gender and premorbid adaptation. They show some similarities with bipolar disorders. They do not fit into the dichotomous concept.