Relatively little is known about the course of TD in patients continuing to receive neuroleptic medication. In a retrospective follow-up study of 192 patients seen two or more times (average 7.7 visits) over 3–55 months in the Yale Tardive Dyskinesia Clinic, 112 (58%) demonstrated a ‘chronic persistent’ pattern, the remainder an ‘intermittent’ pattern. The most important predictors of chronic persistent TD, using multiple logistic-regression analyses, included increased age and the presence of non-orofacial TD at baseline.

A retrospective study of referrals to a child psychiatry liaison service was carried out in order to assess the impact of the reorganisation of the service. A total of 55% of referrals were of in-patients on the paediatric ward; other in-patients made up 12.5%. Of all referrals, 67% were from paediatricians. Of the children who had not harmed themselves, most were referred either for help with the management of physical illness or for investigation of a non-organic physical complaint. The main finding was that liaison referrals increased significantly in contrast to both the total number of referrals and the number of cases of deliberate self-harm.

The prevalence of delusional jealousy in 8134 psychiatric in-patients was 1.1%. Delusions of jealousy were most frequent in organic psychoses (7.0%), paranoid disorders (6.7%), alcohol psychosis (5.6%) and schizophrenia (2.5%), while in affective disorder delusions of jealousy could be found in only 0.1%. Because schizophrenia and affective disorder were the most common diagnoses, most patients with delusions of jealousy were schizophrenics. In schizophrenia, women were more likely to suffer from delusional jealousy, while in alcohol psychosis, men were more likely than women to suffer from delusional jealousy.

During the first ten years of a group started in February 1977 by the Avon Probation Service for the treatment of non-violent sex offenders, many of the offenders have shown a high degree of commitment to the group, and attendance levels have run consistently at over 70%. Of 63 men who came to the group during the ten-year study period, 33 completed their stay at the group, 11 left the group prematurely, and 11 never engaged satisfactorily. The remaining eight were still attending the group at the end of the study period. Of the 55 men whose contact with the group had ended, 36 (65%) had not been convicted of further sex offences by the end of the study period.

The 109 female survivors of a mental hospital population surveyed in 1965 for facial dyskinesia were followed up 16 years later. The 99 survivors with non-organic brain syndromes were analysed. Prevalence of dyskinesia had risen from 18.4% to 46.5% during follow-up and its development was significantly associated with neuroleptic dosage. Enlarged ventricles on brain scans were significantly associated with dyskinesia, cognitive impairment and neuroleptic prescribing.

One hundred medical and surgical patients admitted to an accident and emergency ward were screened for psychiatric disorder. A psychiatric diagnosis was made in 37 patients, 32 of whom were correctly identified by the GHQ. Psychiatric morbidity was associated with being single, lower social class, unemployment, homelessness and living in Bloomsbury Health District or north-east London. It was also associated with not being registered with a GP. The 14 overdose patients were no more likely to receive a psychiatric diagnosis than other patients, yet constituted most of the psychiatric referrals. Few patients were asked by medical staff about emotional worries or problems. A desire to be asked such questions and a past psychiatric history were associated with a psychiatric diagnosis. Routine screening of psychiatric morbidity in both medical and surgical patients and appropriate psychiatric referral of identified patients is recommended. A system of facilitating GP registration is necessary, as much of the morbidity identified could be contained within primary care.

Among 236 in-patients in one hospital for the mentally handicapped, there was a significant relationship between the amount of motor disorder (rated using a comprehensive check-list) and the severity of mental handicap, the presence of associated psychiatric disorder and the use of neuroleptic medication. The population was fairly evenly divided between those currently, previously and never having received neuroleptic medication. All categories of motor disorder, including abnormal movements, were present in all three subgroups. Neuroleptic medication appeared to modify the expression of motor disorder rather than producing it de novo. The range and frequency of motor disorders was comparable with that in patients with severe psychiatric illness. A common cerebral basis for the motor disorders of patients with mental handicap and severe psychiatric illness is suggested.

A total of 2605 old long-stay patients, defined as those admitted to hospital before the age of 65 years and in hospital more than six years, were identified in psychiatric hospitals serving 83% of the Scottish population. The bed occupancy was 59 per 100 000 of the general population, with a range among hospitals of 19–123 per 100 000. Of all patients, 64% were schizophrenic and 15% had organic brain disease; most patients were male, single and over 60 years of age; 41 % had been in hospital more than 30 years; 61 % had either florid psychotic symptoms or symptoms of a deficit state in marked or severe degree, and the rehabilitation potential for 70% was low. An increasing prevalence of deficit symptoms in schizophrenics was associated with increasing length of stay in hospital; the difference was most marked between those admitted before and after 1953.

This study compares the withdrawal responses of methadone and heroin addicts during a ten-day in-patient detoxification programme with methadone. Contrary to suggestions in the literature, the methadone group reported more severe withdrawal symptoms during both the acute withdrawal phase and the recovery phase. There were no differences between the two groups in onset or duration of symptoms. Whereas there may be reasons to favour methadone as a maintenance drug, its use may lead to difficulties during withdrawal.

A cross-sectional survey of the drinking habits of 877 mentally handicapped in-patients revealed 31 patients (prevalence 3.5%) who, in the opinion of nurses, drank five litres or more daily. Low urine specific gravity was a less useful indicator of polydipsia. Polydipsia appeared to be significantly associated with a borderline level of handicap and with a diagnosis of schizophrenia, autism or severe personality/behaviour disorder. Of five cases of water intoxication associated with polydipsia, one was fatal. In two cases excess drinking improved with increased neuroleptic medication. Lithium and demeclocycline were used in two cases to prevent hyponatraemic episodes.

Between 1975 and 1985, 3.8% of patients referred to the Maudsley Hospital with anorexia and bulimia were adoptees. This exceeds the rate of adoption (1.5%) in the general population matched for year of birth. The 18 adoptees with eating disorders had significantly more associated behavioural disturbance and lower academic achievement than the 18 matched controls, and different precipitating factors.

“The incidence of schizophrenia is regarded as being similar between different cultures and times. However, several studies, mostly based on first-admission rates, have suggested that the incidence has declined over the past 10–15 years. Data from England and Wales for 1952–86 have been examined: there has been a substantial decrease, beginning in the mid-1960s, in the incidence of schizophrenia.”

Twenty-five patients with mild mental retardation were compared with 26 schizophrenic patients of normal intelligence. The patients with retardation had suffered an earlier onset and were less likely to have been married or employed. However, the clinical phenomena exhibited by the two groups, as elicited by a SADS–L interview, were very similar. Thus, standardised interviews and criteria for schizophrenia can be readily applied to those with an IQ between 50 and 70.

A total population study of children, aged 13 years and under, suggested that there has been an apparent rise in the frequency of autistic disorder and autistic-like conditions (excluding Asperger's syndrome) in one area of western Sweden over the last ten years. The frequency was 4.0/100 000 in 1980, 7.5/10000 in 1984 and 11.6/10000 in 1988 in the city of Göteborg. Even though the prevalence rates refer to slightly different age cohorts, it was concluded that the apparent increase is in part due to better detection, but also to new cases born to immigrant parents. Typical cases of autistic disorder accounted for 75% of cases, and 20% had normal or near-normal IQs.

One hundred randomly selected residents of a mental handicap hospital originating from Dundee were interviewed using a standardised assessment based on the modified Standardised Clinical Interview Schedule. Information on certain behavioural items and self-care skills was obtained from nursing staff and case records. An ICD–9 diagnosis could be made for 80 individuals, including diagnoses usually reserved for children. Thirty subjects were regarded as needing long-term psychiatric mental handicap hospital care. All but one of the remaining 70 subjects required a staffed residential placement and all but 15 some form of out-patient or short-term in-patient provision from specialist health services. The findings indicate a need for approximately 30 psychiatric mental handicap beds per 100 000 population.

Patients with Alzheimer disease (AD) had reduced regional cerebral blood flow (rCBF) in the posterior parietotemporal region compared with controls, as determined with technetium-99m hexamethyl propyleneamine oxime and single photon emission tomography. Central cholinergic stimulation with physostigmine produced a focal increase in rCBF in the posterior parietotemporal region in the patients with AD but not in controls.

An unselected sample of 204 epileptic patients attending a neurological out-patient clinic in Abeokuta, Nigeria, was evaluated for psychiatric morbidity using the CIS. Thirty-seven per cent emerged as psychiatric cases, almost a third of these being cases of psychosis. Patients with partial seizure of temporal lobe origin were the most psychiatrically impaired, while those with partial seizure of non-temporal lobe origin the least. These findings are broadly similar to those reported for epileptic populations in other studies. However, in spite of the relatively high prevalence of major psychiatric disorders among these patients, their impairments were more likely to remain ‘hidden’ and untreated than those in similar patients in developed countries.