Long-term outcome of post-partum psychiatric illness requiring admission.

Among 65 women admitted to a mother and baby unit within 6 months post-partum, 53 were followed up for an average of 8.8 years. Women who had no previous history of psychiatric illness or who had experienced previous puerperal illness only, did significantly better at follow-up.

Adrenocortical suppression presenting with agitated depression, morbid jealousy, and a dementia-like state.

A 66-year-old woman showed profound neuropsychiatric disturbance after withdrawal from prolonged corticosteroid treatment. Reintroduction of an alternative corticosteroid, at low dose, produced a return to premorbid mental state.

Measures of serotonin metabolism in anorexia nervosa.

Thirty-five consecutive attenders at a clinic specializing in anorexia nervosa were studied. All conformed to a DSM-III-R diagnosis for anorexia nervosa. In addition, 3 cases suffered from major depressive disorder and 9 from dysthymia.

Estimation of human blood plasma 5-hydroxyindoleacetic acid and homovanillic acid.

A method for simultaneous quantification of plasma homovanillic acid and 5-hydroxyindoleacetic acid has been developed, permitting more efficient neurochemical examinations of these often interrelated biogenic amine systems. Zinc sulphate and sodium hydroxide solutions were used for precipitating the protein in plasma prior to injection on the column. This technique allows for cleaner chromatography, greater sensitivity and high precision.

Primary and secondary erotomania: clinical characteristics and follow-up.

A survey within a defined area of the north-east of England (population of approximately 1.25 million) generated a number of patients with current or past erotomanic phenomenology. A casenote study was carried out on the 11 patients identified.

Pica in a patient with anorexia nervosa.

A case of an unusual pica in a patient with anorexia nervosa is described. The patient was also found to have iron-deficiency anaemia. The relationship of mineral deficiency to pica and anorexia nervosa is discussed.

Hostility, hopelessness and deliberate self-harm: a prospective follow-up study.

Sixty-one consecutive patients who presented following an episode of deliberate self-harm (DSH) were assessed on a number of variables, including measures of hopelessness and hostility. Attempts were made to follow all of the patients. Those who were known to have had a further episode of DSH had significantly higher levels of hopelessness and intropunitive hostility after the index episode than those who did not repeat.

Repeat self-harm: an 18-month follow-up.

An 18-month follow-up of cases of deliberate self-harm (DSH) revealed that 30% had repeated the act. Of a large number of items recorded at index DSH only one, a past history of self-harm, was associated with repetition. It is suggested that some factors not predictive of longer term repeat DSH may be important in the assessment of risk for immediate further self-harm.

Cortical evoked potentials and clinical rating scales as measures of depressive illness.

Relationships between clinical ratings and cortical evoked potentials were examined before and during antidepressant drug treatment in 32 patients with major depressive disorder (DSM-III). Clinical rating scales included Hamilton Rating Scale for Depression, Beck Depression Inventory, Present State Examination (PSE) and Newcastle Scale. Evoked potentials included contingent negative variation (CNV), post-imperative negative variation (PINV) and auditory evoked potential (AEP) There were close correlations between all rating scales, and factor analysis produced only one component, suggesting that the common variance between them related to severity of depression.

The dexamethasone suppression test in bulimia nervosa.

In a study of the dexamethasone suppression test (DST) in patients with bulimia nervosa, a non-suppression rate of about 50% was found. The only clinical correlates of DST non-suppression were a previous history of weight loss and/or of anorexia nervosa. These results suggest that DST non-suppression in these subjects may be a trait rather than a state marker of anorexia nervosa.

Age and self-poisoning: the epidemiology in Newcastle upon Tyne in the 1980s.

The epidemiology of 737 consecutive self-poisoning admissions to Freeman Hospital, Newcastle upon Tyne, has been investigated with reference to age in young (less than 35), mid-aged (35-64) and elderly (greater than or equal to 65 year) patients. The most important differences were increased formal psychiatric illness in the elderly, demonstrated by increased likelihood of admission to psychiatric units; less likelihood of overdose with multiple agents in the elderly, and less use of alcohol. There were also differences in the types of drugs used.

The effect of propranolol and thioridazine on positive and negative symptoms of schizophrenia.

Patients with chronic schizophrenia were treated with either propranolol (640 mg daily) or thioridazine (400 mg daily). In a double-blind study lasting five weeks, propranolol was superior to thioridazine on both psychiatrists' and nurses' ratings. Significant improvements were noted with propranolol in both positive (Type I) and negative (Type II) symptoms.

Alaproclate--an open clinical study in depressive illness.

This open study of alaproclate points towards an antidepressant effect in a a relatively chronic and drug-resistant group of depressives. Five patients had an average improvement of more than 21 points on the Hamilton Rating Scale for Depression and six had an average improvement of seven points. Several patients had anticholinergic side effects, abnormal results in liver functional tests and faecal occult blood, but none were bad enough to require being taken off the drug and most side effects improved before the end of the trial.

Serum concentration of depot neuroleptics in tardive dyskinesia.

Using radioimmunoassay techniques, serum levels of depot neuroleptics, fluphenazine and flupenthixol, were estimated in two groups of chronic schizophrenic patients with, and without, tardive dyskinesia. There were high significant difference in dose-related serum levels of either drug between the groups. The hypothesis that patients with tardive dyskinesia develop the syndrome because they do not metabolise neuroleptics as efficiently as those without the syndrome was not supported by the data.