The epidemiology of mental problems in the Gomel region in the republic of Belarus was studied in a two-stage survey of a broad based population sample (N = 1617), using the General Health Questionnaire (12-item version) and the Munich Diagnostic Checklist for DSM-III-R. The Gomel region is one of the areas that was most severely affected by the Chernobyl nuclear diaster in 1986. In the studied population sample 64·8% had a GHQ-score above the threshold of 2. A DSM-III-R psychiatric disorder was present in 35·8%, with especially high rates for affective (16·5%) and anxiety disorders (12·6%). Dysthymia, general anxiety disorder, adjustment disorders and ‘not otherwise specified syndromes’ made up almost two-thirds of the observed morbidity (22·9%). A higher prevalence of mental health problems, both in terms of the GHQ and the DSM-III-R was observed among people who have been evacuated and in mothers with children under 18 years of age. These data indicate that the Chernobyl nuclear disaster may be partly responsible for the high prevalence of (milder) psychiatric disorders and psychological distress in the Gomel region, even 6 years after the event. Future studies comparing the data from Gomel region with an unexposed area will have to provide a more definite answer concerning the impact of this nuclear disaster on mental health.

A female alcoholic presented with Wernicke's encephalopathy subsequent to administration of diazepam and glucose (without thiamine) for treatment of withdrawal seizures. Nystagmus and cerebellar ataxia quickly resolved when administered thiamine, although severe global amnesia consistent with Korsakoffs syndrome persisted. Magnetic resonance imaging (MRI) revealed infarction of the right temporal lobe with hippocampal atrophy, but no lesions of thalamus or atrophy of mammillary bodies. Positron emission tomography (PET) confirmed decreased cerebral metabolic rates for glucose (CMRglu) in the right temporal lobe corresponding to MRI findings, but also significant metabolic asymmetry of dorsal thalamus, i.e reduced CMRglu in left versus right. This patient is unique in that neuroradiological findings revealed intact mammillary bodies and suggest asymmetrical dysfunctions (structural right temporal and functional left diencephalic) to produce her profound amnesia.

Fasting plasma levels of tryptophan, kynurenine and the pteridines, neopterin and tetrahydrobiopterin were measured in seven patients with Gilles de la Tourette syndrome (GTS) and 10 healthy controls. Plasma kynurenine was significantly elevated in the GTS patients. The lowest patient value was higher than the highest control value. Values for tryptophan, neopterin and tetrahydrobiopterin were similar in TS patients and controls. However, in TS patients only, there was a significant negative correlation between tryptophan and neopterin and a significant positive correlation between kynurenine and neopterin when controlling for tryptophan. This finding indicates that activation of cellular immune processes is a possible explanation for the rise in plasma kynurenine.

One hundred and fifty unselected elderly community subjects were assessed by Mini Mental State Examination (MMSE), Abbreviated Mental Test (AMT) and Mental Status Questionnaire (MSQ). The effects on cognitive test scores of potential confounding (non-cognitive) variables were evaluated. Sensitivities and specificities were: MMSE 80% and 98%; AMT 77% and 90%; and MSQ 70% and 89%. The MMSE identified significantly fewer false positives than the AMT and MSQ. The major effect of intelligence on cognitive test scores has previously been underestimated. Age, social class, sensitivity of hearing and history of stroke were also significantly correlated with cognitive test scores. Years of full time education and depression only affected the longer MMSE and CAMCOG. The MMSE (cut-off 20/21) can be recommended for routine screening. However, as scores are affected by variables other than cognitive function, particularly intelligence, further assessment of identified cases may fail to reveal significant functional impairment.

The incidence of cavum septum pellucidum (CSP), which has been widely regarded as a developmental anomaly of little clinical importance in neuropathology, was examined in 113 patients with affective disorders (69 with bipolar disorder and 44 with major depression), 40 schizophrenic patients, and 92 control subjects by magnetic resonance imaging (MRI). Significantly higher incidence of Grade 3–4 CSP (moderate to large) compared with the controls was found only in the schizophrenics. When a broader interpretation of CSP, including indeterminant (Grade 1) and small (Grade 2) CSP was used, three additional patients with bipolar disorder were found to have Grade 1–2 CSP, and the total prevalence of Grade 1–4 CSP in the patients with bipolar disorder was significantly higher than that in the control subjects but slightly lower than that in the schizophrenic patients. CSP was not observed in any patient with major depression. There were no differences between the patients with and without CSP in age, sex, education, or the duration of illness. These findings are consistent with the hypothesis that neurodevelopmental abnormality may be present in schizophrenia, and such an abnormality may also be present in some patients with bipolar disorder.

Anderson et al. (1993) presented two models of psychiatric morbidity that they claimed represented ‘individual’-based and ‘community’-based explanations. They used data from the Health and Lifestyle Survey to test the models and concluded that the data support a ‘community’-based explanation. Their deductions from the models appear to be flawed, nevertheless, their conclusion may be valid.

To evaluate whether a time pattern exists in the occurrence of suicide, 223 cases observed in Ferrara, Italy, over a 10-year period were considered. The determination of the hour of suicide was precise in 99 cases, presumptive (within a range of 1 hour) in 53, while for another 44 cases it was possible to define a probable time of suicide, grouping into four 6-hour periods (night, morning, afternoon, and evening). The remaining 27 cases were excluded as it was impossible to determine the time reliably. The data were analysed both by means of χ2 test for goodness-of-fit and by single cosinor. A specific pattern, characterized by a significant peak in the late morning – early afternoon hours was found for the entire sample and sex subgroups.