It is well known that women with a history of manic-depressive or puerperal affective psychosis are at particularly high risk of relapse in the puerperium. This paper describes the use of lithium given during or after pregnancy to women with a history of bipolar illness or puerperal affective psychosis. The rate of puerperal relapse in these subjects was compared with that in a similar group of women not on lithium. The significantly better outcome of the treatment group highlights the need for a prospective controlled trial looking at the effectiveness of lithium in minimising puerperal bipolar relapse.

We report OCD and paraphilia in two male members of triplets (the two males being monozygotic twins), and discuss the possible aetiological factors for this previously unreported occurrence. We suggest that patients presenting with paraphilia should be examined for OCD and that a detailed sexual history should be obtained in all patients with OCD.

Transsexuals are usually found to have a normal chromosome complement. The literature to data documents four transsexuals with 47,XYY pattern. This paper reports a ferule male with major cell line of 47, XYY and a gender identity disorder.

Five children aged 8–10 years presenting to child psychiatric clinics with hyperkinetic syndrome and severe disruptive early experiences are described. At referral all had been living in stable families for a minimum of four years. Biological risk factors were absent. It is proposed that the disruption of early attachments resulted in ill-regulated search and exploratory behaviour and that this had a continuing effect on the children's ability to focus and control attention skills and motor behaviour.

This report chronicles the verbally mediated traumatisation and subsequent PTSD in an 11-year-old girl. Information obtained from parental interviews, academic transcripts, anecdotal teacher comments, structured and unstructured interviews, and standardised anxiety, depression, and misconduct scales was used to highlight the unique distress of the patient.

A 32-year-old chronically relapsing depressed male patient with a mild mental handicap had tried different forms of pharmacotherapy which were either not tolerated or failed to prevent recurrences of episodes of psychotic depression. The use of maintenance ECT as the mainstay of the therapeutic regime led to a marked consistent clinical improvement.

A 58-year-old woman suffering from delusional parasitosis tried to kill her general practitioner. Her husband shared in her beliefs but lost all delusional conviction after she was compulsorily admitted to a special hospital. The case illustrates the intractable nature and potential dangerousness of some of these cases, and their affinity to paranoia.