The prevalence of psychiatric illness was studied in 150 epileptic mentally handicapped people (both hospital in-patients and living in the community) and a matched group of 150 non-epileptic controls. The Profile of Abilities and Adjustment (PAA) scale was used for the initial screening of psychiatric illness. Mildly to moderately handicapped individuals who had good communication skills and scored positively on the PAA schedule for psychiatric illness were interviewed using the PSE interview schedule. Severely mentally handicapped individuals who scored positively on the PAA's psychiatric illness subscale were observed and information was gathered from their medical notes and carers. A psychiatric diagnosis was made using DSM–III–R criteria. The non-epileptic group showed significantly more psychiatric illness than the epileptic group. Psychiatric illness was diagnosed in 25% of the cohort.

For over 40 years, a 55-year-old woman had suffered from cataplexy, which had been mistakenly identified as hysteria. Sleepiness, hypnagogic hallucinations and sleep-onset paralysis were not present. This is the longest duration of isolated cataplexy reported so far.

We present a case of tabes dorsalis, which consisted of intermittent, sharp pains and diffuse neurological abnormalities, and was initially considered to be a somatoform disorder. The unusual behavioural presentations of neurosyphilis may lead to premature psychiatric diagnoses. It is thus important that psychiatric consultants be aware of the myriad manifestations of the disease.

Specific inhibitors of 5-HT reuptake are reported to have lower preconvulsive activity than other antidepressants. A patient with post-traumatic epilepsy who had remained fit-free for many years until she was given the 5-HT reuptake inhibitor fluvoxamine is reported. Changes in serotonergic function may play a more widespread role in the pathophysiology of seizure disorders than hitherto thought.

The head circumference of a long-stay population with schizophrenia was compared with that of a population with dementia, matched for sex and year of birth. Schizophrenics had a smaller head circumference, even after correction for height and weight. This confirms earlier but inconclusive and controversial reports, and might be taken as supporting a neurodevelopmental hypothesis of the aetiology of schizophrenia.

Depressive illness in a patient with Down's syndrome and autism responded to fluoxetine. The importance of diagnosing superimposed depression in people with developmental disorders is emphasised.

A group of 75 mildly to moderately mentally handicapped people with epilepsy, resident in both a hospital and the community, were studied together with an individually matched control group of non-epileptic patients. Their carers were interviewed to gather information for two observer-rated personality questionnaires, the Standardised Assessment of Personality (SAP) and the T-L Personality Behaviour Inventory. The two groups were compared with respect to the prevalence rates of various personalities. An abnormal personality score according to the SAP schedule was reported in 26% (n = 39) of the cohort, of which 28 (18.6% of the cohort) were personality disorders. A diagnosis of SAP abnormal personality was made in 46% of the in-patients and 6.5% of the community-based population. Of the cohort, 15% had an abnormal personality score according to the T-L schedule. No statistically significant difference emerged between the epileptic and the non-epileptic groups in the prevalence of either the SAP or T-L personality.

When sleep duration and mood were monitored longitudinally in a 59–year-old woman with bipolar illness, sleep loss appeared to mediate the triggering of mania by psychosocial and pharmacological precipitating factors. This interpretation was supported by observations that mania could repeatedly be induced experimentally by depriving her of sleep for one night. The patient's data illustrate how sleep-loss might be a preventable cause of mania in a variety of situations.

A manic-depressive patient hid £3000 during one manic phase and subsequently, when his mood stabilised, could not remember where he had hidden it. He found the money during a subsequent manic phase a few months later. We suggest that this is not a clear case of state-dependent memory, since the patient at no point explicitly recollected where he had hidden the money. Instead we suggest that this represents state-dependent action. The links between this case and previous research on state-dependent memory are outlined.

Previous studies using the Parental Bonding Instrument have shown a general trend for neurotic subjects to score their parents as less caring and more protective. Such a finding was broadly replicated in a study of 80 clinically anxious subjects and age- and sex-matched controls. Although direct comparisons of PBI scores failed to reveal clear-cut differences between generalised anxiety (GA) and panic disorder (PD) subgroups, logistic regression analyses revealed higher odds ratios for parental assignment to aberrant categories in the GA group, with PD patients reporting a more limited pattern of overprotective parenting only. Our findings suggest that adverse parental behaviour may be relevant to the pathogenesis of GA, while parental ‘affectionate constraint’ may be a parental response to early manifestations of PD.