The aim was to identify the amount of psychiatric and physical morbidity identified in suicide victims prior to death.

A survey was made of primary care records of Scottish suicide victims in the years 1988 and 1989.

Less morbidity was encountered than in previous studies. Single persons and persons from lower socio-economic groups were less likely to have a diagnosis of depression. No association was found between physical and psychiatric morbidity. Depressed single persons and depressed persons from lower socio-economic groups were less likely to receive antidepressants. GPs prescribed lower dosages of antidepressants than psychiatrists. Patients receiving antidepressants were more likely to die by drug overdose.

There are groups in whom depression may be being overlooked and others in whom depression could be treated more vigorously. There are risks in prescribing antidepressants which are potentially fatal in overdose.

Creativity, religiosity and madness have long been thought to be aetiologically interrelated.

Henry Maudsley's little known pathography of the 17th century Swedish philosopher and polymath, Emanuel Swedenborg, was examined.

Swedenborg developed a messianic psychosis in middle life, considered by Maudsley to be a monomania, possibly due to epilepsy. Many of Swedenborg's contemporaries thought of him, however, as a religious eccentric. Under criticism from Swedenborg's followers, Maudsley avoided further reference to Swedenborg, and the pathography was lost from view.

Renewed interest is deserved in the contentious issues of the nature of religiosity and its relationship to psychotic experience.

British Journal of Psychiatry (1994), 165, 690–691

It has been suggested recently that the prevalence of autistic disorder may be rising. No prevalence study specifically among learning disabled children exists and so this study was prompted.

Method. 767 children with a learning disability who attended 16 different special schools in the Grampian region of north-east Scotland were studied for a diagnosis of autistic disorder according to the DSM–III–R criteria. The study was conducted in three stages. In the first screening stage, a questionnaire was completed for each child by their teachers. In the second stage, teachers completed another questionnaire based on DSM–III–R criteria for autistic disorder. A final diagnosis was made on the basis of examination and information gathered from the questionnaires.

Questionnaires were completed for 634 (82.7%) children. 14.3% of children with a learning disability fulfilled the diagnostic criteria for autistic disorder. There was a male: female ratio of 3:1. This gave a 9 per 10 000 minimum prevalence of autistic disorder among all school-age children in the Grampian region. There was a higher prevalence of autistic disorder in the cities compared with rural areas. The prevalence did not change with age but increased with decreasing IQ.

Depression occurs commonly in people with Down's syndrome, although there is little published about this association. This study explores the limitations of Diagnostic Criteria for Research, based on ICD-10 (DCR) and DSM–III–R depressive criteria.

Case note examination identified 42 adults with Down's syndrome who have sustained 56 depressive episodes. The clinical features are reported.

All episodes were diagnosed as depression. DSM–III–R criteria for major depressive episode were met by 50% of the episodes. DCR for depressive episode of at least mild severity were fulfilled by 68%.

These criteria were unduly restrictive for this group. Commonly occurring symptoms are not included in the criteria, while certain criteria items never occurred. Criteria should be modified to facilitate future research.

The shortage of mental health care in rural China might be tackled by community care. This study tests the hypothesis that family intervention increases patients' treatment compliance, which is crucial in community care.

A cohort of psychiatric patients were randomly selected to a controlled trial for four months. Compliance rates, clinical and social outcomes were measured double-blindly.

The compliance rate was increased significantly in the trial group, and they had better clinical and social outcomes.

Family intervention is an effective method of improving treatment compliance and should be an important part of community mental health care.

Lethal catatonia and neuroleptic malignant syndrome (NMS) have been suggested to have a common neurochemical cause. We hypothesise that both conditions may be due to a sudden and massive blockade of dopamine neurotransmitters.

NMS was diagnosed in psychotic in-patients treated with neuroleptics if four features were present: diffuse severe rigidity, altered level of consciousness, hyperpyrexia and autonomic instability.

Over three years, five NMS cases were diagnosed. Two presented with catatonic features and were diagnosed as acute reactive psychosis. Their neuroleptic doses were small, arguing for a particular sensitivity in these two cases.

The sensitivity of two patients with catatonic features who developed NMS with small doses of neuroleptics supports a common neurochemical basis for the two conditions.

Neuroimaging of a treatment-resistant patient with schizophrenia revealed the existence of cerebral hemiatrophy. The association of schizophrenia with cerebral hemiatrophy has not previously been reported.

Neuroimaging with X-ray computerised tomography showed marked reduction in the volume of the left cerebral hemisphere with secondary enlargement of the left lateral fissure and cortical sulci. High resolution cranial single-photon emission computerised tomography showed a functional deficit of the regional cerebral blood flow in the left lateral parietal and left temporal lobes.

Cerebral hemiatrophy may belong to the lengthening list of neurodevelopmental cerebral anomalies associated with schizophrenia.