In the general population of Singapore the mean annual suicide rate over 1985–88 was highest in the Indians (20.4 per 100 000), followed by Chinese (15.8 per 100 000), and the Malays (2.4 per 100 000). However, in the elderly population (65 years and over) the rate was highest in the Chinese (61.2 per 100 000) with Indians second (30.5 per 100 000), and Malays still the lowest (3.2 per 100 000). Among elderly Chinese, women had a higher suicide rate than men.

British Journal of Psychiatry (1992), 160, 558–559

Special hospitals are principally concerned with the treatment of patients of dangerous, violent or criminal propensities referred from the courts and prisons. However, patients can be transferred from local NHS hospitals. The case of one such patient illustrates the potential benefits of such a transfer, even for patients who are not of immediate danger to others.

An elderly woman developed the delusion that she was dead (‘Cotard's delusion’) and that she was in another place (‘reduplicative paramnesia’). Charles Bonnet reported this unique combination of symptoms a century before Cotard's influential description of the nihilistic delusions and of Pick's description of ‘reduplicative paramnesia’.

A 32-year-old man presented with koro-like symptoms in association with a depressive illness and HIV infection.

Data on 9235 persons who had attempted suicide and been admitted to hospital over an eight-year period showed that a female:male ratio of 4:1 in young subjects gradually decreased with age; from the age of 79, the number of men slightly exceeded the number of women. More than half the attempts were made by people aged under 24, and the same proportion was unmarried. Attempts occurred mainly after 2 p.m., with the maximum frequency between 8 p.m. and midnight; over the week, the smallest number was on Saturdays. There was a slight seasonal variation, with the highest number in March and the lowest in August.

British Journal of Psychiatry (1992), 160, 560–562

A patient with chronic depression responded to treatment for her major depressive episodes, but was left with a dysthymia which was eventually relieved by anticonvulsants. Sodium valproate may be of use in a range of affective disorders.

A patient with chronic primary depersonalisation responded well to a combination of psychotherapy and abreaction.