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The psychological effects of nicardipine and propranolol were assessed in a group of 30 hypertensive patients who were randomly allocated to treatment with one or other drug., Baseline psychiatric and cognitive assessments were performed after a 4 week placebo washout phase and were repeated after 12 weeks of active drug treatment., Impairments were found in both treatment groups on the Complex Figure Test, which assesses both constructional abilities and the ability to organise complex data. The propranolol group showed a significant increase in performance in the Digit Symbol Substitution Test; this was not seen in the nicardipine group. The nicardipine group reported a decreased sense of proficiency as assessed by a visual analogue scale., In neither treatment group was there detectable impairment in psychiatric well-being or ability to fulfil normal social roles., The interpretation and implications of the findings are discussed. [ABSTRACT FROM AUTHOR]

Two cohorts of anorexia nervosa patients were followed up for a mean of 20 years. All except 4% of each cohort was traced. The crude mortalities were: St George's, 4%; Aberdeen, 13%. The SMRs were: St George's, 136; Aberdeen, 471. If the untraced were assumed to be dead, crude mortalities were 7.6% and 15.9% respectively, and SMRs were 276 and 592 respectively. Causes of death were complications of the illness and suicide. Medical treatment may reduce early mortality, while comprehensive medical and psychotherapeutic treatment may reduce late mortality. [ABSTRACT FROM AUTHOR]

A case report of a 61 year-old male with a long history of complex partial seizures is presented. Multiple psychotic symptomatology developed post-operatively. It is argued that these reflect continuing right temporal epileptogenic activity.

Objectives: Examination of rates of suicide and undetermined deaths in one health board area between 1974 and 1990. Data are presented on contacts between decreased individuals and the psychiatric and clinical psychology services and general practice., Design: Retrospective analysis of data from psychiatric, clinical psychology and general practice case records, and from the General Register Office for Scotland., Subjects: Deaths by suicide, undetermined causes and accidental poisoning., Results: Male suicide rates increased by 25% in the period studied. Rates in females declined by 65%. There was a small decrease in rates of death by undetermined causes in both sexes. 46% of those dying by suicide and 41% of those dying by undetermined causes had current or past contact with the Psychiatric Services., Conclusion: The study offers data on suicide to allow planning of measures to achieve national targets for reduction in suicide rates.

Sixteen female anorectics, nine recovered and seven unrecovered, were interviewed 22 years after onset of illness. Concomitant psychiatric diagnoses were much more common among the unrecovered patients, but three recovered patients have had a major depressive episode occurring after recovery from their eating disorder. The findings point to a linkage between eating and affective disorders and the mechanisms of such a linkage are briefly discussed.

In a retrospective case note study, 73 young females with anorexia nervosa were compared with 88 young females with affective psychosis. These groups of patients did not differ in terms of place of residence, birth order or social class. They differed very significantly, however, in terms of age at onset of symptoms, marital status, educational attainments and in the pattern of family histories of psychiatric illness. It is concluded that anorexics and young females with affective disorders are two quite distinct groups of patients.

Purpose: Short-term therapy with angiotensin converting enzyme (ACE) inhibitors for hypertension is effective and well tolerated, and compared with beta blockers, may cause fewer adverse reactions. Furthermore, enalapril has been observed to have a greater effect on systolic blood pressure than beta blockers. We therefore decided to compare the ACE inhibitor enalapril and the beta blocker atenolol as monotherapy in a double-blind study of patients with mild to moderate hypertension., Patients and Methods: After a four-week placebo run-in period, 162 patients were allocated randomly to receive atenolol (50 to 100 mg daily) or enalapril (20 to 40 mg daily) for 12 weeks. To assess the influence of these drugs on quality of life, a series of psychologic tests was performed, and a subset of patients also underwent treadmill exercise and pulmonary function tests., Results: In 147 patients who completed the study, enalapril reduced supine blood pressure by 19/12 mm Hg, compared with 9/7 mm Hg for atenolol (p less than 0.001/p less than 0.005). The modest blood pressure response to atenolol was not due to poor compliance. A target blood pressure of 140/90 mm Hg or less was achieved by 35 percent of enalapril-treated atenolol (p less than 0.01). The frequency and severity of adverse effects with the two drugs were similar, and few important differences emerged from the quality-of-life assessments., Conclusion: At the doses used, enalapril induced a greater short-term blood pressure response than atenolol; long-term studies of its safety and efficacy are required.