Eating disorders Anorexia nervosa was first described by William Gull in 1868 and is characterised by deliberate and extreme weight loss. In bulimia nervosa, episodes of overeating are followed by…

Psychiatry in primary care The majority of people who are diagnosed with a mental illness have no contact with the psychiatric services; instead they are treated by their general practitioner…

Liaison psychiatry Very few disorders can be considered to wholly affect the body but not the mind, and vice versa. The majority of psychiatric disorders have some impact upon the…

Alcohol dependence I Introduction Alcohol is the most popular of the psychoactive substances available for recreational use. In small quantities it has a stimulating effect, lifting the mood and causing…

Learning disability As with many other areas of psychiatry, the terminology used to describe what ICD10 classifies as mental retardation has changed regularly, to reflect changing philosophies of care and…

Obsessive–compulsive disorder The characteristic features of obsessive–compulsive disorder (OCD) are obsessions and compulsions which interfere with a person’s ability to cope with their daily life. Obsessions, also known as obsessional…

Antipsychotic drugs Antipsychotic drugs are also known as ‘major tranquillisers’ or ‘neuroleptics’. There are now two distinct groups of antipsychotics: the older ‘typical’ drugs such as chlorpromazine and haloperidol, and…

Old age psychiatry II Other conditions common in old age If dementia did not exist, there probably would not be a separate speciality of Old Age Psychiatry. However, there are…

Alcohol dependence II Assessment All patients should be asked about their alcohol consumption, and specific quantities recorded. Vague responses, such as ‘I only drink socially’, are not acceptable; many alcoholics…

Perinatal psychiatry Case history 27 Bronwyn is 32 years old. She has two children and is in the tenth week of pregnancy. She has a history of recurrent depression, including…