A double-blind control trial of gluten-free versus a gluten-containing diet was carried out in a ward of maximum security hospital: 24 patients were studied for 14 weeks. Most suffered from psychotic disorders, particularly schizophrenia. Various dimensions of behaviour were rated on the Psychotic In-Patient profile (PIP) at different stages. There were beneficial changes in the whole group of patients between pre-trial and gluten-free period in five dimensions of the PIP, maintained during the gluten challenge period; these changes could be attributed to the attention the patients received. Two patients improved during the gluten-free period and relapsed when the gluten diet was reintroduced.

Attempts to repeat in human subjects animal studies in which naloxone stopped withdrawal symptoms after prolonged use of heroin failed. Nevertheless, suggestions for further studies are made, as the subjects' subsequent desire for opiates did seem attenuated.

Patients diagnosed as reactively or endogenously depressed were given electroconvulsive therapy (ECT). The endogenously depressed patients tended to respond to the treatment more quickly and favourably. Measures of age and severity of depression were as predictive as the classification into endogenous or reactive depression using the Newcastle rating scale. The degree of psychological stress ascertained and presumed to be operating did not contribute to the prediction of outcome.

The claim of Hansen (1969) and Hansen and Dimitrakoudi (1974) that whole blood adenosine triphosphate (ATP) levels correlate with depressed affect was examined. The findings from 84 patients failed to confirm any relationship between mood and whole blood ATP. One patient showing the highest correlation (r = 0-85; p less than 0-001) between the ATP levels and mood in the original report was re-examined; no relationship was now found (r = -0-25; p greater than 0-1).

It is true that ageand age ofonsetmay nolonger be regarded as reliable predictive factors in view of the somewhat contradictory results reported by different authors (Huffet al, 1987), but the sinister prognostic significance of visuo-spatial dysfunction must be considered as one of the most robust findings in the cliicalliterature on Alzheimer's disease. Its relation ship to dysphasia and other focal features on the one hand and to overall severity on the other is a complex one which my group is trying to unravel in the course ofa prospective study.

In Orthomolecular Psychiatry; Treatment of Schizophrenia, edited by David Hawkins and Linus Pauling (1973), Beebe and Wendel (pp. 278–302) report a high correlation coefficient of r = 0.99 (which we calculate gives N = 42, p very much lower than 0.001) between whole blood glucose and adenosine triphosphate (ATP). This relationship they claim is no longer maintained in schizophrenics with anxiety, r = 0.16 (N = 62, p > 0.1). Erban and Hanzlicek (1966), Hansen (1972) and Hansen and Dimitrakoudi (1974) have suggested a possible significance of whole blood ATP in psychoses, and Naylor, Dick, Dick, Le Poidevin and Whyte (1973) have implicated red cell Na/K ATPases. The mechanisms involved in controlling blood ATP seemed therefore worthy of study especially if they are so dependent on glucose.

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