Schizophrenia is a common disorder with a life time prevalence of approximately 1 per cent. The illness often develops in young adults, who were previously normal, and is characterized by a constellation of symptoms including hallucinations and delusions (psychotic symptoms) and symptoms such as severely inappropriate emotional responses, a disorder of thinking and concentration, erratic behaviour as well as social and occupational deterioration. A considerable proportion of the variance in the liability to develop schizophrenia may be genetic, but segregation analysis, to establish a mode of transmission, has not produced a consistent result. One of these studies was carried out in Iceland and made use of the large family size and extensive geneaological information present in that country. Here we demonstrate genetic linkage of two DNA polymorphisms on the long arm of human chromosome 5 to schizophrenia in seven British and Icelandic families with multiple affected members. The results indicate the existence of a gene locus with a dominant schizophrenia-susceptibility allele. Inheritance of the allele in the families studied suggests that it may also predispose to psychiatric conditions such as schizophrenia spectrum disorders and a variety of other disorders. This report provides the first strong evidence for the involvement of a single gene in the causation of schizophrenia.

Screening tests for the detection of physical illness in 650 newly admitted psychiatric patients were examined critically. Almost 17% of these investigations were found to be abnormal and certain high risk groups were identified. These included patients suffering from significant weight loss, substance abuse, disorientation and self-neglect in addition to the elderly and patients with clinical evidence of physical disorder on examination. The young and physically fit had the least number of abnormalities, and it is suggested that more clinical common sense should determine the screening procedure and that no test is rightly "routine".

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more important to service users than their psychiatrists, this does not tell us what happens in practice. The real question which we should be asking is to service users themselves and how they feel religion has been accounted for in treatment. I worry that the answers might be even more demoralising. Taking a spiritual history is both an easy and important task to be undertaken by any professional. It can substantially help a service user feel understood and hence engaged in treatment. The Spirituality Special Interest Group provides several tools which should surely become routine practice for all mental health professionals, at the very least in screening (www.rcpsych.ac.uk/PDF/ DrSEaggeGuide.pdf). The suggestion of prayer with service users is a troubling one with the potential to lead to transgression of boundaries through sharing such an intimate act. It leads to duplicity of the psychiatrist's role, erosion of the purpose of treatment and in my mind is best avoided.