To assess the efficacy of supervised disulfiram as an adjunct to out-patient treatment of alcoholics, a randomised, partially blind, six-month follow-up study was conducted in which 126 patients received 200 mg disulfiram or 100 mg vitamin C under the supervision of a nominated informant. In the opinion of the (blinded) independent assessor, patients on disulfiram increased average total abstinent days by 100 and patients on vitamin C by 69, thus enhancing by one-third this measure of treatment outcome. Mean weekly alcohol consumption was reduced by 162 units with disulfiram, compared with 105 units with vitamin C, and the disulfiram patients reduced their total six-month alcohol consumption by 2572 units compared with an average reduction of 1448 units in the vitamin C group. Serum gamma-GT showed a mean fall of 21 IU/I in patients on disulfiram but rose by a mean of 13 IU/I with vitamin C. Unwanted effects in the disulfiram group led to a dose reduction in seven patients and to treatment withdrawal in four (and in one vitamin C patient). Two-thirds of the disulfiram group asked to continue the treatment at the end of the study. There were no medically serious adverse reactions.

A series of 100 consecutive psychiatric in-patients who absconded from a psychiatric hospital a total of 231 times over ten months was studied. The reasons given for absconding, duration of absence, and mode of return are described. The legal status and ethnic origins of absconders differed significantly from those of the base hospital population.

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In a double-blind crossover study of 26 long-stay schizophrenic patients, no correlation was found between caffeine consumption and levels of anxiety and depression. No significant changes in patients' behaviour or levels of anxiety and depression occurred when the wards changed to decaffeinated products. Serum caffeine levels confirmed compliance. No evidence was found to support a removal of caffeinated products from this group of patients.

Ergotamine preparations are extensively used in the treatment of migraine. Although not widely appreciated, there have been reports in the literature of ergotamine abuse, related to the development of tolerance and withdrawal headaches, which result in a steadily increasing consumption of the drug (Wolfson and Graham, 1949; Peters and Horton, 1951; Friedman et al., 1955). It is important clinically to recognize this condition, as ergotamine can have dangerous vascular side-effects (Byrne-Quinn, 1964; Cranley et al., 1963; Young and Humphries, 1961).