Tardive dyskinesia is widely believed to be a state of relative hyperdopaminergic and hypocholinergic imbalance in the striatum of patients chronically treated with neuroleptics. However, not all patients with tardive dyskinesia respond to cholinergic drugs, which theoretically should restore the balance and improve the symptoms. We report a controlled, double-blind, crossover study of choline chloride in 11 patients with persistent tardive dyskinesia. Seven patients showed partial or minimal improvement, while two did not change and two deteriorated. The results are discussed in the light of other similar findings in the literature, and the implications for pharmacological subtypes of tardive dyskinesia using cholinergic probes are explored.

The General Health Questionnaire (GHQ) and the Clinical Interview Schedule (CIS) were translated into Portuguese and were used in a pilot study of psychiatric morbidity in primary care at ‘The Health Centre Barra Funda/Bom Retiro’ of the Faculty of Medicine of Santa Casa Hospital at Sao Paulo, Brazil. The Portuguese translation of the CIS was found to be a feasible instrument for community studies in Brazil, but the Portuguese translation of the GHQ-30 was shown to be of limited use in this particular setting. The extent of minor psychiatric morbidity was very high (46%); 33% was regarded as conspicuous (CPM) and 13% as hidden (HPM).

Serum creatine phosphokinase (CPK) levels were compared with assaultive behaviour by 46 psychiatric patients. Significant relationships were found between CPK level and violent behaviour prior to admission and CPK level and seclusion as a danger to others while in hospital. No relationship was found between CPK level and assaultiveness while in hospital.

One hundred and eight women with bulimia were evaluated for affective disorder and alcohol or drug abuse, by means of the DSM-III diagnostic criteria. In this sample, 43·5% had a history of affective disorder and 18·5% had a history of alcohol or drug abuse. Approximately 56% of the bulimia patients scored within the moderate to severe range of depression on the Beck Depression Inventory.