W e met the patient, a retired 71-year-old gardener, following his transfer from a neurology ward. He had initially presented with an acute behavioural change and rapid cognitive decline associated with several generalised tonic-clonic seizures. From a highly functional individual going on holiday cruises with his wife, he had withdrawn from social life and developed difficulties with simple tasks, such as turning on the TV. On the emergence of agitated and paranoid behaviour, with a possible further seizure, he had been hospitalised. Following the detection of positive serum antibodies, he was treated for voltage-gated potassium channel (VGKC)-complex limbic encephalitis with several courses of methylprednisolone and plasma exchange. Little clinical improvement was observed, resulting in consideration of alternative diagnoses (including neurod e g e n e r a t i v e o r p s y c h i a t r i c disorders). At the time of transfer, low dose olanzapine and sertraline

There is currently no first‐line psychotropic indicated in the management of inappropriate sexual behaviours in dementia (ISBD). This case report highlights the treatment of a patient with mixed dementia, who developed significant ISBD symptoms which resolved upon commencing a popular SSRI. The authors include an evidence‐based summary of other medications which have demonstrated some success in reducing ISBDs.

Frontotemporal dementia (FTD) is a heterogeneous neurodegenerative disease whose early behavioural and emotional symptoms often mimic psychiatric disorders. Here, the authors highlight the challenges of diagnosis with the reassessment of an elderly patient receiving electroconvulsive therapy (ECT) for severe depression.

Psychiatry liaison services provide the interface between mental and physical health in the acute medical hospital, however there can be logistical and operational difficulties to overcome.This quality improvement project aimed to improve the timeliness of referrals to a liaison service from an acute hospital through simple interventions of a newsletter, email to staff, and a pilot including attending post-take ward rounds on the Medical Assessment Unit (MAU) of the hospital. This resulted in a faster referral process to liaison as well as improved staff satisfaction with the liaison service, both of which will have a positive benefit on the clinical management of patients and the patients experience in hospital.There was a significant improvement in overall staff satisfaction with the referral pathway, appropriateness of referrals and working hours of the Mental Health Liaison Team -increasing from 14% at baseline to 100% at the end of the study. Referral outcomes also showed a considerable improvement, with the percentage of junior doctors successfully able to locate the referral form increasing from 60% at baseline to 100%. Problem