This paper explores the genesis of sadistic behaviour in men and its relationship to crime. Sixteen male special hospital patients, each with a diagnosis of psychopathic disorder, formed the basis of this descriptive study. In only three cases were the crimes explicable in terms of external circumstances and personality traits. The offences of the remaining 13 cases became comprehensible only when the offender's internal circumstances were explored: investigation revealed repetitive sadistic masturbatory fantasies which had spilled over into overt behaviour because the patients had felt impelled to seek and create increasingly dangerous in vivo 'try-outs' of their fantasies. The paper discusses the crucial link between sadistic fantasy and behaviour.

People with mental health problems often experience self-stigma, whereby they internalise stereotypic or stigmatising views held by others. Self-stigma is known to have negative effects on self-esteem and self-efficacy and a continuing impact on psychological wellbeing. Self-help interventions designed to reduce self-stigma may have an important contribution to make. This review aimed to provide an overview and critical appraisal of the literature on self-help interventions that target self-stigma related to mental health problems. A systematic review of five electronic databases (PsycINFO, MEDLINE, CINAHL Plus, Scopus and EMBASE) was carried out to identify articles published between January 2007 and July 2019. Eight articles that reported on self-help interventions for self-stigma were identified and evaluated using a combination of quality appraisal and narrative synthesis.

Mental health professionals with lived experience often experience heightened stigma and fear that their competency may be questioned. We present a new intervention (HOP-MHP) designed to support them in decisions about sharing their lived experience and preliminary results regarding the intervention’s acceptability and feasibility.

Infective endocarditis caused by Proteus mirabilis is strikingly rare. Here, we describe the case of an 86-year old man with five recurrent septic episodes over a period of three months associated with Proteus mirabilis bacteraemia secondary to underlying Proteus endocarditis. The final diagnosis was made based on clinical findings, blood culture results and transoesophageal echocardiogram. The patient was treated medically with 6 weeks of ceftriaxone and long-term oral ciprofloxacin. On completion of intravenous therapy the patient remained well. We performed a literature review and found this to be only the fourth confirmed case of Proteus mirabilis endocarditis successfully treated with antibiotic therapy alone. This case highlights an important but rare cause of endocarditis, reinforcing the need to consider this diagnosis in recurrent Gram-negative bacteraemia even if by an atypical organism.

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