Patients with AN presenting to a gastroenterology service have profound psychosocial morbidity in excess of those presenting to a specialist eating disorders unit. Their diagnosis is often delayed. Early recognition and prompt referral to a specialist eating disorder unit should form the basis of management.

Twenty-five women with somatisation disorder (SD) were compared with matched patient controls for the presence of personality disorders. Personality was assessed with the Personality Assessment Schedule (PAS). Interviewers were unaware of the patients' diagnoses. All controls had DSM-III-R axis I diagnoses of depressive or anxiety disorders. The prevalence of personality disorders among patients with somatisation disorder was 72% compared with 36% among controls. Certain personality disorders, including passive-dependent, histrionic, and sensitive-aggressive, occurred significantly more often in the SD patients than controls.

Nearly 40% of men with faecal incontinence report it in the absence of a definable functional or structural sphincter abnormality. There are differences in physiological characteristics and coping behaviours of men and women with faecal incontinence.

This study would suggest that SNS is not an effective treatment for chronic anal pain in the majority of patients. PNE is not an effective means of identifying which of these patients are likely to respond to permanent SNS.

SUMMARY BackgroundHome parenteral nutrition is established as standard management for patients with chronic severe intestinal failure. Although the treatment is welcomed by many patients, there are psychological consequences of living with a central venous catheter and there are associated restrictions to the lives of patients on home parenteral nutrition. A subgroup of home parenteral nutrition patients may use their central venous catheter for self-harm.