The case records of 499 victims of civil and terrorist violence were examined, and the presence or absence of post-traumatic stress disorder (PTSD) and associated features recorded. The results support the face, and predictive, validities of PTSD. 'Acting as if the event were reoccurring' and 'survivor guilt' seemed not to be characteristic symptoms, and the homogeneity of the emotional state in PTSD was questionable. Only marital disharmony and suicidal behaviour were associated complications. PTSD seemed to be found in a wide range of stressors, but the danger in over-reliance on results from combat veterans is emphasised.

The sample studied was a group of 643 adults each seeking compensation for "Nervous Shock" and seen by a single Belfast psychiatrist for medico-legal assessment. Demographic information, risk factors, diagnosis, type of incident, symptoms and outcome were recorded for each patient. From the symptoms recorded, a subgroup of 23% were identified as suffering from Post-Traumatic Stress Disorder (PTSD) as defined in DSM III. This subgroup tended to be older, included more females, had more depressive symptoms and had more severe, prolonged disturbance. The findings document our experience of PTSD in the special context of Northern Ireland and suggest it may be a more useful term in describing psychological reaction to violence than the nebulous concept of "Nervous Shock" used at present by our courts.

We report four cases of poisoning with amatoxin-producing mushrooms in suburban Long Island. All occurred when amateur mushroom hunters picked mushrooms from neighboring lawns. Two patients presented 30 hours post ingestion with evidence of acute hepatic dysfunction. One survived, after treatment with charcoal and penicillin; the other, a 90-year-old woman with prior cardiac disease soon developed shock and subsequently died. The other two patients were admitted 18 hours after ingestion of Lepiota chlorophyllum and received prompt charcoal hemoperfusion. Both did well, although one had a mild elevation of transaminases. Although most reports of amatoxin poisoning originate in Europe, these cases confirm that amatoxin-producing mushrooms, including Lepiota chlorophyllum, may be found in northeastern American suburbs. Such patients who present prior to 24 hours after ingestion should receive charcoal hemoperfusion if a lethal dose (> 50 g of mushroom) has been eaten.

This study is an attempt to evaluate the psychiatric sequelae in victims of violence in Northern Ireland between 1979 and 1984. Seven hundred and nineteen consecutive referrals for medico-legal reports were investigated using detailed analysis of case records. These clients were all seeking compensation for psychological injury allegedly sustained following a violent incident. Details of demographic data, diagnosis and utilization of treatment services were recorded. Clients showed a high rate of anxiety and depressive reactions and neuroses, with notable infrequency in the diagnosis of hysteria and phobic neurosis. A large number of people were prescribed drugs, a significant percentage continuing to take these for over one year. The significance of these results is discussed with regard to the issues of compensation neurosis and ‘nervous shock’.