Metformin is effective in reducing weight in South Asian patients with schizophrenia or schizoaffective disorder who had increased their body by more than 10% after treatment with atypical antipsychotics.

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BackgroundObsessive compulsive disorders are a complex group that can have a variety of manifestations. Many authors now describe an obsessive compulsive spectrum disorder where many other specific diagnostic entities such as trichotillomania, tic disorders and body dysmorphic disorder are considered to be related and linked disorders.Case presentationWe report a case of a twenty two year old Sri Lankan male who presented with life threatening self starvation due to severe obsessive compulsive disorder. The diagnosis was not considered till late due to the atypical presentation of the patient. While his symptoms bordered on a delusional psychosis, a decision was made to treat him as for obsessive compulsive disorder with behavioural therapy which was successful in the end.ConclusionsIn analysis of a patient with severe anorexia, the psychological causes should not be forgotten. In fact, if the feeding pattern of the patient was observed at the beginning, unnecessary investigating and life threatening worsening of the condition could have been avoided.

SummaryA serviceman seriously injured in battle after recovery from his initial injuries developed severe stabbing pain in his left leg. The pain was persistent, distressing and caused significant functional impairment. The pain failed to remit with pharmacotherapy which included sub cutaneous morphine. At the time of referral the pain had lasted 18 months. The patient was treated with six sessions of cognitive behavioural therapy with significant reduction of his pain. Nine months later, on follow-up, he was pain free and functioning almost normally. The principles of psychological management of pain are also discussed. SL J Psychiatry 2011; 2 (1): 28-30