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OBJECTIVES: The mechanism of many neuropsychiatric disorders remains unknown, but the ineffectiveness of the sodium channel blocker lidocaine has been suggested to be a biomarker for Attention Deficit Hyperactivity Disorder (ADHD) and a severe form of Premenstrual Syndrome (PMS) that is considered psychiatric. We conducted single-arm double-blind clinical trials to test whether lidocaine ineffectiveness can be used as a biomarker to identify people with these conditions and provide a clue as to the molecular mechanism and potential psychopharmacological intervention. EXPERIMENTAL DESIGN: We developed a noninvasive taste test for lidocaine ineffectiveness, validated by comparing lidocaine injections to pain testing in 12 subjects, and assessed it in individuals with ADHD and PMS. PRINCIPAL OBSERVATIONS: Lidocaine ineffectiveness had a strong association in women with ADHD + PMS in a sample of 53 subjects and controls (p < 0.001). CONCLUSIONS: These results suggest the possibility of the biological understanding of the combination of ADHD and PMS that is characteristic of the psychiatric disorder Premenstrual Dysphoric Disorder (PMDD). These results and comparison to family pedigrees of a neuromuscular channelopathy with overlapping symptoms suggest the possibility that the clinical phenotype in PMDD is produced by sensory overstimulation, and amenable to molecular understanding and treatment.

The COVID-19 pandemic has had a significant impact on the education of medical students. Many final-year students felt overwhelmed by the pandemic and less confident in the clinical setting having missed a significant proportion of their fourth-year studies. In addition, with increased numbers of critically unwell patients, restructure of services and redeployment of staff, it was inevitable that teaching on clinical placement would be compromised.The aim of the study was to develop an innovative near-peer educational programme with integrated simulation to support the learning needs of students and alleviate pressure from clinical specialities.The team developed a programme whereby students attended a full day of protected small-group teaching each week, equating to a total of 72 taught hours per student over an 8-week placement. Each day centred around a common theme, for example, ‘the breathless patient’, working through patient-centred case discussion, diagnostic workshops and simulation (Integrated design of the themed teaching days delivered to final-year students.This innovative teaching programme was implemented over the 2020–2021 academic year and was well received by students as evidenced in the following feedback: ‘It was really helpful and interesting to have each teaching day themed on a presenting complaint’.‘Protected time so (we) do not miss out if clinicians are busy’‘The best teaching I have had during medical school (…) I loved how interactive, clinically focussed and relevant to F1/F2 each teaching day was’.‘Consistently received feedback which I have been able to act upon to improve my clinical practice’‘The improvement in my confidence, understanding & knowledge has been unbelievable’.‘Simulation session was really useful and enjoyable (…) watching and feeding back is a really helpful way to recognize different clinical presentations and critically analyse ABCDE assessment & communication skills’‘These teaching sessions are great and unlike anything normally provided on placement’.The teaching programme has proved to be of such success that the team continue to develop them to integrate further aspects of clinical practice and inter-professional simulation. Furthermore, the team hope to develop themed teaching days for other student year groups to complement their clinical placements.