Few studies of psychological tests which have been shown to differentiate between psychiatric groups have attempted to follow-up the patients originally tested so as to determine what the predictive power of the test might be in the light of subsequent events. One of these few studies has been reported by Walton (1958) and commented upon by Inglis (1959) who was able to show that the test Walton described was better able to predict the outcome of illness after a follow-up period of two years, than was the original diagnostic label. The importance of this kind of study has been pointed out most clearly by Payne (1958). His argument is that, “Description is only one implication of the diagnostic label. Can the test score aid the doctor in making a prognosis? This need not be the case. Let us consider the original validation of the test again. The doctor who diagnosed the standardization group of patients might well be able to give a more or less accurate prognosis for this group of patients. In fact there might be a significant relationship between the presence or absence of the label he assigns, and prognosis. We also know that there is a significant correlation between presence or absence of his label and the test scores. This does not prove, however, that there is any relationship whatsoever between the diagnostic test score and prognosis. Two things which correlate with the same thing do not necessarily correlate with each other, unless the correlations concerned are greater than ·7” (1958, p. 27).

The Anglo-American literature relevant to psychiatry and obstetrics reveals studies of the puerperal psychoses (Tetlow, 1955); papers describing the psychological reactions experienced during pregnancy and labour (Tobin, 1957; Kartchner, 1950) and retrospective studies of patients presenting with obstetric abnormalities of pregnancy and labour (Coppen, 1958; Caldwell, 1958; Cramond, 1954). The present paper describes the psychiatric and obstetric follow-up of a group of neurotic pregnant women, a study of similar material not being previously recorded in the literature.

The purpose of the investigation was the assessment of dementia from a clinical and EEG viewpoint in patients aged 60 and over, resident in a mental hospital containing a high proportion of elderly long-stay persons. All patients of suitable age were examined irrespective of diagnosis, provided that this was technically possible and, if alive, they were re-examined three years later, in the hope that a longitudinal study would give additional information as suggested by Roseman et al. (1952) and Sheridan et al. (1955).

Many phenothiazine derivatives are no. in use in the treatment of schizophrenia. We, in this hospital have used Largactil extensively and more recently Stemetil in the management of chronic schizophrenia.

Iproniazid, introduced as an anti-tubercular drug, has been widely used in the treatment of depression. It is a monoamine oxidase inhibitor and some of its effect on the central nervous system may therefore depend upon its preventing the breakdown of serotonin. It is hepatotoxic. Dally (2) and many others have commented upon a time lag of at least a week after the start of treatment before observable clinical improvement in depressed patients.

The increasing use of tranquillizers in the treatment of mental disorders has made it imperative to study both the immediate and long-term effects of these drugs in order to establish their limits of safety. One of the approaches that appeared important to us was the correlation of the histological findings (Roizin, True and Knight, 1959) with tissue levels of the drug. In addition to its significance from the pathological standpoint, such a study may also furnish information towards a better understanding of the mechanism of action of these drugs.

In spite of a thorough search of the medical literature in this country we have been able to discover only two articles (1, 2) that come within the scope of this paper and these were descriptions of single cases in elderly men at the end of the last century. As it is commonly stated in medical text books that not more than 10 per cent. of all cases of intestinal obstruction are due to volvulus and that of these up to 70 per cent. occur in men, we have been impressed by the incidence of four cases of volvulus in just over three years on the female side of this mental hospital (536 females of all ages).

Convulsive therapy as a form of treatment for schizophrenia originated very soon after insulin coma treatment and the induction of convulsions by an electric current was first used by Cerletti and Bini in 1938. For many years insulin comas were regarded as the treatment of choice, although E.C.T. was recognized as having some value, particularly in catatonic conditions. In the last eight years the advent of effective chemical therapy with the tranquillizers has tended to overshadow the value of any other form of treatment.

In view of their many inter-connections with the cortical grey matter, the effects of lesions in the basal cerebral nuclei are of the greatest theoretical interest. On account of the rarity of naturally occurring lesions confined to these nuclei, there have been few reports of psychological changes in patients with discrete subcortical lesions. Smyth and Stern (1938) described four cases of intrinsic tumour of the thalamus, all of whom gave evidence of organic dementia early in the course of the disease. Eaton et al. (1939) reported six cases of symmetrical cerebral calcification preponderating in the basal ganglia, with no radiographic evidence of cerebral atrophy, of which the clinical concomitants included mental retardation. Alford (1948) has gone so far as to insist that destruction of thalamic nuclei is alone responsible for intellectual impairment, and that “focal” defects associated with different cortical lesions are related either to sensory disturbances or to the psychiatric state of the patient.

A generally acceptable method of comparing psychotomimetic compounds has apparently not been devised. A method of this type would provide the replicability not now available in the newly developed field of psycho-pharmacology. For example, the method employing the Cold Spring Harbor questionnaire devised by the writer and his co-workers has been criticized as being “too suggestible”, “too structured”, or “insufficiently cognizant of unconscious processing”. It is the purpose of this communication to show that the Cold Spring Harbor questionnaire (1, 2) provides a suitable method of study of the psychotomimetic drugs similar to d-lysergic acid diethylamide (LSD-25). The basis for this statement is the comparison made here of the results of an independent study of a series of congeners of LSD-25 made by Isbell, Miner and Logan (3) in another laboratory, in a different milieu, and on a different population sample. It has been found that the comparative effectiveness of a series of LSD congeners both at Cold Spring Harbor and at Isbell's laboratory in Lexington, Kentucky are the same when the Cold Spring Harbor questionnaire is employed.