This paper reports the social results of a double-blind placebo controlled trial of fluphenazine decanoate. Among patients on placebo there was a deterioration in family relationships, which was due to an increase in aggression, noisiness, talking about delusions, and socially embarrassing behaviour after withdrawal of active drug.

Methods are first described for testing for and measuring the proportion involved in the causal link between life-events and psychiatric disorders; the paper then deals with the nature of the causal effect itself. A method is described (and developed mathematically in an appendix) which enables a choice to be made between a triggering effect in which events are seen as precipitating an illness that would probably have occurred before long for other reasons, and a formative effect in which life-events either substantially advance onset in time, or bring it about altogether. The method is used to demonstrate the presence of a formative effect in depressive and a triggering effect in schizophrenic disorders.

Data on serious psychiatric illness (900 cases), suicide (150 cases), indictable crime (1,300 cases), and child welfare problems (800 cases) in individuals living in Brighton have been collected. Rates of these behavioural pathologies have been calculated for 19 wards in the city, and correlated with data collected in the 1966 Census. Results show that the behavioural pathologies are strongly intercorrelated and are associated with in-migrant areas containing rooming houses of poor quality. These areas tend to be in the city centre. Rates of psychiatric illness, including diagnostic groups in different age and sex groups, have been calculated for 110 enumeration districts in the city, and these rates correlated with factor scores from the principal components analysis of 53 census variables. Complex patterning of the data has been demonstrated. The identification of small areas in the city with high rates of behavioural pathology in particular social settings is an important precursor of the establishment of special measures for prevention and treatment. An important area for future research is the establishment of causal patterns, and the investigation of the primary or secondary role of social conditions in the emergence of mental illness and other behavioural pathology.

Patients suffering from anorexia nervosa usually exhibit extreme concern over their physical size and weight. This tendency, noted by many observers, has been variously interpreted. However, few experimental studies of this phenomenon have been reported. In the present paper an objective technique for determining bodily perception is described, together with a series of studies involving investigation of bodily perception in anorexia nervosa. In the first study a group of anorexia nervosa patients was compared with a group of normal female controls, results showing that, unlike the controls, the patients exhibited marked overestimation of the width of their own body. Moreover, this tendency was found not to extend to perception of physical objects. The results of a second study showed that the overestimation of body width was less marked when the patients were required to gauge the size of a female model. In addition, they were found to be remarkably accurate in assessing physical height, both of themselves and of the model. A third study explored the effects of refeeding on the patients' tendency to see themselves as abnormally wide (and fat). The findings showed that this tendency decreased as patients put on weight. Moreover, the degree of overestimation of body width exhibited by patients was found to bear a relationship to their progress after discharge from hospital: when this persisted after weight gain, a subsequent relapse was more likely.

All patients with anorexia nervosa were extracted from three psychiatric case registers— North-East Scotland, Camberwell, and Monroe County. The average incidence varied from 0·37 per 100,000 population per year in Monroe County to 1·6 per 100,000 in North-East Scotland, in all three areas the number of cases reported per year was increasing, and in Camberwell, but not in Monroe County or North-East Scotland, there was a significant excess of patients from middle-class backgrounds.

A principal components analysis has been carried out on the Leyton Obsessional Inventory replies of 302 normal subjects, divided into subgroups by sex and nationality (Irish and English). Three distinct components were found in all the analyses, which have been called ‘clean and tidy’, ‘incompleteness’, and ‘checking’. Other less distinct components are described, and the differences and similarities between the analyses of the subgroups are discussed.

Depressed patients were rated at a psychiatric interview and completed a self-report symptom inventory. Concordance between the two measures was modest. Patients with psychotic depression and those with obsessional personalities were found to rate themselves low on self-report relative to interview assessments. Younger patients, and those showing neuroticism, hysterical, and oral dependent personalities rated themselves as more severely ill than did the clinician. These systematic discrepancies appeared to reflect a self-report response set to exaggerate or minimize psychiatric symptoms together with rater set regarding certain types of patients.

Within minutes of leaving the consulting room, patients are frequently unable to recall what their doctor has told them. This paper describes a simple, practical method for increasing recall by the organization of medical information into ‘labelled’ categories. The success of this technique was demonstrated first in a laboratory experiment with volunteer subjects, and then in a naturalistic setting with general practice patients.

Evidence is presented to show that patients with Alzheimer's disease owe their memory disturbance to both an impairment in short-term memory and an additional difficulty in establishing new material in long-term storage. These findings are particularly discussed in relation to the notion that, since the pathological changes in Alzheimer's disease are particularly manifest in the hippocampal region, then this involvement of the hippocampus might explain the memory disorder. The present experiment, which is similar to one previously reported using subjects with bilateral hippocampal lesions, shows the two types of memory disorder resulting from bilateral hippocampal damage and Alzheimer's disease to be qualitatively different. Some outstanding problems with regard to obtaining a complete understanding of the nature of the amnesic phenomena in Alzheimer's disease are discussed.

An animal model of morphine dependence is described, in which rats learned to overcome their aversion to solutions of morphine and eventually drank such solutions in preference to water on choice trials. Selected aspects of the acquisition, maintenance, and elimination of this type of morphine dependent behaviour were studied and the findings are discussed in terms of their relevance to man.

In close agreement with Essen-Möller, a classification of mental disorders is described. The two basic principles are the application of four independent classifying bases—namely, symptomatology, severity, aetiology, and course, and the breakdown of doubtful disease entities and syndromes to elementary cardinal symptoms and of comprehensive personality terms to simple traits.

As part of its programme on the standardization of psychiatric diagnosis, classification, and statistics, the World Health Organization has sponsored studies in different parts of the world to evaluate systematically a multi-axial approach to classification with particular reference to the field of child psychiatry. Preliminary findings from the United Kingdom study with 22 child psychiatrists are reported. The study included two parts: (1) a reliability study using the case histories of 17 patients; and (2) the testing of the classification in routine clinical practice. The ways in which these methods may be used to evaluate a new system of classification are described. It is concluded that a multi-axial system has such important advantages that it should be tried out further both in the field of child psychiatry and in other branches of psychiatry.

The unit was originally established in 1961 under the directorship of Professor G. M. Carstairs. Within a year of its formation it moved from London to Edinburgh where it has continued since, functioning in close collaboration with the Edinburgh University Department of Psychiatry. In April 1971 it was reconstituted under the same name and under the direction of the former assistant director, Dr. N. Kreitman. Its activities have been directed throughout primarily to the neuroses, personality disorders, and forms of abnormal behaviour such as ‘attempted suicide’ rather than to the psychoses or mental defect. The scientific staff currently number nine whole-time and two part-time workers.