As expected, dements, depressives and patients with a mixed psychopathology were differentiated from one another on the sedation threshold measure and on a number of psychological tests. In depressives responding to treatment significant changes in physiological and psychological measures, which had been reported in an earlier study, could not be replicated except for an increase of psychomotor speed. In the present sample of patients there were significant correlations between various psychological measures and between them and the levels of the sedation threshold, suggesting that sedation thresholds and psychological tests measured related cerebral functions. Evidence obtained from the earlier investigations to the effect that cerebral age changes short of those occurring in dementia may facilitate the occurrence of depression in late life was only weakly confirmed by the replication study.

A retrospective study of alcoholic psychoses is reported. The phenomena of the illnesses corresponded poorly with classical descriptions of alcoholic hallucinosis, delirium tremens and alcoholic paranoia. Alternative diagnostic approaches were tried (Catego, restrictive definition of alcoholic hallucinosis). The problems of distinguishing psychoses with associated organic factors from ‘idiopathic’ forms are discussed.

A review of the psychosocial literature relating to Crohn's disease reveals that most available studies have been aetiologically oriented and that there are important gaps in our knowledge about the psychological and social concomitants of the disease. Some future research possibilities are discussed.

The social reports on 84 children taken to court for failure to attend school were studied. Independent raters were able to assess reliably the presence and absence of a variety of variables concerned with the individual's behaviour, school, family, and involvement with social work agencies. In 68 instances teachers' questionnaires measuring psychiatric disturbance had been completed. There was no evidence that truancy in these circumstances is a homogeneous condition. At least 3 independent sets of features appear to be involved in most cases. One involves antisocial and educational problems (‘clinical truancy’), a second is concerned with adverse social factors and parental complicity (‘school withdrawal’), and a third set includes a tendency to social isolation (‘school refusal’). There was no evidence that individuals tend to exhibit one of these features to the exclusion of the others.

Changes in levels of prolactin, growth hormone, luteinizing hormone, and follicle stimulating hormone in serum, and testosterone in plasma, have been studied in 38 patients with acute schizophrenic illnesses in a 4-week double-blind comparison of the 2 isomers of flupenthixol and placebo. Only prolactin showed changes which could be related either to changes in clinical state or to the effects of medication. Prolactin levels increased during treatment with the therapeutically active α-isomer of flupenthixol but were unchanged with the inactive β-isomer and placebo. Although there was a significant relationship between prolactin level and antipsychotic effect in patients on α-flupenthixol, in the individual case prolactin level was not a strong predictor of therapeutic response; and in patients on inactive medication changes in prolactin level could not be related to symptom change. There was a time lag of at least 2 weeks between the increase in prolactin secretion in patients on α-flupenthixol and the therapeutic effect attributable to medication. This delay suggests that if the antipsychotic effect is dependent upon dopamine receptor blockade it is not a direct consequence of this action. Perhaps dopamine receptor blockade permits other, and slower, changes to take place and it is these changes, rather than dopamine receptor blockade itself, which are reflected in clinical improvement.

Twenty female anxious neurotic patients were compared with 25 normal female volunteers, divided into a low anxious normal and a high anxious group, with respect to dream report content. Dream reports were analysed using an objective and reliable method and were correlated with the day-time attitudes of the subjects measured by Semantic Differential techniques.

Anxiety levels influenced both dream reporting and dream content. In particular, aggression towards the dreamer was more common in the anxious patients. Significant correlations were found in all groups between dream content and daytime attitudes. The results were consistent with the ‘continuity’ hypothesis of dream function.

The 60-item General Health Questionnaire was completed by 90% of 4798 patients aged 15–69 years who consulted, on one day, the general practitioners of 97% of practices in the Perth Statistical Division. A point prevalence rate of minor psychiatric morbidity in various demographic groups was calculated in terms of the population at risk. The demographic pattern of morbidity was compared with that found in a probability sample of 2324 community residents drawn from the same population at risk, and surveyed at the same time using the same screening instrument.

Widowed persons, British-born men who had recently migrated to Australia, and lower-social-class men with minor psychiatric morbidity were under-represented in general practice. Elderly men and women in upper-class occupations with minor psychiatric morbidity were over-represented in general practice. These differences, unlike others that were found, could not be explained by differing consulting habits or by differing completion rates of the screening instrument.

Previous work suggests that allusive thinkers have a broader attentional process associated with weak central inhibition. The method of dichotic stimulation was used to investigate this concept. Sixty-three university students completed a battery of tests including 2 dichotic listening tasks. The Object Sorting Test was used as a measure of allusive thinking.

Allusive thinkers showed a trend towards impaired shadowing performance. Mislabelling of shadow as distractor words and vice versa, on recall and recognition tasks, showed the strongest correlation with allusive thinking. Such mislabelling was considered to reflect impaired discrimination learning, and provides further support for a hypothesis relating allusive thinking to weak Pavlovian central inhibition.

The possibility that pharmacological response might help to refine psychiatric nosology has been the subject of recurrent speculation, but few clear-cut results have been obtained. Only bipolar depressives and several other minor patient subgroups manifest consistent drug responses in association with characteristic psychobiological features. The presence of multiple intervening variables, such as individual differences in drug metabolism, drug-taking behaviour and biological sensitivity to drugs, may mitigate against the reliable identification of clinically distinguishable drugresponding subgroups. Furthermore, the majority of available psychoactive drugs have either multiple or broad spectrum effects inconsistent with hypotheses utilizing the mechanism or site of drug action to argue for a diagnosis-specific biological disorder at such sites.

Nonetheless the successful use of drug-response models in other areas of medicine suggests a rationale for continued exploration in this area, and a number of recent advances make this approach potentially more productive. Pharmacological developments have rendered it possible to assess the biological availability of drugs in potential responders, thus eliminating some of the confounding intervening variables. Further consideration should also be given to the use of drugs with more specific neurochemical effects, even when they themselves are not necessarily therapeutic. The comparison of drug responder and non-responder groups has also been made more meaningful by the availability of more reliable methods of assessing clinical phenomena, more sophisticated diagnostic models and the introduction of other biological measures. Combining several of these approaches may allow the use of one to validate the other.

Recent work has shown that the hypothalamic peptides commonly associated with the control of pituitary function have important behavioural actions of possible psychiatric significance. Thus, vasopressin, ACTH and like peptides may influence memory processes, and ACTH and MSH given intracranially induce a peculiar stretching and yawning syndrome accompanied by penile erection and ejaculation. Thyrotrophic hormone-releasing factor potentiates behavioural excitation, somatostatin is depressive, while luteinizing hormone-releasing hormone facilitates sexual behaviour and the newly identified endorphins are markedly opioid in character. These and other activities of the hypothalamic peptides are reviewed and assessed alongside the clinical information available.

This review has searched the literature to examine the hypothesis that illegitimate pregnancy in girls of school going age is an indicator of underlying psychopathology and, in particular, that pregnancy or sexual activity provide a form of gratification for otherwise deprived young girls. Surveys suggest that precocious sexual activity is more common in disadvantaged young teenagers and that pregnant schoolgirls are especially likely to come from large families, and to have unskilled parents. There is a suggestion that the younger groups of pregnant teenagers come from unsatisfactory home backgrounds. However, these conclusions are derived from inadequate studies and should be treated with caution.

Relatively few sexually active teenagers use contraceptives but there is no evidence that this represents a subconscious intent to conceive and there is greater support for more straightforward explanations. There is a further suggestion that girls who continue with their pregnancy when the choice for termination is available are more disadvantaged than girls who obtain a termination, although the reasons for this association are not clear. Children born to very young mothers appear to do less well than children born to older mothers. However, it may be that this difference can be attributed to greater overall disadvantage in the younger group rather than to specific age related deficiencies in ‘mothering ability’.

The problems of schoolgirl pregnancy are compounded by interruption of her schooling and early re-conception. There is evidence that these complications can be lessened by the provision of specially designed intervention programmes.

Test and retest scores on the Symptom Rating Test (SRT), Manifest Anxiety Scale (MAS) and Maudsley Personality Inventory (MPI) were obtained from 45 non-psychotic psychiatric in-patients. The change in scores and the score distributions were examined to assess the extent to which these tests meet Foulds' criteria for measures belonging respectively to the universes of personality and personal illness. MPI Extraversion emerged as a stable, normally distributed, personality trait in contrast to the SRT which showed the characteristics of a symptom-state measure. MPI Neuroticism and MAS scores could not be allocated definitively to either universe and seemed to be hybrids. It is suggested that more attention must be paid to the ‘ purity’ of scales if meaningful interpretation is to be made in treatment assessment.

This review collates evidence of substantial physical morbidity in patients who receive psychotropic drugs, and evidence that these drugs are not infrequently prescribed for patients with known physical illness. Minor tranquillizers are the psychotropic drugs most commonly prescribed, and the category of physical illness most likely to be associated with psychotropic medication is cardiovascular disease.

The estimation of body dimensions in a group of 31 patients with anorexia nervosa and a control group of 20 psychoneurotic females has been studied with different techniques, including a visual size estimation apparatus and the marking of indicated body points on a paper attached to the wall. The results confirm the previously described tendency by patients with anorexia nervosa to overestimate body size in the stage before their treatment in hospital. Various differences between the two groups were found and the anorexic patients were more inconsistent in the estimation of the different body measures. On the basis of correlations with the results of an internal-external control questionnaire, it is suggested that overestimation and variability in visual size estimation could be promoted by an orientation towards external control.

It proved possible to make lesions which interrupted the striatonigral GABA-containing pathway in the rat brain without causing concomitant damage to the nigrostriatal dopamine containing system. Estimations of striatal concentrations of dopamine (DA), dihydroxyphenyl-acetic acid (DOPAC) and homovanillic acid (HVA) indicated that these lesions had no influence either on normal striatal DA turnover or on the enhancement of DA turnover induced by neuroleptics. Behavioural experiments suggested a motor output function for the striatonigral pathway.

One hundred and twenty-seven out-patients attending a gynaecology clinic completed the General Health Questionnaire (GHQ, 60-item version) and a role problems checklist (RPCL). Principal factors analysis of the GHQ yielded 8 factors which were named: poor performance (which accounted for 63·3 % of total variance), depression-anxiety, sleep-disturbance, anhedonia-anergia, loss of confidence, general illness, social dysfunction and headache. These results were compared with previous principal components analyses of the GHQ (Goldberg, 1972; Goldberg et al. 1976).

A multiple regression analysis indicated that age and 7 of the 8 factors were significantly related to the number of role problems reported by the patients. However, it appears that psychiatric distress (as measured by the GHQ) and role problems were only related to a small degree (multiple R2 = 12·69% only).

Forty-eight medical students took part in a study to assess the value of giving students some feedback about their interviewing skills. During the study they all received training from their clinical firms. In addition, 36 of the students received 1 of 3 types of feedback training. This was given by tutors who used television replays, audiotape replays or ratings of practice interviews conducted by the students.

As in previous studies there was little improvement in the interviewing skills of those students who only received training from their clinical firms. In contrast, all 3 feedback groups improved their ability to elicit accurate and relevant information. However, only the television and audiotape groups also showed gains in techniques. While the differences between these 2 groups were not significant, they all favoured the television group.

The effect of fluphenazine on basal human prolactin (hPRL) concentrations was studied in 10 male schizophrenics who had received fluphenazine treatment for at least 6 months, in 10 male alcoholics before and during the first week of fluphenazine treatment and in 8 alcoholics at daily intervals before and after treatment. The results were compared with basal hPRL concentrations in 17 healthy male controls. Investigations involved giving fluphenazine (Modecate) by intramuscular injection and taking blood samples at appropriate intervals by venepuncture. Basal hPRL concentrations were significantly increased in the schizophrenics. The alcoholics showed a significant rise in hPRL concentrations after fluphenazine but there was considerable variation in hPRL levels between individual patients. Most patients showed marked elevation of daily hPRL levels with peak concentrations occurring 5–6 days after the injection. The results demonstrate that fluphenazine elevates basal hPRL levels and the variation between levels of individual patients merits further investigation.

A self-completion sleep evaluation questionnaire (SEQ), consisting of 10 cm line analogue rating scale questions, was constructed to investigate subjects' responses to aspects of sleep and early morning behaviour. The questions were grouped into 4 chronological areas: the ease of getting to sleep (GTS), the perceived quality of sleep (QOS), the ease of awakening from sleep (AFS), and the integrity of early morning behaviour following wakefulness (BFW). Five hundred and one SEQs were completed during several investigations into the comparative effectiveness of hypnotic drugs. The classical factor analysis produced 4 factors which corresponded to the 4 aspects of sleep and early morning behaviour listed above. The GTS and QOS factors were positively correlated (+ 0·57), as were the AFS and BFW factors (+ 0·48). The 2 sleeping state factors (GTS and QOS) were orthogonal to the 2 waking state factors (AFS and BFW).

Serum folate and B12 estimations were carried out on 272 admissions to a psychiatric unit during 1972 and 1973. 21–3% had serum folate below 2 ng/ml and 26–1% serum B12 below 150 pg/ml. The organic psychosis patients had a significantly lower mean B12 than the others, and were over-represented among the low B12 group. Low B12 status was also associated with low RBC and WBC. Low folate status was linked with depression, malnutrition, physical illness and low Hb, RBC and WBC. There were more chronic alcoholics than others with serum folate > 4·9 ng/ml, low RBC and macrocytosis. The presence of one or more haematological abnormalities (macrocytosis, low Hb, low RBC or low WBC) predicted low folate in 76%, and low B12 in 79%, but these were also found in 40% of the normal folate and 41% of the normal B12 patients. Macrocytosis may prove to be a reliable sign of alcoholic abuse.