An account is given of a multi-centre, controlled clinical trial of the comparative efficacy of lithium, amitriptyline and placebo in terms of the comparative relapse-rates over a three-year period among patients who had recovered from a depressive illness. The results indicate that while both the pharmacodynamically active drugs are more effective than placebo the differences between them are minimal.

Forty-one children who were being treated in a paediatric clinic for enuresis were studied to see how many of them were psychiatrically disturbed on clinical assessment and to ascertain the usefulness of 2 cut-off points of T (total) scores on the Rutter A Scale in identifying them. A score of 13 or more which had previously been recommended was found to be inadequate in this group of cases. There were indications that a cut-off point of 18 or more was more appropriate. The importance of knowing the base rate of psychiatric disorder in the population on which the questionnaire is being used is emphasized, sinec this affects the selection of an appropriate cut-off point.

A monotonous voice is produced by schizophrenic patients whose expression of emotion is damped down and by patients with a severe degree of depression. Clinically, the distinction between these two diagnostic entities is virtually impossible to establish auditorily on the basis of voice quality alone. The laryngograph has been developed recently to record laryngeal activity. It was used to study voice pitch in a series of emotionally blunted and non-blunted schizophrenics, and retarded and non-retarded depressives. The frequency distributions of the laryngographic recordings were analysed to yield kurtosis scores. The group of retarded depressives had a significantly higher kurtosis score than the group of blunted schizophrenics. Hence this technique allows an objective distinction to be made between two kinds of monotonous voice produced by psychiatric patients. Furthermore, blunted schizophrenics had a higher mean kurtosis score than non-blunted schizophrenics, indicating that this measure can also be used as an objective index of blunting of affect in schizophrenia.

Perceived efficacy and reliance on psychotropic drugs is explored in a sample of mainly long-term consumers. A comparison of past and present users elucidates some of the factors involved in prolonged usage and the experiences of those who withdraw from the medication.

A clinical trial was undertaken to assess the effectiveness of social work intervention with a group of depressed women attending their general practitioner for treatment. Social work treatment was ineffective for the group of women as a whole on changes in social scores, clinical ratings, or visits to the doctor. The results suggest, however, that social work help benefited those with ‘acute on chronic’ illness but had no effect on those with more acute conditions.

The 28-item General Health Questionnaire (GHQ) was found to be a valid and sensitive instrument for detecting emotional morbidity in patients attending a multiple sclerosis clinic.