There are only three special security hospitals in England and Wales (Broadmoor, Moss Side and Rampton). They provide an opportunity to investigate what amounts to a national sample of severe behavioural problems, with regional bias reduced to a minimum. Since the article by Tong and Mackay (1959) dealing with relationships between certain offence patterns and eventual social prognosis in terms of relapse rate, nothing has been published about the type of male patient sent to Rampton, nor about his conduct after admission. To our knowledge no similar study has ever been carried out in this country on female patients requiring special security treatment.

R. D. Laing was perhaps the most famous psychiatrist in the latter half of the 20th century. Yet today, for a man of such international repute, within his profession he has many detractors and few admirers. Despite his later writings on birth, his name and fame are inextricably linked with schizophrenia. For the vast majority of psychiatrists, the name of Laing today conjures up images of psychedelic irresponsibility in which parents were blamed and patients misled.

The emergence of a drive to reduce restrictive interventions has been accompanied particularly in the UK by a debate focussing on restraint positions. Any restraint intervention delivered poorly can potentially lead to serious negative outcomes. More research is required to reliably state the risk attached to a particular position in a particular clinical circumstance.

Increased serum creatine phosphokinase (C.P.K.) levels have been shown in acutely psychotic patients on admission to hospital (Meltzer, 1968). Little is known about C.P.K. activity in non-psychotic (e.g. neurotic) patients admitted under similar conditions. Psychotic patients have not been compared with non-psychotic patients over a period of time following admission. Examination of a single serum sample for C.P.K. activity in non-psychotic patients at the time of admission has shown no abnormality (Meltzer et al., 1969).

Reports of childhood sexual experiences with adults were collected from 120 women attending general-practice surgeries and 115 women psychiatric patients. The method of study, research team and county of residence were the same for the two groups. The psychiatric patients tended to report rates of events higher than the general-practice attenders by a factor of 2–3. The results suggest an association between such experiences and later psychiatric patienthood and are compatible with a causal role for them in some cases.

The diagnosis of pre-senile dementia is a clinical one and implies a state of intellectual and/or emotional impairment due to organic cerebral change.

A survey of all admissions of patients under the age of 65 during the first 6 years of a District General Psychiatric Department without mental-hospital support is reported. Three high-uptake groups of in-patients were defined; the long-stay (12 months or more), the medium-stay (6–12 months), and the revolving-door group (more than three admissions in any period of 12 months). Identifying characteristics which distinguish between these groups were examined. During a 7-year period there was no accumulation of long-stay patients, and a striking lack of schizophrenic patients who remained in hospital for more than 6 months or who had more than three admissions in any twelve-month period. This was not accounted for by drift of the high-uptake groups out of contact with the service, but may be related both to the style of service provision and to the socially cohesive nature of the area under study. Local variation should be given due importance when community services are being developed.

A boy prostitute is defined here as one under 16 years old who repeatedly performs sexual acts with other males for reward, and is known for this service by his community. This article is concerned with the antecedents, acts, treatment and follow-up of 33 such boys.

Variations in the attitude of psychiatrists to schizophrenia range from the precise and confident pronouncement of Sargant and Slater (1963) “Chlorpromazine seems to bring the schizophrenic process to a rapid halt, and to lessen the chance of chronicity and deterioration of personality” to the fundamental doubts expressed by Szasz (1957) “The problem of schizophrenia, which many consider to be the core-problem of psychiatry today, may be truly akin to the ‘problem of the ether‘. To put it simply, there is no such problem.” The literature abounds in varying, conflicting and even irreconcilable treatment suggestions. One has only to compare the physical treatment schedules recommended by Sargant (1963) with the advocacy of psychotherapy put forward by Arieti (1959); or the views on drugs of Kalinowski (1958) with the Hordern and Hamilton (1963) assertion that drug results have not been shown to be superior to the effects of “moral treatment” of a century ago. Similar comparisons in the social field might be made between the views of Hamilton and Salmon (1962) and Hamilton (1964) on sheltered workshops and the difficulties of rehabilitation programmes demonstrated by Catterson et al. (1963).

During recent years, a good deal of attention has been drawn to the therapeutic and toxic effects of the new thymoleptics. Although most of these preparations have had a reasonable clinical trial before being released for general use, it is a fact that hitherto unsuspected toxic effects continue to come to light. Among the more recently discovered side-effects of Tofranil (imipramine) are the occurrence of jaundice and a tendency in certain patients to epileptic fits. Experimentally it has been shown that Tofranil increases the excitability of the brain of rabbits and may evoke convulsant spikes (1), and in a recent article by Leyberg and Denmark (2) it is recorded that in four cases of a relatively small series the dose of the drug had to be reduced on account of epileptic fits.

The clinical management of patients with personality disorders is seldom satisfactory. It is suggested that the bewilderment provoked and experienced by these patients can be reduced by a careful analysis of their shifting states of mind. The construction of diagrams tracing such shifts is helpful to both patients and clinicians. Illustrative case histories are presented.

Psychiatric consultation in many general hospitals is regarded in much the same light as the French Revolution; it has its hazards and its critics, but tends finally to be accepted as “a Good Thing”. Various aspects of consultation have been discussed, (1) (2) (3) (4) (5) (6) (7) (9), but the findings of Mendelson and Meyer are of particular interest, for they point out the high degree of social and family disruption in the patients seen. Elsewhere, the same authors indicate that the impetus for consultation comes, not from the patient, but from the physician, and that disturbed behaviour leads to the psychiatrist being called in (8).