Service response to problems in 20 clinical and social competence areas was assessed in 156 long-stay in-patients, using the Needs for Care Assessment (NFC). Although there were few unmet needs for treatment, over 200 instances of unmet needs for the assessment of social skills were found, and reasons for this are discussed, as is the importance of social-skills assessment in this group. In around a third of the sample most of the social-skill areas in the NFC were not applicable.

Stammering has been defined as an interruption in the normal rhythm of speech of such a frequency and abnormality as to attract attention, interfere with communication or cause distress to a stammerer or his audience (Bloodstein, 1960).

Broadmoor Hospital is one of three Special Hospitals provided for the treatment of patients of ‘dangerous or violent propensities', under conditions of security. By definition, it caters for a unique and highly selected group of patients; patients who it is thought are too dangerous to be cared for in more conventional psychiatric facilities. Studies of such selected groups of patients may help us towards a better understanding of the relationship between dangerous behaviour and mental illness. Special groups of patients have been studied (Blackburn, 1970; Le Couteur, 1966; McGrath, 1958), but apart from a general paper by Gould (1957), and a recent research report by Black (1973) remarkably little is known either about the characteristics of those patients who go into hospitals, or about what happens to them after they leave the hospitals.

In 98 depressives of various diagnostic categories, Anderson and Dawson (1962) found that a raised fasting blood acetyl methyl carbinol (AMC) level was associated with marked verbal retardation and depressive preoccupation. They also found that raised fasting blood AMC levels fluctuated more than normal ones. It was suggested that the increases in amount and in fluctuation were best regarded as signs of impaired metabolic homeostasis because there was no reason to attribute any signs or symptoms to the effect of AMC itself.

Forty-two female anorexia nervosa patients, with onset of first illness at 25 or more years of age, are described and compared with 143 patients with onset of first illness between the ages of 15 and 20 years. The data support the view that the older group forms part of the total population of anorexia nervosa patients, but that age exerts a pathoplastic influence on psychopathology and psychosocial stressors. Older patients lost more weight, but did not have significantly higher rates of concurrent mood disorder.

Supervision of lithium treatment among three groups of patients treated in different settings – at a lithium clinic, as hospital out-patients, and by a GP – was studied. The lithium clinic maintained lower levels and checked these more frequently. Elevated lithium levels were most frequent in the GP-supervised group, which also included the 13 patients with the most impaired glomerular filtration. In hospital settings GFR-impaired patients received a lower daily dose of lithium; in general practice, affected patients had a higher mean serum lithium level and were more frequently prescribed lithium once daily. We conclude that patients with glomerular impairment who require lithium should be supervised by a specialist, or at least prescribed lithium in divided daily doses.

During the first ten years of a group started in February 1977 by the Avon Probation Service for the treatment of non-violent sex offenders, many of the offenders have shown a high degree of commitment to the group, and attendance levels have run consistently at over 70%. Of 63 men who came to the group during the ten-year study period, 33 completed their stay at the group, 11 left the group prematurely, and 11 never engaged satisfactorily. The remaining eight were still attending the group at the end of the study period. Of the 55 men whose contact with the group had ended, 36 (65%) had not been convicted of further sex offences by the end of the study period.

In a series of papers, Slater, Beard and Glithero (1963) reported on a group of 69 patients who had suffered from a schizophrenia-like psychosis at some time after the onset of an earlier but continuing epilepsy. They gave a number of arguments, which need not be considered here, to support the view that the epileptic and the schizophrenic states were not independent of one another and merely coincidental, but that the pre-existing epileptic state was the direct cause of the schizophrenia-like illness, and that this could in fact be regarded as a special form of an epileptic psychosis, which took on for a time the appearance of a (symptomatic) schizophrenia. One of the arguments on which reliance was placed was that there was a non-random relationship between the ages of onset of the epilepsy and of the schizophrenia, such that the interval between the two varied about a mean of 14 years. The three clinical groups into which the 69 patients were classified had significantly different mean ages of onset of epilepsy of 20·5, 16·3 and 9·3 years respectively; but there was no significant difference between the three clinical groups in respect of the mean interval between onset of epilepsy and onset of psychosis, 15·6, 14·0 and 12·8 years respectively. In fact, in the case of the duration of epilepsy, with an F value of 0·24, between-group variance was only a fraction of the within-group variance.

During the Arab-Israeli war of 1973 measures had to be taken by the kibbutz civilian population in Israel to cope with the stresses of war. The measures adopted, and the specific characteristics of an organized cohesive group, appear to have succeeded in reducing the severity of the reactions to stress and in lowering the incidence of psychiatric casualties among children and adult members of the kibbutzim.

The stability of self-report of 72 skid-row alcoholics over a one to six month interval was explored. Relatively high response agreement on reinterview was indicated for demographic items, but less reliability was observed on items assessing social functioning and drinking patterns. Implications of the findings for the evaluation of treatment programs are discussed.

Since nutritional deficiencies might worsen the severity of symptoms and prolong the length of illness in non-nutritional disorders, particularly in the elderly, we examined the nutritional status of 216 elderly women newly admitted to a mental hospital. Compared to healthy elderly women, they had lower values for plasma prealbumin, vitamin C, and B vitamins. This was particularly common in senile dementia, and appeared to be the result of inadequate intake of protein or vitamins. Regular hospital diet for one month corrected the very low levels of prealbumin, but supplements were essential to remove deficiency of the water-soluble vitamins. Although vitamin supplements did not influence the length of stay in hospital, we did not exclude the possibility that nutritional deficiencies have a significant effect on the severity of mental illness.

Three males with factor-IX deficiency (Christmas disease) in one pedigree all had severe affective disorder. This apparent cosegregation, if true, would support the hypothesis that in some pedigrees, a gene for major affective disorder is located on the X chromosome.

The results of applied relaxation training in patients with generalised anxiety and panic attacks are reported. ART was taught during one session, by means of participant demonstration, written instructions, taped instructions, or a combination of all three, with instructions to practise at home. All four methods proved superior to a waiting list control, but there were no differences between the treatment groups. There was some evidence for the non-specific effect of expectancy, but this did not completely explain the treatment effect.

“To isolate and quantify possible determinants of any increased prevalence of depressive disorders in women we studied a select group of men and women, initially similar in terms of a number of putative social determinants of depression, and reviewed the sample five years later when social role diversity was anticipated. We used the Diagnostic Interview Schedule (DIS) to generate DSM–III and RDC diagnoses to estimate lifetime depressive disorders, and established (via corroborative reports) the likely accuracy of those data. Despite lifetime depression being a relatively common experience, no significant sex differences in depressive episodes were demonstrated, suggesting the possible irrelevance of biological factors in determining any sex difference. As there was not major social role divergence over the five year study, we interpret the lack of a sex difference as a consequence, and suggest that findings support the view that social factors are of key relevance in determining any female preponderance in depression described in general population studies.”

Renaming disorders to change public beliefs and attitudes remains controversial. This study compared the potentially destigmatising effects of renaming schizophrenia with the effects of renaming bipolar disorder by comparing the label ‘schizophrenia’ to ‘integration disorder’, and ‘bipolar disorder’ to ‘manic depression’, in 1621 lay participants. ‘Bipolar disorder’ was associated with less fear and social distance than ‘manic depression’. ‘Integration disorder’ was associated with increased endorsement of a biopsychosocial cause and reduced attributions of dangerousness but also increased social distance, highlighting the complex effects renaming has on stigma.