With the aim of aiding primary prevention of parasuicide by Samaritans, a study of 325 parasuicide patients admitted to hospital was undertaken to discover the extent of knowledge about Samaritans, the proportion of patients who had contacted Samaritans and the reasons why the remainder had not done so. Ignorance about Samaritans was found in 28 per cent, such ignorance being significantly more common among teenagers than in other age groups. Only 1.4 per cent had sought help from Samaritans immediately before the present parasuicidal act, though a further 13 per cent had contacted Samaritans previously. Suggestions are made for future public education programmes about Samaritans.

It has repeatedly been demonstrated that both acutely psychotic and remitted schizophrenics, as well as some relatives of schizophrenics, show experimentally assessable cognitive dysfunctions, i.e. attentional or information-processing deficits. It is therefore assumed that these are at least potential vulnerability indicators for schizophrenia (Nuechterlein & Dawson, 1984; Nuechterlein, 1987).

The progress over one year of 25 children aged 2½ to 3½ years attending a psychiatric day centre was compared with that of 25 similarly disturbed 3-year-old children identified in a total population study. There were few differences in outcome, and those that were found did not particularly favour either group. Implications for the organization of treatment services are discussed in terms of the need to lay down clear objectives and to pursue systematic controlled evaluation.

Ergotamine preparations are extensively used in the treatment of migraine. Although not widely appreciated, there have been reports in the literature of ergotamine abuse, related to the development of tolerance and withdrawal headaches, which result in a steadily increasing consumption of the drug (Wolfson and Graham, 1949; Peters and Horton, 1951; Friedman et al., 1955). It is important clinically to recognize this condition, as ergotamine can have dangerous vascular side-effects (Byrne-Quinn, 1964; Cranley et al., 1963; Young and Humphries, 1961).

This is the first attempt to study the socio-demographic aspects of anxiety disorders in Egypt and to apply the Arabic version of the PSE in evaluating the profiles of clusters and symptoms of anxiety in a sample of 120 patients with anxiety. There were significant differences in some presentations between males and females, between illiterate and educated groups, and between those exposed to mild and severe crowding. Structured interviews like PSE will help in transcultural comparisons of clinical psychiatric disorders.

The advantages of a new sustained release form of amitriptyline (Lentizol) which can be given in a single dose for the treatment of depressive illness have recently been described by Sims (1972) and Haider (1972). This paper reports a similar double blind cross-over trial in the treatment of depressive illness (ICD 296) of the same substance compared against conventional amitriptyline at an overall higher dosage level.

A research neuroscientist in his fifties, who has recovered from endogenous depression after several years, describes the experience and makes some comments on treatment and management. He found electroconvulsive therapy, mianserin, lithium carbonate and diazepam acceptable. He considers that occupational therapy and conventional psychotherapy were counter-therapeutic. He stresses how physically ill he felt when depressed, and compares this with prolonged influenza. He hypothesises that the underlying psychological disorder in endogenous depression is the learned extinction of optimistic thoughts, and suggests that any psychotherapy used should be aimed at restoring these.

Depression, anxiety and psychomotor performance were assessed in 20 depressed patients during double-blind treatment with amitriptyline or trazodone. There was no difference in onset of antidepressant or anxiolytic action. No decrement or improvement on computerised tasks was found. Dry mouth was significantly more frequent and severe with amitriptyline.

Illicit drug taking, particularly by young people, has increased substantially in recent years. Cannabis offences increased from 51 in 1957 to 4,683 in 1969, and offences involving amphetamines and LSD increased from 1,216 in 1966 to 3,762 in 1969. Most drug taking is undetected by the police, and is hence underestimated by conviction rates. Weiner (1969) found by questionnaire an incidence of drug-taking by London schoolchildren of 5·39 per cent, and Webb (1969) found an incidence of 24 per cent on a university campus.

A five-year follow-up of 25 children who attended a psychiatric day centre for pre-school children is described. This group was compared at eight years of age with two matched control groups who had not received intensive treatment. There were few differences between the treated and untreated groups. Possible reasons for the findings are discussed and some methodological issues involved in carrying out evaluation studies are raised.

The importance of non-drug factors in the response of patients treated with psychotropic agents has been widely commented upon in recent years, though very few investigations have been undertaken specifically to identify and study these factors and to determine their role in pharmacotherapy (Hamilton and Hordern, 1963).

Psychiatry and other medical disciplines have been paying increasing attention in recent years to the relationship between patient and doctor, and psychoanalytic concepts have been applied in order to formulate various aspects of this relationship. One of those most commonly applied is that of transference, which is now often loosely used as a synonym for relationship in general. The concept of transference will be discussed in detail in a further paper in this series, but a distinction has always been made within clinical psychonanalysis between transference ‘proper’ and another aspect of the patient's relation to the doctor which has been referred to in recent years as the ‘therapeutic alliance’, ‘working alliance’ or ‘treatment alliance’ (Zetzel, 1956; Loewald, 1960; Stone, 1961, 1967; Gitelson, 1962; Tarachow, 1963; Greenson, 1965, 1967; Friedman, 1969). The concept has been used in connection with the psychoanalytic treatment situation to describe aspects of what is familiar to all as the ‘therapeutic contract’ between the patient and his doctor (Menninger, 1958), and has been defined as ‘the non-neurotic, rational, reasonable rapport which the patient has with his analyst and which enables him to work purposefully in the analytic situation …’ (Greenson and Wexler, 1969). As far as the psychoanalytic situation is concerned, it has been maintained that the recognition of the difference between treatment alliance and other aspects of the patient-analyst interaction (such as transference) leads to an increased understanding of the processes which occur in that situation and, in particular, of those which enter into therapeutic failure. It is the purpose of this paper to examine the treatment alliance concept as it has developed within psychoanalysis and to consider its applicability outside the psychoanalytic treatment situation (Sandier, Dare and Holder, 1970).

Many mental disorders are linked to personality, but this is rarely recognised in clinical practice. It is suggested here that when the links are very close, the two can be joined. Galenic syndromes are so named because Galen was the first physician to recognise the links between personality and disease.