Twelve patients with obsessive compulsive disorder were studied with psychophysiological measures during a randomised, double-blind placebo-controlled drug trial. Significant clinical improvement followed six weeks of treatment with the tricyclic antidepressant clomipramine, but was not evident after an equal period of treatment with the monoamine oxidase inhibitor (MAOI) clorgyline. Compared to placebo, both drugs reduced skin conductance indices of baseline arousal, but only clomipramine reduced skin conductance and heart rate responses to loud tones and tonic and phasic skin conductance responses in a two-flash discrimination task. This suggests that reductions in autonomic responses to important and/or aversive stimuli may be critical to clinical improvement in obsessive compulsive disorder.

Direct observations were made of patients' behaviour during occupational therapy sessions in a psychogeriatric ward, and were used to suggest changes in the conduct of these sessions, and to evaluate the effectiveness of the changes. The intervention was successful in bringing about situation-specific increases in clients' appropriate behaviour.

In a retrospective study, 20 psychotic children and adolescents with hallucinations were compared with 15 psychotic controls without hallucinations. In the former, auditory hallucinations predominated, which tended to be localised in the internal space of the child. Subjects with hallucinations had significantly more symptoms of depression and anxiety, more precipitants of illness and problems in reading ability. There was a trend for increased laconic speech in them. The findings suggest a link between hallucinations and mood and cognitive changes in children and adolescents with psychoses of late onset.

The dopamine hypothesis of schizophrenia proposes that schizophrenia is associated with increased brain dopaminergic function. Because dopamine is thought to stimulate the production of cyclic AMP in the brain, we hypothesized that CSF cyclic AMP would be increased in schizophrenia. Cyclic AMP in the CSF was determined in 19 schizophrenic patients who had not received neuroleptic treatment in the preceding two weeks. No significant difference could be shown between CSF cyclic AMP in these patients and CSF cyclic AMP in 10 psychiatrically normal controls.

Schizophrenics show a deficit in a variety of verbal memory tasks, except recognition memory, and incidental learning when recall is preceded by an ‘orienting task’ which ensures effective encoding. These two exceptions provide experimental evidence for the currently prevailing theory that it is a defect in effective encoding which is responsible for the observed schizophrenic verbal memory deficit. The present review concludes that these two exceptions are probably artefacts of unmatched tasks, and cannot be used to support the theory.

The present study is the psychological part of a comprehensive study of male patients with the XYY syndrome from the Cytogenetic Laboratory, Risskov (Nielsen, 1968, 1969, 1971; Nielsen et al., 1969a, b; and Nielsen and Henriksen, 1972).

The selection of patients for community reprovision during the first three years of an active closure programme at two large mental hospitals in the North East Thames Regional Health Authority was studied. It was found that a strong selection bias was operating: the patients selected were significantly younger, had spent less time in full-time psychiatric care, were less likely to have a diagnosis of schizophrenia, had larger social networks, and were more likely to want to leave hospital.

A study was made of 57 suicides committed by mental hospital patients in Helsinki in the period 1952 to 1963 (Achté, Stenback and Teräväinen, 1965). This report is concerned with the frequency of physical disease, hypochondria, and alcoholism in these 57 suicides.

Intravenous diazepam is widely used both in general medicine and in psychiatry. It is used to produce sedation in psychiatric emergencies and to enhance systematic desensitization; it is also employed in the treatment of drug-induced dystonic reactions, status epilepticus and tetanus, and as an anaesthetic agent. Its property of relieving severe muscle spasm has been utilized to treat patients suffering from ‘stiff-man syndrome‘.

An eight-year-old boy with Asperger's syndrome was given haloperidol to control agitation and aggressive outbursts. Withdrawal of the drug after two years was followed by Tourette-like symptoms. Subsequently neither haloperidol nor a second antipsychotic drug altered the core features of Asperger's syndrome, despite suppressing the movement disorder. His first exposure to neuroleptics was in utero.

In the British Journal of Psychiatry for July, 1963, Costello and Smith described an investigation based on the prediction that “… reactive depressions would sleep more at the end than at the beginning of a set period of sleep and that endogenous depressions would sleep more at the beginning than at the end of a set period for sleep …”. Hourly observation by nurses of the sleep of 18 patients with endogenous and 41 with reactive depression failed to confirm the prediction.

Few papers have been published on psychiatric disorders presenting in casualty departments. Such a study was last reported at Guy's Hospital in 1960 by Blackwell and Mallett. The present report deals with those psychiatric cases who attended the same casualty department during a recent period of twelve months.

Rehabilitation and support services in psychiatric hospitals and general hospital psychiatric units serving two-thirds of the population of Scotland were reviewed. Although there are wide between-hospital differences, especially between rural and urban areas, the National Health Service in Scotland is making considerable efforts to provide staffing, accommodation, occupational activities, and support services for the long term mentally ill. Services provided by local authorities, with the exception of group homes, are seriously deficient. The total number of services provided by an individual hospital correlated highly with an assessment of its adequacy in providing such services in relation to other hospitals. A simple count of services may therefore be used to assess adequacy. There was also a correlation between the range of a hospital's services and numbers of misplaced new chronic in-patients.

Maternal age at parturition, birth order, and parental loss have all been extensively investigated as possible causal or concomitant factors in a wide variety of mental disorders. Thus, to take an extreme example, the influence of maternal age on one of the two main kinds of mongolism is well known and can hardly have other than a biological explanation, as is also true of a number of other causes of mental defect whose incidence is known to increase with maternal age (Penrose, 1963); and similarly much is now known of the biological effects of maternal age in animals (for a survey see Parsons, 1964).

The case histories of five men who met DSM-lll criteria for bulimia and details of their physical characteristics are given. Various eating disorder questionnaires were administered and the results indicated that most of these instruments would not have identified the men as suffering from an eating disorder. The necessity of caution in asserting the prevalence of bulimia using these measures is emphasised.

It is part of the magical aura of the physician that he must have some omnipotent tool with which he dramatically makes patients better. In individual psychotherapy the individual interview and the interpretation, like the surgeon's scalpel, provides such an omnipotent instrument. In therapeutic community practice it is often group therapy in the form of the daily ward meeting and the review that plays the role of the omnipotent therapeutic tool. But in our opinion it is the daily living situation and not the formally organized therapeutic meeting which provides the greatest potential for learning and growth on the part of patients and staff. We have found the crisis situation and its resolution to be potentially the most useful of these daily living situations.

Basal plasma luteinising hormone concentrations and the LH responses to LH-releasing hormone injection were higher in 11 young men after recovery from mania than in 15 control subjects. Since plasma concentrations of testosterone and sex hormone binding globulin were similar in the recovered manic compared with the control subjects, the increased LH response to LHRH is likely to have been due to the priming effect of LHRH consequent on an increased release of LHRH into hypophysial portal vessel blood. Abnormal control of LHRH, and thereby LH release, is a state-independent feature in male patients with mania and may be a useful trait marker for this disorder.

The head circumference of a long-stay population with schizophrenia was compared with that of a population with dementia, matched for sex and year of birth. Schizophrenics had a smaller head circumference, even after correction for height and weight. This confirms earlier but inconclusive and controversial reports, and might be taken as supporting a neurodevelopmental hypothesis of the aetiology of schizophrenia.

Patients consecutively referred for sterilization were examined at the time of referral, two months and one year after operation.

Twenty-five per cent of the sample were identified as psychiatric cases at the time of referral, and rates of disturbance were even higher in some subgroups of women. The rate of disturbance fell in all these groups by one year after operation.

New psychiatric disturbance following sterilization was similar in amount to that found in the community and was not related to any groups of women said in the literature to be at risk apart from those divorced or separated at the time of referral.

Many experienced improvement in their marital and sexual relationships and only 3 per cent expressed feelings of regret.