Any reader of the handbooks of medical history will know that among the ancient Greeks, the womb was on occasion held to cause various complaints by moving about the body. A particularly graphic account is to be found in the Timaeus (91b–c), where, in likening sexual desire to an actual animal, Plato first mentions “… in men the organ of generation becoming rebellious and masterful like an animal disobedient to reason”, and then alludes to:

A review of reported cases of attempted suicide in Benin City indicates that the incidence has not increased over the four-year period 1978 to 1981, during which the average crude suicide attempt rate was 7 per 100, 000. Eighty seven per cent of the attempters were under the age of 30, but the commonest age-group was 15–19 years (39.4 per cent). The female/male ratio was 1:1.2. The majority of the attempters (64 per cent) were students, housewives, and the unemployed. Ingestion of drugs (68 per cent) or of chemicals (20 per cent) was the predominant method. The major predisposing factors were mental illness (32 per cent) and conflicts with parents (24 per cent).

Complaints of insomnia are very common, especially in older adults. Although pharmacotherapy is the most common form of treatment, recent evidence shows cognitive–behavioural therapy to be superior in the short- and long-term management of insomnia. Low-threshold intervention programmes may reduce both the individual and societal burden of insomnia, coexisting with or without other mental or physical disorders.

A patient given bismuth nitrate in the recommended dose range over 16 months developed panic attacks and a major depressive syndrome and, after 15 months, a myoclonic encephalopathy resembling Creutzfeldt–Jakob disease. He recovered four months after bismuth had been discontinued. Bismuth preparations are becoming popular in the treatment of gastritis; close attention to neurological and psychiatric symptoms seems mandatory.

Erving Goffman's Asylums: Essays on the Social Situation of Mental Patients and Other Inmates is a key text in the sociology of mental illness. It is sometimes seen simplistically as a paradigm of ‘antipsychiatry’, and as a key step in the triumph of community psychiatry over narrower, medical models of mental illness. Reading Asylums today, however, reveals that this portrayal does not capture the richness of the text. My argument is that, rather than being an opponent of biological psychiatry or medical models per se, Goffman's key role was in humanising patients and drawing attention to the patterns of interaction that dehumanised them.

In the revision process leading up to DSM–V and ICD–11, it is important to highlight both similarities and differences between the two classifications. Where irreconcilable conceptual differences are involved, these should be stated in a manner inviting future research to elucidate the advantages and disadvantages of alternative concepts or definitions. Eventually, both DSM–V and ICD–11 will need to be assessed against a set of benchmarks of validity and utility.

In many theories concerning the development of psychological illness, stress has been laid upon the difficulties encountered during the earliest period of life. The problems of feeding in infancy and early childhood have, in particular, been believed to colour if not actually to determine certain neurotic and psychotic behaviour.

In an investigation of white, coloured, and black patients admitted to a psychiatric hospital, the prevalence and treatment of depression in schizophrenia was assessed and found to be 30% in group of acute, nuclear schizophrenics. While the prevalence was similar in the three groups, depression was clinically under-detected in black patients.

Complementarity of roles is chiefly responsible for the degree of harmony and stability obtaining in interpersonal relationships (Spiegel, 1957). Collins et al. (1971) compared decision-making in the marriages of a group of male neurotics and in a control group. They found that patient marriages were more often categorized as ‘segregated’ (where distinct areas of responsibility were demarcated for each spouse) or ‘husband-dominated’ (where most of the decisions were made by the husband). Conflict over decision-making was also commoner in the patient marriages. By contrast, the control marriages were more often co-operative (both partners collaborated equally in a co-operative manner). The authors suggested that the severity of the husband's neurosis led to the adoption of certain patterns of decision-making which in turn led to conflict. They proposed that these patterns of behaviour might partly explain the development of psychiatric symptoms in the patient's spouse. In a series of normal families in Australia, Herbst (1954) noted that as the percentage of separate decisions increased tension rose. The ‘syncratic’ family structure (comparable to the co-operative pattern) was below average in tension, while the ‘autocratic’ (comparable to the segregated pattern) carried the highest tension.

A 27-year-old woman with a post-partum psychosis developed NMS which proved difficult to diagnose because of the organic features of the presenting illness. Possible contributory factors to the development of NMS included exhaustion, a non-specific viral illness, and rapid loading with haloperidol.

The sensitivity of the GHQ and a revised scoring procedure (CGHQ) for chronic psychiatric complaints was investigated on 175 outpatients. The mean level of severity of symptoms of the groups with and without chronic complaints was not significantly different. However, patients with chronic complaints showed a significantly lower mean GHQ score than patients without chronic complaints. The mean CGHQ scores of the two groups did not differ, suggesting that the CGHQ is a better indicator of the severity of the chronic psychiatric state than the GHQ. The revised scoring procedure resulted in a decrease in the number of false negatives. The strongest reduction in false negatives, however, was induced by a combination of the original and the revised scoring procedures. This reduction was achieved at the expense of only a small increase in the number of false positives. Altogether, the revised scoring procedure proved to be only marginally better.

The Visual Analogue Mood Scale (VAMS) was completed for 30 consecutive days by 124 psychiatric patients and 36 non-patient control subjects. The 65 euthymic manic-depressive patients on chronic lithium therapy had similar mean mood ratings to the non-patient controls, but had lower mood variability as measured either by standard deviation of the mood rating or by a measure of the mean successive differences between consecutive mood ratings (delta squared). This unusual mood stability appears to be an effect of lithium therapy. This study thus offers some empirical support for the ‘mood stabilizer’ psychological model of lithium's effects in patients. It is also noted that this effect may be perceived in well patients as an undesirable effect of lithium treatment.

Obsessional neurosis, inasfar as it comes to the attention of the psychiatrist, is a comparatively rare disorder, comprising not more than about 3 per cent of all cases of neurosis. Its rarity is reflected in the fact that the largest series so far described, that of Pollitt (1957), consisted of only 150 cases, though a limited amount of information has been available from the somewhat larger series of the Bethlem-Maudsley Hospital (Blacker and Gore, 1955) and of the Registrar General (1964).

A proportion of individuals suffering from schizophrenia show either physical or psychological signs of gonadal underfunction or incomplete sexual maturation (Hoskins, 1943; Hoskins and Pincus, 1949; Bleuler, 1954; Sands, 1957; Reiss, 1958; cf. Shader and Grinspoon, 1967). Rey and Coppen (1959) reported significantly lower, that is more feminine, androgyny scores (Tanner, 1962) in schizophrenic patients, although reduced scores were also found to a lesser extent in depressive and neurotic patients. Sex chromosome anomalies were not found in those patients with abnormally low androgyny scores (Cowie, Coppen and Norman, 1960), and it is possible that the abnormal physique is caused by some hormonal malfunction during development which also may be associated with a predisposition to psychiatric illness.

Many experiments have been reported suggesting that the serum of schizophrenic patients differs in some way from the serum of non-schizophrenic subjects, either in respect of some specific constituent or of the alterations in function which it can produce when added to various biological systems (Heath, 1957; Walaszek, 1960; Bergen, Koella, Czicman and Hoagland, 1961). These reports suggest that schizophrenia is a pathological mental condition resulting from some disorder of metabolism or of biochemical processes, and it would be logical to expect that this disorder would be most manifest as a disturbance of the neurological activity in the cerebrum—perhaps more specifically in the cerebral cortex—since the clinical picture in schizophrenia is primarily one of gross derangement of the processes of perception, attention and thinking.

There have been only a few investigations into the seasonal prevalence of neurosis. Stocks (1949) found in a morbidity survey by interview the lowest prevalence of “nervous complaints” in July and August and the highest in October and November. Smiley, Buck, Anderson and Hobbs (1954) in Canada found that there was a higher number of insured claiming benefit for “mental illness” in January than in July. McCartney (1962) in private psychiatric practice in New York found that there was a seasonal variation in the number of referrals of various types of neurotic reactions. The purpose of this investigation was to examine the seasonal variation in attendances with symptoms of psychiatric ill health in a general practice and compare this with the seasonal variations of attendances due to physical illness.