In attacking the problem of the relationship of endocrine function to the schizophrenias and other mental diseases, we have avoided the elementary conception that certain hormones are responsible for special psychological traits and have reached the following conclusions. First, the quality of the mental disturbance depends mainly on a genetically conditioned personality pattern, various individuals reacting in different ways to the precipitating causes. Second, the hormones come into the whole picture only in so far as the hormone equilibrium of the body determines how far the individual can adjust himself to the increased demands arising out of the occurrence of various precipitating causes (Reiss, 1955). It is therefore understandable that very many, or even the majority of people suffering from severe endocrine disturbance, need not necessarily show any psychopathological changes, since their personality pattern is not so conditioned and no increased demands for adjustment are made by the occurrence of precipitating causes. On the other hand, it is equally understandable that certain disturbances in hormone production and equilibrium, even when clinically obscure, can be decisive for mental breakdown in individuals with the appropriate personality pattern, at the occurrence of precipitating causes.

Since de Clérambault (1920) described the syndrome of erotomania, there have been several reports in the literature amplifying various aspects of the condition. However, it was only recently that Raschka (1979) reported two cases of what he labelled the ‘incubus syndrome‘. This syndrome is a variant of erotomania and the feature central to it is a delusion of imposed intercourse with an imaginary lover during one's sleep.

—Previous reports of sexual orientation and gender identity in subjects with XYY karyotype are reviewed. Two patients seeking a change of sex operation and found to have an XYY karyotype are described. It is argued that an XYY karyotype may predispose to a disturbed gender identity and possibly to the development of the transsexual syndrome.

All male patients above 180 cm. tall who were resident in the Århus State Hospital on 13 April, 1966, were registered: they numbered 42 out of the total of 440 resident males (8 · 1 per cent.). One patient, a 78-year-old man, died before chromosome analysis was made. Sex-chromatin analysis was made on Feulgenstained buccal smears and chromosome analysis was made on leucocyte cultures according to the method described by Moorhead et al. (1960), slightly modified. Not less than 25 metaphases were counted, at least 15 metaphases with the modal figure and all metaphases with a chromosome number deviating from the modal figures were analysed.

Investigations into possible relationships between EEG and personality traits began in 1935 (Lemere, 1935), and have continued sporadically (Saul et al., 1937; Gottlober, 1938; Lindsley, 1938; Henry and Knott, 1941). More recently there has been a controversial British exchange (Savage, 1964; Fenton and Scotton, 1967; Broadhurst and Glass, 1969; Young et al., 1971).

The sexual asphyxias have, in the past, often been described by forensic pathologists after an apparently accidental death has brought the condition to light. The following case is exceptional in that it came to light before a fatality occurred and suggests that intense self-punitive tendencies may play a part in some cases.

Normal controls and schizophrenic patients on propranolol as sole drug or combined with neuroleptics showed superior active and passive avoidance learning to schizophrenic patients who were medicated with conventional neuroleptics only. Active avoidance involved responding quickly, passive avoidance withholding a response to avoid an unpleasant noise and reacting to the appropriate stimulus. This may reflect an improvement brought about by propranolol in the limbic regulation of stimulus and response processes.

A patient with early-onset Huntington's chorea is described. The diagnosis had been overlooked during previous contacts with psychiatric services because there was no family history, and features typical of the adult disease were absent. Distinctive findings on CT scan and electroencephalography were observed.

The relationship between early treatment response and CT variables was investigated in 50 consecutively admitted patients with DSM-III schizophrenia. Treatment response was defined as the absolute BPRS improvement during patients' hospital stay and was found to be significantly correlated (P<0.05) with the frontal horn ratio (r = −0.36), ventricular ratio (r = −0.32), width of the third ventricle (r= −0.37), width of the frontal interhemispheric fissure (r = −0.33), and average width of the three largest cortical sulci (r = −0.46). According to the results of multiple regression analysis, 35% of the variance in the treatment response was accounted for by the average width of the three largest cortical sulci, the ventricular ratio and the frontal horn ratio. Thus, cerebral abnormalities associated with poor treatment response do not seem to be limited to one particular morphological site, but involve different brain regions.

Two bipolar depressed patients and one unipolar depressed patient developed manic Symptoms after receiving trazodone. The Symptoms resolved when the treatment was discontinued or reduced. We believe the two bipolar patients are the first cases of this reaction reported in the literature.

The relative contribution of genetic and environmental factors to the development of homosexual behaviour is a controversial subject. The original suggestion that homosexuality is a purely inherited trait has been attributed to Krafft-Ebing (Kallmann, 1952). Perhaps the strongest support for this view was Kallmann's series of 40 male monozygotic twin pairs showing 100 per cent concordance for the overt practice and quantitative rating of homosexual behaviour (Kallmann, 1952). This report has been criticized, and Kallmann later conceded that the 100 per cent concordance was possibly a statistical artefact (Kallmann, 1960). Habel (1950), who obtained the index twins from a prison population, found concordant homosexuality in 3 out of 5 monozygotic pairs (60 per cent), but none of 5 dizygotic pairs. In a more recent study, Heston and Shields (1968) found concordant homosexuality in 2 out of 5 monozygotic pairs (40 per cent) and 1 out of 7 dizygotic pairs (14 per cent). Heston and Shields (1968) also report a family with a sibship of 14 which included 3 pairs of male monozygotic twins, in two of which both twins were homosexual and in the third both heterosexual; no environmental factors which differentiated the homosexual from the heterosexual sibs could be detected. These workers also refute the suggestion that the tendency for monozygotic twins to be more alike with regard to homosexuality than dizygotic twins is related not to genetic factors but to problems of sexual identification which predispose to homosexuality (Money, 1962) by pointing out that there is no evidence that monozygotic twins per se are especially prone to become homosexual.

Seven years ago the authors examined 64 consecutive female out-patients with macrocytosis (erythrocyte mean cell volume ⩾ 100 fl). The cause remained undetermined in 23 (35.9%). Their patient histories were evaluated in 1992, and the new highly specific alcohol marker, serum carbohydrate-deficient transferrin, from the frozen sera taken during the initial study was examined. It was elevated in 6 of the 23 women. Furthermore, four of these six had visited the health centre after 1985 and they all had clinical records indicative of alcohol problems. Because early intervention has proved to be effective, information about the risks of alcohol abuse (intervention) should be given to women with suspect alcohol-induced symptoms or signs.

The influence of type of seizure and medication on psychological disability was assessed using the Standard Psychiatric Interview in matched epileptic patients. In comparison to patients with idiopathic tonic-clonic seizures, those with temporal lobe epilepsy complained of more irritability and impaired concentration, and were rated as more depressed and slowed up. Compared to patients on phenytoin, those on carbamazepine complained of more sleep disturbance and were more likely to be taking an hypnotic.

As a test of the social support hypothesis, highly anxious primiparous mothers were assigned in the post-natal stage to either a professional intervention, a lay intervention or to a control group. It was hypothesised that those receiving an active intervention (be it lay or professional assistance) would become less anxious as a consequence of a central therapeutic ingredient – social support. Improvement was assessed by measuring state anxiety levels at baseline and at 12 months, while the degree to which therapists were incorporated into the social network was assessed by the Interview Schedule for Social Interaction (ISSI), given at baseline and at 12 months. While we established that anxiety levels were significantly lowered in those receiving the professional intervention and moderately (but not significantly) lowered in those receiving the lay intervention, ISSI scores for the separate groups appeared stable over the study. Reasons are considered why ISSI scores remained unchanged while intervention groups showed a reduction in anxiety levels.

Results of the sixth quinquennial survey of the resident population of Glenside Hospital, Bristol, are reported. The total population continues to fall, but the rate of decline has slowed; the implications of this are discussed. Many patients live in an emotionally impoverished state, friendless and rarely leaving the hospital. Few in-patients are employed, even within the hospital. Considerable provision is made, however, for the employment of day-patients. To effectively resettle and support in the community those currently remaining in hospital will require increasingly extensive provision.

A prospective study (Fahy, 1974) found that depressed patients referred to psychiatrists by family doctors differed from depressives not so referred in being more often difficult to reassure, diffusely anxious and subjectively retarded. Single men were selectively referred. Absence of hypochondriacal features characterized prompt referrals only. Generally, psychiatric referrals were obviously depressed in mood and showed a wealth of psychiatric symptoms, predominantly of ‘endogenous' type and not associated with overt physical stress-at-onset. For lack of data with a direct bearing on reliability, the repeatability of this study was uncertain and the question of a possible qualitative difference between depression in hospital and in general practice was left unanswered.