Since the interviewing process, or the process of two people talking to each other is an extremely complex phenomenon, it seemed advisable to begin its analysis at the elementary and quantitative level, by first of all measuring the duration both of periods of continuous speech, and of the pauses and then after investigating their various relations and rhythmic alternation, to work up through grammatical analysis to the more complex phenomena.

In a series of papers concerned with the problems of repeated psychopathic and delinquent behaviour, use has been made of a loose theory which interprets the social behaviour or habit as being a particular learned response to stress, anxiety or emotional disturbance, or to stressor stimuli not necessarily activating physiological stress (190-200). This theoretical position was adopted on account of its relative simplicity, its similarity to many clinical theories, and its ease of access for laboratory and operational studies. In a mainly adult hospital setting, the area chosen for research has been the differentiation of stable and unstable patients, the determination of methods which allow for accurate prognosis of future stability or instability and the form which future instability might take. The objective also contains the assumption that an explanation of instability should be in a form which permits therapeutic endeavour or at least indicates some basic principles for therapy to adopt, and utilizes variables which change as the patient changes.

A number of studies on reaction time (R.T.) latency to visual and auditory stimuli in psychotic patients has been reported since the first investigations on the personal equation were carried out. The general trends from the work up to 1943 are well summarized by Hunt (1944), while Granger's (1953) review of “Personality and visual perception” contains a summary of the studies on R.T. to visual stimuli.

A series of studies published since 1951 attempted to clarify what is meant by the neurotic in human nature. In returning to this problem today, I must beg your indulgence for repeating myself at some points. Apart from the kindness of your chairman in inviting me to discuss the Neurotic Process as my contribution to this symposium, my further justification is the opportunity which it gives me to add a few considerations which may round out the hypothesis and make it more useful, and also to indicate that the neurotic process is the meeting place for the organic and psychological approaches to problems of human behaviour (4, 5, 7, 10).

Folklore has had more to say than science about the relation between the outcome of a pregnancy and the psychological history of the parturient: our culture interprets a legitimate stillbirth as the sign of a sick marriage. And sceptics may think that accretions of folklore are with us yet in the form of facile psychoanalytic explanations. Helene Deutsch (1945) ably expounds the case: spontaneous abortion differs from induced abortion, she tells us, in that “the inducing agent is the psyche, and the pregnant woman who resorts to the help of this agent does not act from conscious will or in accordance with conscious wishes”.

The lithium ion has been found increasingly valuable in the treatment of manic illness (1, 2). In the therapeutic use of lithium there are two phases, stabilization and maintenance. These data have been reviewed by Gershon and Yuwiler (1), but a clear explanation of the pharmacodynamics involved is not evident. Animal experimentation has been used to study the behaviour of the lithium ion as compared with other cations. The lithium ion's behaviour resembles sodium in some tissues and enzyme systems but is more like potassium in others. These authors have reported a three- to fourfold increase in the tolerance for toxic symptoms due to lithium ion in manic patients as compared to normals. They found that this increased tolerance decreased to normal as the patient's manic state subsided.

The experience of 82 demented female patients, admitted to Crichton Royal in the period 1957–59, is compared with 107 similar female patients from 1974–76. All finally died in the hospital, or at the closure of the study in November 1981 were long-stay patients there. Results show that on average, each patient in the more recent group spent 24 per cent longer in hospital; the results, however, were only statistically significant in the very elderly—over 85. Further study of the 1970s failed to demonstrate that day care and intermittent holiday admissions had any effect on the length of time the patient spent in hospital on final admission. Using the study data, models of future needs are worked out on the basis of bed requirements for patients admitted without prospect of discharge.

Blood platelets appear to have a somewhat schizoid existence. Haematologically they are intimately connected with the process of clot formation (for review, see Zucker, 1980) and, at least from a research standpoint, this aspect of their being is largely separate from their use as models of monoaminergic neurones (for reviews, see Maynert and Isaac, 1968; Abrams and Solomon, 1969; Lingjaerde, 1977; Stahl, 1977; Pletscher, 1978).

The trial was a double-blind cross-over study in which patients presenting in general practice with anxiety received haloperidol (Serenace) 0·5 mg. twice daily for two weeks and a placebo of identical appearance for two weeks in random order. Forty-three patients entered the trial. Of these, six failed to attend for follow-up and one proved impossible to assess. A further eight completed the first two-week period of assessment only (5 active drug, 3 placebo) but are included in the analysis. There were equal numbers of men and women, aged 24 to 71 years.

Plasma levels of antidepressant drugs were measured in 17 depressed patients at roughly monthly intervals over follow-up periods of three to 26 months. Good results in seven were associated with small fluctuations in level from visit to visit, while big fluctuations were associated with poor outcome. Such fluctuations were probably from poor compliance or drug interaction from self-medication. Severe side effects and cardiotoxicity were associated with high levels.

We describe the case of a 33-year-old man with Down's syndrome and severe eating disorders. The clinical symptoms, and their difference from those of anorexia nervosa, are discussed. The patient responded well to a strict behavioural programme after long, in-patient treatment and was still well at a 2-year follow-up examination.

A group of 30 manic and hypomanic patients was assessed on the Delusions-Symptoms-States Inventory and did not appear to conform well to Foulds' and Bedford's hierarchy model. Failure to fit the hierarchy was caused by lack of scores in the Neurotic Symptom Class. The relationship between delusions of Grandeur and state of Elation, which was found to be inclusive and non-reflexive, did, however, support the hierarchy model.

We assessed premorbid functioning during childhood and adolescence in 50 people with schizophrenia from multiply affected families, 39 of their unaffected siblings, 69 people with schizophrenia with no family history of psychosis, 67 of their unaffected siblings and 83 controls. People with schizophrenia had poorer premorbid social and academic adjustment and exhibited a decline between childhood and adolescence compared with controls. Unaffected siblings from multiply affected families also had poor academic functioning in adolescence, with a decline between childhood and adolescence. This may represent a familial (presumed genetic) effect.

The mechanism of action of electroconvulsive therapy (ECT) in treating major depression is unknown. We studied two candidate mechanisms through inhibiting simultaneously the synthesis of noradrenaline and serotonin in patients immediately after successful treatment with ECT using a randomised, placebo-controlled, double-blind crossover design. There were no significant changes in depression scores under any experimental conditions, or between the amine-depleted and placebo groups despite reductions of 61% in serum homovanillic acid, 47% in 3-methoxy-4-hydroxyenylethyleneglycol, and 89% in serum tryptophan. Catecholamine and serotonin availability may not be necessary for maintaining the initial antidepressant response to ECT.