The mode of inheritance of affective psychoses was studied in 800 first degree and 582 second degree relatives of 122 probands. Morbidity risk for unipolar depression was 12·0±3·2 and 11·4±2·7 per cent respectively for parents and siblings of probands suffering from unipolar depression. Morbidity risk for manic-depressive psychosis for the respective groups of first degree relatives of manic-depressive probands was 15·1±3·2 and 16·9±3·2 per cent. In second degree relatives the morbidity risk was 3·4±1·0 and 5·3±1·4 per cent for unipolar depression and manic-depressive psychosis respectively.

The results indicate the role of genetical factors in the etiology of both types of affective disorder and show that unipolar depression and manic-depressive psychosis are distinct entities. The hypothesis of X-linked dominant transmission was not confirmed in either of these affective disorders. By means of the computational model of Slater, no results compatible with a polygenic inheritance of unipolar depression or manic-depressive psychosis were found.

Although there have been various studies of the treatment of schizophrenia and articles on it are numerous, hardly any work has been done on the subject in Pakistan.

The case is described of a 65-year-old woman who initially presented with delirium caused by polycythaemia rubra vera. Following venesection she was discharged home recovered, but presented again shortly after with an episode of mania associated with relapse of her polycythaemia.

Evidence for an organic component in patients with delusional misidentification syndromes is reviewed and three described who developed the Capgras symptom after a course of ECT which produced a mild organic psychosyndrome. The delusion was a complicating factor during treatment, but remitted in all cases as the organic brain syndrome cleared and the underlying condition improved.

A case-report is presented of folie simultanée in a pair of female monozygotic twins with onset at the remarkable age of 81. The twins demonstrated no evidence of dementia or other psychopathology apart from delusions. Folie simultanée in monozygotic twins provides a model example of the potential role of genotype-environment correlation in the etiology of psychiatric illness.

We report a case of neuroleptic malignant syndrome where the catatonia clearly followed the administration of neuroleptics and where the neurovegetative disturbance was remarkably severe, including episodes of tracheal spasm, apnoea and episodes of bradycardia, and sinus arrest requiring insertion of a temporary external pacing wire. To our knowledge, such severe disturbance has not previously been reported.

The main characteristics of the Yantai model are (a) a three-tier (county, township, village) management structure; (b) the vertical integration of community mental health workers, including a professional advisory group of psychiatrists from the central psychiatric hospital, groups of community psychiatrists at small county psychiatric hospitals, non-psychiatric physicians who run psychiatric out-patient clinics at township general hospitals, and village paramedics (‘village doctors’) who supervise patients in the community; (c) ongoing training of all community mental health workers; (d) registration and yearly follow-up of all patients with mental illnesses in the community; (e) provision of home-care services to a proportion of acutely ill patients; and (f) most of the cost of the service is borne by the state. The network of services provided by this model makes it convenient for patients to obtain treatment and, if necessary, go into hospital; it reduces the economic burden on the family and the community; it combines treatment, prevention, rehabilitation, and supervision under one administrative network; and it decreases the overall level of psychopathology and psychosocial dysfunction in the community.

Amphetamine psychosis and severe amphetamine dependence are now well recognized clinical pictures leading to psychiatric in-patient treatment (Connell, 1964). These pictures, however, are probably seen in only a small proportion of those who take amphetamines. The true assessment of the total incidence of unprescribed amphetamine taking in any group is made difficult by the absence of specific clinical signs (Connell, 1966), denial of drug-taking by the patient (Scott and Willcox, 1965) and the large number of false positives found with the methyl orange screening test (Johnson and Milner, 1966). Gas chromatography for amphetamine substances in the urine (Rowland and Beckett, 1965), though both expensive and time-consuming, provides for the specific detection of amphetamine and many other drugs in the microgram and submicrogram quantities. This paper describes the use of the method to obtain a picture of amphetamine abuse amongst patients in a 20-bedded acute psychiatric ward in a Teaching Hospital.

The ability to interpret the meaning of metaphorical proverbs has been used not only in intelligence testing but also to investigate abnormalities of thinking in schizophrenia; mainly the theories that schizophrenics are either “concrete” or “overinclusive” in their thinking. The theory of concreteness has been proposed mainly by Goldstein (1946), who held that schizophrenics were unable to adopt the “abstract attitude”, and, having lost the ability to form normal abstract concepts, formed concrete ones instead. Cameron (1946) described overinclusion as one of several abnormalities found in schizophrenic thinking. This abnormality has been adopted by Payne and his co-workers (1957, 1959, 1960, 1962, and 1966) as the basic disorder of schizophrenic thinking. Schizophrenics showing this disorder appear unable to maintain the boundaries of a problem, and so form overbroad concepts. Overinclusion, however, is found in only about 50 per cent. of acute schizophrenics and has also reported in other psychiatric conditions (Payne and Hirst, 1957; Payne and Frielander, 1962; Sturm, 1965).

Power spectral analysis was performed on the visual evoked potentials (VEPs) recorded in response to flashes of different intensity in both unmedicated schizophrenic and normal subjects. At occipital locations (01, 02), schizophrenics showed less power than normals in the 10–14 Hz frequency range. In the 18–22 Hz range, schizophrenics showed under-activation in the left hemisphere and over-activation in the right. At temporal locations (T3, T4), schizophrenics showed abnormal (left greater than right) hemisphere patterns of activation in 10–14 Hz and 18–22 Hz ranges. There were no group differences in relationships between power and intensity changes at vertex (Cz). The results suggest abnormal cortical-subcortical interactions during analysis of visual information in schizophrenia.

A number of publications have appeared in the last few years advocating the use of diazepam in the treatment of status epilepticus (Boyer, 1966; Gordon, 1966; Lombroso, 1966; Parsonage and Norris, 1967). The long term therapeutic value of diazepam in epilepsy is not yet so widely reported. However, Lehmann and Ban (1968) showed that the excitement and hostility so commonly encountered in epileptic patients can be successfully and selectively controlled by diazepam. It was also revealed in this study that diazepam had definite anti-convulsant effects in a certain number of epileptic patients; one third (7 patients) also improved psychiatrically.

Juvenile court histories were investigated of male and female juvenile drug offenders and of control groups of juvenile delinquents never charged with drug-related offences. On most of the parameters of drug-related and of other criminal offences, criminal involvement was greatest among opiate abusers, followed by those abusing sedatives, and then by cannabis abusers. However, this difference was less marked among females than among males. Involvement with crime not related to drugs was greater among delinquents abusing opiates and sedatives than among delinquent controls, while the criminality of delinquents abusing cannabis was less than that of the controls. There were significant differences between the patterns of offences of the four groups, which did not support the economic necessity hypothesis of crime among (at least juvenile) drug abusers. The findings were consistent with progression from soft to hard drugs, and with the view that where juvenile delinquency and drug abuse co-exist, the former tends to precede the latter. The association between juvenile drug abuse and delinquency seems to be accounted for by a common denominator of a sociopathic character development, rather than by some form of causal relationship between these two phenomena.

Alcohol-related brain damage has a growing impact on service provision. Despite the benefit of therapeutic interventions and a relatively good prognosis in the context of service provision, few services exist. Both national and local initiatives are required in order to provide psychosocial rehabilitation for this marginalised group of patients.