Relapse in psychosis typically necessitates admission to hospital placing a significant financial burden on the health service. Exposure to childhood trauma is associated with an increased risk of psychosis, however, the extent to which this influences relapse is unclear. This report summarises current research investigating the influence of childhood trauma on relapse requiring psychiatric hospital admission for psychosis. Seven studies were included; two revealed a positive association between childhood trauma and relapse admission, two studies found a negative relationship and three found no significant difference. Inconsistent current evidence suggests a need for further research in this area.

Three is no branch of neuro-surgery in which the assessment of results is more difficult than in psycho-surgery. The main sources of uncertainty are:

1. (a) Mental impairment or improvement cannot yet be measured as precisely as neurological disorders, such as visual field or motor defects.

2. (b) Spontaneous recovery and the influence of the incidental psychotherapy and drugs involved in any form of surgical attention cannot be evaluated with certainty in many cases.

3. (c) Most of the cytoarchitectural fields of the frontal cortex cannot yet be defined during life by any physiological test or anatomical measurement.

4. (d) Finally, from a technical point of view the surgeon is liable to produce many incidental lesions which cannot be ascertained during the patient's life.

Whereas fall of body temperature is always a danger signal in ordinary starvation and only occurs just before the end, in hypoglycaemia changes of temperature take place in an early stage parallel with the characteristic neuropsychiatric signs. Many workers (Sakel, Gellhorn, Fortuyn and others) have observed and commented on the drop of temperature in coma. The present paper is an attempt to describe the fluctuations of temperature during insulin treatment of psychoses and their correlation with the clinical signs of hypoglycaemia and to discuss their significance.

Twenty-six psychotic children were examined by means of psychological tests and EEGs. The parents of these patients were also tested with the EPI and the Grid Test of Thought Disorder. The mothers of children with the symptom of autism tended to have some cognitive disorganization, which was less common in the mothers of children without the symptom. The extraversion and neuroticism scores of all parents were not markedly different from population statistics.

The incidence of EEG abnormality in the children was high and not related to diagnosis or other criteria.

These findings are interpreted as providing suggestive evidence for a two-factor theory of childhood psychosis. It is postulated that a neurological disorder is a necessary condition for the development of such a disorder; and that a second process related to parental characteristics is also involved, which has the effect of determining the particular symptomatic manifestations seen in the psychotic child.

Two studies have been made of the relationship between premenstrual tension and phase of the menstrual cycle at the time of suicide attempt. Tonks et al. (1968) reported a negative relationship. Women without premenstrual symptoms accounted for the premenstrual increase in suicide attempts. Zacco et al. (1960) reported a significant positive relationship, women with the premenstrual syndrome being more likely to attempt premenstrually.

The syndrome of autoerythrocyte sensitization is characterized by painful ecchymotic lesions of the skin that develop in a very stereotypic manner. Onset occurs in a palm-sized skin region, usually on the limbs, with a stinging and burning sensation. After varying lengths of time, in general 2–6 hours, the skin becomes red, hot, oedematous and tender. This inflammatory phase may last anything up to twenty-four hours. Over the next few days the rubescent heated infiltration turns into an ecchymosis which spreads annularly at the same time as the tenderness and swelling diminish. Originally described by Gardner and Diamond (1955), thirty-one cases of the syndrome have now been reported. Up to the present all reported cases have come from North America and Australia and been confined to women with an age at onset of between 15 and 66 years.

The clinical features shown by 50 psychotic patients were documented by interviews held with the patient and next-of-kin, brief videotaped interviews and nurse rating in addition to the hospital case record. Three raters studied all the available material and made master ratings. Comparison of the ratings made at mental state interview with these master ratings showed that this interview missed a great deal of the pathology agreed to be present. The interview with the next-of-kin was helpful in identifying manic symptoms. Nurse rating based on an 8-hour period of observation was less effective overall, but highly significant associations with the master ratings were achieved in 29/57 areas studied. In four areas (uncooperative behaviour, concern for others, agitation and distractibility) it was superior to either interview.

The last thirty years have witnessed the rise and fall of many theories and therapies on a supposed relationship between psychiatry and endocrinology, and perhaps the time is now ripe to weigh the evidence and attempt to draw at least tentative conclusions. A clear picture of an existing situation not only often leads to improved understanding but also to greater clarity of purpose.

Largactil is one of the phenothiazine group of compounds. It is, therefore, related to promethazine (phenergan) and diethazine (diparcol). It is also known as R.P. 4560 and chlorpromazine. It has been used on the Continent in psychiatric cases since 1951, because of the relaxation and calm it produces. It has been on trial at Netherne Hospital since 1953 and 80 patients have received this treatment.

Drug-related incidents dealt with by ten Accident and Emergency departments in Greater London during July 1982 were compared with those obtained from an identical survey in 1975. The number of incidents remained high, but there was a significant reduction in them and in the number of drug dependent attenders, compared with 1975: hynotic drugs were used in a significantly smaller percentage of drug overdoses, but there was increased use of minor tranquillisers. The possibility of using A & E departments to monitor drug misuse on a Regional basis is discussed.

Three patients suffering from bipolar affective disorder, manic phase, and who were resistant to conservative treatment were successfully treated with clonidine. This would support the nor-adrenergic hyperactivity theory of mania. The rapidity of action of clonidine and its lack of relatively serious side-effects renders it a potential alternative to conventional anti-manic agents.

The effects of videotape feedback on patients' self-perception were assessed in a study which was a partial replication of an investigation reported by Griffiths and Hinkson (1973). Subjects were randomly allocated to one of three groups. After a semi-structured interview, they were either (1) shown a videotape of the interview, or (2) shown a videotape of another person being interviewed, or (3) engaged in other activities not involving videotape. Patients' self-ratings indicated that videotape feedback has immediate effects on self-assessments of social ease and physical attractiveness. Feedback produced changes in ratings of social ease, but individuals differed in the direction of the change (i.e. whether social ease was ‘better’ or ‘worse’). The direction of the change was predicted by a questionnaire measure of response style. Feedback also tended to make patients rate themselves as less attractive in the eyes of other people. All changes were, however, temporary and had disappeared at a two-week follow-up.

The results are generally consistent with those reported by Griffiths and Hinkson in that they indicate temporary and specific changes in response to videotape feedback. The implications of the results are discussed.

The facts that neither the International Classification of Diseases (ICD) nor any other major standard diagnostic system have offered a full definition of psychiatric illness and that earnest definitional attempts reported in the literature (e.g. Spitzer & Endicott, 1978) have not received wide acceptance, have led distinguished nosologists (e.g. Kendell, 1985) to suggest that all we can say about psychiatric classifications is that they are classifications of kinds of problems which psychiatrists currently deal with. However, one immediate difficulty with this characterisation is that it is based on what psychiatrists do, when in fact psychiatric problems are dealt with also by other professionals of various types and levels of training. Another difficulty is that it implies that there is not even an approximate common denominator or core concept underlying the various forms of psychiatric disorder listed in the ICD or other standard diagnostic systems.

A pair of MZ male twins concordant for early infantile autism (E.I.A.) is presented. A distinction is drawn between E.I.A. and infantile psychosis (I.P.) with associated mental retardation as a guide to prognosis and the necessity to provide suitable social training and education. The relevance of aetiology is discussed, and the importance of abnormal ante-natal history and delivery status, even in cases with strong genetic predisposition, is noted.

Goldstein (1962) and Frank (1963) have emphasized the importance in the treatment process of the patient's and therapist's assumptive world. A number of authors have related certain personality variables, such as thinking introversion, to choice of medical specialty and orientation to treatment on the part of the doctor. The immediate fore-runners of the present investigation are the reports of Caine (1970), Smail (1970) and Caine and Leigh (1972), in which a test of ‘direction of interest‘, in terms of an interest in the external world rather than in the internal world of thoughts and feelings, and a test of ‘conservatism’ were found to relate to nurses' attitudes to patient care and patients' symptomatology and treatment expectancies. This report is an extension of the search for the personality variables underlying patient and therapist expectancies. A third variable, namely convergent-divergent thinking, as defined by Hudson (1966), has been added. Convergent-divergent thinking has to do with whether one prefers to converge on a single solution to a problem or whether one prefers to investigate several possible solutions. Personality variables similar to the ones with which we have been working have been described in association with these thinking types.

The object of this study is to investigate the extent to which the MMPI reveals personality changes following prefrontal leucotomy, and how these compare with personality changes as shown in the results of intelligence testing.

The management of aggressive and disruptive behaviour in mentally handicapped patients is a severe problem, and it is widely accepted that drug therapy is only one component in the range of measures required for a comprehensive regime, although the use of depot phenothiazines is widespread (Craft & Schiff, 1980). The evidence for their therapeutic effectiveness in the mentally handicapped is usually empirical, and sometimes based on anecdotal evidence. Clopenthixol decanoate is widely used in the management of aggressive and disruptive behaviour in such patients, probably as a result of experience of the use of this drug in schizophrenic patients. Carney & Rutherford (1981) reported a marked improvement in both aggressive and non-aggressive behaviour disorders in 20 chronic schizophrenic patients treated for 11 months with clopenthixol decanoate, while Visiwanathan & Rajhkowa (1982) stated that it was of undoubted value in the management of chronic in-patients, especially those with ‘positive affective’ symptoms such as hostility, aggression, suspiciousness, and irritability.