The assessment of suicidal intent is one of the most important problems of clinical psychiatry. An earlier study (Robin, Brooke and Freeman-Browne, 1968) has confirmed the high incidence of suicide in admissions diagnosed at first contact as suffering from affective disorders, and found that 8 per cent. male in-patients and 5 per cent. female in-patients so diagnosed committed suicide during a follow-up of 6–11 years. It was also shown that in male patient suicides unemployment at the time of first admission and a previous history of self-poisoning or self-inflicted injury occurred more often than in matched controls, while a history of more than one suicidal attempt was found more often in female suicides than in matched controls. Female suicides were treated less often with E.C.T. than their controls, and more often with tranquillizers.

Where preventable causes of a disorder are unknown, the epidemiologist will be concerned to search for an association between an environmental factor and some attribute of the disorder, commonly its incidence. In choosing what environmental factors to study, the epidemiologist will be attracted, firstly to those which on current hypotheses seem likely to have a causal role, and secondly to those for which the necessary data are easily collected. No doubt it is for the second of these reasons that studies have been made on the relation between schizophrenia and season of birth: the date of birth of a patient is rarely unknown, and the information, which may be accepted as being accurate in the great majority of instances, is routinely recorded in the case notes of most hospitals and clinics. All that the investigator has to do (it would seem) is to count the numbers of patients born in the different seasons of the year and compare these with the numbers to be expected from the season-of-birth distribution of the general population.

The aim of this study was to examine the factors leading to prolonged stay in hospital of patients admitted with mental disorder. It is part of a larger investigation on the interaction between the services provided for the same area by the psychiatric hospital and the psychiatric unit in the general hospital.

This paper deals with the early results and problems of establishing and developing a regional training programme in psychotherapy, using peripatetic senior lecturers. The difficulties of a psychoanalytic approach to psychotherapy in mental hospitals are discussed, and a model of psychotherapy more suitable for general application in mental hospitals and district general hospital psychiatric units is proposed.

Subjects in Botswana were asked to state their preference between modern (doctor or nurse) or indigenous (traditional or religious healer) care for three case vignettes of epilepsy, psychosis, and tuberculosis. Nurses, medical patients, and a general village population were studied. Many subjects preferred modern care for all disorders, whilst a small number favoured indigenous treatment only. A significant percentage discriminated between disorders, choosing indigenous care for some and modern for others. Indigenous care was most favoured for epilepsy, and least for tuberculosis. Psychosis took an intermediate position. The size of the discriminating group varied between populations, but the overall pattern of attitudes remained the same. Neither demographic factors nor aetiological beliefs consistently identified those who choose indigenous care.

A follow-up study of 17 old long-stay psychiatric patients resettled in private facilities for the elderly is reported. Resident satisfaction with the placement and functioning (using the CAPE Behaviour Rating Scale) was assessed, together with the quality of the physical and social environment, and the regime characteristics in the establishments. All residents were satisfied with life and their functioning had improved significantly. The private facilities were more resident-orientated, and had a generally superior social environment to their local authority ‘old people's home’ counterparts. The physical amenities, safety features, and architectural choice available were of a similar standard to those in local authority old people's homes, but there were fewer prosthetic and orientational aids and on-site recreational amenities.

The Netherne Resettlement Unit, established in 1957, has been described in detailed publications including those by Bennett et al. (1) and Folkard (15, 16). These authors stressed the Unit's dual function of assessment and preparation of disabled patients for resettlement, and described results of its first two years in terms of discharge, readmission and employment. The basic Unit aims of resettlement in optimum employment and accommodation have remained unchanged since that time. The programme has been geared towards minimizing the patients' handicaps by improving their coping abilities (24) so that they can manage in less protected situations, by utilizing the pooled experience of a multidisciplinary rehabilitation team (18) and by mobilizing community resources (36). Hospital living and working conditions are repeatedly scrutinized so that factors which might provoke, increase or reactivate the patients' symptoms (10) are reduced. The Unit's policies, therefore, remain dependent on the forward-looking hospital administration which has encouraged democratization, effective communication and clear definition of function (33).

Brain-type creatine phosphokinase isoenzyme (CPK BB) was measured by radioimmunoassay in the serum of 31 depressed patients undergoing bilateral ECT. Samples were taken shortly before and at one hour, two hours, and six hours following ECT. ECT did not cause a significant alteration in serum CPK BB concentration during the six hours following the treatment. Similarly, there was no difference in mean pre-ECT concentration of serum CPK BB between patients receiving the first ECT of their current admission and those receiving subsequent treatments. These findings do not support suggestions that ECT causes alteration in permeability of the blood-brain barrier, nor that it causes detectable brain injury.

The drawings of children have been studied by many observers during the past forty years, and have yielded valuable information for the psychologist, the ethnologist and the pedagogue. Many of the studies were concerned with the development over a period of years of the drawings of a single child (Luquet (12), Stern (19), Eng (3)). Others were concerned with drawings taken from a large number of children of varying ages. Principal among these studies is that of Rouma (17) in 1912, drawn from a wide field, carefully and accurately observed, and published with a wealth of illustration. More recent researchers have employed the quantitative method, and McCarty's (14) study, published in 1924, is of value principally for its elaborate statistical survey.

Similarity between certain of the visual effects of mescaline and hypnagogic imagery has been independently noted by several investigators, one of the earliest of these being Weir Mitchell (1896). Our own research group first became interested in hypnagogic experiences when one of the writers, as subject, in seeking to communicate the character of his mescaline visions, likened them to images he had encountered just before sleep. This led to an investigation of hypnagogic imagery as such, the results of which have been published elsewhere (McKellar and Simpson, 1954). Further experiments with mescaline, and consideration of the relevant literature of the two fields, suggest that the mescaline-induced and hypnagogic states are more than superficially alike, and that a comparison may illuminate the processes at work in each.

The present paper will deal with eye blink frequency and its relationship to scores on “personality” questionnaires and to frontalis and right forearm muscle tension measured electromyographically. This analysis forms part of a larger experiment with the main aim of investigating levels of muscle tension in four groups—(i) introverted neurotics, (ii) extraverted neurotics, (iii) extraverted normals and (iv) introverted normals—during relaxation and while responding to a series of questions about neurotic symptoms.

The tell-tale facies of the subject of long-standing tabes is familiar to all clinical observers, and is the sum of several components. The pallor and thinness of the face are, in all probability, largely related to the impaired state of the patient's nutrition, and this in turn is often an expression of chronic infection of the urinary tract. The remaining components, namely, the ptosis, the pupillary anomalies and the equally constant changes in the appearance of the iris, are of neurogenic origin.

The experiments described in this paper were performed in an attempt to elucidate the mechanism of the convulsion following the administration of cardiazol (pentamethylenetetrazol). The paper is divided into four sections—a description of experiments, a résumé of the relevant pharmacology of cardiazol, a discussion and a summary.

During the last two years, the medical profession in Britain has been participating in a public debate – perhaps in a more exposed way than for some time. Eminent Presidents have been writing letters to The Times, and less eminent ones demonstrating in Downing Street. This can all be seen as contributions to the discussion on the state of the National Health Service. But there is, I believe, a wider and in my view a more long-lasting change going on, namely the relationship between the medical profession and the public – the citizens of this country. You may feel that the basic premise is based on a false dichotomy, rather like the sterile debates on community care. Hospitals are part of the community. Doctors are citizens. Yet there is an implicit or explicit contract, social if not financial, between a country's medical profession and its citizens. As we are in the era of negotiating or inventing or specifying contracts, I wanted to consider this.