Introduction The therapeutic community method of treatment was developed by Maxwell Jones at Belmont Hospital (Jones et al., 1952; Jones, 1954; Rapoport, 1960) for the treatment of psychopathic personalities. The method has been applied to an admission unit by Wilmer (1958) and to psychopathic personalities by Craft (1965). Clark (1964) has differentiated between ‘the therapeutic community approach’, of increased activity, freedom and responsibility for all patients in the hospital, and the ‘therapeutic community proper’, the small unit with face-to-face gatherings of all members, social analysis of events, opening of communications, flattening of the authority pyramid and blurring of roles.

The long-term effects of electroconvulsive therapy (ECT) on the risk of stroke are unknown. We examined the association between ECT and risk of incident or recurrent stroke. A cohort of 174 534 patients diagnosed with affective disorder between 2005 and 2016 in the Danish National Patient Registry were followed for stroke until November 2016. The association between ECT and stroke was analysed using Cox regression with multiple adjustment and propensity-score matching on sociodemographic and clinical variables. In 162 595 patients without previous stroke, 5781 (3.6%) were treated with ECT. The total number of patients developing stroke during follow-up was 3665, of whom 165 had been treated with ECT. In patients <50 years, ECT was not associated with stroke (adjusted hazard ratio (HR) = 1.29, 95% CI 0.87–1.93). In patients ≥50, ECT was associated with a lower risk of stroke (adjusted HR = 0.69, 95% CI 0.57–0.89), but this estimate was likely influenced by competing mortality risk. Of 11 939 patients with a history of stroke, 228 (1.9%) were treated with ECT. During follow-up, 2330 (19.5%) patients had a recurrence, of which 26 were patients treated with ECT. ECT was not associated with risk of a new event (HR = 0.69, 95% CI 0.46–1.00; P = 0.05). ECT is not associated with an elevated risk of incident or recurrent stroke.

Eighty chronic schizophrenic women hospitalized for an average of 6·8 years received group hypnotherapy twice weekly in addition to tranquillizers. After four months, 42 per cent. were discharged on convalescent leave; by the end of a year, a total of 48 patients (60 per cent.) had been released. All discharged patients—except four who required rehospitalization —made a satisfactory adjustment to their family and social responsibilities during the one-year follow-up period.

A rare case of infantile behaviour of a fetishistic nature in an 80–year-old man was possibly related to a head injury at the age of six, when his regression first began. Treatment was deemed unwarranted.

In recent years a number of studies have been undertaken in which the “night vision” or dark-adaptation of psychiatric patients has been compared with that of normal subjects. These studies have their origin in a wartime observation that the incidence of “night-blindness” among neurotics was higher than among normal Service personnel. Evidence of functional disorders of vision is of interest from several points of view, psychiatric and ophthalmological as well as psychological and physiological. The aim of this article is to make a critical evaluation of the results so far obtained, determine what generalizations are possible and consider implications for further research.

In the following observations I propose to describe a feature in the mental condition of Epileptics, which, to the best of my knowledge, has not attracted that attention to which its frequency entitles it. I refer to the exaltation of the religious sentiment. Irritability, suspicion, impulsive violence, egotism, strong homicidal propensities are among the most commonly observed characteristics in the insane epileptic; but in strange contradiction with these we very frequently find combined a strong devotional feeling, manifesting itself, it may be, in simple piety or in decided religious delusions. I do not pretend that the forms of religious insanity to be afterwards noticed are peculiar to epilepsy, but they are very frequently found in connection with it, and, I believe, I have only to describe a few illustrative cases to bring to your recollection numerous others which have occurred in your own experience. The causes which combine to develope a devotional frame of mind in Epileptics are probably numerous. In congenital cases or those arising from diseases of childhood education no doubt exercises a powerful influence. The epileptic child is necessarily less able to join in the amusements and occupations of healthy children, and a large share of his time and attention may be devoted at home to religious instruction. The mysterious nature of the disease, the consciousness of infirmity and helplessness developes a craving for sympathy in the epileptic which we rarely see in other lunatics. In the wards and airing-courts of our asylums, epileptics may be distinguished from their fellow-patients by the fact that they are generally found associating in little groups of twos or threes. They sympathize with each other, lean on each other for help in the time of trouble, and however much they exhibit violence and viciousness to others, they rarely attack each other. Along with this desire for sympathy, the epileptic is mercifully endowed with strong hope. He is always getting over his trouble, he thinks the turns are less severe, and will tell you perhaps the day before a fatal seizure that he thinks he will have no more fits. We all know how much hope has helped the physician in his efforts to combat this disease with a whole battery of drugs, each of which in its turn seems for a time to promise success, only too surely to fail in the end. This craving for sympathy finds a deep response in the highest development of hope—religion; and the sufferings of this life are assuaged by the assurance of sympathy and aid from heaven, and of a blessed future where suffering and sorrow are no more.

The need to clarify the “confusion in neurology and allied disciplines between the body image, the body schema, the body concept and the perceived body” was emphasized by Smythies (1953). For the neuropsychiatrist it is perhaps the disorders of the body schema and perceived body which are of the greatest interest and importance, but the confusion which still exists between the body concept and the body percept make it probable that a definition and examination of the body concept would clarify thinking about all Body Image problems.

During the course of an investigation of the effectiveness of various components of electric convulsive therapy in the treatment of hospitalized psychiatric patients (Brill et al., 1957, 1959) observations were made on the spinal fluid concentrations of cations and total protein before and after treatment. The possibility existed that alterations in brain function and structure (which are believed by many to occur during a course of electro-convulsive treatment, and to be responsible for improvement in patients receiving such treatment) might be associated with, or reflected by measurable changes in the cerebral spinal fluid.

Two surveys of mental hospital in-patients, one by Gore and Jones (1961) the other by Cooper and Early (1961) resulted in different conclusions when the present and future need for psychiatric accommodation was considered.

In order to investigate the validity of Foulds' hierarchical model of psychiatric illness a cross-cultural study was carried out. The DSSI, a self-report symptom inventory, was administered to 100 English psychiatric patients and a translated version was administered to 100 Turkish psychiatric patients. The report of symptoms in both nationality groups conformed to Foulds' hierarchy principles in 93 per cent and 87 per cent of cases respectively.

When the reporting of symptoms within classes was investigated, nationality effects were observed to influence the self-reporting of ‘hysterical’ neurotic symptoms, irrespective of diagnostic class. Nationality was also observed to influence the reporting of ‘delusional’ symptoms, but in non-psychotic patients.

These results suggest that Foulds' model is a useful one in cross-cultural psychiatry, because it indicates both the universal features of hierarchical ordering of symptoms and the cultural influence on those symptoms which do not define the diagnostic class of the patient.

Recently Kay, Beamish and Roth (1964) have shown that there is only a small fraction of old people with psychiatric disorder being cared for either as hospital in-patients or as residents in Homes. Their investigation was carried out in Newcastle-on-Tyne. They pointed out that various other reports concur with the view that medical services at the present time deal only with the visible part of the “iceberg” of mental disorder and handicap.

Lippold and Redfearn (1964) reported psychological effects from sending small direct electrical currents through the brain (polarization). For 26 subjects they found that scalp-positive current caused ‘alertness or more involvement in the environment’, whereas scalp-negative current caused ‘quietness and withdrawal’ (p. 771). Three other subjects reliably produced opposite changes. The observations were made during brief talks by judges unaware of the kind of current being administered. The present study, details of which are given by Nias (1968), aimed to observe the effects of polarization upon symptoms of depressed patients.

There is no longer much doubt that there is a small but real association between psychosis and violence directed at others, as well as between psychosis and self-directed violence, including suicide. Schizophrenia and the affective psychoses appear to have a similar order of association with suicide (Caldwell & Gottesman, 1990), but schizophrenia is more likely to be associated with serious other-directed violence. The evidence for the effect of schizophrenia comes from three main directions. There are two substantial cross-sectional USA community studies (Swanson et al, 1990; Link et al, 1992), respectively showing a significant quantitative association between schizophrenia and violence. Comparative studies of illness and offending careers (Lindqvist & Allebeck, 1990; Hodgins, 1992; Coid et al, 1993; Taylor, 1993; Wessely et al, 1994), all show different patterns of violent offending by people with schizophrenia compared with those without a psychotic illness, the 1993 studies confirming that the onset of violence is almost invariably after the onset of illness. The third type of evidence is from phenomenology. Taylor (1985) and Link & Stueve (1994) have shown a strong association between delusions and serious violence, the former demonstrating a specific effect of acting on delusions. (For a more extended discussion see Taylor, 1995.)

At the moment, cybernetics cannot point to any established triumph for, as a science, it is very young and is being applied to psychiatry in few laboratories. Nevertheless, I hope to show that there are good reasons for thinking that its relation to psychiatry is close, and that its application will eventually yield a rich harvest.

Scattered throughout the literature on the psychiatric aspects of asthma are reports of cases where the psychiatric disturbance was severe enough to be described as “psychotic” (Reichmann, 1922; Hansen, 1929; St. Saxl, 1933; Oberndorf, 1935). The term “psychotic” was used in the sense that the psychiatric diagnosis was either that of manic-depressive psychosis, schizophrenia, or paranoid psychosis. It has been postulated, moreover, that the co-existence of a psychosis and attacks of asthma was no chance relationship, and that there was an intimate link between the psychosis and the somatic disturbance. This relationship, it has been said, is of considerable theoretical significance. Appel and Rosen (1950), for example, consider that “there is a reciprocal relationship between the so-called physical manifestations of psychosomatic illness and the psychological manifestations of psychiatric illness.” This concept is also held to apply in disorders other than asthma—in ulcerative colitis, rheumatoid arthritis, and in certain skin disorders. The treatment of such disorders psycho-therapeutically is said to result at times in an alleviation of the physical disorder, but the concomitant development of a psychotic reaction (Appel and Rosen, 1950; Lindemann, 1950). During the past three years an investigation of patients suffering from asthmatic attacks has been in progress, and the opportunity has arisen to examine these points on a fairly large case material. The present paper reports an attempt to investigate scientifically some aspects of the relationship between asthma and psychosis.