Numerous studies have attempted to relate brain morphology to treatment outcome in schizophrenia in an attempt to define subtypes of schizophrenia that may respond well to antipsychotic treatment (Brown & Herz, 1989). This has potential clinical significance since, if we can predict outcome based on brain structure, it would then influence treatment.

The evolution of the Zhengyang Community Mental Health Rehabilitation Centre described in this paper proves that community-based mental health services initiated and developed by enthusiastic and committed community members can be successful in the Chinese setting. The most important step is to utilise community resources to secure a stable source of income, preferably by establishing a profitable welfare enterprise that can both finance the provision of other services and provide work for mentally ill clients who cannot obtain regular employment. The ultimate goal is to reintroduce as many clients back into the community as possible, so a range of services is needed: supervision of medication, social skills training, occupational rehabilitation, and, most importantly, work placement. The vitality of the organisation depends on its flexibility and responsiveness to the changing needs of patients; it must use its experience to guide policy decisions about the development of new services and the alteration or termination of existing services.

Although much effort has gone into the description and classification of schizophrenic behaviour patterns, little attempt has been made to detail the course of the disorder. The present paper is an effort to trace the effects of chronicity on perception by use of a cross-sectional method. The specific tasks were selected to maximize autochthonous factors in perception. At the same time a demonstrable sensitivity to emotional states was desired, since changes in the schizophrenic condition are often considered reflections of reaction to stress. A wide enough area of behaviour was encompassed so that a general pattern, if one emerged, could be considered typical of perception as a whole.

In recent years there have been an increasing number of attempts to survey the distribution of psychiatric morbidity, or to estimate the need for psychiatric treatment, in the general population. Various methods of defining or diagnosing psychiatric illnesses have been used (Blum, 3; Scott, 20). These methods include interviews by psychiatrists (Lin, 17; Essen-Müller, 13; Hagnell, 14); the judgment of family physicians (11; Kessel, 16; Shapiro and Fink, 21); the use of self-administered symptom check lists (White et al., 23); and structured interviews by non-psychiatrists relating to symptom occurrence, attitudes, personality scales, etc. This paper outlines an attempt to determine some of the relationships between the results of a symptom-questionnaire; the diagnoses recorded by physicians; and the physicians' request for psychiatric consultation.

In 1964 Cutler et al. (1) reported on a family in which 11 members apparently had primary hyperparathyroidism. Seven cases were diagnosed at surgery; four other members had elevated serum calcium and other evidence of the disease. It was noted as an incidental finding that two of the affected members also suffered from severe psychiatric illness. The present study is a six-year follow-up investigation of the family from a psychiatric viewpoint, using non-hyperparathyroidism family members as controls to explore the possible relation of hyperparathyroidism to psychiatric illness.

To demonstrate how 'senile dementia emerged as an important psychiatric concept is not an easy task. Although the history of general psychiatry can be satisfactorily traced to the spirited endeavours of Hippocrates (460–375 B.C.), Celsus (circa 30 a.d.), Soranus the elder (circa 100 a.d.), and Aretaeus (circa 150 a.d.), the psychiatry of old age unfortunately lacks such a clear and well-defined genealogy. The term 'senile dementia’ itself seems to have been first used by Aretaeus, the physician of Cappadocia, but exactly how it had evolved and how it was differentiated, if at all, from normal senescence is not at all clear. Certainly modern psychiatry has inherited a wealth of graphic description of old age in general, and for a detailed account of the relevant ethnographic literature the reader is referred to the excellent article by Rosen (1961). From a scientific point of view, however, it is unfortunate that the spirit of enquiry and the descriptive contributions of the early writers seem to have been tempered more by the degree of optimism or pessimism with which they anticipated the intellectual and behavioural foibles of old age, than by a desire to explore and evaluate systematically its possible deviations.

In this issue, El Marroun et al suggest an association between prenatal selective serotonin reuptake inhibitor (SSRI) exposure and autistic traits in children, as well as an association with prenatal depressive symptoms. However, SSRIs may be mere markers of severity of underlying illnesses and it may be premature to reach such conclusions about effects of treatment. Studies like this raise concerns as this may fuel further anxiety and guilt among women who are faced with depression in pregnancy and possibly leave some women without treatment.

Positive change in prescribing practice in psychiatric services can be achieved with participation in the UK Prescribing Observatory for Mental Health (POMH-UK) quality improvement programmes. Key elements are feedback of benchmarked performance for local clinical reflection and customised change interventions informed by the national audit findings and parallel qualitative work. However, progress is gradual and gains generally modest.

In this editorial we, as members of the 2022 NICE Guideline Committee, highlight and discuss what, in our view, are the key guideline recommendations (generated through evidence synthesis and consensus) for mental health professionals when caring for people after self-harm, and we consider some of the implementation challenges.

Personalised prediction models promise to enhance the speed, accuracy and objectivity of clinical decision-making in psychiatry in the near future. This editorial elucidates key ethical issues at stake in the real-world implementation of prediction models and sets out practical recommendations to begin to address these.

It is a recognised fact that nervous and mental disorders are more frequent after influenza than after any of the other zymotic diseases. Dr. Risien Russell has specially referred to the action of the influenza bacillus and its toxin on the nervous system. Dr. Clouston has expressed the opinion that the effects of influenza on the mental condition of Europe far exceeded in destructive powers all the continued fevers put together. An increase in the admissions of melancholic patients into several of the asylums of this country during the prevalence of influenza has been reported at Edinburgh, Hanwell, Birmingham, Nottingham, and other institutions. Dr. Macpherson and Dr. Farquharson have discussed the pathological aspects of depressed emotions, and the physical reduction caused by influenza, as favourable to the onset of melancholia.

The social problems connected with alcohol are always before us, but social reconstruction after the great war has brought them into greater prominence than ever, while America having gone “dry” and the prohibition campaign starting in this country have brought the question of alcohol home to even the unthinking section of the community. In the past we have had the physiological effects of alcohol put before us almost ad nauseam, and everyone is fully aware of the disastrous wide-spread results of excessive drinking. Well-meaning temperance reformers are continually pointing out the intimate relationship existing between alcoholic excess and illness, crime and pauperism. Not so very long ago in the press, we had the almost amusing incident of a manifesto issued by a list of eminent physicians, who decried its use in medicine, followed not long afterwards by another manifesto signed by an equally eminent catalogue of medical men, who laid much emphasis on the beneficial effects of alcohol as a therapeutic agent. The personal factor is always apt to colour one's views, and I may be no exception to the rule. It is a common fallacy to suppose that science is free from bias and prejudice, but the facts I shall bring before your notice with regard to the relation of alcohol to mental disease will tend to indicate their presence.