The effects of biperiden and piroheptine on the serum level of zotepine were studied in 15 schizophrenic and 6 mentally retarded in-patients. Neither of these anticholinergic drugs affected the serum level of zotepine nor caused significant side-effects. In the schizophrenics the total scores on the BPRS did not change significantly with either combination of drugs.

Amitriptyline hydrochloride is 5–(3 dimethylaminopropylidine)–dibenzo (a,d) (1,4) cycloheptadiene hydrochloride. Structurally it is not related to the hydrazines and is not a monoamine oxidase inhibitor. It bears some resemblance to the phenothiazines and its chemical structure is related to imipramine, in which the central seven numbered ring is azepine, nitrogen replacing the partially unsaturated carbon of the amitriptyline cycloheptadiene ring (Dorfman, 1960; Vernier, 1961).

The Children's In-patient Department of the Maudsley Hospital has now been running for two years, and currently accommodates twenty to twenty-five in-patients of both sexes. These range through severe organic disabilities, early cases of delinquency or behaviour disturbances and emotional or psychoneurotic problems. In the under fives there are a high proportion of acute disturbances of behaviour and habits. It is believed that our experience in developing this unit and discussion of our problems solved and still to be met will prove of value to other hospitals planning similar accommodation.

Prochlorperazine (Compazine, Stemetil) and chlorpromazine (Thorazine, Largactil) frequently produce tremor and rigidity. Less well known are the severe tonic spasms of the muscles of the head and neck which can result from these phenothiazine derivatives. This paper directs attention to these spasms and their similarity with “extrapyramidal seizures” and oculogyric crises.

An evaluation of 15 patients treated by subcaudate stereotactic tractotomy (SST) for treatment-resistant unipolar affective disorder was made for frequency and severity of recurrence of illness. One-third had died by the time of assessment, but none by suicide. Two-thirds of the sample experienced a reduction in the severity of depressive episodes after the operation; only one-third reported a reduction in frequency of episodes.

Contextual constraint is a measure of the degree to which any one word in a passage is determined by the words which precede it, and can be expressed in terms of dependent probabilities. A recall task devised to investigate this topic was designed by Miller and Selfridge (1950) for an investigation on the statistical structure of words in context. Contextual constraint is at its highest in a passage of English text and at its lowest in a passage of unrelated words selected at random. The Miller and Selfridge task requires the subject to listen to seven passages of words in turn and at the end of each passage to write down the words he can remember. The seven passages are arranged in order of increasing contextual constraint from random words to a piece of text.

Early reports on enhancing occipital alpha through feedback noted that subjects reported the experience as being pleasant and relaxing. This paper reports the subjective experiences of 140 subjects who participated in four studies which examined the alpha enhancement phenomenon. Under both eyes-open and eyes-closed conditions, approximately 50 per cent of the subjects reported that alpha enhancement was ‘pleasant’ and 50 per cent ‘unpleasant/neutral’. With eyes-open training conditions, about half the subjects stated that the experience was ‘relaxing’ and the other half ‘not relaxing’. During eyes-closed training, 63 per cent of the subjects noted that enhancing alpha was ‘relaxing’, while 37 per cent reported that the experience was ‘not relaxing’. However, in the last case the circular relationship between increased alpha and deep relaxation may obtain.

The treponemal serological status of 800 patients above the age of 65 was reviewed. Twenty-one were found to be positive and the venereologists advised against treatment in all referred cases. The question is posed whether syphilis serology screening in the elderly mentally ill should be confined to those patients with obvious clinical manifestation of syphilis or with obscure psychiatric presentations.

A review of some of the literature concerned with the aetiology of homosexuality shows that certain variables, in particular those involving the relationship between the homosexual and his parents, differ between studies involving populations of neurotic homosexuals and those concerned with non-psychiatric populations. Investigators concerned with the former group (Bieber et al., 1962; O'Connor, 1964; West, 1955), have placed emphasis on the importance of the mother-child relationship, having found this to be abnormally intense in the case of many homosexuals. On the other hand, a well controlled study by Bene (1965), involving a non-psychiatric population of homosexuals, revealed no difference between her homosexual and heterosexual groups as regards maternal overprotection. Her findings caused her to place more emphasis on the father-child relationship.

Despite the advent of the stimulant phenothiazines—effective, sometimes, when older dimethyl compounds fail—a proportion of chronic schizophrenics continue to resist treatment with both types of drug, and also fail to respond to intensive nursing regimes designed to combat the effects of institutionalization. These patients constitute a major therapeutic problem.

The challenges for scientific journals at the beginning of 21st century are exciting but formidable. In addition to reporting faithfully new knowledge and new ideas, each journal, or at least all those aiming for a general readership, has to cater for a potentially huge lay readership waiting at the internet portals, a hungry press eager for juicy titbits, and core readers who, while impressed to some extent by weighty contributions to knowledge, are also looking for lighter material that is both informative and entertaining. In the past this type of content was frowned on as mere journalism, fluff of short-term appeal but no real substance. The lighter approach was pioneered by Michael O'Donnell as editor of World Medicine in the 1970s, who introduced a brand of racy articles, debates and controversial issues in a tone of amusing and irreverent iconoclasm. At this time it was dismissed as a comic by some of the learned journals but its popularity ensured that in subsequent years its critics quietly followed suit, as any current reader of the British Medical Journal and the Lancet will testify.

Imipramine and amitriptyline have each been tested by controlled trials and have been shown to be effective (Garry et al., 1963; Skarbek et al., 1962; Ball et al., 1959; Leyberg et al., 1959, and many others). Their uses have been discussed in articles in the “Today's Drugs” series in the British Medical Journal for 1959 and 1961 respectively. The literature has been summarized by Burt et al. (1962).

Alcohol-related dementia represents an underrecognised mental disorder with both clinical and public mental health aspects. There is considerable scope for improving its assessment within both mainstream and specialist mental health services, but ongoing challenges remain in ensuring its timely detection so that appropriate preventative and rehabilitative interventions can be applied.

Delusions of poisoning often dominate the clinical picture in schizophrenia. In an earlier publication (6) we have suggested that these cases may be phenomenologically distinct from other schizophrenics. Patients who believed they were poisoned or gassed reported more somatic symptoms, headaches, decreased visual acuity and disturbances of taste and smell.

The following assessments represent two reviewers' comments on both the original and revised versions of the paper by J. Peuskens on behalf of the Risperidone Study Group. The reviewers were originally anonymous.