Perhaps in no other applied discipline are there to be found so many differences of opinion as exist in clinical psychology today. Clinical psychologists in fact even disagree about the fundamental approach to their own subject. Let us examine briefly what appear to be the major approaches.

Imipramine hydrochloride (N-(γ-dimethylaminopropyl)-iminodibenzyl hydrochloride, “Tofranil”) has been shown by many investigators to be of value in the treatment of depressive states. The reports of Kuhn (1957, 1958) and of Kielholz and Battegay (1958) have been followed by confirmatory papers from other authors. A number of contributors to the McGill University Symposium on Depression and Allied States (1959) commented favourably on the value of imipramine in depression; Hoff, however, while agreeing that the drug is useful in acute depressions stated that he found it ineffective in chronic depression.

“In a cluster of illness reported among students at an elementary school parents mentioned many signs and symptoms including headache, pallor, dark circles under the eyes, nausea, and vomiting – which they attributed to exposure to recurrent leaks of natural gas at the school. It is likely that the parents spread among themselves the notion of toxic exposure at the school. A questionnaire revealed no spatial clustering, but increased reports of symptoms were related to intense media coverage. A thorough environmental and epidemiological investigation was negative, there being no evidence of a continuing gas leak or other potential causes. At a strictly biological level, the complaints in this reported ‘cluster’ apparently represented the sporadic occurrence of common childhood illnesses. The possibility of an epidemic from toxic exposure at the school caused intense parental concern and led to a major public health problem. The established term ‘mass sociogenic illness' seems inapplicable here because complaints did not come principally from the students and the apparent epidemic illness was not transmitted among them. The term ‘mass sociogenic illness by proxy’ is proposed to describe this incident, in which transmission in one group (the parents) resulted in reports of an epidemic in another group (students).”

At a child psychiatry clinic 122 boys were scored on scales of aggressiveness, noncompliance and antisocial behaviour. Their biological fathers were scored on aggressiveness and antisocial behaviour. The fathers' scores were modestly but significantly correlated with those of their sons. The correlations were also computed separately for the 64 boys whose biological fathers were no longer in the home and for the 58 whose fathers had stayed. Father–son resemblances for the latter group were considerably higher than those observed in the whole sample, and for the father-absent group were insignificant.

Two cases of Capgras' syndrome are described in which patients committed serious acts of violence towards famly members who had become the subject of delusional misidentification. The cases illustrate some typical features of Capgras' syndrome including its potential for dangerousness. Intoxication with alcohol is proposed as a precipitant for violence in these patients.

A 24-year-old male schizophrenic had a delusion that he was female and had lived his life as a woman for almost two years. Unlike the only other reported case, his ‘symptomatic transsexualism’ responded to the effective treatment of his schizophrenia.

The European Medicines Agency (EMEA) is the regulatory body that provides the institutions of the European Community with the best possible scientific advice on the quality, safety and efficacy of medicinal products. Drugs approved by the EMEA are automatically marketable in all the European member states. Since the beginning of the EMEA's activities a number of drugs acting on the central nervous system obtained marketing authorisation. This editorial highlights some aspects of the EMEA rules that may negatively affect the evaluation of medicines for psychiatric disorders.

In the previous paper we have given a brief discussion of the reasons why figural after-effects are of interest in the study of personality and why stimulant and depressant drugs would be expected to have certain effects upon them (Eysenck and Easterbrook, 1960a). In this paper we describe an experiment using kinaesthetic figural after-effects rather than visual ones. By and large results with kinaesthetic figural after-effects have been more clear-cut and definite in relating these after-effects to personality; several studies have shown extraverts to have greater figural after-effects than introverts (Eysenck, 1957). Furthermore there is at least one study demonstrating that stimulant and depressant drugs have the predicted results upon kinaesthetic figural aftereffects (Poser, 1958). The reasons for this may be that whereas for visual experiments it is difficult to check on the subject's ability to maintain fixation, nothing comparable is required in experiments on kinaesthetic figural aftereffects. Furthermore any departure from instruction on the part of the subject can easily be checked by the experimenter. For these reasons kinaesthetic tests have very definite advantages over visual ones.

I—The Problem. II—Method: (i) General Outline; (ii) Apparatus; (iii) Test procedure. III—Subjects. IV—Results: (i) Correction for arbitrary zero; (ii) Analysis. V—Discussion. VI—Summary. References.

While the importance of psychological factors in attempted suicide has long been acknowledged, the use of standardized psychological techniques has been neglected. The paper by Vinoda (1966) is the first in Britain to describe the personality characteristics of attempted suicides using a battery of objective tests. She tested and compared a group of female attempted suicides, who had been admitted to the psychiatric ward of a general hospital, with a group of psychiatric patients and a group of non-psychiatric patients from the same hospital. Where differences on testing occurred it was usually the case that the attempted suicide and psychiatric groups were discriminated from the normal controls but not from each other.

In April, 1946, an experimental form of hospitalization for psychiatric patients was set up in Montreal.∗ This form of hospital, described by Ewen Cameron (1947), admitted any type of patient, the only criterion being that they should be well enough to stay at home over-night. To such an institution he gave the name of Day Hospital. At about the same time J. Bierer (1951) was experimenting in the same direction in this country. in connection with his attempt to extend the principles of “social psychiatry” to the everyday treatment of patients. Since then there have been several other short communications on the subject such as those of A. E. Moll (1951) and H. Gilmore (1952).

Collaborative care is a well-studied and effective model of integrating behavioural healthcare into primary care medical settings. Despite evidence of its effectiveness, it has been difficult to implement into the US healthcare system. The upcoming reorganisation of US healthcare will rely heavily on adaptations of this model to improve its uptake and cost-effectiveness.

Those people who are dangerous often have personality disorders. Should these individuals be dealt with by criminal justice or mental health services? England (note not Scotland) has taken the mental health route with the Dangerous and Severe Personality Disorder Programme. Is this bold move wise or foolish? To answer this question we have both evidence and opinion – neither is conclusive.

It is suggested that a finding that apparently challenges current practice guidelines, namely that patients with a rapid-cycling pattern of bipolar disorder can take antidepressant monotherapy for months without increasing risk of cycling, may be parsimoniously understood by the way that the investigators defined rapid cycling and by their use of acute-phase fluoxetine monotherapy prior to randomisation to continutaion-phase therapy with fluoxetine, lithium or placebo.

In this editorial, we discuss a UK-based cohort study examining the mortality gap for people with schizophrenia and bipolar disorder from 2000 to 2014. There have been concerted efforts to improve physical and mental healthcare for this population in recent decades. Have these initiatives reduced mortality and ‘closed the gap’?

Codes of ethics have existed for medicine since the time of Hippocrates. However, a written code of ethics (like a written constitution) has so far eluded British psychiatry. In this editorial we discuss the arguments for and against a code of ethics as an essential aspect of our identity as medical professionals. Our professional identity as psychiatrists is coming under scrutiny from the General Medical Council, the emergence of the user movement and the proposals in the draft Mental Health Bill. At a time when psychiatry is seen increasingly as a guardian of public safety, there has never been a more pressing need for a code of ethics.