Since the pioneering studies of Hebb and his associates (2) on the effects of sensory deprivation on human beings, numerous investigators have conducted experimental studies under varying conditions in an effort to establish consistent trends in behaviour of subjects exposed to such conditions. Since only two other laboratories, both using male subjects, have reported underwater studies in deprivation (1, 5), an attempt to replicate our findings of sex differences in response to the situation by use of this method seemed to be in order.

Slowly but surely the emphasis of the mental health service is moving from the mental hospital into the community which it serves. The trend of these community developments can be seen as far back as the establishment of psychiatric out-patient clinics at general hospitals under the Mental Treatment Act, 1930, together with arrangements for after care, and continued by mental hospitals and regional hospital boards since the advent of the National Health Service. While the new era in British psychiatry awaits the implementation by local health authorities of their mandatory functions under the Mental Health Act, 1959, much can still be done within the hospital services proper to shift the emphasis into the community. One such method is described in this study of a Day Hospital developed within a large general hospital.

In a previous paper (Morrice, 1973a) an account was given of a day hospital run as a therapeutic community. Emphasis was laid upon the way staff had learned to diagnose and treat patients not only according to conventional labels but also in terms of their disturbed social relationships—so-called social diagnosis and social prescription. At that time also an attempt was begun to identify life events which appeared to have precipitated the patients’ referral to psychiatric care. This paper considers the data derived from 266 consecutive admissions to the day hospital. Information obtained in each case was discussed by the staff group and noted on a standard form (Fig. 1) according to agreed principles.

Domestic and world opinion is gradually changing towards the idea of tolerating or even legalising active euthanasia. The implications of this are examined using Foulke's concept of the ‘levels' in group discussions. Psychiatrists have a unique experience in using the statutory mental health legislation, in addition to the ordinary law, to regulate medical care. A new ‘special defence’ is suggested, to be enacted by Parliament, intended to justify, but also designed to control, deliberate acts of medical euthanasia.

Mental health professionals form an important component of the response teams currently working in the Democratic Republic of the Congo to treat what is historically the second-largest Ebola outbreak. They provide psychological treatment to patients under extraordinary conditions, helping them cope with anxiety and the daily death of other patients.

One meta-analysis of ketamine anaesthesia for electroconvulsive therapy found no improvement of end-point antidepressant outcomes; another meta-analysis with a broader range of included trials found that ketamine improved both early and late outcomes. If ketamine anaesthesia is useful, researchers may need to look for benefits earlier during the treatment course.

Holzinger set up his equations to show the combination of the factors—nature (A), nurture (B), and error(E)—which go to make up a score obtained by a particular twin on a particular test. If iX1 and iX2 are the twins in an identical pair and fX1 and fX2 are the twins in a fraternal pair then: —

The controlled study of the major physical treatments in schizophrenia (and other psychiatric conditions) has been retarded by the view that it is unethical to withhold treatment from the patient. Although this argument is clearly dubious until a treatment is proved, the number of forward-looking controlled studies of E.C.T., insulin coma therapy and leucotomy may nevertheless be counted on the fingers of two hands. Not all schizophrenics have, however, received every possible treatment, and if it were possible to make comparisons of treated and untreated cases retrospectively, there would be no ethical objection to overcome.

When normal human skin is moderately cooled it goes blue, owing to a contraction of the arteries and arterioles, and a relaxation of the capillaries and subpapillary venous plexus of the epidermis. This blueness is light in colour. In certain individuals, however, it is deep, or relatively saturated, in the hands or feet or both; these include cases of acrocyanosis (extremity, = dark blue). This condition, though rare in the general population, is common among the inmates of mental institutions.

Woolley has repeatedly drawn attention to the possible role of serotonin (5-hydroxytryptamine) in mental functioning (1, 2, 3, 4). In particular, this author has stressed the possibility that some forms of mental illness, such as schizophrenia, may be related to disorders in cerebral serotonin metabolism.

The olfactory organ in man appears in a rudimentary condition as compared with its highly developed state in certain macrosmatic animals. To comprehend the immense change that has taken place in the smell apparatus, together with the development of the higher brain, and which has attained its climax in man (of those animals still possessing a sense of smell), it is necessary to be acquainted with the anatomy of the limbic lobe in macrosmatic animals, and to follow the transitions occurring until the high mammal type of brain be reached. Moreover, in this process is to be found the only means of discerning in the human cerebrum the rudiments of an important organ and of allocating its present site of functional activity. The researches of Kölliker, and, still later, of Elliot Smith, have largely removed the confusion existing in respect to the true limbic lobe, and the definition of this and its constituent parts may now be safely attempted. The extensive and hardly yet completed work of the latter author, contained in a series of valuable contributions to the Journal of Anatomy and Physiology, and in the Transactions of the Linnean Society, N.S.W., has been used by the present writer in giving the following sketch of the constitution of the limbic lobe and the cerebral commissures.

We all know cases who have got better and we like to think that we played a part in causing their improvement. To prove this is, however, a very different matter. We have all read the follow-up studies based on a carefully selected group of cases where the authors report on those whom they could trace—but what of the untraced? At times, an overall survey of one's case material may reveal facts unnoticed in the preoccupation with the day to day clinical work.

Although in the majority of cases E.C.T. is swiftly effective in the treatment of morbid depression there are some who regard it with repugnance, and have long hoped for drugs which would obviate its use. It was that hope which prompted this trial of imipramine (“Tofranil”).

A three-year deinstitutionalisation and rehabilitation pilot intervention project was implemented at Leros PIKPA for people with severe learning disabilities. Initial conditions at the asylum were appalling. Residents suffered severe deprivation, extreme institutionalisation, and violation of basic human rights. Intervention involved professionals from different disciplines, and involved residents, their families, care staff, the institution, and the local community. As a result, resident care and adaptive behaviour has started to improve. Communication between residents and families has increased. Owing to training and sensitisation, care staff's poor resident-management practices and negative attitudes toward disabled people have changed. Living and hygienic conditions have been upgraded and building renovation is under way. Asylum administration and the local community have been sensitised to residents' needs. Eleven residents have moved to the project's pilot community home in Athens; two others now live with foster families. The results suggest that deinstitutionalisation and rehabilitation can be successfully initiated even in residential institutions of the severest kind.

Of 107 recently admitted psychiatric patients screened for eating-disorder symptoms by questionnaire, 17% met DSM–III–R criteria for eating disorders. Eight patients (one male) had bulimia nervosa. Ten patients had eating disorder not otherwise specified: seven (three male) bulimic type, and three (one male) anorexia nervosa type. The most common concurrent diagnoses were mood and personality disorders. As eating-disorder symptoms are relevant to the diagnosis and management of other psychiatric disorders they should be assessed routinely in all psychiatric patients.

Studies in North America and Europe indicate that the prevalence of blood-borne viruses (BBVs) is elevated in individuals with severe mental illness; there are no comparable data for the UK. We offered routine testing for HIV, and hepatitis B and C in an inner-London in-patient psychiatric unit as a service improvement. Of the patients approached 83% had mental capacity to provide informed consent for testing and 66% of patients offered testing accepted. Although it was not our objective to establish the prevalence of BBVs, 18% of patients had serological evidence of a current or previous BBV infection, we found that offering routine testing in an in-patient psychiatric setting is both practical and acceptable to patients.