The development of techniques for studying sex chromatin from oral mucosa (Moore and Barr, 1955; Marberger at al., 1955), and chromosomes from peripheral blood (Moorhead et al., 1960), has made it possible to undertake population surveys to identify individuals with abnormal sex chromosomes. The present knowledge of psychiatric effects of the sex chromosome abnormalities has been derived mainly from comparing their frequency in the psychiatric population with that in the general population.

A recurrent theme in psychiatry is the belated and often confused appreciation of advances in other relevant disciplines. An example of this is the “split-brain syndrome”, which provoked a Zeitgeist in the kindred field of neuropsychology and which has shaped notions of mental functioning impinging on the domain of psychiatry as well as philosophy, aesthetics, and education (Benson & Zaidel, 1985). The ‘left brain – right brain story’, while giving rise to much creative scientific enquiry, has also spawned some rather dubious psychophantasy. The purpose of this article is therefore to summarise this vast and growing body of work, to highlight areas of particular relevance, and to steer the reader away from the more wayward regions of speculation.

Twenty psychiatric in-patients were studied before and after five bilateral electroconvulsive treatments for major depression. There were significant memory and neuropsychological changes after treatment, and significant reductions in depression rating scores, but they did not correlate with various measures of blood pressure elevation during treatment. The importance of ECT-related amnesia is discussed.

The aspirations, mores, and family structure in Cypriot immigrants, which are illustrated in four cases of hysterical behaviour, have many similarities to nineteenth century Viennese society. Such behaviour may mask more sinister diagnoses; one of the cases remains diagnostically uncertain and another passed through a transient hysterical psychosis with Ganser-like symptoms. The cultural, dynamic, and nosological issues are discussed.

There have been a number of studies attempting to quantify anxiety under stress, using biochemical measures such as plasma Cortisol concentration and urinary catecholamine excretion as concomitants of the emotional response. A limitation of some of this work has been the lack of predictable and adequate stresses studied, which have included disturbing interviews (Bliss et al., 1956), admission to hospital and anticipation of operation (Mason, 1959), stressful films (Levi, 1965) and hypnotically induced anxiety (Persky et at., 1959).

In recent years there has been increasing interest in the sociocultural aspects of psychiatric disorders, particularly schizophrenia (World Health Organization, 1975; Sartorius et al, 1986). This has extended from multicentre international studies of prevalence, through national incidence or phenomenological studies in different ethnic groups (Cochrane, 1977; Teggin et al, 1985), to outcome assessments in different cultures (Sartorius et al, 1986, 1987).

The literature on Werner's syndrome is scarce, and to our knowledge, no documented evidence is available to substantiate central nervous system involvement in this multisystem disease. We present a case of Werner's syndrome associated with recurrent delusional psychosis in the presence of cognitive impairment and computerised tomography (CT) radiological changes in the posterior cerebral cortex.

The psychiatric hospital can be viewed as a social system which is evolving slowly by attempting to improve. In order to systematically study and learn about itself the mental hospital and its care providers need continuous pertinent information. Yet, at present the psychiatric hospital is not organized in a way that readily allows isolation of problems or systematic learning from prior experience (8). In that sense, the hospital is a non-system which lacks an information system necessary for meaningful feedback to the decision-makers of the institution (7).

In European and American psychiatry, catastrophes like divorce and death of parents occurring in childhood are considered to be important factors, contributing to the psychogenesis of emotional disturbances. However, while dealing with neurotic Ethiopian students, the authors were struck by the conflicting role played by the apparent instability of marriage in this country, the frequency of death of one or both parents and the early departure from home of a child to get proper education. On the one hand there were such observations as the obvious unhappiness about his past of a neurotic student, who was deserted by his mother and left in a hospital for more than a year when her husband abandoned her. Later his mother accepted him once more, and he was called “the one who died and came back to life”. His father even started to visit his first wife again, among other things to tell her that the children of his second wife were so much more clever. Are these experiences exceptional and significant, or is the next observation more representative? Two small children were examined during a home visit, and afterwards directed to return to their mother. Without the slightest doubt and with evident affection they chose their grandmother, while their own mother, a next-door neighbour since she had taken another husband, stood looking at the scene with nothing more than neighbourly interest. It is obvious that the significance of a broken home (by which is meant death of one or both parents and permanent separation) needs to be reconsidered under the circumstances prevailing in a country like Ethiopia. One way of approaching the problem could be provided by a child's behaviour at school as related to the occurrence of above-mentioned catastrophes. Sherwin and Schoelly (1965) name the school-community as one “reference group” providing standards of normal behaviour. Employing the native teachers as observers would include an additional advantage. We, as European observers, might run the risk of introducing cultural biases when we judge a child's behaviour ourselves.

In this study, we compare the rates of psychiatric disorders found among women in a random sample of the general population with those of patients referred to specialist services. Both these groups were drawn from the same geographical area. The ratio of prevalence rates is less than the ratio between inception rates in the two groups. When only those with affective disorders were considered, the results revealed that the point prevalence in the treated-disorders group was only 1% of the community-group prevalence, while the inception into care in the former group was nearly 6% of that in the latter. Single women and older women were over-represented in the hospital sample.

Schizophrenia is one of the most severe and debilitating major psychiatric diseases, with a yearly prevalence of 0.4–0.8% in the general population (Dohrenwend, 1980; Flekkoy, 1987) and a lifetime risk of 1–1.5% (Regier et al, 1984; Robins et al, 1984). It is the prototype of a severe mental illness, with the capacity to disrupt routine daily functions in all areas of life, but especially work, social relationships, and self-care. Schizophrenia also increases the vulnerability of a patient to physical and other mental disturbances (Koran et al, 1989). Until recently, the clinical course of this disease has been far worse than that of most other psychiatric disorders, thus making it devastating for many individuals and costly to society (McGlashan, 1988). Schizophrenic patients occupy 20–25% of all the beds available for psychiatric in-patient care and account for 40% of all long-stay hospital days (Talbott et al, 1987; Meise et al, 1992). It is not so much the direct costs associated with treatment, but rather the indirect costs, such as those that arise from morbidity and mortality, that place a severe burden on the social economy (Gunderson & Mosher, 1975; Hall et al, 1985; Rice et al, 1992).

A handedness test, administered to 88 manic male patients and 86 male control subjects, showed no difference between the two groups. The results suggest that unlike schizophrenia, mania is not associated with increased left and/or mixed-handedness.

Seven drugs of the imino-dibenzyl group are now generally available in Great Britain (imipramine, amitriptyline, desipramine, nortriptyline, protriptyline, trimipramine and opipramol). All are similar in their actions and side-effects. Imipramine, the first to appear, has been shown to be more effective than placebo in the treatment of depression, though with much better results in men than in women (M.R.C. Clinical Trial, 1965). Desipramine, a metabolite of impramine, was introduced with the claim that its action was quicker than that of imipramine, though this has never been clearly demonstrated. Trials of desipramine against imipramine (Waldron and Bates, 1965; Rose and Westhead, 1964) showed no significant difference between these drugs. Comparison of amitriptyline and imipramine (Burt, Gordon, Holt and Hordern, 1962), showed amitriptyline to be at least as effective as imipramine and significantly superior in the treatment of endogenous depression. Comparisons of nortriptyline and amitriptyline (Forrest, Affleck, Gibb and Priest, 1964; Rose, Leahy, Martin and Westhead, 1965) showed no significant difference between these drugs.

The case notes of 1069 children and teenagers admitted to Bethlem Royal Hospital (‘Bedlam’) in the 19th century were analysed with particular reference to the frequency and types of delusions. Delusions were present in 700 (65%), among whom there were significantly more boys than girls. There was a statistically significant rise in the frequency of delusions from 1830 to the end of the century. Sixty-six per cent of the patients were discharged cured and, taken overall, the presence of delusions did not affect the prognosis: specifically, delusions did not worsen the prognosis in those diagnosed as suffering from mania or melancholia. Nevertheless, the prognosis was worse in boys with single paranoid delusions, or paranoid delusions in combination with auditory hallucinations of people, and worse for girls with delusions of exaltation in combination with other types of delusions.

A man suffering from persecutory delusions attempted to commit suicide by holding the head of a three-inch masonry nail against a wall and head-butting its point until he had driven it fully into his forehead.