Studies in Great Britain concerning intentional self-harm in adolescents have been few (Haldane and Haider, 1967; Leese, 1969). Such behaviour amongst teenagers is now common, and usually takes the form of self-poisoning with drugs; in fact it is probably becoming commoner, although the reasons for this are not altogether clear. The present survey concerns 50 consecutive patients aged between 14 and 19 years, admitted to the General Hospital, Birmingham, following self-harm behaviour in 1970 and 1971. The lower age limit for the group was determined by hospital admission policy, since children under 14 are admitted elsewhere in the city. All the patients had taken drug overdoses, and none had used other methods of self-harm, such as wrist-slashing. All cases classified as intoxication or poisoning within these age limits admitted to the hospital during the relevant period were scrutinized, and care was taken to make sure that no cases of intentional self-harm were being overlooked amongst so-called accidental poisoning. All patients in the intentional self-poisoning group were interviewed by the psychiatrist within 24 hours of regaining full consciousness. Information was obtained in a standard form covering specific aspects of the history. The parents (when available and willing) were seen either by medical staff or by a social worker in an open-ended interview. The Eysenck Personality Inventory (EPI) and Raven's Progressive Matrices test were administered by the psychiatrist at a later date, when all drug effects had worn off.

A review of the history and experimental findings relating to the spiral after-effect can be found elsewhere (5) and will not be repeated here. The reliability of the after-effect, the major role played by the cortex in its production and the evidence already obtained that the after-effect is modifiable in accordance with Eysenck's drug action hypothesis (2) indicated it to be a promising test in the investigation into the effects of meprobamate on perception.

Despite swings between over-valuation and rejection of psychotherapy on the part of some psychiatrists, there remains a valid and necessary place for psychotherapy in psychiatry. The essential elements of that place are described.

The problem of differentiating, in patients of the pre-senile age group, the degree and quality of intellectual impairment that is due to depression from that which is brought about by some organic, cerebral deterioration is one of some practical importance. It is, in fact, as Henderson and Gillespie (1950) stress, an important point to determine with regard to the prognosis of depressive cases of this age” whether or not there is any complicating organic process causing a failure of memory and efficiency. If such is present then the prognosis must be viewed much more gravely than would otherwise be indicated.”

Drinking practices and attitudes to alcohol among the members of a Southampton church were investigated by questionnaire (602 subjects) and by interviews (126 subjects). Teetotallers were older than drinkers, and included a higher proportion of women. They perceived their childhood upbringing and the teaching of the Bible as the main factors influencing them to abstain. Both teetotallism and alcoholism were more common among relatives of teetotallers than among relatives of social drinkers.

In a survey of training in child psychiatry in Great Britain, all senior registrars were sent questionnaires; the response rate was 69 per cent. We describe background factors of the trainees, details of the clinical and academic experience available to them, and their attitudes towards their training.

Most trainees had had extensive previous experience in adult psychiatry and the predominant orientation was psychoanalytic. In general, they approved of the guidelines for training issued by the Joint Committee for Higher Psychiatric Training. Family therapy was the most popular treatment method. We comment on their training experience where the interest expressed was not matched by adequate availability of the training facilities.

Loxapine was introduced to the British market two years ago although it has been used in North America for eight years. We report the first probable case of neuroleptic malignant syndrome (NMS) secondary to loxapine in Britain. Two previous cases have been reported in North America (manufacturer's data).

Prader–Willi syndrome (PWS) is a rare condition because of the deletion of paternal chromosomal material (del PWS), or a maternal uniparental disomy (mUPD PWS), at 15q11-13. Affective psychosis is more prevalent in mUPD PWS. We investigated the relationship between the two PWS genetic variants and brain-stem serotonin transporter (5-HTT) availability in adult humans. Mean brain-stem 5-HTT availability determined by [123I]-beta-CIT single photon emission tomography was lower in eight adults with mUPD PWS compared with nine adults with del PWS (mean difference −0.93, t = −2.85, P = 0.014). Our findings confirm an association between PWS genotype and brain-stem 5-HTT availability, implicating a maternally expressed/paternally imprinted gene, that is likely to account for the difference in psychiatric phenotypes between the PWS variants.

Most spontaneous movements are considered to be motor expressions of the feelings and emotions (Stagner, 1948). Many movements of this kind are referred to as “nervous” habits or mannerisms, a description in which this assumption is also implicit. It is surprising, therefore, that so readily available and objective a guide to the affective organization of the personality has been studied relatively little: the difficulties of definition, description and measurement may account for this. Olson (1929), however, devised a useful time-sampling technique for measuring nervous habits, but I know of no investigations in which it has been used to compare the spontaneous movements made by healthy and “nervous” subjects.

Interest in the concept of moral injury among researchers, clinicians and policy makers can have undesirable consequences that are rarely considered. It can lead to misunderstanding of post-traumatic stress disorder, risks of primary and secondary gains for affected individuals and tertiary gains for third parties. This editorial calls for critical assessment of this sensitive matter.

I value very much the honour of giving the Maudsley Lecture. Henry Maudsley was a pioneer in the study of the physiological basis of mind, and hence of the physiological interpretation of mental disorder. In the preface to his book, The Physiology of Mind (Maudsley, 1876), he said with a blend of optimism and modesty: “The current of psychological thought having set so strongly in physiological channels, it is pretty certain that the reflections which one person has had, however original they may seem to him, some other person has had, has now, or will very soon have.” But half a century was to pass before physiology and psychiatry began to develop techniques which could illuminate the physiological basis of mind, and even now we are only entering the era which Maudsley would have found the fulfilment of his hopes and anticipations. Though intolerant of the idea that metaphysical speculation about mind could take the place of scientific study, he was nevertheless a philosopher, and my aim in this lecture is to try to use a philosophy of perception to interpret the clinical observations of perceptual disorder.

In contrast with the vast literature devoted to the adult type, reports on the form of general paralysis which occurs in childhood or adolescence have been few and far between, and in this country the papers of Mott (I) and Watson (2) form the chief source of our knowledge of its clinical and pathological features.

An important basis for this work is the vulnerability model proposed by Zubin & Spring (1977). They integrated findings on schizophrenia in a second-order model showing the relationship between vulnerability to schizophrenia and stress, adaptation to stress, and especially coping breakdown, i.e. the incapacity to adapt in the shorter or longer term. Thus, given a certain degree of vulnerability, stress, and how the affected individual copes with it are the critical factors for the occurrence of a schizophrenic episode. The work presented here describes an empirical investigation of these two components.

A patient presenting with mixed affective symptoms was found to have active neurosyphilis after intermittent cognitive impairment suggested an organic cause. Most of these symptoms resolved after treatment with penicillin.

A case of doll phobia in a 14-year-old boy is presented and discussed.