While there is general agreement that deafness, either congenital or acquired in early childhood, is psychologically damaging (Oléron, 1953; Furth, 1961; and Vernon, 1966), opinions are divided on the adverse effects that deafness beginning in adolescence or in adult life may have on mental health. For example, Furth (1966) has reported that the way of life of the adult deaf should not be all that different from people with normal hearing, although it has been generally held that deafness in adults predisposes to the development of irascibility and paranoid attitudes (Kraepelin, 1915; Slater et al., 1969). The relationship between deafness and paranoid illness has been investigated by Houston et al. (1964) and Kay et al. (1961).

Genetic factors in the aetiology of Alzheimer's disease (AD), are now being intensively investigated. The homogeneity of AD is under investigation. There are a few large kindreds with early onset of AD in whom transmission appears to be typically autosomal dominant, and 65% or more of the remaining cases at any age may have genetic aetiology. Both multifactorial and autosomal dominant inheritance with age-dependent expression have been proposed, but the late onset and death of unaffected relatives from competing causes make it difficult to choose between them. Lifetime risk gives the best estimate of incidence in family studies, but clinical and pathological criteria are not clear enough for confident diagnosis of AD in late old age. A role for external factors is indicated by twin studies, and the role of aluminium is currently under investigation. Molecular genetics promises to resolve many questions. The clinicians' role will be to provide well documented families for interdisciplinary research and to help in clarifying diagnosis in late old age.

A mirror-image pair of monozygotic twins concordant for obsessional–compulsive disorder had remarkably similar clinical symptoms, and brain electrical activity mapping showed slower alpha and more theta activity than normal for their age.

In no other branch of medicine have doctors appeared so nihilistic or so defeatist as in the domain of psychiatry. It seems to me questionable whether this is due to the disparity in the therapeutic results between psychiatry on the one hand and general medicine on the other. In general medicine it is frequently forgotten that the really specific remedies at our disposal are so few that they can be counted on the fingers of one hand. If, on the other hand, we remember that as late as the time of the French Revolution mental patients were kept in chains, and that to-day in modern hospitals we see impressive results with such specific treatments as malarial therapy, then it must be admitted that the psychiatrist is not the only nihilist; but that this also applies to representatives of other branches of general medicine.

Insulin shock treatment of schizophrenia is to-day a recognized part of our therapeutic armamentarium in mental disease, and with selected cases is yielding results which are more encouraging than those given by other methods. At the same time the method is largely empirical, and the theories of its mode of action are only equalled in number by the hypothetical causes of the disease itself.

These notes are divided into three sections. In the first, consideration is given to cases of aphasia occurring in childhood. In addition, the handedness of defectives is touched on, and there is a note on the influence of heredity. The section as a whole owes its existence to ideas set in motion by Brain's “Speech and Handedness” (Lancet, 2, 839, 1945). For that reason somewhat disparate elements are dealt with together. Section two is concerned with stammering; an endeavour is made to apply to this condition propositions put forward in the first section. Brief attention is given to bad spelling—or rather to that group of bad spellers in whom there is consistent discrepancy between their intellectual capacity and attainments, and their performance in oral and written spelling. The last section deals with “motor” or executive aphasia. A plea is put forward for the recognition of a dysarthric component in this condition. An anatomical configuration is suggested by which unilateral cortical dysarthria would become a possibility.

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.

A review of treatment trials with DTγE revealed widely discrepant results. Relevant variables were the variety of measures employed for monitoring psychotic symptoms, and the different criteria used to judge the degree of improvement. The authors suggest a uniform outcome criterion for early trials of new treatments, which would generate more consistent and comparable results between studies, and give a stronger indication of the value of the treatment under test. When the data from the various treatment trials of DTγE were re analysed, applying a uniform outcome criterion of improvement of a change of 80% or more on rating-scale score, the results were more consistent than would have been suspected from the original reports.

As scientific technologies become more sophisticated, clinicians may come to think that they must devolve into passive recipients rather than contributors to the advances in basic knowledge. This perception and accompanying modesty towards the neurosciences, however, is an error. The intellectual trade between clinician and bench scientist has always been bi-directional and nowhere is this more clearly evident than in recent interactions between psychiatry and neuroscience.

Choice, understanding, appreciation and reasoning compose the standard model of decision-making capacity. Difficulties in determining capacity can arise when patients exhibit partial impairment. We suggest that a pragmatic approach, focusing on how capacity status affects the ultimate decision to override the patient's wishes, can help evaluators resolve difficult cases.

Traumatic psychological and functional somatic syndromes in military personnel, following recent conflicts, have generated considerable interest in recent years (Jones et al, 2002). However, there has been near-total academic neglect of forensic military psychiatry, despite the anticipated major changes in British military psychiatric provision (Winyard, 2001) and the military judicial system (Syal, 2002). The indications are that civilian psychiatrists are likely to become increasingly involved in all aspects of the assessment and treatment of mental illnesses in service personnel. This demands a knowledge of the British military judicial system, and the relationship between mental illness and criminality in the military, extending beyond that usually required of a civilian psychiatrist.

Previous papers in this series (Shapiro, 2, 3, 4; Shapiro and Tizard, 6; Yates, 13 and 16) have been concerned with the investigation of an aspect of the reproduction of designs called the rotation effect. Rotation is the term used to describe the fact that subjects often, when copying a design, make their reproductions in an orientation which is different from that of the model (see Figure 1).

This paper examines the family background, premorbid personality traits and adverse life events preceding childhood depression. The non-depressed group proved more likely to have experienced pre-school bereavement and familial disturbance, and to come from the more deprived background; there was also an excess of premorbid anxiety and hysterical personality traits in this group. School phobia and premorbid obsessional traits were associated with the depressed group. Although there was an association between depression and the total number of adverse life events, this was more substantial when the perceived impact of the events was taken into account. Of the individual classes of life event, only illness and a change in social relationships were associated specifically with depression.

Although ancient writers have given short descriptions of mental diseases affecting children, it was not until the commencement of this century that the subject began to attract attention. Since then Esquirol, Guislain, Delasiauve, and others have written on the matter, and in 1856 Le Paulmier, in a thesis, gave the most complete description of the affection which had previously been published. Numerous authors in England, Germany, and France have since 1856 written on the subject, but still there seems to be a good deal of want of knowledge regarding the mental affections of children.

It has been reported that delinquents of superior intelligence differ from those of average and below average intelligence in their psychological, social, criminal and educational characteristics (Burt, 1944; Simmons, 1956 and 1962; Caplan and Powell, 1964; Cowie et al., 1968). Simmons has suggested that bright delinquents are more likely to be emotionally disturbed. He describes the boys at an Approved School for highly intelligent boys as suffering generally from ‘deep emotional disturbance’, and maintains that ‘the emotional disturbances which turn an intelligent child into a delinquent have usually been far more severe than they would have been in a less intelligent, less sensitive one’.

Bilateral palmar skin conductance and heart rate were measured throughout a series of psychological tests and during both sitting and ambulant social interactions in 14 right-handed men with chronic schizophrenic disorder and 12 healthy volunteers matched for age and handedness. Miniature radio telemetry equipment was used to collect the physiological data. The schizophrenic group was effectively unresponsive to 70-dB auditory stimuli, while all but one of the control group responded and habituated to a nil response by the tenth tone in sequence. The schizophrenic group showed some evidence of increased skin conductance activity at rest, and in socially demanding conditions skin conductance level and variability were increased in the right hand. The present group of electrodermal ‘non-responders' was not in general autonomically underactive. Asymmetry of skin conductance activity during social interaction may be a characteristic of chronic schizophrenic disorder.