Biological rhythms exist in a rich variety and almost bewildering profusion to attend and equilibrate the physiology of man. Such dynamic phasic activity appears not only to be intimately concerned with the phenomenology of life and biological processes in general, but is also to be found in purely chemical systems (Hedges and Meyers, 1926). Modalities of the periodicities associated with life can be divided into those external to the organism—including diurnal and climatic variation, sun-spot activity, etc., and into those inherent within the individual such as the respiratory and cardiac rhythms, the menstrual cycle, sleep and awakening. Only less well marked are certain psychological periodicities such as “cyclothymic “variations in mood and personality. In the course of the present century much painstaking research has attempted to link external with internal rhythmic activities, significant correlations being adduced between seasonal variation and, for example, the incidence of psychiatric disorder (Huntington, 1915), immunity from disease (Spencer and Melroy, 1943, Webster, 1944), temperament and behaviour (Petersen, 1934-36; Mills, 1942), and an impressive array of biochemical and physiological variables ranging from blood pH, lactic acid and protein to breath-holding time, plethysmography, tests of hand strength and fatigability, dark adaptation time and various tests of urinary function (Petersen, 1947).

The draft Mental Health Bill, which amends the Mental Health Act 1983 for England and Wales, proposes protections for people with intellectual disability and/or autism (ID/A) to prevent detention in hospital in the absence of mental illness. This editorial critically appraises the positive impact and unintended consequences of the proposed reforms for people with ID/A.

Recent advances in attachment-informed relational neuroscience point to possible mechanisms of action of psychological therapies, with implications for effective practice.

Two studies have been performed to evaluate the effect of activation tasks on neuroleptic-induced akathisia (NIA). In the first sample (30 patients) we found a consistent increase of symptoms during mental activation while motor activation led to a decrease. In a second study 34 patients with the same diagnosis were evaluated, using slightly different statistical procedures: while the effects of motor activation were corroborated, mental activation did not change NIA. Since mental and motor activation are usually considered to increase tardive dyskinesia and Parkinsonism, these measures might be helpful in differentiating NIA from other antipsychotic-induced movement disorders.

In 1978, Michael Shepherd gave a Maudsley Bequest Lecture in which it was necessary for him to argue from first principles for the need for epidemiological research within clinical psychiatry (Shepherd, 1978). This paper will take stock of the 20 years since his lecture and point to the new directions for this research approach. Shepherd listed the contributions of psychiatric epidemiology as follows:

1. (a) the completion of the spectrum of disease;

2. (b) the establishment of outcome;

3. (c) the actuarial assessment of morbidity risk;

4. (d) the evaluation of efficacy of treatment; and

5. (e) the conceptual construction of diag nosis/classification.

Ability to learn and retain relatively unfamiliar materials has been shown to be impaired in many clinical syndromes, both organic and functional. The testing of this ability features in some form or other in several clinical tests of intelligence, such as the Wechsler Scale and the Binet, while it is more directly tested in the various memory scales. As is well known, efficiency of learning declines with age, and can be greatly reduced by organic brain damage. There is evidence also, which we shall briefly review, that it can be variably reduced in schizophrenia and in psychoneurosis.

A 13–year-old boy developed severe kleptomania after a depressive illness. This was a response to psychological trauma, and appeared in the context of a probable ‘lethargic’ encephalitic process.

My first duty is to thank you for having elected me President of this Section. I am conscious that this is one of the greatest honours which can come to a psychiatrist and I shall do my very best, within my limitations, to prove worthy of it. It is customary for the presidential address to deal with a topical problem of common concern, and one on which the President can speak with authority based on personal experience. I have chosen to talk about the teaching of psychiatry. I have called my address “Reflections” in order to make it clear that I cannot offer you more than some personal observations on a subject on which I feel deeply.

Forty-one demented patients admitted to a psychogeriatric assessment unit in 1977–78 were matched by diagnosis, sex and living group prior to admission with forty-one patients admitted to the same Unit in 1981–82. While the two cohorts showed no significant difference in their overall levels of disability at the time of admission, the latter group were more disabled at the time of discharge and were more likely to be placed in long-stay hospital care. The 1981–82 cohort stayed significantly longer in the assessment unit. These differences suggest that health and social service resources are failing to keep pace with the rising numbers of demented elderly patients.

It is over a year since the conference on ‘The Responsibilities and Role of the Doctor in the Care of the Mentally Handicapped’ was held, at which Sir George Godber delivered the opening address published in the Journal for December 1973 (pp. 617–20).

A case of autoscopy in a 43-year-old epileptic and mentally handicapped woman is described. The possible significance of this phenomenon to the patient is discussed.

In recent years, the Maudsley Personality Inventory (M.P.I.) has been widely used in experimental, psychiatric, social and applied research (Eysenck, 1959a, 1959b). Its use in a university setting has been described by Furneaux (1962) and Lynn and Gordon (1961).

The role of phenothiazine derivatives in controlling the symptoms of mental diseases has been investigated by many workers by determining its site of action in the central nervous system.