In another paper in collaboration with Reiss and Taylor (1944) I have described and classified the state of testis function in schizophrenia, mental defect, and the common mental illnesses from an examination of specimens obtained by biopsy from 115 representative subjects, selected for adequate physical health and development. It was found convenient to classify all material in five grades according to the histological appearances. These have been fully described in our paper. In brief they indicate (1) complete normality, (2) normality with slight defects, (3) moderate atrophy, (4, 5) severe and very severe atrophy amounting in the worst cases to total loss of normal function. While we have regarded a Grade 3 specimen as significant in young subjects, it is probably not necessarily outside the normal expectation from the fourth decade upwards. Grades 4, 5 are, of course, indicative of a severe atrophying process at any age. In analysing the defects we noted and described degeneration of the seminiferous elements with changes in the tubular capsule. The basement membrane was affected first and principally, and underwent a form of hyaline degeneration. This, we felt, was the underlying cause of the atrophy of the seminiferous epithelium, and eventually led in many instances to complete destruction of lengths of the affected tubules. The interstitium was not subject to important change.

The absence of a motor-perceptual learning measure which has a control or partialled out effect for age and general intellectual level has become obvious and the need for such a measure has been seen to be urgent in relation to the assessment of cognitive functioning in the elderly. Work by Savage and his colleagues (1971) has highlighted the fact that the measurement of intellectual levels and intellectual learning ability for both verbal and performance or motor-perceptual aspects of cognitive functioning is essential if the normal and abnormal structure and changes in cognitive functioning at any age is to be more fully understood. This paper reports on the development of the Block Design subtest of the WAIS as such a performance learning test. To our knowledge, there has so far been no measure of motor-perceptual or performance learning which has built into it an acceptable level or process of automatic control for general or performance intelligence and for age.

The results from a small series of persons suffering from alcoholism suggested that the amounts of water and electrolytes in their brains (obtained post mortem) differed from those of control and depressed individuals (Shaw, Frizel, Camps and White, 1969). Since publishing this work we have analysed brain tissue from a further series of alcoholic subjects, and in this paper we compare these findings with the original data from control and depressed groups.

An auto-antibody screen for SLE, which included anti-nuclear antibodies, was performed on 296 patients admitted to acute psychiatric and psychogeriatric wards. Three cases (1% of those screened) of previously undiagnosed SLE were found, and one patient was found to have autoimmune chronic active hepatitis. An auto-antibody screen may be a useful investigation in psychiatric practice.

We have recently had the opportunity to investigate clinical and behavioural characteristics of a pair of 17-year-old twin boys who were discovered to have the XYY karyotype (18). Since these twins, known to this department since infancy, had been studied at the age of three, early direct findings as well as retrospective data are available regarding their symptoms and development.

It is suggested that a clearer distinction should be made between the statistical validity and the clinical utility of the Grid Test of schizophrenic thought disorder. The results of three published studies are examined, and in each case the Grid Test is found to have appreciable statistical validity in terms of correlations between grid predictions and clinical judgements of thought disorder. Two criteria are proposed for assessing the usefulness of the Grid Test as a diagnostic instrument, and from an examination of the results of three published studies it is concluded that, despite its statistical validity, the test, at least in its present form, has no appreciable clinical utility.

The following review deals with all persons remanded for trial or sentence in 1965 and 1966 on whom psychiatric reports were furnished by senior psychiatric staff of Leverndale Hospital, excluding those remanded directly to hospital under Section 54 of the Mental Health (Scotland) Act, 1960, this latter group having been the subject of a previous article by ourselves.

Lithium is widely prescribed, but the timing of key effects remains uncertain. The timing of onset of its relapse prevention effects is clarified by placebo-controlled randomised trials (3 studies, n = 1120). Lithium reduced relapse into any mood episode over the first 2 weeks of treatment (hazard ratio 0.40, 95% CI 0.16–0.97). Fewer manic relapses were evident within the first 4 weeks, however, early effects on depressive relapse were not demonstrated. There is an early onset of lithium relapse prevention effects in bipolar disorder, particularly against manic relapse. Full effects against depressive relapse may develop over a longer period.

A case of schizophreniform episode following measles infection in a 27-year-old woman is presented. The possibility that the clinical picture is a first description in the literature of an association between a schizophreniform episode and possible measles-induced allergic encephalitis is discussed. Other possible connections between measles infection and schizophreniform episode are also mentioned.

Treatment by prefrontal leucotomy, though undoubtedly of value, still rests upon an insufficiently scientific basis. Its anatomical and physiological effects are being increasingly discovered, but many of its psychological effects are still unpredictable and obscure. Its effect on intelligence, on immediate memory, and on simple learning ability are now well known, but with these we are not concerned. Rather, we have attempted to assess the effect of leucotomy on “creative ability.” By this phrase we shall refer to that ability by which the ideational content of past experience is utilized in a situation to provide concepts and actions not directly evoked by the new situation, but elaborated by the patient's more complex cerebral reactions to the situation; The ability is worthy of examination, since the more intellectual the work the more is it evident. The architect, for instance, needs more creative ability than the bricklayer, the novelist more than the amanuensis, and the Royal Academician more than the house painter.

The Huli people of the Southern Highlands Province of Papua New Guinea mourn in culturally patterned ways that differ for men and women. One difference is that women are expected to express their emotions, while men are discouraged from doing so. In this study the mortality of bereaved spouses was determined by following 100 widowers and 208 widows for four years following their bereavements. Widowers showed an excess mortality in the first year following bereavement while widows showed no such tendency. The possible relationship between these findings and Huli mourning practices is discussed.

A case of dependency on prescribed pressurised aerosols in a patient with asthma and mild mental handicap is reported. The majority of reported cases involve young asthmatics, abuse being reported mainly using salbutamol inhalers although other inhalers have also given cause for concern. The agent of addiction is uncertain although it may be the fluorinated hydrocarbons used as propellents, rather than the active substance itself.

Certain conditions associated with mental deficiency derive their name from some characteristic skeletal deformity. One of these is abnormal highheadedness or acrocephaly, a term often used interchangeably with oxycephaly, tower skull or turricephaly. To be sure, certain criteria have been recommended by some workers for confining each of the above terms to different sub-varieties of highheadedness and many alternative names have also been proposed (Günther 1941), but none of these have taken root. A distinction is made by many writers between acrocephaly and hypsocephaly or ordinary highheadedness: it is stated that the essential feature of acrocephaly is not highheadedness in itself but exaggerated upward pointing or angling of the head at some distance along its superior curvature so that, in theory, an acrocephalic head need not necessarily be hypsocephalic. However, it is doubtful if this distinction can always be sustained since many otherwise quite normal individuals have abnormal angling of the skull, while some recorded cases of acrocephaly presented a smooth and rounded profile of their upper cranial curvature in photographs and lateral skull X-rays.

Socio-economic differences between schizophrenics on an acute in-patient unit and their parents were studied in relation to indices of dangerousness and of psychiatric status, It was found that, whatever their class of origin, a large proportion of patients had dropped in occupational attainment, relative to that of their parents, but that patients tended to be higher in education than their parents. Patients who had committed an assaultive act prior to admission were lower in social status than their parents.

The present study has been made with the purpose of studying the frequency of chromosome aberrations in a male psychiatric hospital population, especially in order to look for possible associations between minor chromosome aberrations such as variations in short arms or satellites in D or G chromosomes as well as in Y length on the one hand and mental illness and criminality on the other.

When a patient tells his therapist, directly or indirectly, that he is contemplating suicide, his communication is likely to evoke a strong reaction, although, like the patient's plea, it may, or may not be straightforward.

Some conceptual problems in relation to the interaction of genetic influence and social disadvantagement are discussed, and some of the results of a study of 144 families with mentally handicapped children reported. The work of Heber and his associates in Milwaukee is briefly reviewed, and the Edinburgh data discussed in relation to the study in Aberdeen by Birch et al. (1970). Possible strategies for intervention are considered.