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.

Beck's original book on cognitive therapy was published in the USA in 1976 but not reviewed in the Journal until December 1979 (139, 582–583). The review was favourable. A second book (Beck et al, 1979) was not reviewed, although by then there was a substantial and growing literature on cognitive approaches to treatment.

Psychotherapy can borrow an empirical base from behaviour technology, a discipline which involves the control and prediction of behaviour through environmental manipulation. Fundamental to the achievement of control and prediction is measurement.

Two papers have recently appeared in the Journal indicating a causal relationship between indoxyluria, alimentary toxæmia, and melancholia. One paper, published by Arthur A. D. Townsend in January, 1905 (Journal of Mental Science, 1905, p. 51), is entitled “Mental Depression and Melancholia, considered in regard to Auto-intoxication, with Special Reference to the Presence of Indoxyl in the Urine and its Clinical Significance”; the other paper, published by Lewis C. Bruce in July, 1906 (Journal of Mental Science, 1906, p. 501), bears the title “The Clinical Significance of Indoxyl in the Urine.”

This paper presents work that formed the basis of a fourth-year project at Southampton University Medical School. Thirty patients were seen prior to their first psychiatric consultation and asked about their hopes, fears and expectations. Twenty-five were seen subsequently.

The study, which is largely descriptive, shows that many patients have unrealistic expectations about various aspects of the interview, and afterwards many are dissatisfied with its outcome. The paper discusses these findings and makes some tentative recommendations.

The object of this paper is to assess, in retrospect, the relative effectiveness of amitriptyline (‘Triptizol’) and amitriptyline with perphenazine (‘Triptafen’) in the treatment of depressed patients.

A positive correlation has been found between changes of blood pressure and sedation threshold in two autonomic tests. In the Cold Pressor test the blood pressure changes were measured following the immersion of the hand in water at + 4-5° C. and in the Mecholyl test following the subcutaneous injection of a parasympathomimetic drug (Mecholyl). Both tests were considered to demonstrate differences in individuals' autonomic lability.

Whilst it is well known that drugs can cause behavioural changes (Trouton and Eysenck, 1960) relatively little attention has been given to the effects of drugs on complex cognitive functions. The purpose of this study was to determine the effects of two drugs frequently used in psychiatric treatment (chlorpromazine and chlordiazepoxide) on performance in problem solving situations as well as in tests involving speed and accuracy.

The blood pressure response to the injection of the parasympathomimetic drug methacholine (Mecholyl) has been used extensively in psychiatry to delineate various aspects of mental disease. Although originally used in diagnostic classification (Altman et al., 1943), its use, following the investigations of Funkenstein and his co-workers (1948, 1952), has more often been as an aid in prognosis or as a guide to the most useful type of somatic therapy. Investigations into this aspect of the test have resulted in many contradictory reports, and even after so many years there is still no agreement on the test's validity or usefulness.

The effects of hypothyroidism are protean, involving many systems. Electrocardiographic changes are almost invariable, and include bradycardia, low QRS voltage and flattened T waves: these are usually reversible with replacement therapy (McDonald, 1978). Psychiatric disturbances are also well known, although they are seldom the presenting feature and are notorious for mistakes in diagnosis (Lishman, 1978; Whybrow and Ferrell, 1974). Most such disturbances comprise apathy and depression, some an organic reaction and a few manifest as an acute schizophrenia-like psychosis. Phenothiazines, the most generally used neuroleptic medication, may interfere with cardiac conduction. When hypothyroidism presents as acute psychosis and the patient is hypersensitive to phenothiazines a dangerous situation can arise.

In the biological and social sciences the research worker is frequently faced with a two-dimensional, entity by variable, matrix of numbers. The matrix may contain scores of persons on tests, judgments of persons or objects by persons, measurements of physical characteristics of insects, economic statistics of areas, party votes in electoral districts, demographic or epidemiological or ecological counts of areas, and so on.

Having stated the case for the atomistic approach to Rorschach validation (Keehn, 21), we must now turn to an examination of the methods and results of the application of the approach to a single Rorschach sign.

There have been many studies concerned with families of schizophrenics. Both environmental and genetic factors are claimed to be responsible in the development of this condition. Nowadays, there is no absolute hereditarian or environmentalist. A number of studies have shown that genetic factors are present in schizophrenia. The issue of whether this condition is caused by a single major gene with diminished penetrance or by polygenes has not yet been satisfactorily proven. Although this issue is difficult to resolve, it is important to distinguish between these two possibilities of genetic inheritance. In the case of single gene inheritance, biochemical investigation would be fruitful, but not in the case of polygenic inheritance manifesting clinical abnormalities once it exceeded a given margin of tolerance.

The last few years have produced an extensive literature on the chemotherapy of schizophrenia (Foote, 1955; Shepherd and Watt, 1956; Wing, 1956; Kinross-Wright, 1957). Enthusiastic reports continue to appear in the American journals (Feldman, 1957; Winkelman, 1957) whereas a more cautious note is usually struck in psychiatric papers published in this country. The value of reserpine is now generally accepted (Moore and Mankin, 1957; Elkes, 1957) but it is not without dangerous side-effects (Wardell, 1957). Chlorpromazine is now used extensively and is probably a safer drug; the danger of jaundice has not proved to be a real contra-indication to the use of the drug. However, reports of deaths during treatment with chlorpromazine have been published (Stënback, 1956).

The operation of prefrontal leucotomy first performed by Moniz (1) in 1936 in Lisbon will be by now more or less familiar to most psychiatrists, on paper if not in actual practice.

At first sight the operation would appear to be a revolutionary proceeding; and so it is in some ways. It is, however, no more drastic than the convulsion or insulin treatments in which the patient is near enough the line which separates life and death.

All patients formally detained in a Scottish psychiatric hospital between 1974 and 1979 were identified and their outcome determined 2½–8½ years later. A matched group, detained under Emergency Orders only, were also followed-up. Those formally detained had more previous psychiatric contact: functional psychoses were significantly more common in them. They remained in hospital longer, and required extensive community support when discharged. Those detained under Emergency Orders only, consisted of two sub-groups–one who left the area within two years of admission and could not be traced, and the remainder, who continued to require hospital treatment but for shorter times and with less continuous support. Amongst those detained, lack of insight was a predominant feature, which may create difficulty with regard to informed consent to treatment, given the present Amendments to the Mental Health Acts.