“Assessment of the physiological effects of physical and emotional stress has been hampered by a lack of suitable laboratory techniques. Since hypnosis can be used safely to induce specific emotional states of considerable intensity, we studied the effect on distal colonic motility of three hypnotically induced emotions (excitement, anger, and happiness) in 18 patients aged 20–48 years with irritable bowel syndrome. Colonic motility index was reduced by hypnosis on its own (mean change 19.1; 95% CI 0.8, 37.3; P < 0.05) and this change was accompanied by decreases in both pulse (12; 8, 15) and respiration (6; 4, 8) rates (P < 0.001 for both). Anger and excitement increased the colonic motility index (50.8; 29.4, 72.2; and 30.4; 8.9, 51.9, respectively; P < 0.01 for both), pulse rate (26; 22, 30; and 28; 24, 32; P < 0.001 for both), and respiration rate (14; 12, 16; and 12; 10, 14; P < 0.001 for both). Happiness further reduced colonic motility although not significantly from that observed during hypnosis alone. Changes in motility were mainly due to alterations in rate than in amplitude of contractions. Our results indicate that hypnosis may help in the investigation of the effects of emotion on physiological functions; this approach could be useful outside the gastrointestinal system. Our observation that hypnosis strikingly reduces fasting colonic motility may partly explain the beneficial effects of this form of therapy in functional bowel disorders.”

In several previous studies it has been shown that the mean tremor amplitude displayed by morbidly anxious patients is greater than that of normal control subjects. The most detailed experiments were those carried out by Redfearn (1957). He compared the findings obtained in groups of male morbidly anxious patients and controls, and in addition to confirming the existence of a difference in tremor amplitude, he reported that the tremor of male anxious patients showed a greater degree of accentuation of the 8–10 c/sec. components than the tremor of a matched control group. Halliday and Redfearn (1956) compared the tremor spectra obtained from normal male and female subjects, and found that the curve for men was similar to that for women.

A 54-year-old man developed an acute encephalitic illness and subsequently suffered from marked memory difficulties. Considerable improvement with anticonvulsant therapy was demonstrated using a ward-based observation programme and serial neuropsychological assessments. The case report highlights the prominent role played by epileptic activity in determining the severity of the patient's amnesia.

British Journal of Psychiatry (1992), 160, 546–549

In 1975 a long-term follow-up was undertaken on patients collected as in-patients, treated and studied in 1962–64 (Bovill, 1972). Treatment was by didactic group psychotherapy and relaxation. Treatment was for a mean of six months and of 30 sessions, treatment remained available on demand for a mean of two years after discharge from attendance. In 1975 30 treated patients and 24 control patients were traced out of the original 36 in each group. The criterion of success was, as before, the inverse of days spent re-hospitalized. The success ratio fell from 7: 1 in 1962–64 to 2½: 1 in 1965–74 and to 2: 1 in the single year 1974. This fall was expected in view of the known spontaneous recovery rate operating on the controls.

The well-developed community psychiatric services in the 13th Arrondissement use a large number of places in sheltered accommodation. Reasons for this are explored. It may be that there are areas in the U.K. where the need for such accommodation is greater than the Department of Health and Social Security has estimated.

Antidepressants, as the term is currently understood, were introduced into clinical practice in the late 1950s. The first of these was imipramine, shortly to be followed by amitriptyline and then by a series of related compounds - all chemically ‘tricyclics’. These subsequently became known as the ‘first-generation’ antidepressants; imipramine and amitriptyline in particular have since become the standards against which others have been compared.

The overall prescription rate of psychotropic drugs in a Nigerian teaching hospital was 33.1%. This was slightly higher among surgical than medical patients. It is suggested that more attention needs to be paid to psychotropic drug education in developing countries in order to ensure a more rational use of these drugs.

In considering the cost of different forms of care for patients with mental deficiency there is a tendency to compare crude averages. Mental deficiency has many manifestations and occurs in people of widely differing degrees of physical ability and behaviour so that comparisons which do not take this into account are not meaningful. An attempt has been made to assess the cost of hospital care for different groups of patients and to show that there is a wide variation in the costs which arc normally expressed as an average. This average is often used to compare with the expenditure, say, in a hostel, when in fact those patients suitable for hostel care are at the lower end of the cost range. Again, whilst everyone would like to see patients dealt with in small groups, the extra cost this would involve is often overlooked. The analysis presented helps to clarify points such as these.

The experience and meaning of grief differs with the progression of self-awareness of the experiencer in his ontogenetic evolution from utter dependence to differentiated integration. Autonomy, achieved by very few adults, carries with it the connotation of transcendence over mere obedience and conformity to the canons of society. This is different from deviance in two important respects. Deviance is a movement in a horizontal direction away from cultural dominance, and therefore could manifest itself in antisocial activities. Autonomy, being a movement in a vertical direction, is supra-cultural and non-conformist rather than antisocial. All this has a great deal to do with existential grief, the experience of which can change according to the level of ontology of the experiencer. The following operational definitions are needed to treat the subject of ontological grief in a meaningful manner.