Steinberg et al. (11) have recently described, in a case report in this Journal, a combination of manic psychosis in the course of and following an influenza infection with high levels of complement fixing (CF) antibody titre, with a view to encouraging further research-work in this direction. Following their suggestions, we should like to describe a similar observation. At the same time, we will take the opportunity to make some critical remarks on the comments made by Steinberg et al. as to the correlation between the specificity of an exogenic noxious agent and a mental reaction, since, in our opinion, it might lead to a certain misunderstanding to talk about a direct or even specific relationship between influenza infection and manic psychosis.

Lader and Wing (1965) compared amylobarbitone sodium and chlordiazepoxide as daytime sedative drugs in anxious patients. Using a formal bioassay technique they found that 65 mg. of amylobarbitone sodium was equivalent to 9 mg. of chlordiazepoxide. Essential differences in the physiological and clinical actions of the drugs were not demonstrated, and the incidence of side effects, including drowsiness, was similar in each case.

Whereas there are many reports from Western societies on the prevalence of psychiatric disorders few systematic studies are available for a culture such as the Indian. Certain efforts in this direction have been made recently, and a few reports have emerged. Dube (1970), in a psychiatric survey conducted in Agra City and its suburban areas found a period prevalence of 18 per 1,000. In a study of 184 families of a rural community in India, Elnaggar et al. (1971) observed a prevalence rate of 27 per 1,000. In a study of 300 urban families, Sethi et al. (1967) found a psychiatric morbidity rate of 72 per 1,000 whereas this rate was only 39 per 1,000 in a surveyed population of 500 rural families (Sethi et al., 1972a). We also observed (Sethi et al., 1972b) that psychiatric disorders were commoner in the migrant families. The present study was undertaken to estimate the extent of mental illness in an urban society in India and to find out the relevant variables associated with various psychiatric disorders.

Stammering has been defined as an interruption in the normal rhythm of speech of such a frequency and abnormality as to attract attention, interfere with communication or cause distress to a stammerer or his audience (Bloodstein, 1960).

It is generally accepted that in mammalian evolution from rodents to primates, including man, aggressiveness, and more particularly intra-species aggression related to the assertion of dominance in the social hierarchy of the group, is a characteristic of the male (Gray, 1971). There is also an increasing body of evidence which shows that mammalian behaviour patterns are basically female and that male patterns are determined by the action of the sex hormone testosterone on neural structures during critical phases of intra-uterine development (Seymour Levine, 1966). Ounsted and Taylor (1972) have proposed that the X chromosome is sexually neutral, essentially equivalent to an autosome, and that its role in sexual differentiation lies in that it maintains ovarian function in the female. The Y chromosome is sex-determining by causing potential autosomal and X-coded information to become manifest in the phenotype. This is achieved in part by determining the development of foetal testosterone during a critical phase of foetal life. In the absence of testosterone the fundamental female morphology would be established in either sex.

The Tavistock conference model of Group Relations Training, described in some depth by Rioch (1970) and O'Conner (1971), provides participants with a focus on the problems of leadership and authority as they develop and emerge in a variety of relatively unstructured group contexts within a time-limited laboratory setting. The major conference experience involves participation in ‘here and now’ groups with the use of staff in a consultative role, i.e. the staff function being to focus exclusively on the covert or unconscious processes in the group. So the usual consultant role involves no comments to individuals but a rigorous focus on the dynamics of the group as a whole; a role which has been described in more clinical settings by Bion (1968), Coffey (1966) and Ezriel (1950). ‘One of the major aims of the conferences is to contribute to people's ability to form serious work groups committed to the performance of clearly defined tasks …. A second major aim … is the development of more responsible leadership and fellowship in group life’ (Rioch, 1970, p. 347).

Studies in Great Britain concerning intentional self-harm in adolescents have been few (Haldane and Haider, 1967; Leese, 1969). Such behaviour amongst teenagers is now common, and usually takes the form of self-poisoning with drugs; in fact it is probably becoming commoner, although the reasons for this are not altogether clear. The present survey concerns 50 consecutive patients aged between 14 and 19 years, admitted to the General Hospital, Birmingham, following self-harm behaviour in 1970 and 1971. The lower age limit for the group was determined by hospital admission policy, since children under 14 are admitted elsewhere in the city. All the patients had taken drug overdoses, and none had used other methods of self-harm, such as wrist-slashing. All cases classified as intoxication or poisoning within these age limits admitted to the hospital during the relevant period were scrutinized, and care was taken to make sure that no cases of intentional self-harm were being overlooked amongst so-called accidental poisoning. All patients in the intentional self-poisoning group were interviewed by the psychiatrist within 24 hours of regaining full consciousness. Information was obtained in a standard form covering specific aspects of the history. The parents (when available and willing) were seen either by medical staff or by a social worker in an open-ended interview. The Eysenck Personality Inventory (EPI) and Raven's Progressive Matrices test were administered by the psychiatrist at a later date, when all drug effects had worn off.

The introduction of techniques for the measurement of the serum concentrations of anticonvulsant drugs has opened up new opportunities of studying epilepsy in many of its aspects. Until the present time authors have studied variations in, and factors effecting, the metabolism of the drugs, and the relationship of serum drug concentrations to seizure control and well known side effects (see Woodbury, Penry and Schmidt, 1972). In this paper we report some preliminary observations on drug concentrations in patients with and without marked changes in their mental state.

Numerous studies of the reliability of psychiatric diagnosis have been published in the last twenty years, but most have been based either on a comparison of the diagnoses made by two or more raters at a single joint interview, or separate interviews a few days apart (the observer agreement model), or on a comparison of the overall spectrum of diagnoses assigned to two comparable series of patients (the frequency agreement model). Comparisons between the diagnoses assigned to patients on successive admissions, or at other widely separated points in time (the consistency or stability model), have been carried out less often, in spite of the fact that the usefulness of our diagnostic categories is just as dependent on temporal stability as on reliability in an observer agreement situation.

Stammering has been and still is one of the most challenging disorders in psychiatry. It may be the result of constitutional or neurological differences (Karlin, 1950; Boland, 1951), of delayed auditory feed-back (Lee, 1951), of neurosis or of a learned response (Wischuer, 1950, 1952). Schmoigl et al. (1967) studied 50 cases of stammering and found abnormalities in 70 per cent of cases. The possibility of organicity in stammering tempted us to make EEG studies in Egyptian stammerers.

R. D. Laing has offered a challenge to society and to psychiatry which is difficult to accept, for it implies that ‘sane’ society and psychiatry as its instrument actually perpetuate rather than alleviate certain kinds of mental illness. In spite of Laing's growing popularity with the counter-culture, there is a conspicuous lack of consideration of Laing's thought in the psychiatric literature. This may be taken as a rejection of what Laing says, a sort of professional passive aggression. Indeed many would suggest that Laing has passed the limits of sanity; he is certainly deviant. Yet psychiatry's reticence may reflect the difficulty in responding appropriately to Laing's indictment. Apparently there is much truth in Laing's analysis. It is existential, and his considerations involve each of us as persons, not just as members of a corporate group, psychiatrists or sane citizens. Furthermore there is a temptation either to accept or to reject what Laing says as a whole without careful attention to the implications of his arguments.

In a previous study of old people living in the community, those with functional psychiatric disorders (usually neuroses) were found to have relatively low IQs on the Wechsler Adult Intelligence Scale (WAIS) (Britton et al., 1967). This observation required confirmation and was open to a number of interpretations.

The aim of this paper is to describe and compare the prevalence patterns of completed suicide and so-called ‘attempted suicide’ or parasuicide, as they occur in a single, defined population over the same period of time.

Phenothiazines and other neuroleptic drugs are known to cause extrapyramidal side-effects. Consequently antiparkinsonian (AP) drugs are commonly prescribed at the same time as antipsychotic medication in order to prevent these complications. Once this medication has been started it may be continued for prolonged periods.

In recent years reports have shown that in psychiatric practice in this country short treatments with relatively brief interviews and much reliance on drugs are the rule (Carstairs and Bruhn, 1962; Sargant and Slater, 1964). That this is also true of general practice has been demonstrated (Cooper, 1965; Shepherd et al., 1966).

The psychiatric anamnesis is a lengthy enquiry based on the Meyerian principle that most aspects of a patient's past and present history are relevant to the diagnosis and management of psychiatric disorder. Despite widespread use by both clinicians and research workers, the anamnesis has been the subject of few investigations regarding its reliability and validity. The studies reported have not encouraged confidence in traditional history taking (Haggard et al., 1960; Wenar and Coulter, 1962; Beckett et al., 1967). The present study was carried out to investigate the reliability of the family and personal history.

The incidence of Trichuris trichiura infestation in the United Kingdom appears to be particularly high in hospitals for the mentally subnormal (Lynch et al., 1972) and amongst immigrant children (Thompson et al., 1972). Whether or not these, mainly light to moderate, infestations are harmful appears to be in doubt, but in view of the recommendations of the WHO Expert Committee (1964), the possibility of spread of the infestation to ward attendants, and the publicity (Western Mail, 1970) which may attend attempts to eliminate the parasite from the environment of a subnormality hospital, treatment is desirable if not obligatory.

Hald and Jacobsen (1948) introduced disulfiram as an adjunct in the treatment of alcoholism. Its usefulness has, however, been limited by the ease with which patients may discontinue medication and resume drinking. A preparation of disulfiram suitable for implantation was developed some years ago, and though its use has been mainly confined to the continent of Europe, several case reports have been published in this country (Kellam et al., 1968; Kellam, 1969). Madden and Malcolm (1972) suggest, from a follow-up study of 47 alcoholics, that implantation is followed by a period of sobriety of about six months, but they have made no comparison with a control group of patients.

Penrose and Smith (1966) have reviewed the literature on Down's syndrome in great detail, and this has been followed by an important recent review by Richards (1973). In Chapters 10 and 11 of Penrose and Smith's book they discuss the remarkable frequency distribution of the ages of mothers of patients, compared with that of the general population at the corresponding place and time, and they summarize the large number of studies made on this subject. The mean age of the mothers is shifted upwards by amounts which vary in different countries from about 6 to 8 years. The remarkable feature, however, is that there appear to be two bumps in the curve. These are usually (but not always) not large enough to make the curve bimodal, and J. B. S. Haldane therefore coined the term ‘bitangentiality’ for this phenomenon, which appears in most published studies and in the group of all sample cases (9,441) given by Penrose and Smith, Fig. 76. Collmann and Stoller (1962) make a complete survey of all mongol births in Victoria, Australia, from 1942 to 1957 and here there is a distinct bimodality.

Investigations into possible relationships between EEG and personality traits began in 1935 (Lemere, 1935), and have continued sporadically (Saul et al., 1937; Gottlober, 1938; Lindsley, 1938; Henry and Knott, 1941). More recently there has been a controversial British exchange (Savage, 1964; Fenton and Scotton, 1967; Broadhurst and Glass, 1969; Young et al., 1971).