In the present paper the author will try to elucidate the stability of nosological categories as revealed by a personal follow-up investigation of 301 previously hospitalized patients with paranoid psychoses. Since the terminology used will be the Scandinavian one, a short review of the diagnostic concepts will be given. The Scandinavian concept of schizophrenia is rather narrower than that employed in the rest of Europe, and especially narrower than that prevailing in the Anglo-American literature. Many American authors include in their concept of schizophrenia what may be called “the schizophrenic reaction types”. In the present paper, the concept of schizophrenia used by Langfeldt (1937, 1939), sometimes, referred to as “process schizophrenia” or “nuclear schizophrenia” is used. “Primary symptoms” occur in clear consciousness; these include disturbances of thinking, disintegration of emotions, autism, marked feeling of influence and passivity, massive depersonalization and derealization. As a rule the illness has an insidious development and a chronic course ending up with a greater or lesser degree of mental deterioration.

There seems little doubt from available statistics that the Republic of Ireland has the highest rate of hospitalized psychiatric morbidity in the world. There are no complete international figures available for this statistic but the World Health Organization published for the first time in 1961 returns for numbers of patients treated in hospital in 119 different countries (W.H.O. 1961). In many cases the returns were incomplete or unsatisfactory in one or more particulars. The ideal was to establish for each country the total number of patients treated during each one of the five years 1955–1959. The number treated was defined as “the patients present at the beginning of the year in the various public and private institutions specializing in psychiatry and in other institutions (general hospitals, etc.) plus admissions and readmissions during the year”. Unfortunately this ideal was achieved for only a minority of the 119 countries. The difficulties encountered in compiling the figures are set out in the publication itself.

From time to time, normal human beings not suffering from any mental illness have reported experiences either akin to or identical with hallucinations (Byrd, 1938; Slocum, 1948; Ritter, 1954; Bombard, 1955). The common features in these reports have been the social isolation of the people involved and the physical hardships of their living conditions. They have usually been solitary mariners or polar explorers. Scientific interest was not aroused in these phenomena until directed to them by the experiences of prisoners of war in Korea who had undergone “brain-washing” techniques. At this time, Hebb and his colleagues began a series of experiments which opened up an era of widespread research into the field of Sensory Deprivation.

It is twenty years since the appearance of Stoll's paper: “Lysergic acid diethylamide, a hallucinatory agent of the ergot group” (23). In this he sought to reproduce in a group of subjects Hofmann's personal experiences of the drug, and so set the LSD snowball on its way. Some 1,500 papers must by now have been gathered to it; they deal with a greater range of uses than has been thought of for any drug, a greater variety of benefits and disasters, and a confusing number of claims. Yet we have little hard information about this curious substance.

The immense literature on schizophrenia abounds in discoveries of single associations between the symptoms of the disease and certain other factors. Braithwaite (1960) says in speaking about “science like psychology and the social sciences which make great use of tendency statements… that to assert an isolated tendency statement is to say very little”. Such isolated statements in themselves are not explanations. A theory, on the other hand, interprets information; it explains.

There is no uniformity in the use of the terms habituation, addiction, intense desire, and craving. V. Petran (19) talks of craving as the irresistible desire to acquire a drug and the impossibility of abstaining from it. Craving may be manifested immediately after first consumption, but addiction represents a regular use, from which craving may develop in time.

It is part of the magical aura of the physician that he must have some omnipotent tool with which he dramatically makes patients better. In individual psychotherapy the individual interview and the interpretation, like the surgeon's scalpel, provides such an omnipotent instrument. In therapeutic community practice it is often group therapy in the form of the daily ward meeting and the review that plays the role of the omnipotent therapeutic tool. But in our opinion it is the daily living situation and not the formally organized therapeutic meeting which provides the greatest potential for learning and growth on the part of patients and staff. We have found the crisis situation and its resolution to be potentially the most useful of these daily living situations.

Surprisingly little has been written on the interview with the child as a diagnostic tool, in contrast to the voluminous literature on the therapeutic interview. Whereas standard texts on child psychiatry usually include a discussion of the physician-child relationship and of the use of play situation, it is rare for there to be any systematic account of the interview with the child as a diagnostic procedure.

Current views on aggressive behaviour (Buss, 1961; Berkowitz, 1962) propose a direct relationship between the frequency and intensity of aggression, both of which are in turn considered to be related to extraverted personality patterns (Buss, 1961; Bendig, 1961). The frequency and intensity of aggressive responses, it is maintained, are both indications of the habit strength of the aggressive response. Such conclusions are derived from laboratory studies in which, for obvious reasons, intensity of response will not reach extreme proportions. However, studies of those who have indulged in extremely aggressive behaviour are not in accord with this view. Megargee and Mendelsohn (1962), for example, found that extremely assaultive criminals scored lower than nonviolent criminals and normals on personality scales related to hostility and lack of control, and more recently Megargee (1966) has reviewed the literature on this subject, which suggests that a large proportion of those who have committed crimes of extreme violence have no previous history of assaultive behaviour and are well controlled in their behaviour generally.

An attempt is reported here to evaluate the results of a modified form of leucotomy. Subjects of the investigation were 64 consecutively operated patients, for all of whom the same technique of bimedial leucotomy was employed. This operation is similar to the full division of white matter (as described by Poppen, 1948) through a superior frontal approach, but the cut is limited to the medial 2 cm. (Greenblatt and Solomon, 1952). The operation is carried out under direct vision through two 4 cm. trephine openings placed immediately anterior to the coronal suture on either side of the midline. The plane of the cut is found with a brain needle and extends from the middle of the trephine opening (2 cm. in front of the coronal suture) to the line of the sphenoidal ridge. The white matter is cut with a metal sucker for a width of about 2 cm. subjacent to grey matter medially and inferiorly. The incision skirts the front of the lateral ventricles and divides the thalamo-frontal bundle, thereby isolating the cortex of the frontal pole and also interfering with the fibres to the remaining anterior prefrontal areas which lie in the midcentral segment of white matter. This cut does not necessarily extend sufficiently far back to interfere with all the fibres related to area 13, but is free from the disadvantages of misplacement into the septal area.

The literature on “psychogenic” potency disorders in the male is vast, and opinions abound on every aspect of these disorders. However, despite this abundance there is a dearth of factual data. The present author has been able to find only two major studies which have set out to study systematically and objectively facets of these conditions. El-Senoussi et al. (1959) undertook a statistical study to delineate psychological factors related causally to impotence; whilst Johnson (1965b) retrospectively studied male potency disorders to define their natural history.

An earlier commentary on the level and regional variation of Irish hospitalized psychiatric illness was limited by the absence of age-specific and standardized data (Walsh and Walsh, 1968). The present paper presents age- and sex-standardized rates by county for 1959, and then suggests some socioeconomic influences in [partial explanation of the variation in these rates. Psychiatric services in Ireland are provided on a county basis: in eleven instances one hospital serves a single county, in six cases there is one hospital to two counties and the remaining hospital serves three counties.

Relatively little is known about female homosexuality, and there are very few published studies which are based on a representative sample of the lesbian population. Many ideas on the subject are mere extrapolations from studies of male homosexuality. The majority of reports are psychoanalytically orientated and in most instances are concerned with very few highlyselected and atypical cases.

Many investigators have studied the relationship between life events and psychiatric illness to discover whether certain events predispose to some disorders or precipitate them, and to discover the effect of illnesses already in progress on subsequent life events and the effect of events on established illnesses. The validity of such studies depends, among other things, on the selection of suitable controls. For example, if adult patients with depression differ from a group of controls in that they had a higher incidence of parental death, it might indicate that bereavement had made them more susceptible to the development of the illness. But if the depressed patients were from a lower social class than their controls, the greater incidence of bereavement might be explained by the fact that there is a higher death rate in that stratum of society. This would then cast doubt on a conclusion about a causal relationship in that group between childhood bereavement and depression in adult life.

The aim of the present study is to compare the mental health of children of schizophrenic mothers born before, during and after the onset of the mother's illness.

This study is mainly based on my work in psychiatry in the Clinic of Nervous Disorders, Khartoum North, and with my private practice patients. I have seen altogether 2,160 patients. The distribution of psychiatric illness in these is shown in the table below. The two populations of patients attending the Government clinic and private practice are comparable, and the same patients interchange. A comparison is made in this paper between psychiatry in the West, mainly British psychiatry, and Sudanese psychiatry.

The importance of diagnostic procedure in child psychiatry does not need emphasis. In most clinics dealing with the emotionally disturbed child a substantial proportion of children referred are not seen again after the initial appraisal (Rogers, 1939), and on the basis of information obtained at this single appearance decisions may need to be made about the nature and severity of the child's disorder and the suitability of the child for treatment. Certainly with children taken on for treatment, elements of the diagnostic process enter into the therapy situation, yet even here a programme affecting the child's life will often have been laid down after the first session.

Since 1952 over 200 patients have been treated in the Guy's-Maudsley Neurosurgical Unit for intractable temporal lobe epilepsy by anterior temporal lobectomy. Each case has been evaluated before and after operation by a neurosurgeon, psychiatrists, and psychologists. Electroencephalography and air encephalography have been routine and the operative technique standardized. The resected portion has been removed in one piece allowing detailed pathological examination. The results in terms of relief of seizures, effects on personality, effects on psychological test scores, and the pathological findings have been reported at intervals (Hill, Pond, Mitchell and Falconer, 1957; Falconer and Serafetinides, 1963; Falconer, Serafetinides and Corsellis, 1964).

In the following paper a short clinical, descriptive account is given of the first 1,000 patients attending Ain Shams University Psychiatric Clinic from the beginning of 1966. Although the clinic is in the centre of Cairo, its catchment area extends all over Egypt. Patients are referred through three channels; either general practitioners send them for a psychiatric opinion or they come from other medical out-patient clinics at the University. The third group represents those who come independently and ask for psychiatric examination. Usually these are patients from the countryside who have tried lay therapy in their villages but without improvement. This group represents a deficit in the organization of referral, as many of them, having been examined at the psychiatric clinic may have to be referred to another medical out-patient clinic because of a non-psychiatric organic pathology.

The relationship between mental disorder and social background has for many years attracted the interest of epidemiologically oriented psychiatrists. Investigations in several countries have demonstrated that patients admitted to mental hospitals are recruited to a large degree from the lower social strata of society, but there is still a vast difference of opinion in so far as interpretations of these findings are concerned.