There is a good deal of evidence that hereditary factors make some contribution to determining a predisposition to neurotic illness, and some of the relevant literature has recently been reviewed by one of us (Slater, 1964). Raised incidences of neurotic illnesses and neurotic traits of personality of a like kind have been found among the first-degree relatives of obsessional neurotics, anxiety neurotics and persons diagnosed as suffering from hysteria. The evidence is much stronger in the case of the first of these types of illness than in the last. Such observations do not absolutely require a genetical explanation. It is possible that the similarities shown by relatives are not caused by their blood relationship, but by similarities in such aspects of the environment as early upbringing, social milieu, family tradition, etc. However, these findings do suggest that, if there is a genetical contribution to the personality traits which are associated with neurotic illness, this will most likely be due to a number of genes, additive in their action. This again would lead one to expect to find continuous variation between individuals in the degree to which they show such personality traits, and in our view the available evidence supports a multidimensional mode of variation.

Barbiturates arc commonly used in treating anxious, disturbed patients. Well controlled trials have shown that at least amylobarbitone (‘Amytal’) is therapeutically active (Scott, 1955; Raymond, Lucas, Beesley, O'Connell and Fraser Roberts, 1957; Robin, 1959), and that a newer barbiturate, nealbarbitone (‘Censedal’) is, weight for weight, equally effective (Robin, Cronin and Scotton, 1961). Since nealbarbitone is less hypnotic (Ryde, 1959; Hinton, 1963), it may be used in larger doses than are expedient with amylobarbitone, and this could make it more useful in controlling anxiety. Phenobarbitone is widely used, especially in general practice, to relieve symptoms of anxiety. Its activity in experimental animals, for example in preventing electrically induced convulsions without causing sleep, differs considerably from that of amylobarbitone (Merritt and Putnam, 1938), but it appears not to have been compared directly with amylobarbitone in a controlled clinical trial upon patients with anxiety.

The present paper is a three months survey of psychiatric referrals from the hospitals constituting the in-patient services of the Mayo Clinic, and discusses some clinical and administrative implications. The data were obtained from November 1st, 1961, to January 31st, 1962 inclusive. All referrals were seen by one of three consultants, two of whom (including the author) were responsible for the in-patient unit of 50 beds.

The aim of this paper is to report our experience with a new psychometric test, the Eysenck Personality Inventory, or E.P.I. (Eysenck and Eysenck, 1964).

The present study is part of a sex-chromatin survey in a mental hospital. It has been made as a preliminary step in finding the prevalence and incidence of sex-chromosome abnormalities among patients with mental illness; and it also has the purpose of studying the psychopathological and genetic aspects of sex-chromosome abnormalities. The study comprises all clinically hypogonadal patients referred by the psychiatrists at this hospital to the cytogenic laboratory during a period of approximately 1 month. In a survey of this kind we can expect to find patients with certain abnormalities of the sex chromosomes.

Out-patient drug trials have relied largely on observer-rated improvement measures to evaluate the efficacy of psychotropic medication (4). Less frequent use (5, 7, 9) has been made of patient ratings or the combination of observer plus patient ratings. Thus a comparison of improvement ratings made by the patient and his treating doctor would be of considerable methodological interest.

There has recently been an emphasis on creating a therapeutic milieu in mental hospitals. Numerous publications reflect this trend (1, 2, 5, 6, 7, 8, 9, 11, 14, 15). In addition, studies on attitudes of nurses and patients and on some of the factors which seem important in creating a favourable ward atmosphere have become commonplace (3, 4, 10, 12, 13, 16, 17).

The Symptom-Sign Inventory (SSI) consists of 80 questions presented orally. The administration and part of the scoring have already been described in some detail (Foulds, 1962); but, since then, a continuum has been suggested from neurosis through integrated psychosis to non-integrated psychosis. This continuum is considered to represent increasing degrees of failure to maintain or establish mutual personal relationships (Foulds, 1965). Measurement of this continuum, which has only been completed for women, involves three scales.