The progress over one year of 25 children aged 2½ to 3½ years attending a psychiatric day centre was compared with that of 25 similarly disturbed 3-year-old children identified in a total population study. There were few differences in outcome, and those that were found did not particularly favour either group. Implications for the organization of treatment services are discussed in terms of the need to lay down clear objectives and to pursue systematic controlled evaluation.

The incidence and quantities of dimethyltryptamine and O-methyl-bufotenine were studied in the cerebrospinal fluid of patients suffering acute schizophrenic illnesses and in surgical and neurological control groups. Some schizophrenic patients have higher levels of both amines than do controls, though the differences in distribution did not reach statistical significance in the sample studied. The gas-chromatographic technique used is sensitive at the low picogram level.

Using successive analyses of hospitalized mentally handicapped people from a geographically defined Welsh catchment area, this article attempts to evaluate changes in cohorts of such patients. It suggests the likelihood that the level of hospital accommodation predicted in the White Paper ‘Better Services for the Mentally Handicapped’ will be sufficient.

The addiction and conviction status of 60 male patients, examined at a London drug clinic in 1970 was reassessed at four-year follow-up. Forty-three per cent had become abstinent, 23 per cent remained dependent and 15 per cent had died. Ninety-seven per cent had received a court conviction and 73 per cent were convicted during follow-up. A prognostic assessment was determined in combined terms of continued addiction and continued delinquency. Poor outcome related to a lack of educational attainment, earlier first conviction and regular opiate use on arrival, and was associated during follow-up with an irregular clinic attendance beyond one year, drug conviction and death. Good outcome related to an absence of parental loss and later first conviction, and was associated during follow-up with discharge within one year without hospital admission. Analysis of the data indicates the value of combining forensic information with drug history in prognostic assessment.

A search was made of records available for 65 non-psychotic patients referred to a psychiatric day hospital. Assessments were made of whether they had shown various specified types of deviant social conduct, such detailed objective surveys of social conduct being regarded as superior to the use of concepts such as ‘psychopathic personality’. The correlational structures of the areas of deviance produced four factors, i.e. deviant family roles, poor social integration, violence, and a more heterogeneous antisocial behaviour factor.

The relationship was examined between areas of deviance and indices of the course and outcome of day hospital admission. The prognostic significance of social deviance was different for men and women; for example, only men showed a correlation between the number of areas of social deviance and the outcome of day hospital admissions. Violence and poor social integration showed no relation to outcome at all. It is suggested that there is no basis for excluding such patients from day hospitals on the assumption that they are less likely to be helped than other non-psychotic patients.

Nine depressed patients received ECT to the dominant (left) side along with nine matched depressed patients who received ECT to the non-dominant (right) side. Neuropsychological tests showed that the right hemispheric functions were more frequently abnormal as compared to left hemispheric (dominant) functions in the pre-ECT tests. ECTs delivered to either the right or left side improved right hemispheric functions when the depression was ameliorated. This study indicates that in depression right hemispheric functions are initially disturbed and ECT, instead of being deleterious to these functions, tends to improve them.

Gamma-aminobutyric acid (GABA) levels in the CSF were measured in 9 normal individuals, 17 drug-free schizophrenic patients and 10 of these same schizophrenic patients after neuroleptic treatment. There was no significant difference between CSF level of GABA in the control group compared to those in schizophrenic patients; however, 6 of the 7 lowest GABA levels were from schizophrenic patients. There was a significant decline of 12 per cent in mean GABA levels in the CSF after a mean of two months of neuroleptic treatment.

This paper describes a supported lodgings scheme as an alternative to group homes. It is pointed out that the County Council has a statutory duty to finance supported lodgings and that schizophrenics are ideally suited to such a scheme. Some short-stay, the majority of the ‘new’ non-demented long-stay, and a large number of the ‘old’ long-stay patients have been discharged by this means. Aftercare facilities were important, as nearly half attended the day centre and over one third were regularly visited in their lodgings by the community psychiatric nurses and social workers.

Fifty cases of Korsakov's syndrome and 13 of ‘alcoholic dementia’ were identified from hospital records with the aim of examining the claim of each to be regarded as a clinical entity. Korsakov's syndrome, as diagnosed, was not homogeneous and comprised two groups. One resembled cases labelled as ‘alcoholic dementia’: the onset was gradual, the patients were older women with poorer intellectual functioning and there was a better outcome. The other group conformed to the conventional notion of Korsakov's syndrome, with preservation of intellect and a poor outcome. The combined group of gradual-onset cases and ‘alcoholic dementia’ was not entirely homogeneous. Within it were patients with ‘accelerated psychological deterioration’, others with Korsakov's syndrome superimposed on this pre-existing psychological deficit, and some with subacute confusional states.

A prospective follow-up of schizophrenic patients treated with depot neuroleptic injections demonstrated the variability of the prevalence rate of morbidity from drug-induced extrapyramidal symptoms. Factors influencing this morbidity are discussed. This study suggests that the need for the treatment of drug-induced symptoms by the use of antiparkinsonian drugs is less than commonly accepted. It is suggested that our psychological set to the problem of drug-induced side-effects requires revision, and in particular that the prescription of anticholinergic drugs needs justification.

Attitudes towards self-poisoning were investigated in 80 psychiatric patients, half of whom themselves had previously taken overdoses. They were asked to comment about self-poisoners in general, and on four specific cases in particular. In addition to motives spontaneously suggested they were asked to choose from a list of alternative motives in explaining each case.

The subjects who had previously taken overdoses differed from the rest in seeing such behaviour as more often due to a disturbed state of mind and less often an expression of hostility. Both groups tended to see self-poisoners as mentally ill; and, unless they were offered a ‘vocabulary’ of goal-directed motives, they tended to see the behaviour as a reaction to events (i.e. expressive) rather than goal-oriented (i.e. Insteurnental). The implications of these findings are discussed.

An extensive psychometric test battery was administered to 125 children with a reading disability, to their parents and siblings, and to members of 125 matched control families (N = 1,044). In addition to expected differences in spelling and reading, probands obtained significantly (P ≤ · 01) lower scores than controls on tests of other cognitive abilities. Manifold deficits were also found in siblings and parents of probands, conclusively demonstrating the familial (genetic and/or common-family environmental) nature of the disorder.

The HLA (Human Leucocyte Antigen) types A and B were studied in 80 patients diagnosed as schizophrenic. There was an increased incidence of HLA-BW5 and a decrease in HLA-AW29 and HLA-BW17 as compared with healthy controls. In the sub-group of patients exhibiting Schneider's first-rank symptoms there was an increased incidence of HLA-A1 with a decrease in HLA-A2 and HLA-BW17.

Among 84 adoptees, 18 years of age and older, separated at birth from their biological parents and without further contact with them, alcoholism was found more frequently in those whose relatives included an individual with alcoholism or in whom heavy drinking had been noted. Adoptee alcoholism did not correlate with any other diagnosis in a biological parent.

Childhood socialized conduct disorder was significantly higher in those adoptees who later received a diagnosis of alcoholism or suspected alcoholism, and was positively, but not significantly, related to heavy drinking or alcoholism in parents.

Age of adoptee, time spent in foster care, age of biological mother at the time of the birth, socio-economic status of adoptive home, psychopathology other than alcoholism in the biological background, and psychiatric or behavioural problems in the adoptive family (parents or sibs) were all unrelated to adult alcoholism in the adoptee.

This study examines the mental health of 187 patients who had a rhinoplasty fifteen years earlier. Of 101 who had the operation following disease or injury 9 are now severely neurotic and one schizophrenic; of 86 who had the operation for aesthetic reasons 32 are now severely neurotic and 6 schizophrenic. The differences between the two groups are significant, and show that dysmorphophobia is an ominous symptom.

In a random sample of the general population (N = 142) a strong inverse relationship was found between social bonds and the presence of neurotic symptoms. This association was strongest in the case of close affectional ties. Together, measures of social bonds accounted for 47 per cent of the variance in neurotic symptoms. While there is likely to be contamination between the two sets of variables, and while the data do not indicate the direction of causality, these findings constitute an aetiological lead which should be pursued.

A three-month long study was undertaken of the utilization of the local psychiatric out-patient clinic by the geographically delimited population of Århus, Denmark.

Of the 307 males and 580 females contacting the clinics, 107 males and 148 females were new referrals, corresponding to 1·25 males and 1·48 females per 1,000 inhabitants 15 years or more, respectively. The ratio of treated females to males increased from 0·87 in the 15–24–year age group to 2·22 for patients 55 years or above.

Manic-depressive psychosis accounted for 43 per cent, followed by schizophrenia and other functional psychoses in males, and neuroses and other functional psychoses in females. The clinics collaborated closely with the in-patient facilities. Thus about 75 per cent were referrals from the in-patient clinics and 70 per cent of the discharged out-patients admitted.

This paper confirms previous findings that the incidence of suicide in England and Wales is greater than that in Eire, but shows that the incidence in 1968–70 was only twice as high, and not four times as stated in the official statistics.

Ninety-two schizophrenic patients of both sexes admitted to hospital at Taif, Saudi Arabia were examined to discover the incidence of Schneider's first-rank symptoms and their usefulness in diagnosing schizophrenia in this country. Fifty-two patients (56.5 per cent) were found to have these symptoms, most frequently ‘made’ phenomena and ‘somatic passivity’. The role of possible socio-cultural factors and the need for serious studies on transcultural psychiatry are discussed.

The correlation between serum and saliva lithium levels in patients undergoing lithium prophylaxis therapy is discussed. Although a high correlation can be obtained, there is an unacceptably high individual variation of paired results. Two strategies were used in an attempt to improve the reliability of saliva as a predictor of serum levels. A naturally occurring marker in saliva and serum was used. This showed high correlation but still did not prevent large sporadic differences. Serially paired results in individual patients also showed occasional excessive variation. Although saliva lithium has been used for monitoring when serum assessment is impracticable, it is considered that it is, as yet, an unreliable technique.