The size and utilization of the primary group (those with whom one has interaction and commitment) was examined in 50 patients with non-psychotic psychiatric disorder and 50 matched controls. The hypotheses tested were that the patients would have a smaller size of primary group, less contact with its members and an inferior affective quality of interaction with it; and that this deficiency would be most marked in transactions with the principal attachment figure. Patients were found to spend the same amount of time as normals with their primary group, but proportionately more of that time was affectively unpleasant. They had fewer good friends and fewer contacts with persons outside the household. They had fewer attachment figures, almost one half of them reporting that either they had only one, or that they had had no recent contact with those alternatives that did exist. The majority of patients considered that their principal attachment figures gave them insufficient support. The complexity of interpreting these data is discussed.

On Tuesday 10 June 1975 G.M.B. was convicted at Bristol Crown Court of the murder of a young woman and sentenced to imprisonment for life.

This case report augments a paper published in 1971 (Gunn and Fenton) in which it was indicated that automatic behaviour is a rare explanation for the crimes of epileptic patients. It was claimed that although two possible ‘automatic’ crimes were committed by two epileptic patients among the 46 male epileptics at Broadmoor there were no such crimes committed by any of the 158 male epileptic prisoners who came into a national sample. Since then it has become clear that one man serving life imprisonment, excluded from the epileptic prisoner sample in 1967 because of a doubt about his diagnosis, is definitely epileptic and probably killed his wife during an epileptic attack or its immediate sequela.

A group of 30 manic and hypomanic patients was assessed on the Delusions-Symptoms-States Inventory and did not appear to conform well to Foulds' and Bedford's hierarchy model. Failure to fit the hierarchy was caused by lack of scores in the Neurotic Symptom Class. The relationship between delusions of Grandeur and state of Elation, which was found to be inclusive and non-reflexive, did, however, support the hierarchy model.

Two measures of extraversion were administered routinely to a group of drug dependent offenders, on admission, after six months and after one year's treatment in a therapeutic community. On admission the sample was relatively introverted. During the treatment there was a progressive move towards extraversion, and after one year's residence there was a significant change in the direction of extraversion. It is suggested that this change constitutes an important factor in the success of this type of treatment.

Analysis of medical students' formulations and replies to clinical problems indicates difficulty in deciding on the nature and organization of treatment. A programme describing a problem-solving approach was devised, and students taught in this way were shown to be significantly more able to formulate organized treatment plans with more precise aims. It is suggested that problem-solving methods are likely to be much more effective than conventional teaching of psychiatry.

In a transcultural setting, psychiatric diagnosis is often impeded by language and cultural barriers. A greater reliance on observed or reported behaviour than on the self-reporting of subjective discomfort may thus be expected, and this could result in the low prevalence of reported anxiety and depression in many transcultural psychiatric surveys. The language of the Pintupi Aborigines of Central Australia, until recently palaeolithic hunter-gatherers, is seen to contain lexical categories for anxiety and depression. This attests not only to their capacity to experience such affects, but also to their ability to express them verbally. The implications of this finding for psychiatric diagnosis are discussed.

The paper describes the therapeutic programme of the Young People's Unit, Macclesfield. Admission is based on a therapeutic contract agreed with the youngster and family. Data on the first 150 admission to the Unit are presented. The information was collected from all referring agencies and a sample of youngsters and parents after an average period of two years since discharge. Results were similar to those of other follow-up studies of discharges from adolescent units, i.e. 78 per cent of neurotic disorders, 53 per cent of mixed neurotic and conduct disorders and 47 per cent of conduct disorders showed improvement. There was a high incidence of recurrence of the most significant presenting symptom (72 per cent). Nevertheless, referrers and youngsters showed a positive attitude to the treatment experience. The possible relationship of this to the contract system is discussed. A longer period of stay was found to correlate positively with improvement in conduct disorders. There is a need for further research into what aspects of a treatment milieu produce significant and lasting changes in conduct disorders.

People working in the field of social psychiatry concern themselves with social factors which may affect the onset, duration or outcome of psychiatric disorders. This concern encompasses the full range of psychiatric conditions and virtually every aspect of the structure of society, so that in this short review we can only attempt to convey the flavour of the subject and to highlight some salient contributions.

A two-year follow-up inquiry was made of the residuum of a cohort formed by all senior registrars in general psychiatry in post in late 1974. Of the original 155, nearly half are in permanent posts, but only three-quarters of these are in general psychiatry in the United Kingdom. Twelve have already emigrated.

Two child observation and assessment centres run by a Social Services Department have quickly filled up with older children who stay indefinitely. Many of these children have physical as well as emotional problems and have been admitted as family emergencies in an unplanned way. The paper discusses how, if at all, the psychiatrist called in for advice by social workers can help. This is thought to be a widespread problem.