Lionel Sharples Penrose was born in London on 11 June 1898. He came of Quaker stock and was brought up according to the principles of the Society of Friends. The Quaker education he received and his service in the Friends’ Ambulance Train in France during World War I, immediately after leaving school, confirmed him in his compassionate interest in human suffering and in his detestation of war.

Amark (1951, p. 154) discovered a high frequency of ixoid and ixothymic personality traits resembling those encountered among epileptics in a clinical material (49.5 per cent), and institutional material (38.0 per cent) and a material from the Temperance Board (37.1 per cent). Amark's description of these ‘epileptoid’ personality traits (1951, p. 151)) which also covers normal character variations, is fairly wide and includes a tendency to perseveration, adhesiveness, explosions or dysphoric states of dejection, querulousness and paranoid reactions. In a previous study (Kristianson, 1970, p. 173) it was suggested that Amark probably overestimated the frequencies of ixoid and ixothymic personalities, because alcoholics are so often explosive. But this quite unspecific pattern of behaviour is not sufficient for the diagnosis of ‘epileptoid’ traits, if this concept is to have a reasonable definition. Explosive aggressiveness is scarcely a primary personality trait, but is one of the symptoms of a deterioration in the chronic alcoholic's mental condition. However, it is important to differentiate these explosive aggressive reactions caused by chronic alcoholism from the adequately defined personality traits of epileptics. This problem of differentiation will be analysed in greater detail in this study.

The opportunity to conduct a prevalence study of psychiatric disorder among young adolescents arose because a Family and Community Project had been established in Blackburn and the neighbouring town of Accrington. This Project, which is under the direction of Dr. G. Rose, aims to study the causes and possible methods of prevention of delinquency. As part of the survey, the secondary school population had been screened by means of questionnaires given to parents, teachers, and the children themselves, and this provided the starting point for the study described here.

On 17 November 1969, Dr. A. A. Baker, then Senior Principal Medical Officer, Department of Health and Social Security, sent a letter to consultants at mental subnormality hospitals in which he requested them to introduce the World Health Organization International Classification of Diseases, Eighth Edition, 1965, in the completion of Mental Health Inquiry Index Cards. The booklet A Glossary of Mental Disorders, No. 22 in the General Register Office Studies on Medical and Population Subjects was enclosed with the letter for information and to facilitate the use of the Classification.

This paper reports the finding of one section of the third of a series of surveys on the training and background of a group of recently appointed consultant psychiatrists. The original survey was a postal enquiry primarily concerned with training, which was circulated to every consultant psychiatrist in the United Kingdom who had been appointed to a post in general psychiatry, with at least 6 N.H.S. sessions, between 1 October 1963 and 30 September 1966 (Royal Medico-Psychological Association, 1969). The second survey, using a different form of questionnaire, and enquiring more closely into background and motives for going into the specialty, was circulated to consultants appointed between the 1 October 1966 and 30 September 1969 (Brook, 1972; Brook, 1973).

To achieve a successful marital partnership is probably the most difficult of life's social requirements, whether successful is defined biologically as the production of healthy offspring or in the more human terms as achieving a relationship which allows each partner to lead a satisfying life. To be successful each marital partner must often defer to the other, especially if there are dependent children present. Failure to show this capacity to defer or to be unselfish inevitably leads to conflict, and conflict can easily build up to the point of violence. The ethological study of animal reproduction, including that of primates, shows how universally true this is and what a wealth of convention and ritual is developed to reduce such dangerous confrontation.

One of the most important contributions of child psychiatry to the general raising of standards of child care has been the identification of various abnormal life experiences which appear to be harmful to healthy emotional development. Two outstanding contributions, the descriptions of ‘institutionalization’ (Goldfarb, 1944; Bender and Yarnell, 1941) and ‘maternal deprivation’ (Bowlby, 1951) have had considerable impact on the organization of children's homes and the setting up of services designed to prevent family breakdown.

Ferenczi (1927, orig. 1911) thought that on clinical grounds he had clearly established two types of homosexual males. One type combined masculinity and a preference for pubescents, and the other type combined femininity with a preference for physically mature partners. However, Hirschfeld (1920, p. 267, 277, orig. 1914), who had examined a very large number of homosexual males, doubted the existence of any relationship between femininity and age preference.

Even though I do not propose to discuss the work of Professor Penrose directly, I should like to express my appreciation to the organizers of this symposium in his memory for giving me an opportunity to pay tribute to a man whom I regard as having been both my teacher and my friend.

Emotional illness in psychiatric post-graduate trainees has been the topic of several papers in recent years (1, 2, 3). In summary, these papers suggest that emotional illness in psychiatric training is common. Anxiety and depression characterize these illnesses and occur most frequently in the first year of training. But, as Halleck and Woods have stated, ‘Information as to the prevalence of anxiety states, depression, suicide, psychoses or serious acting out is unavailable’ (4).

Folie à deux, the psychosis of association, has been defined as ‘the transference of delusional ideas and/or abnormal behaviour from one person to one or more individuals who have been in close association with the primary affected person’ (8). At least three conditions have been regarded as pre-requisite for its diagnosis: (a) definite evidence that the partners have been intimately associated, (b) identical content of the delusional ideas in both the patients, and (c) unequivocal evidence that the partners share, support and accept each other's delusions (7).

In a previous paper (Leff, 1973) data from the International Pilot Study of Schizophrenia (IPSS) (WHO, 1974) were analysed, and it was found that patients from developed countries showed a greater ability to differentiate between unpleasant emotional states than those from developing countries. The data on which this finding was based were scores derived from the sections on Depression, Anxiety and Irritability in the Present State Examination (PSE), a semi-structured psychiatric interview (Wing, Cooper and Sartorius, 1974). The scores were the sums of ratings made by psychiatrists interviewing patients from their own countries. The psychiatrists judged whether or not a symptom was present on the basis of the patient's verbal response to a series of questions, most of which are stipulated in the PSE. The patient's nonverbal behaviour is not taken into account in making these ratings.

Previous electroencephalographic studies of persons with sex chromosome aberrations have indicated that there might be more electroencephalographic aberrations in males with double Y and double X than in the general population. A survey of these studies has recently been made by Fenton et al. (1971).

Most studies on the personality of homosexuals have been based on patients or prisoners (e.g. Cattell and Morony, 1962), and much less is known about those who do not fall into these categories. This report summarizes a comparison of the personalities of a sample of normal British homosexuals with a patient group who sought treatment. It was hoped through this investigation, an offshoot study of a major treatment programme for homosexuals, to determine the relationship between personality characteristics and referral for treatment; also to obtain further information about the personalities of non-treatment-seeking homosexuals.

In a previous paper, a preliminary report (Offord and Cross, 1971) found that adult schizophrenics differed in their school performance from both their siblings and their age mates. For instance, the pre-schizophrenics were significantly more likely than their siblings to have repeated at least one grade in elementary school and to have scored significantly lower on childhood IQ, tests than their siblings and age mates.

After I had agreed to give this talk about Lionel Penrose's contributions to genetics and mental deficiency I realized what an impossible task I had undertaken. His research career in these areas spanned a period of more than forty years, during the whole of which he was making important and significant contributions on an extraordinarily diverse range of topics. Furthermore, during this period both of these subjects advanced from an almost pre-scientific infantile state to rigorous and critical disciplines, and Penrose's work played no small part in this development.

Recent reviews dealing with psychiatry in sub-Saharan Africa have stressed the overall similarity in the incidence of psychiatric conditions and their diagnostic distribution to those seen in other parts of the world (German, 1972; Giel and Van Luijk, 1969; German and Arya, 1969). All authors emphasize, however, that some clinical pictures seen in Africa, such as those of depression and anxiety states, vary from the manifestations one encounters in European and North American patients.

Classification systems such as diagnosis have two primary properties, reliability and validity. Reliability refers to the consistency with which subjects are classified; validity, to the utility of the system for its various purposes. In the case of psychiatric diagnosis, the purposes of the classification system are communication about clinical features, aetiology, course of illness and treatment. A necessary constraint on the validity of a system is its reliability. There is no guarantee that a reliable system is valid, but assuredly an unreliable system must be invalid.

It has repeatedly been demonstrated that hyperactive children improve in behaviour and school functioning when treated with amphetamine, methylphenidate and, according to recent studies, imipramine (Conners, 1972). While these drugs affect catecholamine and indoleamine metabolism, there have been few studies intercorrelating the clinical and biochemical effects of these agents. A small number of untreated hyperactive children have been found to have normal urinary catecholamine and indoleamine excretion (Rapoport et al., 1970; Wender, 1971) although whole blood hydroxyindole concentrations have been reported as reduced (Coleman, 1971). In the present study, platelet serotonin content was examined before and during treatment with methylphenidate and imipramine of a group of boys with the hyperactivity syndrome.

Arguments about the role of heredity in schizophrenia have largely given way to arguments about the genetic mechanisms involved. Discussions of the various genetic models by leading workers in the field have been presented in recent years (Rosenthal and Kety, 1968; Kaplan, 1972). Single gene theories have prevailed, Slater's intermediate model being preferred because of its good fit with the observed risks of schizophrenia in specific categories of blood relatives (Slater and Cowie, 1971).