Patients in an affective disorders out-patient clinic were studied with four depression rating scales: the Hamilton rating scale (HRS) the Carroll rating scale (CRS) a clinical global rating of depression (CGRD) and the visual analogue scale (VAS). The overall correlations between the self ratings (CRS, VAS) and the observer ratings (HRS, CGRD) were highly significant. Both the HRS and the CRS distinguished mild from moderate, and moderate from severe depression. CRS scores increased more rapidly than HRS scores with increasing severity of depression. The concordance of self ratings and observer ratings was highest for the two structured instruments (HRS and CRS), and was lowest for the two global scales (CGRD and VAS). The global scales have the advantages of speed and simplicity, but at the cost of some reliability. Patients with non-endogenous depression had significantly increased self rating scores in comparison to patients with unipolar or bipolar endogenous depression. The correlations between the self ratings and the observer ratings were notably lower in patients with non-endogenous depression than in patients with endogenous depression. Euthymic bipolar patients rated themselves on the VAS as significantly less well than euthymic unipolar patients. The clinical and research implications of these findings are discussed.

The prevalence of phobic and anxiety symptoms was investigated in school children and students aged 11–23 years by questionnaire to find age-sex trends of these symptoms.

Phobic symptoms were found more prevalent in girls except for fear of talking. Among symptoms which tended to appear in anxiety or under stress, frequency of micturition was more prevalent in boys and the remaining symptoms showed no persistent sex difference. Fear of going out of doors alone and feeling of impending death tended to decrease with age. Symptoms which peaked in adolescence (fear of blushing, fear of being looked at and most anxiety symptoms) occurred at an earlier age in girls than in boys.

Abnormal sexual behaviour in pre-pubescent children is uncommon even in a psychiatrically referred population. Among 516 referrals there were 6 boys and 10 girls, the girls starting younger. The boys differed little in history or background from other conduct-disordered boys, but the girls were more commonly victims of sexual abuse and lacking a father in the home. The personalities of the girls suggested continued risk of sexual experimentation and possible development of personality disorder.

One hundred patients aged 65 and over were psychiatrically assessed before and in the first week after elective surgery. Thirteen were psychiatrically ill before operation and 21 developed post-operative illness. Post-operative confusional states (14 patients) were associated with physical complications but not with environmental or pre-operative psychiatric variables. Affective disorders either improved following successful surgery (5 patients) persisted or developed after operation in association with continuing physical illness (6 patients).

Five consecutive patients referred to a psychosexual clinic are described to illustrate the diversity of aetiology and pathology, and the need for a range of treatment techniques. Three patients responded to a cognitive-behavioural therapy which is described, and one to antidepressive drug treatment.

One hundred children between the ages of 7 and 12 admitted to a hospital for orthopaedic procedures were studied to determine the frequency of depression, according to the DSM III diagnostic criteria for major depressive disorder. Of the total sample, 23 showed evidence of depression. Loss of interest or pleasure was the most frequent symptom. Significantly more parents of these depressed children were themselves found to have adjustment or emotional problems. The authors emphasize the importance of paying special attention to this high risk group of child patients because of their propensity to depression and other emotional disorders.

A simple and portable ultrasound system, using a transducer attached to a pair of spectacles, to measure disorders of facial movement is described and applied to the measurement of tardive dyskinesia. Product-moment coefficients of correlation for the split-half and test-retest assessments of reliability in 20 patients were 0.96 and 0.93 respectively. Concurrent validity was confirmed by assessing the consistency between ultrasound scores and time-sampled scores based on video films (Pearson r = 0.86). Serial measurements of tardive dyskinesia over five months revealed striking individual consistency.

The symptoms of premenstrual syndrome should be rated daily, or at frequent intervals throughout the menstrual cycle. Self-rating is usually most feasible and separate rating of differing symptom groups is important, as symptoms differ in their response to therapy. Daily scores should be analysed to assess periodicity, either by subdividing the cycle into phases or by using the least mean square method of fitting sine waves. Standardized scores enable data to be compared across cycles. In a clinical trial it is important to include an untreated cycle to assess whether the subject has premenstrual syndrome and as a baseline with which to compare treated cycles. Allowance should be made for a carry-over effect and for high placebo response. One solution is to use a change-over design balanced for carry-over effects. The criteria used to define a patient should be stated.

While maternal overprotection appears associated with several neurotic and psychotic disorders, little is known about determinants of such a parental characteristic. Several hypotheses have been tested in a large nonclinical sample. Maternal and cultural factors seemed of greater relevance than characteristics in the child. Overprotective mothers gave evidence of marked maternal preoccupations before having children, of showing a capacity to be overprotective after the active stage of mothering, and of having personality characteristics of high anxiety, obsessionality and a need to control. Maternal overprotection appears associated with low, rather than with high maternal care. This has important primary prevention and treatment implications.

A longitudinal study of psychological disturbance in the affected population in Sri Lanka after the cyclone disaster of 1978 was carried out. The post-cyclonic stress identified among the rural communities after their return to the same destroyed environment was studied. Symptoms tended to be early or delayed in appearance. The degree of unpreparedness is postulated as the cause of the former. Group cohesiveness and feelings of community tended to delay the manifestation of symptoms. Realization of losses, family needs, and continued habitation in damaged homes acted as reminders and reinforcers. Morbidity continued to affect over half the population one year later. Early intervention within community settings after such disasters is recommended.

This study examined characteristics of 296 alcohol and/or drug abuse clients assigned to either (1) in-patient programmes, (2) out-patient programmes, or (3) a lower cost primary care alternative. Multivariate analysis indicated that clients admitted for in-patient care reported greater alcohol consumption and associated problems, fewer community supports and more severe symptoms such as depression and anxiety. They tended to be more frank about their problems while defence mechanisms were more apparent in clients admitted to out-patient and primary care programmes. In general, out-patients ahd more favourable prognostic indicators, such as higher social stability and lower level of alcoholic involvement. The differences among treatment programmes were along quantitative dimensions of problem severity. In particular, the alcohol dependence syndrome was a major discriminating dimension.

Averaged evoked potentials were recorded from a group of obsessional patients and matched normal controls for three types of visual stimulation: passive monitoring of a light flash, a pattern consisting of gratings and a cognitive task involving discrimination of two similar shapes. As the complexity of information processing required by the tasks increased, differences in the evoked potentials of obsessionals became more marked. The main finding was of faster latency and reduced amplitude of the component in the cognitive task. The relevance of this finding to a theory of obsessional disorder is discussed.

A naturalistic study was undertaken of 36 video and audio-taped interviews undertaken by 7 different psychiatric trainees. The interviews studied were those conducted in the ordinary course of clinic work for diagnostic and therapeutic planning purposes by trainees when first seeing the parent or parents of a child newly referred to a psychiatric clinic. It was found that a variety of rather different interview techniques seemed to facilitate emotional expression. These included a low level of interview talk with few interruptions, a high rate of open rather than closed questions, direct requests for feelings, interpretations and expressions of sympathy. The issue of how far these associations reflected causal influences is discussed.

A prospective study was carried out on post-influenzal depression. Four hundred patients presenting with psychiatric illness for the first time took part. The results show that there is no correlation between depressive illness and the demonstration of influenza antibody titres, an indication of recent influenza infection.

The records of 79 children whose firesetting led to referral to a Children's Hearing (the Scottish equivalent of a juvenile court) were examined. All but one of the children were boys. They had very disturbed backgrounds, with much family disruption and absent or unemployed fathers. Firesetting was predominantly a group activity and the damage caused was extensive. Although the children frequently engaged in other offences, in over 90 per cent there was no recurrence of reported firesetting within the limited period of possible follow-up.

The communication difficulties of prelingually profoundly deaf patients render psychiatric diagnosis extremely difficult. A study of 12 prelingually profoundly deaf schizophrenic patients revealed that visual hallucinations occurred in 10, and 10 also had experiences analogous to auditory hallucinations although voices may not have been heard.

The marked seasonal fluctuation in suicide rates observed by Durkheim appears to be diminishing, and in some cases, to have vanished. In this study, suicide data in Britain from 1958 to 1974 were studied by auto-correlational methods. A cyclical variation was found for both men and women. Men showed a single twelve monthly cycle whereas women showed two cycles. No explanation for this difference is immediately apparent.

Over an 18 month period, 49 patients in a physical rehabilitation hospital were referred to an attached psychiatrist. Formal psychiatric disorder was uncommon, and the mood changes and behaviour disturbances observed often resulted from a poor adjustment to recent physical disability by patients or their families. The most important role of the psychiatrist in management was in helping rehabilitation staff use their own skills to deal effectively with the inevitable emotional disturbances which occur in this setting.

This report describes an investigation into a possible relationship between barometric pressure and relative humidity, and depressive and manic admissions in the London area. A negative correlation between manic admissions and relative humidity was observed when the data were examined in several ways.