Computerized tomographic procedures have been used extensively since their introduction to examine specific language disabilities in aphasic patients and to correlate anatomical and clinical changes. The resulting overwhelming evidence in favour of lateralisation and localisation has been confirmed by regional blood flow studies and punctate electrical stimulation as well as by the topographic maps provided by neurometries. That specific lexical functions are localised within the peri-Sylvian cortex in the left cerebral hemisphere is now generally accepted, but the macroscopic mapping, which largely ignores the contribution of the ipsilateral thalamus and possibly of the basal nuclei, must not be mistaken for the language encoding processes in the parallel pathways which have been identified.

Despite more than a decade of studies, biological psychiatry has yet to satisfactorily resolve the issue of whether new brain imaging technologies reliably indicate the presence of abnormal cerebral morphology in schizophrenia. The present Perspective offers an alternative view on this topic, as a counter-point to one previously offered in the Journal. It addresses several of the methodological problems inherent to such studies, and evaluates some of the more recent aspects of the literature. Those structural abnormalities which have been reported in schizophrenia appear most readily explicable as a consequence of neurodevelopmental anomalies.

All twenty-nine bipolar 1 patents who satisfied DSM-111 criteria following their first hospitalisation for mania and subsequently discontinued their prophylactic lithium after a mean of 29 ± 21 months were studied. Patients were classified into poor prognosis (relapsed within 3 months of discontinuation, n = 8) and good prognosis groups (relapsed after 3 months or did not relapse, n = 21). Poor prognosis patients were more likely to have been prescribed additional psychotropic medication in the previous year (P = 0.026) and had higher serum lithium levels immediately prior to lithium discontinuation (P = 0.0043). Recent additional psychotropic medication may indicate that the patient is at an increased risk of early relapse if lithium prophylaxis is being stopped for any reason. The increased risk for those patients with higher lithium levels suggest that gradual phased reductions would be prudent.

This paper presents the programme perceptions of male young offenders involved in 2 Dublin community training workshops. Most of the sample indicated that they perceived their training to have had an overall positive impact (ranging from a moderate to a very substantial extent) in various areas of skills and personal development. Those emerging with a higher level of self-confidence, predictably, had also perceived themselves to have benefited more in almost all areas. Ambivalent predictions of the sample in respect of their future employment and re-offending tended to be associated with fewer perceived programme benefits, than were optimistic predictions.

We studied the impact of a first myocardial infarction or episode of unstable angina on four areas of subjective health: wellbeing, perceived functional status, body confidence and emotional symptoms. A questionnaire in which the patient was asked to compare status before and after hospital admission was given to 61 cardiac patients attending follow-up rehabilitation clinics.

Worries about health and fears of straining oneself were common in the 24 patients surveyed less than 3 months from discharge. But in patients over 3 months from discharge, sense of wellbeing was significantly improved post-infarction compared with pre-infarction: 86% of patients noting a change reported an improvement. Perceived family role performance was significantly improved, while confidence in work performance and general competence remained unchanged. The prevalences of depression, anxiety and worry were unchanged from pre to post attack, patients in whom these symptoms developed being off-set by patients who lost symptoms.

Previously-reported adverse sequelae of acute coronary disease may exaggerate the extent of the problem. Restriction of studies to neurotic symptoms and failure to compare pre and post attack periods may fail to elicit improvements in quality of life associated with rehabilitation and secondary prevention programmes.

Running Title: Subjective health in post-coronary patients

One hundred and sixteen new referrals who attended a psychosexual clinic and one hundred and twenty non-attenders are compared on characteristics derived from their referral letters. Only the widowed and divorced are more likely to attend. It is concluded that non-attendance cannot be predicted from the referral letter.

92 adolescents (mean age 13.8 yrs) at a North Dublin school completed the GHQ - 30 and the attitude to authority scale. A high level of psychological distress (as measured by the GHQ - 30) was found, with 44% of the sample reporting 6 or more symptoms. The majority of students (84%) however expressed pro-authority feelings. A negative correlation was found between the level of distress and positive attitude towards parents. The possible clinical relevance is discussed

Suicide and attempted suicide are common phenomena amongst psychiatric inpatients and outpatients. Self-immolation or self-incineration are dramatic attention seeking events which may have religious or political significance. Deliberate self burning which incorporate these may also encapsulate elements of attention seeking, parasuicidal and suicide behaviour. The present study shows that psychiatric inpatients who choose to injure themselves by self burning are a seriously disturbed group whose intention is largely suicidal and who have a previous history of attempted suicide. They tend to be female, single, suffering from either schizophrenia or personality disorder in contrast to the majority of people who take their lives by other methods who tend to suffer from depression, alcoholism or both.

This paper describes a husband and wife sharing bizarre beliefs, which were felt to result from Pseudologia Fantastica rather than delusions in the inducer (the wife).

This paper is an attempt to address issues encountered in the Supervision of a community meeting in a psychiatric unit which is scheduled for closure. An initial practical problem which took the form of difficulty in meeting for the supervisory session is examined from a psychodynamic perspective and related to difficulties encountered by the therapists in their work with the patient group and ultimately to the dynamics of the patients themselves.

Material provided by patients and staff is discussed in terms of the concept of relatedness to the non-human environment as described by Searles and it is suggested that this may contribute to the understanding of the process of hospital closure as it affects patients and staff.