Surprisingly little is known about the course of intellectual development in children with infantile psychosis. Kanner (1943; Kanner and Lesser, 1958) has stated explicitly in several papers that “even though most of these children are initially considered feeble-minded, they are all unquestionably endowed with good cognitive potentialities, which are masked by the basic disorder” (original italics—Kanner and Lesser, 1958). The expectation would seem to be that the child's IQ, should fluctuate with the course of the psychosis, particularly the autistic aspects, but this has not been tested. It has been suggested (Anthony, 1958) that an intelligence test result in a young child with infantile psychosis is most unreliable and virtually meaningless if the child is without speech. Perhaps because most investigators have shared this view, neither of the two major follow-up studies of children with infantile psychosis, that of Kanner's cases (Eisenberg, 1956; Eisenberg and Kanner, 1956; Kanner, 1943 and 1949; Kanner and Eisenberg, 1955; Kanner and Lesser, 1958) and that of psychotic children seen by Creak (1962, 1963a and b) has included information on IQ changes.

The possibility of a relationship between early parental loss and mental illness, suicide, or delinquency in later life is a well-known, although by no means universally accepted, theory. In this investigation, we have attempted to compare patients with carefully matched controls and to investigate, when possible, the various categories of depression separately. Also, as we felt that a study concerned with childhood deprivation based solely on the physical absence of parents would tell us little of the daily emotional experiences of the child, we have attempted to take into account the quality of the family relationships present in childhood.

There has been a tendency to dispose of all the problems peculiar to children under ‘Primary childhood behaviour disorders'. This term would, as pointed out by Cameron (1955), have as broad a meaning as the legal term ‘insane’ or the social term ‘delinquent’. Unless there is delimitation of the terminology used, any aetiological investigation is bound to produce confused results. Furthermore, most aetiological studies suffer from lack of a normal control group and many published works apparently dealing with childhood conditions include adolescents in their case material.

Do psychiatrically disturbed teenagers tend to be physically immature? This paper describes an investigation designed to answer this question by formal methods and to test beliefs based on imperfect evidence. Through the development by Tanner, Whitehouse and Healy (1962) of a refined technique for the estimation of physiological maturity by measurement of skeletal age, it has been possible for an investigation to be carried out in this area with considerable confidence in the instrumentation. For the author, interest in physiological maturity was prompted by both clinical impressions and experimental findings, both of suspect validity, yet each pointing to the possibility that physiological maturation might be significantly different in normal and in disturbed adolescents.

A number of studies have suggested that psychiatric syndromes differ in the socio-cultural factors with which they are associated, such as age, race, social class and religion, as well as in the patients' family and personal backgrounds.

It is well known that when affective illness has its onset in later life a family history of this illness is significantly less common than in cases where the onset is early. Thus, Kay (1959) compared cases in this respect before and after 60 years of age; the morbidity risk was 10–12·7 per cent for relatives of the early onset group and only 3·5–5·7 per cent in relatives of those falling ill for the first time after 60. Similarly, Hopkinson (1964), taking the age of 50 to divide his probands, found a significantly lower risk for affective illness in relatives of the older-onset probands.

In recent years there has been growing interest in the subject of circadian rhythms of various metabolic processes in manic-depressive psychosis. This has been prompted in part by the cyclic self-limiting course of the condition itself as well as by such characteristic changes in its clinical manifestation over the twenty-four-hour period as mood variation, disturbed sleep pattern with early morning wakening, and impaired appetite, which Pollitt (1965) has attributed to a primary change in hypothalamic function. Alterations in the circadian rhythms of plasma corticosteroids, urinary corticosteroid excretion (Bridges and Jones, 1966; Curtis et al., 1966; Knapp et al., 1967; McClure, 1966), salivary flow and salivary electrolyte excretion (Jenner et al., 1967; Palmai and Blackwell, 1965) have been reported.

Emotional disturbance during pregnancy and the postpartum period is very common and at times leads to serious psychotic reactions. Studies comparing the relative frequency of psychotic breakdown in women during pregnancy or postpartum, or at other times, indicate that there is a greater frequency of psychotic reaction in the postpartum period (Pugh et al., 1963; Ryle, 1961; Tobin, 1957; Strecker and Ebaugh, 1926; Richardson and Guttmacher, 1967).

Controversy over the classification of depressive phenomena has been a prominent feature of the psychiatric scene for about forty years and the issues involved have been reviewed on a number of occasions (Partridge 1949; Grinker et al. 1961; Kiloh 1965; Rosenthal and Klerman 1966; Mendels and Cochrane 1968). Briefly it may be stated that a number of attempts have been made to support or refute the validity of classifying depressions into those which are “endogenous” and those which are “reactive” or “neurotic”; using a variety of statistical methods which have included factor analysis, principal component analysis and multiple regression analysis.

Bright young schizophrenics, like bright young people generally, are interested in reading about their condition. From the vast and varied selection of literature available to them, they appear to show a marked preference for R. D. Laing's The Politics of Experience (1967). The present authors, like other members of the 'square’ older generation, are of the opinion that they know what is best, and that this book is not good for these patients. It is an appealing book, and emotionally there is not a false note in it. This alone makes it important. But it contains treacherous confusions, and while we do not presume to make choices for our young friends we do feel that it is our duty to clarify the alternatives as presented in this book.

Many neurotic patterns of behaviour are considered to be adaptations to the environment, although often thought of as “maladaptive” in the sense of not being the optimum adaptation, and as reflecting pathological needs and expectations.

Although the value of phenothiazines is without question in the treatment of acute schizophrenia, their value in chronic schizophrenia is questionable. Cawley (1) states that social and environmental factors become more prominent for symptom relief and social adjustment with increasing chronicity. Both Ekblom and Lassenius (2) and Simon et al. (7), who did long-term follow-up studies on drug-treated schizophrenics, found only slight improvement when compared with control groups. Letemendia and Harris (4) found no significant improvement on phenothiazine treatment of previously untreated chronic schizophrenics when compared with a control group. On the other hand Kelly and Sargant (3) found a distinct improvement after two years in a group of phenothiazine-treated patients, who were compared with earlier admissions to the same hospital before the introduction of drugs. However, whilst Pritchard (6) found the short term prognosis was better for phenothiazine-treated schizophrenics when compared with patients admitted prior to introduction of these drugs, he found the three-year follow-up produced little difference.

Among a group of patients referred to the psychiatric out-patient departments of the Maudsley and King's College Hospitals primarily for emotional disorders, 40 patients who were at least 15 per cent above their ideal weight (Metropolitan Life Insurance Co., 1959, Statistical Bulletin, 40, 1) were selected for weight reduction. There were thirty-one women and nine men in the sample, and they were aged 25 to 54. The psychiatric diagnoses given were: anxiety (20), depression (17), and personality disorder (3).

Comparatively high intelligence level has recently been reported as an exception in patients with the chromosome constitution XYY (Borgaonkar et al. (1968), Forssman et al. (1968), and Leff and Scott (1968)). We found, however, normal or high intelligence level in all nine patients with the XYY syndrome diagnosed in our laboratory and found in psychiatric institutions (full scale IQ, by WAIS 99, 90, 93, 100, 120, 93, 96, 98, and IQ low in the normal range).