Our concept of the structure and function of the normal and diseased brain has developed throughout the centuries. The first stage in the discovery of the brain stretched over three millennia, from the earliest descriptions by the Egyptians in the sixteenth century B.C. to the comprehensive anatomical treatise of Vesalius. The invention of the light microscope brought to the eye a previously invisible world, and heralded the beginnings of the systematic histological investigation of the immensely complex cellular networks of the brain. With the advent of electron microscopy, the organelles and connections of brain cells have been revealed, and the new era of molecular biology has begun. Neuropathology, which concerns itself with diseases of the brain, spinal cord, nerve and muscle, has enormously benefited from these developments to establish the morphological basis of diseases of the nervous system.

Adult coeliac patients taking a gluten-free diet for one year showed an increase of 33% in the concentrations in CSF of major monoamine metabolites (5-HIAA, HVA and MOPEG). Tryptophan in CSF rose by 10%. There was concomitant morphological improvement in the jejunal mucosa, and the results would seem to indicate that the reduced central monoamine metabolism in untreated adult coeliacs is not primarily genetically determined but is probably related to the poor intestinal absorption.

The frequencies of various forms of eating-related behaviour (such as vomiting and laxative abuse) are reported for a series of non-anorectic bulimia patients seen for evaluation in an eating disorders clinic. The results of serum electrolyte, glucose and other screening tests in these patients are presented. Electrolyte abnormalities were found in 82 of the 168 patients (48·8%) who were diagnosed as having either bulimia or atypical eating disorder. The most common abnormality was metabolic alkalosis (27·4%); hypochloremia (23·8%) and hypokalemia (13·7%) were also commonly seen. No significant blood sugar abnormalities were encountered. An elevated serum amylase level was found to be associated with frequent binge-eating and vomiting behaviour. The pathophysiology of electrolyte abnormalities in this patient group is briefly reviewed.

Twelve manic patients were treated for 2 weeks with oral haloperidol; in 6 patients treatment commenced with intravenous haloperidol, and intravenous ‘test’ doses were given after 1, 3–5 and 14 days of oral medication. From 24 hours to 14 days baseline serum prolactin levels rose towards a plateau, as did the improvement in clinical ratings. After the first intravenous test doses of haloperidol, prolactin levels peaked at 1 hour; however, they fell to a low point at 24 hours, and no response to further test doses was seen for 3–5 days. The response tended to return at 14 days. The mechanisms underlying the changes in prolactin levels, and in clinical state, are discussed.

Electrodermal, electroencephalographic and perceptual measures of lateral hemispheric function were obtained from groups of chronic schizophrenics, depressives and normals on 2 occasions, separated by 4 weeks. The measures of hemispheric function were derived from previous research. About half of the schizophrenics were medicated on both occasions; the other schizophrenics underwent drug ‘washout’ before the first session. Results revealed that the measures of laterality were not strongly intercorrelated. In the perceptual task, the schizophrenics and normals displayed different laterality effects. Unlike the normals, the schizophrenics' left hemisphere function appeared to be inferior to the right hemisphere function in the perceptual task. The laterality effects of the depressives and normals differed on two electrodermal measures: skin conductance level and skin conductance response amplitude. The depressives' electrodermal activity from the right hand was diminished as compared with the left hand; the normals did not show this effect. Medication decreased electrodermal activity in the schizophrenics, but had no significant effect on laterality. These results suggest that the various measures of laterality used singly in previous research in psychopathology may not all assess the same phenomenon.

The EEG synchrony between hemispheres during cognitive activity differs from that during rest. With common reference recording and a visual imagery task it increases in healthy right-handers and neurotic patients, and it decreases in healthy left-handers and schizophrenic patients. It is suggested that this implies a less lateralized brain organization in schizophrenia which may account for the often reported association with left-handedness. When associated with impaired corpus callosum transmission, it may contribute to the disturbed behaviour and thought processes in this condition.

A review of the literature describing patients with functional visual loss reveals that a significant proportion of them do not manifest psychiatric disease as defined by current nomenclature. Apparently, these individuals are highly suggestible and do not necessarily have psychological pathology. The ramifications of this finding are discussed.

Forty-two patients with functional visual loss were followed for more than 4 years after presentation. Only 22 patients had a diagnosable psychiatric syndrome or personality disorder at follow-up. Twenty-three patients continued to have findings of functional visual loss at follow-up. Despite continued signs of functional visual loss, few were socially or economically impaired, and 8 of these 23 patients had no evidence of any psychiatric disorder. The implications of these findings are discussed.

The relative memorability of pleasant and unpleasant personal experiences was investigated by measuring their speed of recall. In keeping with most previous work, pleasant material was found to be more readily accessible than unpleasant material. In addition, the retrieval rates of both classes of material were found to be influenced by the intensity of affect associated with the memory.

A number of studies have attempted to explain obstetric difficulties on the basis of psychosocial conditions which exist during pregnancy. In addition, recent research in the field of life event stress has indicated that life experiences occurring prior to a pregnancy may influence pregnancy outcome. The present study examines the ability of life event stress as well as a variety of medical, social and psychological variables to predict complications of pregnancy. In contrast to previous small-sample research, the present study examines 782 subjects. Multivariate statistical techniques are employed to analyse the numerous variables measured. Results suggest that ‘age at birth of first child’, ‘education level’, ‘menstrual history’, ‘attitudes to pregnancy’ and ‘age at menstruation’ best predict obstetric difficulties. However, only a small percentage of the variance of pregnancy complication scores is explained by these factors.

Although most chronically impaired psychiatric patients now reside in community-based residential homes, a substantial number show little progress in their social rehabilitation. To establish the rehabilitative needs of this population, the current study sought to examine the social behaviour of residents of a large residential care facility. After an analysis of the social behaviour of all residents, two groups were selected for detailed study on the basis of their contrasting patterns of social interaction.

These two groups were found to differ significantly with respect to their interpersonal activity, social contact, conversation skill, employment, and participation in community rehabilitation programmes. Psychiatric status was substantially different in each group. The implications of these findings for rehabilitation strategies in the management of severe mental illness are discussed.

Validity coefficients of the 30-item, 28-item and 12-item versions of the General Health Questionnaire (GHQ) were determined by comparison with the Present State Examination (PSE) in a sample of 200 17-year-olds. The PSE classified 7 people (3·5%) as cases, although only 47% were identified as free of symptoms. Misclassification rates, sensitivity and specificity values are presented for different cutting scores for the three versions of the GHQ. The GHQ-28 had superior values, especially with a cutting score of 5/6; the GHQ-12 with a 2/3 cutting score also had acceptable values. All versions of the GHQ correlated highly with the PSE Index of Definition and total scores, providing support for the treatment of GHQ scores as a continuous variable in this kind of population. Correlations between sub-scales of the GHQ-28 give further evidence for a general factor and the relative independence of the social dysfunction sub-scale.

This paper reports the factor structure of the symptoms comprising the GHQ when it is administered in the general practiāe service of a hospital. Two shorter versions are proposed: one with 6 scales and 30 items, and the other with 4 scales and 28 items. The latter is compared with the 28-item English version. Preliminary data concerning the validity of the scales are presented. In a comparison of the screening potentiality of the 60- and 28-item versions, no significant differences were found.

The 30-item General Health Questionnaire (GHQ), the 24-item Self-Reporting Questionnaire (SRQ), and a Chinese version of the Minnesota Multiphasic Personality Inventory (MMPI) were administered to 225 English-speaking Chinese. The GHQ was found to have high internal consistency as a scale and to assess 5 dimensions of psychopathology: anxiety, inadequate coping, depression, insomnia, and social dysfunctioning. As a brief screening instrument, it correlated 0·49 with the SRQ. In the ‘case–non-case’ classification, it yielded a concordance rate of above 75% with the SRQ. Using the MMPI modal profiles derived from classification research as criterion measures, sensitivity, specificity and correct classification rates were above 70%. Implications for future research with the GHQ are discussed.

A consecutive series of 94 patients recently admitted to hospital from a defined catchment area and diagnosed as having a depressive illness were examined using standardized techniques for eliciting mental state, etc. The overlap between psychotic and neurotic diagnoses was 8·5% on discriminant function analysis of mental state items. A sub-sample of 71 patients was given a comprehensive postal and case record follow-up 5 years later. When patients developing organic and other complicating illnesses were excluded, those suffering from psychotic depression showed a significantly poorer outcome, as defined by relapse and required lengths of hospital care, than those diagnosed as suffering from neurotic depression.

From a total of 410 post-mortem examinations on Gaiway residents deceased in 1978 the examining pathologist and 3 psychiatrists were in close agreement in 22 cases that death was by suicide. These figures were extrapolated, and a Republic of Ireland minimum true rate of suicide was computed which was 3 times greater than the official reported rate. Irish suicide data were found not to be dependent on coroners' reports as is commonly believed. It is concluded that under-reporting reduces Irish suicide rates to a far greater extent than has been supposed. The substitution of clinical for legalistic methods of recording suicide data is recommended.

The Personality Assessment Schedule, an interview schedule specifically designed for assessing personality disorder, was administered twice to 28 psychiatric patients, with a mean interval of 2·9 years between each assessment. The first assessment was made by a psychiatrist and the second by a medical student who had no prior knowledge of the patients. The reliability of the 2 assessments was measured using 4 different techniques. Although the reliability of individual personality traits was inconsistent over time, the categorical diagnosis of personality disorder was good (Kωw = 0·64), giving some support to the validity of the schedule. Reasons for discordance in the assessments were examined and appeared to be due mainly to confusion between clinical symptoms and personality traits, retrospective errors in recording past personality in chronic patients, and special difficulties in determining the primary abnormality in severe personality disorder.