This paper argues: (1) that analysis of the issues upon which Popper and Kuhn have been thought to differ – the possibility of conclusive falsification, the incommensurability of theories, and the existence of normal science – reveals no appreciable difference at all; (2) that the basic point of disagreement concerns the role of truth in scientific inquiry, i.e. whether or not truth should be considered the regulative ideal of science; (3) that confusion concerning these issues results from a paradigm shift in epistemology; and (4) that Popper's epistemology proves more attractive than Kuhn's for unification in psychology.

The law about expert evidence is unsatisfactory: it gives scope for the expert to usurp the role of judge, jury and parliament; it brings the professions of the experts into disrepute; and it sets juries the impossible task of sorting pseudo sciences from genuine ones. The law should be reformed by changing statutes which force expert witnesses to testify beyond their science, by taking the provision of expert evidence out of the adversarial context, and by removing from the courts the decision whether a nascent discipline is or is not a science.

This paper offers a conceptual and historical analysis of descriptive psychopathology. The first section defines it as a cognitive system constituted by terms, assumptions and rules for its application. It traces the conceptual implications of this definition and relates them to clinical practice. The second section contains an up-to-date assessment of current historical work on descriptive psychopathology and offers a new hypothesis to account for its development during the nineteenth century. It is suggested that the work involved in the testing of the hypothesis should be carried out by psychiatrists with historical training and as a separate speciality. It is concluded that the historical calibration of psychiatric symptoms must be considered as an essential stage in the construction of a viable descriptive psychopathology.

A historical analysis of the syndrome concept shows that this term has been used in many different ways, ranging from clinical experience to records of coinciding symptoms. However, there seems to be broad agreement on the use of the word ‘syndrome’ in daily practice. If empirical–mathematical methods are applied in syndrome detection, however, a precise operation-alization of the syndrome concept is needed. Traditional procedures have often used models more dictated by methodological considerations than derived from the field of application, i.e. psychiatric syndromatology. An alternative approach, Boolean factor analysis, is presented in this paper. This relatively new method is illustrated by means of the analysis of a small artificial sample with a known structure. As a point of reference, traditional methods (factor analysis, cluster analysis, and multidimensional scaling) are also briefly discussed. It is demonstrated that they all share a deficiency of information about inter-group structure. In contrast, Boolean factor analysis uses a syndromic definition which builds on the basic notion of concurrent symptoms. Moreover, this approach can easily be understood by clinicians.

This paper focuses on the morphology of affective disorder. We set out to confirm on the island of Lewis a cross-over result originally found on the island of North Uist, whereby in those sections of the population where the rates of depression were lowest the rates of anxiety were highest. These sections of the population varied in the degree to which their members were integrated into the traditional way of life. ‘Integration’ was characterized in terms of churchgoing and crofting (the word for farming in the Hebrides). It is predicted here that the churchgoing rather than the crofting component of the integration measure would account for any cross-over result found concerning the morphology of symptoms. This hypothesis, derived from a theoretical concern with links between repression and anxiety, is not confirmed. Instead, crofting is found to be the component of the integration index which predicts anxiety/phobia without depression. In seeking to explain this unexpected finding further significant associations between crofting, pure anxiety/phobia and the style of personal relationships are revealed. It is also confirmed that types of severe events among women are also found to vary with the degree of integration into traditional society. A perspective is then developed which might explain how the interaction between style of personal attachments and types of provoking event could produce variations in the morphology of affective disorder.

A community survey of psychiatric disorder carried out in South London enabled the authors to investigate the ‘vulnerability model’ proposed by Brown & Harris (1978). In the current study none of the ‘vulnerability factors’ proposed by Brown & Harris fulfilled the requirements of the model. It was, however, found that working class women with children seemed particularly prone to develop minor psychiatric disorder in response to adversity. A similar result is apparent in the analyses of the earlier authors. A number of studies now published give some support to the vulnerability model using what are broadly measures of social support, but there is little corroboration using the other variables proposed by Brown & Harris.

The extent of psychiatric morbidity was investigated in a consecutive series of patients attending a south London general practitioner. The GP identified a psychiatric component in the reason for consultation in 40% of the sample, and he regarded 24% as ‘psychiatric cases’. The estimated true prevalence of psychiatric morbidity in the sample was 34%. These data are used as the basis for a theoretical discussion of prescriptive screening strategies for psychiatric disorder in general practice.

Healthy multiparous women having elective interval (N = 69) or postpartum (N = 69) sterilization were interviewed pre-operatively and 6 weeks and 6 months post-operatively, using standardized instruments. They did not differ significantly from control samples of comparable non-sterilized women with respect to mental state (Present State Examination) or subjectively-assessed mental or physical health or abdominal pain. More sterilization subjects than control subjects reported subjectively experienced improvement in sexual satisfaction at the later follow-up. Reports of poor physical health and abdominal pain increased over time within both the sterilization and the control groups. Reports of adverse effects at follow-up were often associated with higher PSE scores initially. Regrets and wish for reversal were rare and were also associated with higher initial PSE scores. Since the adverse effects were more common among postpartum subjects, it is suggested that subjectively experienced sequelae of sterilization may sometimes be attributable to ‘normal’ postnatal events.

Two hundred and forty women with young children who were patients in a Harrogate general practice were studied. About a third of them were found to be suffering from ‘mental distress’. Younger mothers were more affected. The number and spacing of their children were not related to symptoms of depression and anxiety, but poor personal relationships and difficulties getting out and about were so related, despite relatively affluent circumstances. Children of distressed mothers were more inclined to be disturbed. A controlled trial using amitryptyline involving 25 of the women suggested that this drug can improve depressive symptoms under these circumstances and that the improvement is likely to be maintained over the course of a year.

Following a television documentary on bulimia nervosa, people who thought that they had this type of eating problem were asked to complete a confidential questionnaire. 579 women who fulfilled self-report diagnostic criteria for bulimia nervosa were thereby identified. These women closely resembled patients with bulimia nervosa, although the age range was wider. They had grossly disturbed eating habits and almost half vomited at least daily. Laxative abuse was also common. Although almost two-thirds had been overweight in the past, the majority had a weight within the normal range. A minority had previously fulfilled diagnostic criteria for anorexia nervosa. On standardized measures, these women had abnormal attitudes to their weight and shape, as well as significant levels of psychiatric symptomatology. Nearly three-quarters thought that they definitely needed professional help, yet only a third had ever been referred for psychiatric treatment. Using data from this sample and an independent sample of 499 probable bulimia nervosa cases, the significance of three issues relating to the diagnosis of bulimia nervosa were examined: laxative abuse, the frequency of self-induced vomiting, and a history of anorexia nervosa.

Previously employed techniques for the measurement of body image are briefly described, with a short consideration of methodological or procedural limitations associated with each technique. A new procedure is described which employs a simple modification to a standard video camera to produce an image which appears from 20% thinner to 40% fatter than the actual person, without other distortion of the image. Reliability and preliminary validity data for the new procedure are presented.

This study had two aims: first, to investigate the attitudes of deaf and hearing people towards deafness; and, secondly, to study the difference between how deaf people perceive the attitudes of hearing people towards deafness, and how hearing people perceive the attitudes of deaf people towards deafness. The results showed that the deaf had more negative attitudes towards deafness than the hearing. In addition, the deaf believed that hearing people have more negative attitudes to deafness than hearing people actually have. This lack of empathy between the two groups was discussed. The amount of contact with the deaf was found to be associated with more realistic and less stereotyped attitudes to the deaf. The results are discussed in the context of research on social interaction with disabled people.

Unlike previous studies, this study shows that in controlled conditions non-chronic schizophrenics receiving neuroleptic medication show no disparity between recall and recognition. Patients receiving both neuroleptic and anticholinergic drugs show this disparity, performing less well on recall than on recognition. These patients also seem more severely disturbed. The importance of task matching, drugs and chronicity are discussed.

Forty-nine patients with low serum and cerebrospinal fluid folate levels completed the Ottawa–Wechsler Scale after 7–11 months of folate supplementation (10 mg daily). Twelve patients exhibited major neurological symptoms, while 37 patients displayed depression and minor neurological signs. After folate therapy, Verbal, Performance and Full Wechsler scores were significantly improved (P ≺ 0·0·01). The order of improvement in scores on the Wechsler subtests (from the statistically most significant to the least as measured by the t-statistics) was: Block Design, Digit Symbol, Similarities, Picture Completion, Picture Arrangement, Arithmetic, Object Assembly, Digit Span, Information, and Comprehension.

Disturbed behaviour was studied in relation to two contrasting ward environments, one representing the ‘medical model’ of psychiatry and the other being a modified form of ‘therapeutic community’. A mathematical model was used in order to identify the characteristics of disturbed patients. The results suggested that behavioural disturbance of a patient in our sample was related to diagnosis, to the ward of admission and to the length of stay in hospital. Patients in all diagnostic categories tended to be more disturbed in the ‘therapeutic community’ than in the ‘medical model’ ward.

Recent follow-up studies of depression in old age have highlighted the high relapse rate in older patients compared with younger patients. The consequences for the provision of acute psychiatric beds for elderly patients has been investigated by comparing the usage of beds by younger and older patients with depression over a 4-year period. Overall, elderly depressed patients consumed one and a half times as many bed days as younger depressed patients and a quarter of all acute bed days available in the hospital were used by elderly depressed patients.