Animal experiments demonstrate that it is not only the quality of transmitted and received social signals that is important, but also their frequency and the timing of the information transmitted. In order for progress to be made in the investigation of human social behaviour and its disorders, methods must be developed which allow the transmission of verbal and non-verbal information to be measured. Experiments carried out with healthy adults and healthy and disturbed children to investigate human eye contact and distance behaviour are reported, along with experiments on the influence of gaze and body posture on spoken communication. Finally, a report on the use of behaviour therapy for an autistic child is outlined in order to explore the psychobiological correlations between social behaviour and language, which concur with extensive experiments on brain stimulation. It is suggested that there is a cerebral representation for species-specific social behaviour and a vocalization system embedded in these brain structures which is a phylogenetically patterned prerequisite for the development of human language.

The concept of akinesia deserves to be looked at again in the light of recent work on Parkinsonism, particularly those findings which have resulted from the use of L-dopa in Parkinsonian syndromes. Akinesia and bradykinesia are integral parts of such syndromes, at times even constituting their essential element. Akinesia belongs to a group of psychomotor syndromes, the semiology and pathogenesis of which were the subject of numerous discussions at the beginning of this century. As we have pointed out elsewhere, akinesia cannot be defined solely in terms of its own characteristics: it must be understood equally in its paradoxical aspects—‘paradoxical kinesia’ in post-encephalitic Parkinsonism in particular, and ‘paradoxical akinesia’ in Parkinsonian patients treated with L-dopa.

There have been many battles in the last 100 years between those who consider hysteria to be a ‘morbid entity’ or ‘disease’ and those who would like to drop it once and for all. The controversy still goes on. It has not been settled by follow-up studies or by applying genetic considerations. Hysteria is a tough subject, unlikely to be killed so long as clinicians find it useful, if not indispensable.

The concept of social abnormality can be given a fairly precise meaning and is relevant to the theory of legal responsibility. Much work, however, would need to be done before it could take its place alongside mental abnormality as an excusing condition in the courts. The implications of such a plea would, moreover, be far reaching, two of the more obvious being the individualization of excuses and the relinquishing of the general preventive possibilities of punishment.

Nostalgia, a psychopathological condition affecting individuals who are uprooted, whose social contacts are fragmented, who are isolated and who feel totally frustrated and alienated, was first described in the 17th century and was a problem of considerable interest to physicians in the 18th and 19th centuries. by the 20th century it seemed to have disappeared, but reappeared under other labels.

The probenecid technique was used in a study of the central dopamine DA metabolism in patients with depressions, psychotic disorders, and Parkinson's disease. The disturbances found were neither nosologically nor syndromally specific, but appeared to be symptom-specific. Decreased DA turnover was associated with hypomotility, and increased DA turnover with hypermotility. Decreased DA turnover was probably related aetiologically to the hypomotility: the symptoms subsided after replenishment of the DA deficiency. The relation between increased DA turnover and hypermotility is still under investigation. In view of the findings obtained, a plea is made for the development of a functional psychopathology, in which psychiatric syndromes are ‘dissected’ into their constituent psychological dysfunctions. This development is expected to stimulate human brain and behaviour research. It can be achieved only by intensive collaboration between psychiatrists and experimental psychologists.

This is a prognostic study on 41 patients with anorexia nervosa (including three males) who satisfied defined diagnostic criteria. The patients had all been admitted to a metabolic unit where the mainstay of treatment was nursing care aimed at rapid restoration of body weight. A follow-up was conducted after a minimum lapse of four years after each patient's discharge from hospital. The outcome of the patient's illness was expressed in terms of an ‘average outcome score’ and a ‘general outcome’. The series included a relatively high proportion of patients with a long illness who had received previous psychiatric treatment. Their families tended to come from higher social classes; a disturbed relationship with the patient was frequent. Premorbid disturbances in personality development were also common. The immediate response to treatment was excellent, with the majority of the patients returning to a normal weight, but relapses after discharge were common and readmissions were necessary in half the patients. At follow-up, the patients fell into the following defined categories: ‘good’ (39%), ‘intermediate’ (27%), ‘poor’ (29%), died (5%). Most of the patients who failed to recover continued to display the clinical features characteristic of anorexia nervosa. Among predictors of an unfavourable outcome were found a relatively late age of onset, a longer duration of illness, previous admissions to psychiatric hospitals, a disturbed relationship between the patient and other members of the family, and premorbid personality difficulties. It is suggested that the long-term outcome found in a series will depend more on factors influencing patient referral according to the severity of their illness, rather than on the method of treatment itself. The illness may last several years before eventual improvement or recovery, and a follow-up study must be extended over at least four years to be meaningful. An accurate prediction of eventual outcome is almost impossible, but late recoveries justify an optimistic outlook and continued therapeutic endeavour.

A study of 120 inpatients diagnosed as suffering from hysteria is presented and the validity of the diagnosis questioned. Clinical study showed that 13% showed only hysterical symptoms, 33% showed hysterical symptoms occurring with affective symptoms, 28% showed affective symptomatology only, and the remainder were either of other or uncertain diagnostic grouping. It is concluded that the 13% are suffering from a condition that can only be diagnosed as hysteria.

Some problems of prognosis in patients with head injury are reviewed, and a case of late and unexpected recovery from post-traumatic dementia presented. The possible mechanism of recovery is discussed with particular reference to normal pressure hydrocephalus.

A review of the literature relating to multiple personality is presented together with a study of a single case of hysterical aetiology that demonstrates the development of multiple personality from a fugue amnesic state. A re-examination of this case after 15 years without significant psychotherapeutic intervention demonstrates a tendency towards remission. The view that multiple personality is a form of fugue, not necessarily hysterical, in which an alternative personality is adopted and that this behaviour is reinforced by the attention that it receives, is discussed.

A study was designed to assess the therapeutic value of attaching a social worker to a metropolitan group practice in the management of chronic neurotic illness. The psychiatric and social status of a group of patients before treatment and after one year was compared with the status of a control group treated more conventionally over the same period. The results indicate that the experimental service conferred some benefit on the patient population.

From a series of 255 patients who had undergone temporal lobectomy for the relief of intractable psychomotor epilepsy, all 47 patients with ‘alien tissue’ (small tumours, hamartomas, focal dysplasia) in the resected temporal lobe were contrasted with a group of 41 patients who showed mesial temporal sclerosis in their resected lobe. Five per cent of the mesial temporal sclerosis group and 23% of the alien tissue group were psychotic. A marked interaction occurred between psychosis and ‘left handedness’. In the alien tissue group, females, especially left-handed females, were the most likely to have developed a schizophrenia-like psychosis.

A study of the neuropathology of the superior olivary nucleus and its relationship to schizophrenia or auditory hallucinations was undertaken. No relationship was found to exist between them, but atrophy of the superior olivary nucleus was found in all the patients who had presented with seizures during life. The aetiology of superior olivary atrophy is discussed.