The opportunity to conduct a prevalence study of psychiatric disorder among young adolescents arose because a Family and Community Project had been established in Blackburn and the neighbouring town of Accrington. This Project, which is under the direction of Dr. G. Rose, aims to study the causes and possible methods of prevention of delinquency. As part of the survey, the secondary school population had been screened by means of questionnaires given to parents, teachers, and the children themselves, and this provided the starting point for the study described here.

One of the most important contributions of child psychiatry to the general raising of standards of child care has been the identification of various abnormal life experiences which appear to be harmful to healthy emotional development. Two outstanding contributions, the descriptions of ‘institutionalization’ (Goldfarb, 1944; Bender and Yarnell, 1941) and ‘maternal deprivation’ (Bowlby, 1951) have had considerable impact on the organization of children's homes and the setting up of services designed to prevent family breakdown.

Recent reviews dealing with psychiatry in sub-Saharan Africa have stressed the overall similarity in the incidence of psychiatric conditions and their diagnostic distribution to those seen in other parts of the world (German, 1972; Giel and Van Luijk, 1969; German and Arya, 1969). All authors emphasize, however, that some clinical pictures seen in Africa, such as those of depression and anxiety states, vary from the manifestations one encounters in European and North American patients.

It has repeatedly been demonstrated that hyperactive children improve in behaviour and school functioning when treated with amphetamine, methylphenidate and, according to recent studies, imipramine (Conners, 1972). While these drugs affect catecholamine and indoleamine metabolism, there have been few studies intercorrelating the clinical and biochemical effects of these agents. A small number of untreated hyperactive children have been found to have normal urinary catecholamine and indoleamine excretion (Rapoport et al., 1970; Wender, 1971) although whole blood hydroxyindole concentrations have been reported as reduced (Coleman, 1971). In the present study, platelet serotonin content was examined before and during treatment with methylphenidate and imipramine of a group of boys with the hyperactivity syndrome.

Many theoretical accounts of the affective disorders, in particular those by writers of the psychodynamic schools, have emphasized the central role of hostility and aggression. However, there have been very few objective studies of the expression of aggression in patients with affective disorders. Of these, two have used the Hostility and Direction of Hostility Questionnaire (HDHQ,) of Foulds (Foulds et al., 1960; Foulds, 1965). Mayo (1967) tested 24 depressed patients before and after treatment and found a significant decrease after recovery, both in their level of general punitiveness and in their level of intropunitiveness. The psychotically depressed patients scored significantly higher than the neurotic depressives. Philip (1971) tested depressed women, and found that extra-punitiveness did not change over time, but that improved patients were less intropunitive than those who showed no improvement. No studies have reported the hostility pattern of manic patients.

Disturbance of attention has been frequently suggested as one of the mechanisms underlying schizophrenic thought disorder (Weckowicz and Blewett, 1959; Chapman, 1961; Payne, 1966). Much effort has, therefore, been directed toward studying this variable in schizophrenia (McGhie, 1971; Neale and Cromwell, 1972). The approach undertaken has been determined by the psychophysiological and theoretical constructs presumed to be involved. To enumerate a few, disordered attention has been studied with indices of arousal (Venables, 1960; Venables and Wing, 1962), vigilance tasks (Mackworth, 1970), reaction time (Shakow, 1962), size constancy (Weckowicz and Blewett, 1959; Silverman, 1964a), tachistoscopic detection (Kornetsky, 1972), the WAIS Digit Span subtest (Blum et al., 1969), and immediate recall (McGhie et al., 1965). The lack of correspondence between these various procedures has become increasingly apparent (Neale and Cromwell, 1972). In one recent study, for example, the intercorrelations of five purported measures of attention ranged from –.23 to +.31 (Kopfstein and Neale, 1972).

This study concerns the scores on a questionnaire measure of ‘Psychoticism’ of patients with a diagnosed psychotic illness.

Eysenck (1952) postulated the existence of three main dimensions of personality—Extra-version, Neuroticism and Psychoticism. The label ‘Psychoticism’ as used to suggest the hypothesis: ‘that there exists a set of correlated behaviour variables indicative of predisposition to psychoticbreakdown, demonstrableas a continuous variable in the normal population and independent of E and N (Eysenck and Eysenck, 1968a). Psychotically ill patients are held to mark the extreme end of this dimension.

Beginning with the hypothesis that ‘there exists a set of correlated behaviour variables indicative of predisposition to psychotic breakdown, demonstrable as a continuous variable in the normal propulation, and independent of E and N’ (H. Eysenck and S. Eysenck, 1968), the Eysencks have been concerned to develop a questionnaire scale to measure such a variable. From an initial pool of potential items, hypothesized to be related to psychoticism, several factor analyses of adult responses have been conducted to obtain a small group of items measuring a factor orthogonal to the factors of neuroticism and extraversion, and these items have been called the Psychoticism or P Scale (H. Eysenck and S. Eysenck, 1968; S. Eysenck and H. Eysenck, 1968; S. Eysenck and H. Eysenck, 1972). The same arguments have been applied to children, and a similar set of items have been assembled to measure this variable (H. Eysenck and S. Eysenck, 1971; H. Eysenck, G. Easting and S. Eysenck, 1971; S. Eysenck and H. Eysenck, 1969).

For some years we have monitored a steady increase in the rates for parasuicide (attempted suicide) in Edinburgh (Aitken et al., 1969; Kreitman, 1972). Some changes in the character of the group have been demonstrated; in particular, the proportion of young people admitted has increased. The proportion readmitted within 12 months has, however, remained constant at around 15 per cent. Identification of potential repeaters is dependent on the group possessing characteristics which remain consistent over time. In this paper the characteristics of both repeaters and non-repeaters are compared over a three-year period, and stable predictors of repetition are identified. An earlier study (Buglass and McCulloch, 1970) suggested that prediction of repetition was best considered separately for each sex. This question is reconsidered in the light of new data. Thirdly, the interaction between the type of disposal recommended after the parasuicidal episode and subsequent repetition is examined.

This paper describes the distribution of female attempted suicide and other psychiatric admissions to the twenty-bedded Psychiatric Unit of Trinidad and Tobago (population about 1 million). Reports from this area have hitherto been concerned with the socio-cultural but not the clinical aspects (McCandless, 1968; Roberts and Russell, 1969) of psychiatric disorders.

A substantial part of Freud's (1925, orig. 1905; 1926, orig. 1922) theorizing on the causes of male homosexuality was the assumption of a fear of the female genitals, and according to Radó (1969) “fear of the genitals of the opposite sex is the basic dynamic of the individual who wants a sexual relationship with a member of the same sex”. Radó's stress on the phobic component in the causation of male homosexuality is shared by many theorists and practising clinicians.

The current status of the psychotherapy of obsessive-compulsive conditions is somewhat confusing. For many years the condition has been regarded as resistant to psychotherapeutic intervention, but recently some success has been claimed by both behaviour therapists (for example Boulougouris et al., 1971; Rackensperger and Feinberg, 1972) and psychodynamic therapists (for example Barnett, 1972; Suess, 1972). The confusion arises because despite the plethora of published work we seem little closer to an understanding of why the techniques have worked.

Despite the popularity of the Beck Depression Inventory (Beck et al., 1961), only Salkind (1969) has attempted to validate this instrument for a general practice population. For some purposes, particularly clinical research, measurement of change in a depressive mood is more important than an absolute measure. So far only Little and McPhail (1973) have considered this aspect of use.

Several surveys (Carstairs and Bruhn, 1962; Shepherd et al., 1966; and Johnson, 1973a) have demonstrated that the treatment of psychiatric disorders in general practice consists principally of prescribing drugs, with relatively little use of social agencies and psychotherapy. Although Shepherd et al. (1966) comment that the treatment is often haphazard and inadequate, the published surveys of general practice give little specific information about the prescribing habits of doctors. The present author surveyed the prescribing habits of general practitioners in the treatment of depression in the belief that it is necessary to have this information in order to evaluate the need for education in this clinical expertise, and also to act as a comparison for other surveys which will undoubtedly be carried out in the future to test the effectiveness of the current expansion of undergraduate teaching in psychiatry.

The Tunbridge Report on Rehabilitation (1972, para 71) comments on ‘the paucity of research on the requirements of rehabilitation and the evaluation of rehabilitative treatment and techniques.’ An unusual way of evaluating the effectiveness of rehabilitation is to study its cost.

Previous studies have shown that in-patients in psychiatric hospitals may not always take prescribed drugs reliably (Hare and Wilcox, 1967; Wilson and Enoch, 1967; Irwin et al., 1971).

These studies were carried out in Park Prewett Hospital (1,400 beds) which serves most of northern Hampshire, a population of just over 300,000 people. Our aim was to describe in some detail the gross features of this hospital population. Three descriptive techniques were employed.