Psychotherapy and the changes it produces can be understood in terms of simple basic essentials. Intensive and longstanding clinical experience demonstrates its therapeutic potency. Those factors in the therapist which are most important in leading to change are described. The significance of the therapeutic relationship is discussed, as well as the necessity of its candid and intensive examination during the therapy, if marked change is to occur. What is not psychotherapy is also explored.

The development and definition of four contrasting interview styles is described. The four styles were designed using different permutations of techniques which, on the basis of an earlier naturalistic study, appeared to be most effective in eliciting either factual information or feelings. A ‘sounding board’ style utilized a minimal activity approach; an ‘active psychotherapy’ style actively sought to explore feelings and to bring out emotional links and meanings; a ‘structured’ style adopted an active cross-questioning approach; and a ‘systematic exploratory’ style aimed to combine a high use of both fact-oriented and feeling-oriented techniques. Quantitative measures based on video-tape and audio-tape analysis showed that two experienced interviewers could be trained to adopt these four very different styles and yet remain feeling and appearing natural. An experimental design to compare the four styles is described.

The Munchausen syndrome was first described by a physician (Asher, 1951), the classical criteria being exaggerated symptoms, factitious physical signs, and the tendency to wander between hospitals (Bursten, 1965).

Dextroamphetamine (0.15 mg/kg) intravenously administered to a group of normal postmenopausal women induced a dysphoric reaction with drowsiness, annoyance, sadness and anger. Young normal men, receiving the same dosage, responded with elation of mood and alertness. It is suggested that age and hypoestrogenism may alter the behavioural response to amphetamine.

A simple and portable ultrasound system, using a transducer attached to a pair of spectacles, to measure disorders of facial movement is described and applied to the measurement of tardive dyskinesia. Product-moment coefficients of correlation for the split-half and test-retest assessments of reliability in 20 patients were 0.96 and 0.93 respectively. Concurrent validity was confirmed by assessing the consistency between ultrasound scores and time-sampled scores based on video films (Pearson r = 0.86). Serial measurements of tardive dyskinesia over five months revealed striking individual consistency.

Averaged evoked potentials were recorded from a group of obsessional patients and matched normal controls for three types of visual stimulation: passive monitoring of a light flash, a pattern consisting of gratings and a cognitive task involving discrimination of two similar shapes. As the complexity of information processing required by the tasks increased, differences in the evoked potentials of obsessionals became more marked. The main finding was of faster latency and reduced amplitude of the component in the cognitive task. The relevance of this finding to a theory of obsessional disorder is discussed.

Electromyograms (EMGs) from the corrugator, zygomatic and splenius capitis muscle sites and Beck depression inventory scores were obtained from 21 depressed in-patients shortly after admission and after two weeks in hospital. Contrary to the result of a previous study by other investigators, significant covariation between depressive symptoms and corrugator EMG levels was not seen. However, consistent with a second finding of the previous study, initial corrugator EMG levels were shown to be significantly predictive of treatment outcome. Further, initial EMG from the zygomatic was also found to predict changes in depression. The explanation is unclear and further research is needed.

A double-blind comparison between benzodiazepines and neuroleptics was carried out for 1 ½ years on 30 schizophrenics who had hitherto continuously received neuroleptics and remained apparently in full remission for at least 3–5 years. The benzodiazepine-group had a significantly higher relapse rate than the neuroleptic-group, meaning that we cannot stop neuroleptics for these patients yet. Three possible reasons for this are (1) demand of the natural course of the illness, (2) the fact that the patients agreed to stay in therapy for so long may signify a need for therapy, (3) some of the relapses on stopping neuroleptics may be ‘withdrawal psychosis' after prolonged neuroleptic therapy. If withdrawal of neuroleptics is really needed, however, it may be considered for a subgroup of female patients whose illness started after the age of 40.

Delusions of altered personal identity were studied over a four-year period in 53 young schizophrenic in-patients divided into 13 with persistent delusions, 16 with fleeting delusions and 24 with no delusions of identity alteration at first examination. The three groups were clinically otherwise comparable. Follow-up showed that those with persistent delusions of altered identity had a poor prognosis and deteriorating course.

HLA antigens were typed among 136 Japanese schizophrenics. Increased frequencies were seen in A9 (Aw24), A10 (A26) and Bw54, and decreased frequency in B40 antigens when compared to 187 Japanese controls. It is suggested that there may be an association between A9 (Aw24) and schizophrenia with a chronic-progressive course and also an association between A10 (A26) and hebephrenia.

Eleven schizophrenic and three manic patients were randomly administered 0.3 mg/Kg b.wt. of naloxone or placebo in a drug-free state using a double blind procedure. BPRS and CGI were employed for making periodic assessment of mental status; the MRS was additionally used for manic patients. The authors discuss their findings, which are essentially negative.

The prevalence of emotional disorder in a total of 72 patients suffering from myasthenia gravis or from peripheral neuromuscular disorders was assessed, using the General Health Questionnaire and Present State Examination.

Approximately half the patients were being treated with an alternate day regime of prednisone, receiving high dosage one day and low the next. Emotional disorder was found to be less prevalent among these patients than among patients not on steroids. The significance of the finding is discussed.

The initial period of enthusiasm for the surgical treatment of certain psychiatric illnesses, has later given way to increasing rejection of this mode of therapy. But more recently there has been a reappraisal of the therapeutic possibilities of the modern refined operations, which are now receiving more objective assessment.