This paper presents a study of patients' social and domestic functioning preceding admission to a psychiatric hospital. A method is described for the quantitative assessment of ‘social breakdown’ in the areas of work, domestic performance and social group activity, based on reports from the patient and from another household member. Complementary changes in the domestic tasks carried out by other family members are also investigated. The sample consisted of 28 women and 17 men. Their usual level of functioning and their degree of breakdown are related to psychiatric diagnosis on admission, to the patient's position within the family and to the social class of the household. Discrepancies between reports are also investigated in relation to these variables.

The effect of attitudes of therapists, patients and researchers on the conduct and outcome of combined drug and psychotherapy research was examined in a brief crisis-oriented psychotherapy clinic. Seventy-seven consecutive patients were given one of two anti-anxiety drugs or a placebo in conjunction with the typical psychoanalytically-oriented treatment used in the clinic. The therapists' attitudes favouring psychotherapy over drug therapy (and psychotherapy research) were clearly conveyed to the patients. Indicative of this are the following: (a) 82 per cent of the patients dropped out of drug taking, although a similar percentage remained in treatment; (b) only a third of the patients perceived it as being important to their therapists that they should take medication; (c) 87 per cent of the patients were rated as improved; and 75 per cent of patients completing forms considered that most or all of their improvement was attributable to talking.

The research team, made up of members of the same department who therefore had similar values as the therapists, diligently collected outcome data, but ignored its responsibility to enforce drug-related portions of the protocol. Overall, patients remained in therapy, improved and participated in completing forms, so that only the research goals of combined therapy were thwarted, while traditional clinic service and training goals proceeded as usual.

Twenty-six psychotic children were examined by means of psychological tests and EEGs. The parents of these patients were also tested with the EPI and the Grid Test of Thought Disorder. The mothers of children with the symptom of autism tended to have some cognitive disorganization, which was less common in the mothers of children without the symptom. The extraversion and neuroticism scores of all parents were not markedly different from population statistics.

The incidence of EEG abnormality in the children was high and not related to diagnosis or other criteria.

These findings are interpreted as providing suggestive evidence for a two-factor theory of childhood psychosis. It is postulated that a neurological disorder is a necessary condition for the development of such a disorder; and that a second process related to parental characteristics is also involved, which has the effect of determining the particular symptomatic manifestations seen in the psychotic child.

A survey was made of all female admissions to the State Hospital, Carstairs, between the time of the first female admissions in 1959, and 31 December 1973. There were 66 female admissions, constituting 7·1 per cent of the total admissions over the same period. The females fall into two separate sub-groups. The first consists of persistently violent patients transferred from other hospitals, suffering from mental subnormality or personality disorder; they have a poorer prognosis than the second group, who are sent from Courts or prison because of single serious acts of violence often directed at a member of the family, and who suffer from a personality disorder or from schizophrenia. Some features of the two groups are compared and contrasted. There may be an increase in the proportion of patients in the first group being admitted to the State Hospital, and some implications of this trend are discussed.

Personality profiles of 79 non-psychotic male offenders admitted to a security hospital were subjected to a cluster analysis. Four profile types were generated, classifying four-fifths of the sample, and differences were found between the types in previous antisocial behaviour. Two of the types were identifiable as primary and secondary psychopaths, while the remaining two showed little resemblance to the concept of the psychopathic personality. The primary psychopaths were extraverted but not neurotic, while the secondary psychopaths were neurotic, but not extraverted. Both were highly impulsive but distinguished by a dimension of sociability-withdrawal.

In a minority of persons interviewed for the purposes of a court report it will be found impossible to determine retrospectively their intention at the material time with any exactness. This in itself is an indication of an abnormal mental state when the alleged crime was committed, irrespective of Bow the accused may appear when interviewed later. As well as issues arising under the McNaughton Rules or Diminished Responsibility to which intention is relevant, many offences require a specific intention to be proved so that the reporting psychiatrist should enquire into the accused's intention when preparing a court report.

Previous reviews of hysteria have emphasized the most severe and disabling forms and ignored evidence from a wide variety of sources. It is argued that hysteria is more prevalent in medical settings than is usually recognized, that the same psychological mechanisms are of wide occurrence, often being accepted as normal for the culture. Discussion of the social factors affecting prevalence suggests that there is a universal potential for the hysterical reaction, with individual variation in susceptibility in appropriate circumstances.

Two similar groups of adult psychiatric patients carrying the diagnosis of anxiety neurosis were compared in their response to different methods of training in deep muscle relaxation. One group received EMG feedback and the other a modification of the Jacobson Progressive Relaxation method. The frontalis muscle was chosen as the target for feedback training and for the measurement of tension reduction in both groups, for the reason that this muscle has been shown to reflect the general muscle tension level in anxious patients. Training was carried out under controlled laboratory conditions, and objective muscle tension levels were obtained. Overall changes in the status of the anxiety symptoms, as determined by global ratings from patients and from primary therapists, were also compared in the two groups at the end of training. The results of the study indicated that both EMG feedback and the progressive muscle relaxation training produced significant reductions in frontalis tension levels. However, EMG feedback was found to be generally superior in producing larger reductions in muscle activity, with a concomitant relief in anxiety symptoms, for a greater number of the patients.

The claim of Hansen (1969) and Hansen and Dimitrakoudi (1974) that whole blood adenosine triphosphate (ATP) levels correlate with depressed affect was examined. The findings from 84 patients failed to confirm any relationship between mood and whole blood ATP. One patient showing the highest correlation (r = 0·85; p < 0.001) between the ATP levels and mood in the original report was re-examined; no relationship was now found (r = −0·25; p > 0·1).

Thirty years ago it was suggested that the apparently higher incidence of manic-depressive illness in women might be due to X-linked heredity. The hypothesis was undermined by subsequent reports of the frequent occurrence of father to son transmission. Winokur and his associates recently revived it, providing data which indicated that such transmission is absent or rare in the bipolar form of the illness. Additional support has come from linkage studies with known genetic markers located on the X chromosome. The present study, based on the 400 parents of 100 male and 100 female bipolar manic-depressive probands, failed to discover a lack of father-son compared to other affected parent-child pairs. This finding, together with a review of the literature, would indicate that it is premature to invoke X-linked heredity as a general explanation for bipolar manic-depressive illness, though there is mounting evidence that it may account for the illness in some family pedigrees.

This paper represents part of an investigation designed to establish the validity of the Clifton Assessment Scale (a brief psychogeriatric assessment procedure) and the Stockton Geriatric Rating Schedule. One hundred consecutive admissions over the age of 60 were assessed soon after admission to the acute wards of a psychiatric hospital. The results indicated a close relationship between the scores and psychiatric diagnoses. Outcome was differentiated in terms of discharge home or of transfer to psychogeriatric and to other non-psychogeriatric wards, and significant differences were obtained between groups. The assessment procedure had predictive validity comparable with other reported procedures, with the advantages of brevity and test acceptability for an elderly population.

Previous studies have shown varying rates of discrepancy in drug administration in psychiatric hospitals, and the present survey attempted to elucidate this problem further, using two methods of investigation simultaneously.

Two wards in a psychiatric hospital and one ward in a mental subnormality hospital were studied. Urine specimens were tested for psychotropic drugs, and ward drug rounds were observed to detect discrepancies in administration.

Of the 266 instances of drug administration tested for in urine specimens, prescribed drugs were not detected in 7·9 per cent of cases and non-prescribed drugs were found in another 29 instances. Observation was made of 3,689 instances of drug administration, and in 1·7 per cent of these the drug was not given or taken as prescribed, whereas no instances of ingestion of non-prescribed drugs were observed. The reasons for the discrepancies and the different results obtained by the two methods are discussed.

The training experiences of 35 academic psychiatrists first appointed in the years 1966–72, obtained by a postal questionnaire, are reported and compared with those of N.H.S. consultant psychiatrists appointed in the same period. The academic group reported less satisfactory training in a number of important areas, including psychogeriatrics and work in the community. Academics also differ from consultants in their fathers' socio-economic status and educational background.