Homicide is a universal phenomenon which occurs both among developed and developing communities, but to a varying extent. Homicide in this context does not include the lawful killing of criminals convicted of capital offence, or killing in war or in conditions of political strife. Considerable work has been done on various aspects of criminal homicide in many countries—Verkko (1951) in Finland, Jacqueline H. and Murray A. Strauss (1953) in Ceylon, Wolfgang (1958) in the United States. The book African Homicide and Suicide edited by Paul Bohanan (1960) contains only a chapter on homicide among the Tivs of Central Nigeria, and this is based on a retrospective study of case files. Lambo (1962) reported twenty-nine cases which he had interviewed for the courts; these came from the whole of Nigeria, and therefore represent different peoples and cultures.

There are only four studies which deal exclusively with the electroencephalographic investigation of murderers (Stafford-Clark and Taylor, 1949; Hill and Pond, 1952; Mundy-Castle, 1955; Winkler and Kove, 1962). In several other reports, murderers are included as a sub-group of a population described as psychopaths and criminal offenders (e.g. Silverman, 1943, 1944). The general finding of these studies was that the murderer population had an incidence of EEG abnormality far above that found in non-criminal, non-psychiatrically ill subjects. However, the range of incidence of abnormality was large, being from around 20 per cent to 80 per cent. Despite the complex psychopathology commonly leading to an act of murder, it has been not uncommon to conclude, from the finding that the populations studied had a high incidence of epilepsy, that there was some association between epilepsy and murder. Alström (1950), however, in a study of 897 epileptics, found that no patient had committed a crime during psychomotor seizure. The Jack Ruby Trial in America highlighted the assumed association and Livingston (1964) summarized the true situation: ‘… an epileptic might kill, not because he has epilepsy, but because he is a human being …’.

Section 54 of the Mental Health (Scotland) Act, 1960, enables a court to remand to hospital for psychiatric examination and report persons charged with an offence who also appear to be mentally disordered. This article reviews this section of the Act in its practical aspects as experienced by the consultant staff of one Scottish mental hospital during the two-year period 1965–6.

The following review deals with all persons remanded for trial or sentence in 1965 and 1966 on whom psychiatric reports were furnished by senior psychiatric staff of Leverndale Hospital, excluding those remanded directly to hospital under Section 54 of the Mental Health (Scotland) Act, 1960, this latter group having been the subject of a previous article by ourselves.

The ordinary process of specialist examination of individuals on remand involves among other things the making of judgments of several kinds. Among these judgments are those as to normality, subnormality, abnormality, and types of abnormality. For some, such as the establishment of subnormality, there are technical aids, e.g. standard tests of IQ. For others, available aids are often inadequately standardized, inordinately time-consuming, or subject to other critical objections, e.g. as to their appropriateness. This may leave the specialist clinical observer dependent solely on his clinical acumen over a considerable area. This may not matter as regards the outcome in final judgments made, but may make the process unduly burdensome and lengthy.

In the Republic of Ireland hospital services are available without charge to persons on the General Medical Services Register. Eligibility for registration is decided by an individual means test and is reserved for those ‘unable to provide by their own industry or other lawful means the medical or surgical treatment or medicines or medical or surgical appliances necessary for themselves or their dependants'. These amount to some 30 per cent of the total population.

Referrals for psychiatric specialist treatment under the National Health Service have increased steadily in numbers, until the annual rate for new patients in England and Wales now stands at over 200,000 (Ministry of Health, 1965). The trend has led some critical observers to conclude that, in the words of one of their number, “Partly because it has oversold itself psychiatry has become oversubscribed” (Kessel, 1963). This is a serious charge, but in the absence of proper evaluative studies it must be judged non proven.

Some investigations suggest that the attitude of a psychiatrist to therapy with drugs may affect his patient's response to treatment (Sheard, 1963; Reynolds, Joyce, Swift, Tooley and Weatherall, 1965), though the evidence is far from conclusive and earlier findings have not always been confirmed by further research (Hordern and Hamilton, 1963; Uhlenhuth and Park, 1964). The possibility that a particular drug may be more effective if administered by a physician who believes it to be superior to alternative drugs appears to have received little attention. Such preferences exist in medical practice. The present study was undertaken to test the hypothesis that they have a measurable effect, provided the drug is administered knowingly. The efficacy of the drug of choice of three psychiatrists was therefore compared (a) under single blind and double blind conditions, and (b) with that of alternative medication.

The association of mental disorders with reduced thyroid function has been recognized for many years, the thyroid disturbances concerned falling into two distinct categories. The first involves a gradual reduction in the output of thyroid hormone over a period of months, or years due, for example, to Hashimoto's disease. Clinically recognizable myxoedema may eventually appear, and in some cases—one-third of Jellinek's (1962) series—it is associated with mental disorders of almost any type and degree (Akelaitis, 1936; Asher, 1949). Two reports (Logothetis, 1963; Pomeranze and King, 1966) make it clear that major mental illness, often clinically indistinguishable from what might be called the normal run of schizophrenias, affective disorders and dementias, can be caused by hypothyroidism even before any clinical evidence of thyroid disorder appears.

This paper examines the degree of electroencephalogram abnormality among the three phases of manic-depressive disease and the changes brought about by lithium carbonate. The earlier investigators (Berger, 1931; Lemere, 1936) reported no abnormalities in the EEGs of manic-depressive patients. Later workers (Davis, 1941; Hurst et al., 1954; Hes, 1960) found prominent changes between the two phases. However, Harding et al. (1966) noted no common pattern in their three cases when analysed for mean abundance, harmonic mean and variability of alpha rhythm.

There is ample evidence that placebo can cause most, if not all, of the effects due to any active drug (Beecher, 1962; Honigfeld, 1964). A detailed case history of apparent dependence on a placebo can be added to these, in the form of the following clinical experience.

Chlormethiazole (Heminevrin) is a sedative and anticonvulsant that has been reported by Glatt et al. (1965) to be more effective than placebo for the alcohol abstinence syndrome. The present study was designed to compare the substance with trifluoperazine (Stelazine).

In conjunction with a longitudinal study of ageing twins (Jarvik, 1967) the opportunity arose to examine the postulated relationship between increasing aneuploidy and age (Jacobs et al., 1961, Hamerton et al. 1965, Court Brown et al., 1966). Chromosome analyses have been completed for 59 subjects, ranging in age from 77 to 93 years with a mean age of 84.5 years for the 23 men and 84.6 years for the 36 women.

The most appropriate time and way to inform parents of a diagnosis of mongolism is often discussed among physicians and others who have early contact with mongol children. Despite this, however, few attempts have been made to ascertain systematically the views of the parents themselves. We have had an opportunity to do this in the course of a clinical and cytogenetic investigation of mongolism. Information on the subject was obtained from 95 mothers of mongols, all of whom were personally interviewed by at least one of us during the past three years. Nearly all the parents were from north-west London and adjoining counties, and represented all social classes.

In an investigation of dermatological out-patient attenders, psychometric tests measuring marital patterns, hostility and personal illness were administered to 49 married patients aged under 60. Scores on these tests did not differ significantly between groups of cases classified according to the likelihood that psychosomatic factors were operative.

A continuing problem in the care of patients suffering with depression is the assessment of how depressed the patient is, and how the level of depression changes over time. In clinical practice the patient is used as his own control, but the psychiatric assessment often has to be made in ways prone to the errors of subjective assessment. The psychiatrist is interested in how the depressed patient views himself and the world around him, that is, in terms of Kelly Personal Construct Theory, what constructs the patient uses to structure areas of his life and where on these constructs the patient sees himself. Personal Construct Theory and the Repertory Grid Techniques provide a useful framework for idiographic estimates of change.

The predecessor to the Eysenck Personality Inventory (E.P.I.) (Eysenck and Eysenck, 1964) was the Maudsley Personality Inventory (Eysenck, 1959) which has won wide popularity, and evidence has been presented for its high retest reliability for a number of different populations and over periods of time ranging from 1–2½ years (Marley and Bartholomew, 1959; Knowles, 1960; Ojha, Kelvin and Lucas, 1966).

This study sampled the London area remand (under 21) population to try to ascertain the current incidence of amphetamine taking, for comparison with the earlier study by Scott and Willcox (1965) on a slightly younger group. In addition to laboratory analysis of urine samples collected during reception procedure at the Remand Centre, we also assembled some psychological test data, information as to current offence, and patients' reports as to their drug-taking habits, if any.