Two repertory grids relating to body image and interpersonal relationships were administered to dysmorphophobic, psoriatic and control subjects. Both dysmorphophobics and psoriatics expressed dissatisfaction with their body image and, in addition, dysmorphophobics were dissatisfied with their interpersonal relationships. The dysmorphophobic group were also less happy with their self-concept than the other two groups.

Six schizophrenic patients treated with lithium and neuroleptics for at least two years had their lithium medication stopped. Two patients relapsed within two weeks, and four did not after one year of follow-up.

Possible psychiatric implications of impairment of the blood-brain barrier were studied in 25 patients with paranoid psychosis. Determination of the ratio between the albumin concentrations in cerebrospinal fluid and serum showed increases, indicating impairment of the blood-brain barrier, in seven patients and normal values in 18. The two groups were compared for clinical, pharmacokinetic, neurophysiological and anamnestic variables. The highly significant finding that onset of psychosis had occurred, on average, 20 years earlier in the patients with impairment of the blood-brain barrier than in those without suggests that such impairment might influence the development of psychosis in predisposed individuals.

Review of studies from the past 16 years employing quantitative measurement of memory functions before and after ECT revealed the following trends: impairment of non-verbal memory functions after less than five unilateral non-dominant ECTs; improvement of non-verbal memory functions after five or more unilateral non-dominant ECTs; no change or improvement of verbal memory functions with unilateral non-dominant ECT; consistent impairment of verbal functions with unilateral dominant ECT, and impairment of both verbal and nonverbal functions with bilateral ECT. The relative lack of impairment in memory functions with unilateral non-dominant ECT is consistent with the theory of asymmetrical hemispheric disorganization in affective disorders, and supports the choice of unilateral non-dominant ECT over bilateral or unilateral dominant ECT in the treatment of depression.

Suicide risks for psychiatric hospital in-patients may be described by empirical relationships that take account of sex, length of admission and diagnosis. Risks are highest in males, in the first week of admission, and in depressed patients. Hospital suicide rates do not follow the same pattern as those for the general population and it is suggested that this effect may be the result of current selection procedures. The standard mortality ratio, which compares hospital with general population suicides, has remained unchanged over fifty years.

A classificatory system for mental disorders in the elderly proposed by Roth in 1955 was examined in a comtemporary population. Ninety per cent of patients could be allocated to the five psychosyndromes originally defined. Examination of outcome in the present sample, at six months and two years, showed important differences. The outlook for patients with paranoid psychoses showed an improvement though for those with affective illness (at 2 years) there was little change. Of special importance was the increased long-term survival of very elderly female patients with senile dementia. This, in conjunction with the general rise in admissions for mental disorders in the aged over the past 25 years, has considerable implications for the future development of psychiatric services for the elderly mentally ill.

The pneumo-encephalographs and computerized axial tomography scans of fifty patients with severe affective disorder were studied. Measures of ventricular size were compared with those reported by other workers. Findings suggested that some patients suffering from severe affective illness showed abnormalities of brain structure as demonstrated by ventricular enlargement.

The quarter of birth of 536 schizophrenic, 1,991 neurotic and 12,085 psychiatrically normal twin pairs from the National Academy of Sciences-National Research Council Twin Registry was compared. When either all twin pairs, or only monozygotic or dizygotic twin pairs, were considered, no significant differences were found in the quarter of birth between the 3 groups. No difference in quarter of birth was found for twin pairs concordant versus discordant for schizophrenia. Despite the increased risk for intrauterine and perinatal complications in twin births, schizophrenic twins appear (at least) to be no more vulnerable than schizophrenic singletons to the seasonal gestation and birth-related insults which probably underlie the seasonality in schizophrenic births. Controlling for season of birth probably has little effect on the results of twin studies of schizophrenia.

The purpose of the study was to evaluate whether the mood of an alcoholic contributed to the impairment on intellectual tests. The Marke-Nyman Temperament Scale and the Beck Depression Inventory were administered to 37 male alcoholics. It was found that there were no significant differences in personality or mood between intellectually impaired and intellectually intact subjects.

The seasonal variation in suicides in Finland during the period 1961–1976 was examined using individual records from 16, 312 death certificates and time-series analysis. De-trended figures show that suicides are usually concentrated in early summer but a secondary rise in the late part of the year is noted, particularly in females, among those aged 15–24 years and in the highest and lowest (i.e. unknown) social classes. In modern occupations (technical, administrative, clerical, sales and service work) suicides usually occur in late autumn. It is suggested that the original seasonal peak in suicides lies in spring–summer, while the autumn peak is of later origin and typical of those living in a man-made environment.

Four healthy people on lithium for manic depressive liability relapsed within 14 days of the drug being secretly replaced by placebo. Their new manic attacks were at least as severe as any of their previous episodes.

A self-report Social Adjustment Scale (SAS-M) for use in British populations was devised by modifying the original North American version, and its usefulness was evaluated among 331 women drawn from two local populations. In a group of mothers of one year old babies (n = 130), high levels of agreement were found between the subjects' self-ratings on the SAS-M and (i) a psychiatrist's ratings of their social adjustment made at interview; (ii) ratings of the subjects' social adjustment made by their husbands on the SAS-M; (iii) measures of concurrent mental state. In a group of women undergoing elective sterilization (n = 201), the SAS-M was found to be sensitive to changes in mental state over time. Possible applications of the SAS-M in psychiatric research, particularly when an interview is not feasible, are discussed.

Tourette syndrome is a disorder of chronic multiple motor and vocal tics with an age of onset between 2 and 15 years. Clicks, grunts, barks, coughs and yelps are common vocal manifestations, while coprolalia eventually occurs in 60 per cent of cases (Shapiro et al, 1978). Nine years or more (Bruun and Shapiro, 1972) may pass between the onset of the disorder and its diagnosis. Although mental and mood changes are not an intrinsic part of the syndrome, suicide may occur secondary to the profound social disruption produced by the disorder.

The most relevant psychological and neuropsychophysiological effects induced by lithium in healthy volunteers or in patients during the free interval are changes of vigilance and possible changes in patients' personality. In EEG terms lithium acts as a “chopper” and induces left-hemispheric asymmetry. Interesting concepts for description of personality changes are the typus melancholicus of Tellenbach and the psychoanalytical view of depression. Effects in an individual patient are heterogeneous and cannot be predicted. Primary and secondary psychological effects may influence compliance, and a detailed analysis of compliance seems necessary.

A randomized controlled study of 38 catchment unit psychiatric in-patients in a discussion group showed no significant additional benefit compared with 36 in-patients in an activity group. Symptom change scored by three rating groups agreed closely, average r = +0.64. Patients treated with ECT showed 2.6 times as much reduction in morbidity as those not so treated, but there was still no appreciable difference between discussion and activity groups when this was allowed for. Other treatment factors and the Hawthorne effect appeared to obscure any effect due to group therapy.

A systematic study of 50 adolescent self-poisoners aged from 13 to 18 demonstrated considerable discrepancies between the reasons chosen by the subjects to explain the overdoses and those chosen by clinical assessors. Most adolescents indicated that they had been feeling lonely or unwanted, or angry with someone, and had taken the overdose to alleviate or demonstrate this distress. A third said they had wanted to die. In contrast, clinical assessors tended to attribute the overdose to punitive or manipulative reasons and suggested that only seven out of the 50 had wished to die.

The adolescents rarely indicated that they had taken the overdose to get help; this may explain the resistance that may be shown to psychiatric intervention, and casts doubt on the possible effectiveness of preventive agencies. Modification of attitudes to both self-poisoning and early help-seeking may be a more effective means of prevention.

Survivors from a group of 40 carefully evaluated subjects with senile dementia who had been scanned over two years previously were followed-up, re-scanned and given simple cognitive tests. Of the 12 survivors, 10 agreed to participate. These fell into two sub-groups: one who showed further deterioration in cognitive function and one who did not. The first sub-group showed an increase in ventricle-brain ratio while the second did not. Although the numbers were too small for clear statistical differences to emerge, there was a tendency for affective admixture to be a favourable prognostic indicator and low radiological attenuation density particularly in the right parietal region to be an unfavourable one.

The Hamilton Anxiety Scale (HAS) was administered to 51 patients with anxiety neurosis along with an independent criterion of severity. Each item from the HAS was significantly correlated with severity, and those items with the highest correlations were combined to form new anxiety scales. These scales were then used on a new group of 27 patients suffering from anxiety neurosis. All the new scales had better correlations with severity than the full HAS. The six-item scale was selected as being the most suitable to be a new Clinical Anxiety Scale.

An unselected series of 100 psychiatric in-patients was independently diagnosed by two clinicians using the PSE and by two computer diagnostic systems: CATEGO based on PSE items and DiaSiKa based on AMDP items. The computer programs are compared with respect to their diagnostic agreement with the clinical diagnoses.

Enema abuse is a pernicious disorder, not extensively reported in the psychiatric literature. It may occur as an isolated paraphilia, klismaphilia (Denko, 1973, 1976), or as a symptom reflecting more pervasive illness or abnormality of attitude (Engel, 1975; Greenberg-Englander and Levine, 1981). Our patient had been using enemata excessively for sixteen years and presented in a state of cachexia; she had both obsessive-compulsive and affective symptoms, both frequently found in association with anorexia nervosa (Snaith, 1981).