An investigation was undertaken into the first admissions to (for the years 1963, 1965, 1968, 1972) and the total discharges from (for the years 1963–72) Scottish mental hospitals and psychiatric units of male doctors and other social class I males. The overall rates for both first admission and for all discharges were more than twice as high among male doctors as among other social class I males. First admission and total discharge rates for drug dependence, alcoholism, neurotic and ‘functional’ depression and for affective psychosis were all significantly higher among doctors than non-doctors. Doctors were more likely than non-doctors to have been referred by themselves or by medical sources other than general practitioners, and were as willing as non-doctors to enter hospital voluntarily. Greater access to psychiatrists may have contributed to their higher rates of in-patient care, but it is improbable that such factors accounted for all of the excess in rates of drug dependence, alcoholism and depression.

A quotation from Edward Mapother can serve admirably as text for this address: ‘In practically all properly investigated cases of insanity, it is found that it is the result of a summation of multiple causes, effective in combination, though inadequate singly. It is this that renders all controversy between extremists of the physiogenic and psychogenic schools so futile’ (Lewis, 1969, p 1359). In the same year, 1922, in his Salmon Lecture, Adolf Meyer said: ‘The overmechanization of psychiatry … (has) led to too much reliance on chemistry and physiology as curealls in mental ills, while psychoanalysis, by laying too much emphasis on the subconscious and sex, has lost sight of the … functions of the conscious mind and has … disregarded the fact that man is subject to physical … biological … and social laws' (Meyer, 1922).

Mental retardation may be associated with a number of environmental factors such as undernutrition, lead poisoning or exposure to neuroactive drugs during a critical period of brain development. Possible biochemical mechanisms operating in these various conditions and in animal models are reviewed in relation to the vulnerable period hypothesis. Small brains are common in the mentally retarded, and this may be related to a developmental abnormality particularly at the level of the synapse.

The monthly number of births in Norway fluctuates between a maximum in January–May and a minimum in October–December. This cyclic seasonality is assumed to be of biological origin, but indirectly it is influenced by social factors and consequently tends to vary a great deal. There is a secondary birth maximum in September, corresponding to a peak of conceptions during the traditional festivities around Christmas and New Year. It is shown that this maximum is much less variable within the country studied, though it probably varies from one country to another in relation to the impact of the mid-winter traditions.

The January–May birth maximum is known to be higher in schizophrenia than in the general population, while no such difference is observed in Norway for the September birth peak. It is felt that there is a fundamental difference between the two birth maxima and a corresponding difference between schizophrenic patients and the general population. Minimal paranatal brain damage of seasonal origin is suggested as an explanation.

The responsibilities of a Consultant Psychiatrist are similar to those of other consultants within the National Health Service. The few differences arise from the special circumstances within the specialty, particularly relationships with other disciplines. The ability of Consultants to accept medical responsibility rests on their training, qualifications and statutory responsibility. Medical qualifications carry professional, ethical and legal responsibilities. These responsibilities are exercised towards and given by the public; are aimed at the cure or alleviation of human suffering; are independent of remuneration; and follow the medical practitioner wherever he may be, even within his private life.

Eight hundred psychiatric patients and eight hundred controls completed a handedness preference questionnaire. There was no significant difference in handedness between the two samples, but, contrary to some previous reports, excess of sinistrality was not associated with male sex. The distribution of handedness was similar in neurotics and controls, but among psychotics in general there was a higher proportion of fully right-handed subjects. Among schizophrenics there was a significantly higher proportion of left-handed writers among males than females. There were relatively few left-handed writers of either sex among patients with affective psychosis. Female patients with personality disorders had a significantly higher proportion of mixed handedness than controls. The findings are considered in relation to suggestions that functional psychoses may be associated with asymmetrical cerebral dysfunction, and that poorly lateralized function may be related to anomalous psychological development.

This article formulates a definition of the term dangerousness, indicates why the commission of dangerous offences cannot be reliably predicted, and then reviews the several factors which have been or might be used by those who have to make decisions about dangerousness in criminals. It suggests that these factors are useful insofar as they help to illuminate the individual's capacity to feel sympathy and to learn by experience. Since the accuracy of prediction varies inversely with time, the maintenance of personal relationships and good communication seems the inescapable requirement in the management of potentially dangerous criminals.

A study of the cases of 100 doctors admitted to The Retreat, York, confirmed the findings of a'Brook et al (1967) in all important respects, addiction being the outstanding feature of the series.

Earlier this year I was invited by the American Psychiatric Association to deliver a public lecture on the contributions of Sir Aubrey Lewis to psychiatry, with particular reference to his work in its historical perspective (Shepherd, 1977). By a happy chance the lecture in question is linked with the name of Adolf Meyer, an eponymous association which facilitated the exposition of the principal theme of my address. It was, I believe, Manfred Bleuler who first drew attention to the similarities between Adolf Meyer and Aubrey Lewis despite profound differences in their temperament and background (Bleuler, 1966). In retrospect it is now apparent that Lewis was Meyer's natural successor, both men standing out as the representative psychiatrist of his generation in the mainstream of psychiatry, each owing his pre-eminence as much to what he stood for as to what he achieved. This was the argument which I did my best to elaborate, drawing for the purpose on the sources and development of Sir Aubrey's ideas, on his manifold achievements and on the various legacies which he has bestowed to his own successors. And, since I was addressing a largely North American audience to whom he was a somewhat remote figure, I attempted to introduce my subject with a few words about the origins and character of the man himself.

It was only after much hesitation that I accepted your flattering invitation to contribute to this meeting in commemoration of Aubrey Lewis. On the one hand, I have the natural diffidence of a layman amongst experts. But as against this, although we were of the same generation, I cannot but be moved by a feeling akin to filial piety towards one whose work I so greatly admired, and to whom I am indebted for so many personal acts of kindness and generosity as I have been to Aubrey Lewis. I hope, therefore, that since the latter emotion has prevailed you will think it fitting that I should ask you to look back, from the standpoint of nearly a quarter of a century later, at the impressive paper on Health as a Social Concept which Aubrey Lewis read to the British Sociological Association in 1953.