In 1961, in collaboration with Dr D. Lindsay Walker, who supplied much information concerning the Association's birthplace, the Gloucester Asylum, I published in the Journal (1961) a detailed account of the origins of the Medico-Psychological Association, or rather of the ‘Association of Medical Officers of Asylums and Hospitals for the Insane’, as it was called for the first 24 years of its existence. This account ended with the 1854 Annual Meeting, the first to be reported in the Association's Journal. I now propose to cover a further instalment of its history.

Platelet and plasma amine oxidase activity was determined in a group of 99 healthy male (active duty military) alcoholics referred for hospital treatment who had been abstinent from alcohol for 2–10 days, and compared with that of a control military group. Platelet MAO activity was slightly but significantly lower in the alcoholic group. Both groups were significantly lower in MAO activity compared to a group of 42 non-military controls. In the alcoholic group there was no correlation between platelet MAO and severity or chronicity of drinking, nor was there evidence of iron deficiency to account for the lowered MAO activity. When the alcoholic and military control groups were split at the median, the first degree relatives of both the ‘low’ MAO alcoholics and the ‘low’ MAO military controls had a higher incidence of alcoholism than did the relatives of both ‘high’ MAO subgroups. No personal or family history data of alcohol-related problems were available on the non-military control group.

A double-blind placebo-controlled trial of L-tryptophan, with pyridoxine and ascorbic acid, was carried out in 10 female patients suffering from mania.

In contrast to earlier studies led by Prange and Murphy, L-tryptophan was found to be no better than placebo.

Nine depressed patients received ECT to the dominant (left) side along with nine matched depressed patients who received ECT to the non-dominant (right) side. Neuropsychological tests showed that the right hemispheric functions were more frequently abnormal as compared to left hemispheric (dominant) functions in the pre-ECT tests. ECTs delivered to either the right or left side improved right hemispheric functions when the depression was ameliorated. This study indicates that in depression right hemispheric functions are initially disturbed and ECT, instead of being deleterious to these functions, tends to improve them.

This study examines the mental health of 187 patients who had a rhinoplasty fifteen years earlier. Of 101 who had the operation following disease or injury 9 are now severely neurotic and one schizophrenic; of 86 who had the operation for aesthetic reasons 32 are now severely neurotic and 6 schizophrenic. The differences between the two groups are significant, and show that dysmorphophobia is an ominous symptom.

Ninety-two schizophrenic patients of both sexes admitted to hospital at Taif, Saudi Arabia were examined to discover the incidence of Schneider's first-rank symptoms and their usefulness in diagnosing schizophrenia in this country. Fifty-two patients (56.5 per cent) were found to have these symptoms, most frequently ‘made’ phenomena and ‘somatic passivity’. The role of possible socio-cultural factors and the need for serious studies on transcultural psychiatry are discussed.

There is growing evidence that early parent death can affect the severity of adult depressive illness. It was anticipated, therefore, that early-bereaved depressed patients might score higher on certain MMPI clinical scales than non-bereaved, depressed controls matched for age and sex. This is shown to be the case, the most affected scales being Hypochondriasis and Paranoia. Hypochondriasis is shown to be more strongly associated with early father death, while Paranoia is associated equally with mother and father death. There is some suggestion that early mother death is also associated with elevation of the F score. Early parent death is shown to have no effect upon the MMPI scores of non-depressed patients.

Forty patients took part in this study. Twenty patients treated by group desensitization were compared with twenty treated by individual desensitization. Group desensitization appeared the more effective treatment if outcome was measured on the patients' self-rating scale, but the less effective if outcome was measured by the sexual interest questionnaire. Of the two, the group method took longer to administer, but more patients treated in this way completed the course of treatment.

The account of mental processes emerging from the work of cognitive psychologists is briefly reviewed, and aspects of the theoretical basis of the work of psychoanalytic and behaviourist psychotherapists are considered in the light of this. It is argued that in both traditions increasing attention is being paid to cognitive processes. A restatement of psychoanalytic theory in cognitive terms could free it from its present confusion of metaphors, and an extension of behaviourist theory in this direction could free it from reductionism. The advantages of the adoption of a common language, based on the models of cognitive psychology, to theory, practice and research are briefly considered.

The problem of assessing outcome in psychotherapy is considered by examining the experiment conducted by Bloch et al (1977). The experimental design and statistical considerations in investigating psychotherapy outcome are briefly examined. It is argued that attention should be directed towards assessing the severity of patients problems rather than improvement after treatment.

Legal findings of unfitness to stand trial are returned ten times more frequently in Scotland than in England and Wales. Sixty-five patients in the State Hospital who had been found insane in bar of trial were compared with a control group of 64 offender patients. They showed a significantly greater incidence of homicidal crimes and diagnoses of psychotic disorders, 19 per cent of which later proved to be unstable. They had also been detained longer at the State Hospital. These findings are discussed and particular reference is made to the tendency for psychotic offenders to be almost automatically regarded as unfit to plead. A brief comparison is made with the situation in England, and some modifications in forensic psychiatric procedure are suggested.

The use for hallucinogenic purposes of an indigenous mushroom, Psilocybe semilanceata indigenous to Britain is reported in three patients. Typical psychedelic, transient psychotic and more prolonged schizophrenia-like states were seen, with sympathomimetic signs noted in two cases, in one being prolonged. Enquiry about such mushroom abuse should be considered in individuals presenting to medical or psychiatric emergency clinics.

On Tuesday 10 June 1975 G.M.B. was convicted at Bristol Crown Court of the murder of a young woman and sentenced to imprisonment for life.