It has been suggested that amnesic patients suffer a selective loss of episodic memory while semantic memory remains well preserved. To assess the validity of this idea we studied remote memory in an amnesic patient, (M.R.L.), using several different measures that differ in the extent which they engage episodic or semantic memory. On two different versions of the Albert et al. (1979) remote memory battery M.R.L. displayed severe retrograde amnesia (RA) extending backwards in time for about 15 years with excellent preservation of older memories. With standard recall instructions his overall performance on the Crovitz test of autobiographical memory was impaired and all of M.R.L.'s specific, temporally dated memories were given from the first half of life. When asked to reconstruct his past residential history in detail, M.R.L. provided specific and generally accurate information for residences occupied from his boyhood until 1970, but thereafter his memory became quite unreliable. On a test of knowledge of terms commonly employed the surveying profession, in which he worked for the past 20 years, M.R.L.'s performance was also impaired. The consistent pattern of RA displayed by this patient on all of the tests of remote memory indicates that both episodic and semantic memory are impaired in amnesia.

Bulimic and non-bulimic anorexics were compared on psychological variables during a hospital treatment study. Although before treatment bulimic anorexics displayed more overall psychopathology than non-bulimics, many of the differences disappeared with treatment. There was no difference in severity of depression or body size estimation in these groups both before and with treatment. There was no difference in treatment response as measured by rate of weight gain. More expression of discomfort by bulimic anorexics during the acute phase of illness may in part account for some described differences in these two groups.

Auditory-event-related potentials, including the P300 response, were recorded from 20 patients with Aizeheimer-type dementia (ATD), 17 patients with Korsakoff's syndrome (KS) and 23 age-matched control subjects. Each of the subjects was assessed using a version of the Luria Neuropsychological Investigation. Prolonged P300 latency and reduced P300 amplitude, which are features of normal ageing and which also occur, to a greater degree, in ATD, correlated significantly with degree of impairment of language ability in both Alzheimer patients and controls. On the other hand, the association between P300 latency changes and various tests of memory was not consistent across the three subject groups; there was a significant negative correlation between P300 latency and visual memory in ATD and a significant positive correlation in KS, whereas in controls no significant correlation was found. By contrast, P300 latency and memory for words were significantly negatively correlated in controls, but in neither of the patient groups.

Detailed studies of language function may further elucidate the complex relationships between neuropsychological measures and P300 changes in normal ageing and dementia.

The buffer theory postulates that social support moderates the power of psychosocial adversity to precipitate episodes of illness. In this paper, we review the theory as applied to minor affective disturbances. Research in this area suffers because of the many disparate conceptualizations of social support and the resulting difficulty of deciding on the content of measures. Moreover, the meaning of the term buffering is itself unclear. These problems have not, however, inhibited research, and many cross-sectional and longitudinal studies have now been carried out. Our review leads to the conclusion that evidence for a buffering role of social support is inconsistent, reflecting methodological differences between studies but probably also indicating that buffering effects are not of dramatic proportions. Moreover, it is possible that the observed relationships are the result of spurious association or contamination of measures.

On the basis of a literature review it is concluded that mass hysteria can be divided into two syndromes. One form, to be called ‘mass anxiety hysteria’, consists of episodes of acute anxiety, occurring mainly in schoolchildren. Prior tension is absent and the rapid spread is by visual contact. Treatment consists of separating the participants and the prognosis is good. The second form, to be called ‘mass motor hysteria’, consists of abnormalities in motor behaviour. It occurs in any age group and prior tension is present. Initial cases can be identified and the spread is gradual. Treatment should be directed towards the underlying stressors but the outbreak may be prolonged. In mass anxiety hysteria the abnormality is confined to group interactions; in mass motor hysteria abnormal personalities and environments are implicated.

Mood swings accompanying the motor fluctuations of patients with Parkinson's disease on chronic levodopa treatment frequently occur, but are poorly recognized. Occasionally, their functional impact may be greater than that caused by the motor disability itself.

In this study we have assessed the nature of, and relationship between, mood and motor fluctuations in nine Parkinsonian patients with ‘on—off’ motor swings. The results of an additional questionnaire survey confirm that ‘on–off’ mood swings occur in approximately two thirds of patients with Parkinson's disease experiencing motor fluctuations on dopaminergic treatment. Aetiological and therapeutic implications are discussed.

Sixty-seven patients with melancholia and 42 normal controls were tested with a battery of neuropsychological tasks selected to assess regional cortical functioning in both hemispheres. Compared with controls, melancholics exhibited a pattern of bifrontal and right parietal impairment, which was independent of age, sex, handedness and drug administration. These findings confirm and extend prior studies and contrast with those we and others have reported in patients with schizophrenia.

Four diagnostic systems for dementia and depression are compared on a community sample of 274 subjects. They are: DSM-III, Gurland's system, AGECAT and a clinician's ratings. These are compared, not in the usual terms of prevalence rates and cross-tabulations of diagnostic categories, but by examining the performance of each system in terms of hypothetical, continuously distributed traits underlying the symptoms of dementia and depression, as in the latent trait model described by Duncan-Jones et al. (1986). Each diagnosis is characterized by the level of severity (threshold) at which it operates, and its accuracy. Evidence is given to support a dimensional view of dementia.

Families with more than one member affected by schizophrenia were identified and their members were interviewed. Four standardized diagnostic definitions (PSE, DSM-III, ICD-9, Feighner) were applied to all subjects who were classified as schizophrenic or not schizophrenic according to each definition. Non-schizophrenic psychiatric disorders which have been shown to be familially associated with schizophrenia were also identified. Twenty blood markers were ascertained for all subjects and evidence of co-segregation with schizophrenia was sought. No selective segregation was found and therefore there was no evidence suggesting linkage or supporting a monogenic theory of transmission of susceptibility to schizophrenia.

Thirty-eight boys, referred for psychiatric treatment because of serious problems of behaviour, underwent a double-blind, placebo-controlled, crossover trial of methylphenidate and placebo. Methylphenidate was an effective treatment over a 3-week period. A good response to methylphenidate was predicted by higher levels of inattentive and restless behaviour, impaired performance on tests of attention, clumsiness, younger age and by the absence of symptoms of overt emotional disorder. DSM-III and ICD-9 diagnoses of ‘hyperactivity’ were not good predictors. The results support the validity of a construct of hyperactivity in describing childhood psychopathology, but emphasize the need for a refinement of diagnostic criteria.

Before treatment 49 obsessive-compulsive (o-c) ritualizers were presented with two series of brief stimuli – 15, 100db tones (brief neutral) and 15 presentations of a ritual-evoking object (brief aversive). Habituation of skin conductance (SC) responses to the tones was reduced compared with that previously found in normal subjects. Neither habituation rates to tones nor aversive stimuli were related to coexisting anxiety or depression or to the severity of o-c symptoms. The increased arousal induced by the aversive stimuli was sustained, that induced by the tones was short-lived and SC level and subjective anxiety had returned to resting levels by the end of the tone series. Concordance between SC activity and subjective anxiety was much greater during and after the presentations of ritual evoking stimuli than of tones. There were few correlations between SC and clinical measures, though patients who strongly resisted and were able to control their compulsive urges were more aroused.

The purpose of the present study was to determine whether individuals with unusually high scores on the Scale for Physical Anhedonia (Chapman et al. 1976) would differ from average scorers in their emotional responses to affect-evoking stimuli. Ten male and ten female anhedonics, well as ten male and ten female control subjects, were each shown brief filmclips that were expected to elicit emotional responses. The subjects' facial expressions were videotaped while they watched the filmclips, and they also completed adjective checklists describing how they felt while watching them. The anhedonics and nonanhedonics did not differ in their self-reports of emotional experience, nor did they differ in their facial expressions of emotion while viewing the filmclips. Compared to men, women reported experiencing more emotion, and their facial expressions also indicated greater responsiveness.

The memory scanning performance of both unipolar and bipolar depressives and patients with anxiety states was compared with that of control subjects. Four versions of Sternberg's memory comparison task were used. Unipolar depressives showed impaired memory scanning in 3 of the tasks compared with controls, and in one task compared with patients with anxiety states. They were also slower than the other patients and controls in the non-scanning processing stages. They seemed to adopt a less efficient search strategy, and showed more controlled processing as opposed to automatic detection in a paper-and-pencil version of the task.

In a sample of 268 cases of first-episode schizophrenia, 15 patients were found to have organic disease which appeared relevant to the mental state. There were three cases of syphilis, two cases of sarcoidosis, three of alcohol excess and two of drug abuse. There was one case each of carcinoma of the lung, autoimmune multisystem disease, cerebral cysticercosis, thyroid disease and previous head injury. In this series, identified organic disease was associated with less than 6% of cases of schizophrenia.

Accounts of musical ability in idiots-savants have up till now been confined to stressing the astounding musical memory which such persons may possess. The present study investigates compositional and improvisational skills in five idiots-savants. The findings are interpreted as indicating that a representational system of musical rules and structures is accessible to persons of low general intelligence, and that such a system may underlie reproductive as well as generative musical capacity.

Reported cases of violence during sleep are reviewed. Two new cases are reported where the subjects were charged respectively with attempted murder and murder; both were acquitted on the grounds of non-insane automatism. Clinical features and aetiological factors are analysed. The legal concepts surrounding non-insane automatism are discussed and criticized.

This study examined the relationship between personality factors and depression in subjects who may have a familial vulnerability to depression (i.e. first-degree relatives of depressed patients). Four groups comprised our study sample: relatives who had never experienced a psychiatric episode of depression; relatives who had experienced a psychiatric episode of depression but were currently well; relatives who had never experienced a psychiatric episode of depression but were currently depressed; and relatives who had experienced a past history of depression and were currently depressed. Of the four personality characteristics measured (Psychoticism, Extraversion, Neuroticism and Lie), the only significant effects between groups appeared to be attributable to Neuroticism (N).

The strongest association was between current illness and N. There was also a tendency for subjects with a past history of depression to have an inflated N score. However, this appeared to be associated with the presence of current depressive symptomatology. Our findings indicate that when current symptomatology is taken into account Neuroticism does not seem to reflect the trait of liability to depression, but is strongly associated with the state of being depressed.

The blood counts of 80 patients with depression were examined (50 unipolar, 30 bipolar). Many had reduced numbers of circulating lymphocytes. This abnormality was more common in the unipolar group (52%) than in the bipolar group (27%). When those patients with an abnormal dexamethasone suppression test response in both groups were compared, the relative and absolute lymphocyte counts were significantly lower in unipolars. Although cortisol hypersecretion may reduce lymphocyte numbers it is not yet clear whether the findings can be satisfactorily explained in this way.

Seventy eight men were assessed one month before coronary artery bypass graft surgery using standardized measures of psychiatric morbidity and personality as well as a measure of emotional expression (the CECS). All patients had at least one coronary vessel occluded by 75% or more of its diameter, and functional capacity was assessed by calculating the exercise treadmill time (in seconds) for each patient.

Most of the variance in exercise treadmill time was accounted for by the following variables: young age, short duration of symptoms, and less severe angina. Only one in five men was designated a psychiatric ‘case’. The only psychological measure significantly associated with atherosclerosis was expression of fear (on the CECS). A measure of Type A behaviour (Bortner score) was related to exercise treadmill time, but not to any of the angiographic or clinical indices of coronary heart disease (CHD).

Like other measures of Type A behaviour, the Bortner scale is psychometrically impure and has doubtful validity. More valid behavioural variables (such as those measured by the CECS) require further investigation. Future studies on the relation between psychological factors and the extent of CHD should take account of not only sex differences but also patients without significant CHD: high rates of psychiatric morbidity in such patients confound the relation between psychological trait measures and atherosclerosis.

Body image in 38 obese and normal weight subjects was measured using a video TV monitor. Tasks included a continuous task where subjects manipulated the size of their body image on a TV screen, and a discrete task, where they judged the accuracy of their TV image which was presented as either too heavy or too thin. Subjects viewed their images in both regular street clothes and with minimal clothing.

Results from the continuous task revealed that obese subjects overestimated body size. All subjects were more accurate on trials in which the initial image was adjusted in the heavier direction.

On the discrete task, a signal detection analysis revealed sensory sensitivity differences between obese and normal weight subjects. Obese subjects were better at detecting distortion caused by a too thin image, but were inferior in detecting a too heavy distortion. No significant differences were obtained in response criteria or between clothing conditions.