Elderly persons over the age of 60 who were admitted for psychiatric care were compared with a random sample of persons living in the same community in respect of psychiatric, medical and socio-economic variables. The group admitted to hospital for psychiatric reasons was very similar to the latter in general characteristics. However, those people admitted to old age homes, which are the other major resource for psychiatric illness, constitute a distinctly separate population, being older and having considerably more physical illnesses and socio-economic problems. Factors predicting admission to an old age home were largely irremediable age-related conditions (dementia, physical infirmity, etc.), but there were also adverse social circumstances, including marked isolation and a lack of social and emotional support. A comparative analysis of the many psychiatric, social and medical factors is presented, with particular reference to reasons for referral and prevention of admission.

Andrews' method of plotting n-dimensional data in 2 dimensions allows one to summarize all the data on one patient using a single curve. Comparisons have been made between different diagnostic groups on the basis of the 12 scales from the In-patient Multidimensional Psychiatric Scale (IMPS) using data from a sample of 787 newly admitted in-patients. For each diagnostic group, a figure was produced containing the Andrews' curves from all the patients in the group. Those groups that were particularly homogeneous or heterogeneous were noted. The main features of the different groups could be discerned.

In the city of Mannheim the introduction of an extensive community mental health service has been shown, by means of case-register data over 4½ years, to have led to a considerable increase in utilization, mainly at the out-patient level of care. The rates of admission to hospital increased very little. Due to the simultaneous decline in long-term bed occupancy, the overall need for psychiatric beds remained stable at a rate of about 1·2/1000, a rate which is very low by international standards.

The sharp decline in the ‘old’ long-stay population was followed by a smaller increase in ‘new’ long-stay patients which it has not been possible to prevent. These patients are, however, admitted for a long-term stay significantly later than formerly, and their diagnostic composition has changed significantly.

The increase in the bed requirements for short- and medium-term stay patients resulted from different sources: an increasing morbidity in some groups of disorders, the rising utilization in case of emergencies and severe crises, and the transfer of long-stay patients to alternative care services. The level of these needs was very similar in Mannheim, Salford, Samsø and Camberwell, whereas the rates for long-term beds still show clear national differences.

Serum levels of 7, 8-dihydrobiopterin were significantly raised in female patients with depressive illness who were being treated with tricyclic antidepressants.

Groups of elderly people, matched by level of dependency and probability of dementia, were identified in day centres, day hospitals, wards, and local authority homes, and followed up over 9 months to determine the impact of type of care upon outcome. No difference in mortality or changes in dementia scores were found, but the survivors' levels of dependency improved most in day centres and local authority homes. This finding, and the problems of matching, are discussed.

While many of the characteristics of psychotropic drug consumers have been established by means of cross-sectional studies, little is known about new consumers and the factors which predispose to long-term treatment. We report on a longitudinal study of 153 general practice patients beginning a new course of psychotropic drug treatment and characterized by extensive physical and psychological morbidity. About 1 in 5 were still receiving psychotropic drugs 6 months later and this prolonged treatment was associated with increased age, previous psychotropic drug-use, higher levels of psychological morbidity at the inception of treatment and, for the women only, social problems as perceived by the general practitioners.