Sixteen depressed in-patients from a hospital in Athens were assessed using the Hamilton Rating Scale and the Hostility and Direction of Hostility Questionnaire. Comparison of admission, discharge and mid-treatment scores showed that:

(1) There was a larger drop in depression score in the first half of treatment.

(2) Hostility scores, except for extrapunitiveness, decreased significantly over time, larger changes occurring in the first half of treatment.

(3) Comparisons with British scores showed that during illness there were no significant differences between British and Greeks, though the latter tended to be more extrapunitive. At recovery, the Greeks were significantly more extrapunitive.

The movement of hostility in depressive illness, the validity of the HDHQ and need for national norms are discussed.

Two of the tryptophan pools in the body and their associated fluxes, as defined by multicompartmental analysis, were studied in patients with unipolar affective disorder, bipolar patients (manic) and control subjects. The 2 pools were tentatively associated with extra- and intracellular compartments. The investigations were performed fasting and may have been mildly stressful. Under these conditions the concentration of tryptophan in plasma and perhaps amounts in the extracellular space were reduced in unipolar depression, with intermediate values after recovery. Some model parameters were lower in females than males. The results in unipolar affective disorder were interpreted in terms of a previously presented hypothesis that this illness may result in an idiosyncratic response to stress in which patients are unable to maintain normal amounts of tryptophan in the body. In manic patients extracellular levels of tryptophan were unchanged but intracellular and total quantities of ‘freely available’ tryptophan may have been reduced.

Patients admitted to Friern Hospital in 1972 stayed on average for about 5 weeks and spent a total of less than 2 hours individually with senior and junior doctors. Long-stay patients (1 year or more) saw their doctors for an average of less than 1 hour a year. These findings, which in the case of junior doctors were corroborated in 1974, refer only to the time doctors spent with patients alone. The admission, and long-stay discharge rates were greater in the Islington than in the Camden division, and probably reflect differences in clinical practice. It is argued that more psychiatrists are needed – precisely how many will depend on studies of the relative efficiency of different services and training programmes, and on agreement among psychiatrists about minimum professional standards.

Plasma chlorpromazine measured by a gas chromatographic procedure was found to disappear rapidly during the first week after withdrawal of chlorpromazine treatment in a group of 17 chronically hospitalized patients. The drug or its metabolites were no longer measurable in plasma after 8 days.

A group of 49 patients with depressive illness were treated in an uncontrolled study by the intravenous administration of the beta-adrenergic stimulant, salbutamol. The results suggested a rapid antidepressant action in the majority of cases without significant adverse effects.

This preliminary communication reports that the mothers of 104 schizophrenic patients had: (1) a significantly higher incidence of thyroid disease than a carefully matched control group; (2) significantly more abortions, still-births and greater infant mortality. The findings and possible relevance of thyroid disease to schizophrenia are discussed. Three prospective studies currently in progress are outlined.

One hundred and nineteen primiparae, who were routinely attending ante-natal clinics, were interviewed repeatedly between the 12th and 36th weeks of their pregnancies. The incidence of depression was highest in the first trimester and, overall, about a fifth of the sample was found to be suffering from clinically significant neurotic disturbances. In a proportion of these expectant mothers there was an association between depression and anxiety early in pregnancy and a previous history of induced abortion; this phenomenon may reflect a reactivation of mourning which was previously suppressed.

A preliminary survey of 10 married couples was carried out to test the hypothesis that women express greater dissatisfaction with their health and other personal life domains than men. Although the women made more use of medical facilities for minor complaints than their husbands, no difference was found in expressed satisfaction, or in number or severity of symptoms reported at interview. However, there was a discrepancy between husbands' and wives' perception of their spouses' satisfaction levels and experience of illness-symptoms, in the direction of wives being perceived by their husbands as considerably less healthy and more dissatisfied than the husbands were rated by their wives. Some evidence was also found for greater emotionality in women. The results are regarded as indicating that illness is more socially acceptable in women than in men.

Fourteen chronic male schizophrenic patients and six male control subjects were com pared in an escape paradigm involving temporal warning of the presentation of an aversive tone stimulus to which an escape response was to be made. The characteristic heart rate deceleration shown immediately prior to the aversive stimulus by control subjects was absent in the schizophrenic group. Further features of this novel test paradigm distinguished the control and schizophrenic groups. This psychophysiological test procedure may be fruitful for schizophrenia research.

The hypothesis that schizophrenia is caused by the release of prostaglandin E into the hypothalamus and may sometimes be accompanied by an elevation of temperature was examined by a clinical trial of the prostaglandin E suppressant N-acetyl-p-amino-phenol (paracetamol, acetaminophen). Ten acute schizophrenic patients were included in a double-blind, crossover trial of paracetamol and a placebo, in which each treatment was given for a week. Regular 4-hourly temperatures were recorded in all these cases and in 5 non-schizophrenic patients for comparison. The findings provided no evidence that paracetamol mitigated the symptoms of schizophrenia. The temperatures of the schizophrenics were not elevated more than those of the controls, but the number of cases used was probably too small for this finding to be conclusive.

Thyrotropin response to thyrotropin-releasing hormone is impaired during endogenous depression and normalized between the depressive periods. Changes in the thyrotropin response to thyrotropin-releasing hormone were shown to be of predictive value and might be useful in the control of continuation therapy with antidepressants in patients with endogenous depression.

Previous reports suggest that high serum dopamine-β-hydroxylase (DBH) activity may be associated with vulnerability to alcoholism. However, there are also contradictory studies in the literature. Therefore we measured serum DBH in chronic alcoholics followed for 12 months in a treatment programme after psychiatric hospitalization for acute alcoholism. Mean serum DBH activity in the alcoholics was unchanged from controls at 3 months, 6 months and 12 months following hospital discharge. These data imply that serum DBH activity does not provide a useful metabolic screen for vulnerability to chronic alcoholism. However, prospective studies of patients at high risk to develop alcoholism will be helpful in further clarification of this issue.