Previous studies have suggested that, because of the chronic and disabling nature of mental illness, psychiatric patients do not fare as well in their careers as they should do. In the present study the parental social class, the current social class and the social mobility has been compared in 2,861 male referrals to the psychiatric services in North-Eastern Scotland and 1,487 men randomly selected from the local population. Within the psychiatric sample similar comparisons have been made between diagnostic groups. In all three aspects of social class considered decade of birth was shown to be an important variable.

A self-assessment inventory for measuring severity of depressive illness is described, Its chief merits are brevity and simplicity. The correlation with the Hamilton Rating Scale is +0·87. At a cut-off level of 14–15 points 3% of patients and 7·5% of ‘Normals’ are misclassified. The mean scores for male and female patients do not differ significantly and the small positive correlation of score with age is of little practical significance. The limitations in this inventory are discussed but, despite them, it has practical value and merits further development.

The regulation of body temperature was investigated in 11 patients with anorexia nervosa, initially while they were in a malnourished state and again after refeeding when they had reached a near normal weight. The results suggest that there may be a primary defect of temperature regulation in anorexia nervosa which is linked in some way with the feeding disorder characteristic of this illness.

Each of 16 phobic patients was treated by six sessions of flooding and six sessions of desensitization in a balanced crossover design. Clinical and physiological measurements were made before treatment and after the sixth and 12th sessions of treatment. Physiological measures were made of increase in heart rate and in spontaneous fluctuations and maximum change in level of skin conductance during neutral and phobic imagery. Patients estimated subjective anxiety during the imagery. Heart rate, skin conductance, and subjective anxiety ratings all differentiated significantly between phobic and neutral imagery. Increase in autonomic activity during imagery was roughly proportional to the intensity of the imagery in a phobic hierarchy. Autonomic changes during imagery imagined in silence did not produce autonomic changes considerably different from those during imagery stimulated by a running commentary from the therapist. Clinical ratings correlated significantly with measures of skin conductance, so that autonomic measures can be useful indicators of change after treatment. However, heart rate, skin conductance, and subjective anxiety during brief periods of imagery did not usually correlate significantly with one another. This supports the view of emotion as a System of responses linked imperfectly across several Systems.

At least for heuristic purposes, certain operationally definable concepts of conditioning theory can serve as a framework for research on ‘drug dependence’ both in man and in animals: primary and secondary pharmacological reinforcement, either of which may be direct (‘psychic’) or indirect (‘physical’); and social reinforcement (‘cultural’).

This paper describes an investigation into the relationship between senile dementia and slowing of peripheral nerve conduction velocity. Twenty-eight demented patients and 19 controls were studied. Each patient was rated clinically and given a battery of simple psychological tests in addition to the physiological recordings. The results were as follows: (1) Motor nerve conduction was slower in the demented group than in the control group but this difference was not significant. (2) When subjects were divided according to their dementia score, those with scores above 7 were found to have motor nerve conductions which were significantly slower than those with scores of 7 or less. (3) There was a significant correlation between the severity of the dementia as measured by the rating scale and the psychological tests and the degree of slowing of motor nerve conduction. (4) In those patients who were retested after one year, increase in dementia was significantly correlated with a further slowing of conduction in motor nerves. (5) The possible role of vitamin deficiency was investigated in a small sub-group of demented patients. Deficiencies of thiamine, nicotinic acid, and vitamin B12 were not thought to be important but some patients had low folate levels. The significance of these results is discussed.

Some current problems in clinical psychopharmacology are examined and pharmacological approaches towards their elucidation outlined and discussed. Particular topics reviewed include the concepts of potency and maximum effect, the balance between wanted and unwanted effects, and the problems of heterogeneity and variability as they apply to patients and their responses to psychotropic drugs. Types of methods for the assessment of drug effects are listed and the growing importance and relevance of pharmacokinetic studies stressed. A more general and intensive use of the pharmacological approach is urged in order to acquire much-needed basic data on psychotropic drug action in man.

The 8th revision of the International Classification of Diseases (ICD) favoured classification of mental disorders by a combination of predominant syndrome and predominant aetiology. However, this important principle has been carried through incompletely, to the disadvantage of diagnostic flexibility and innovation. In addition, too much work is required for the retrieval of cases with the same aetiology irerspective of the syndromes they exhibit, or of cases with the same syndrome whether in the setting of a personality disorder, a neurosis, or a psychosis. The present paper suggests certain simplifications by which the principle of combined classification can hopefully be applied to develop a more comprehensive and flexible instrument.

It is argued that personality deviance and personal symptomatology fall within different universes of discourse and that any individual may belong to either, neither, or both classes. In order to develop suitable measurements, distinctions are drawn between symptoms, states, deviant and normal traits, which have implications for the distributions of scores and for their stability or change over time. Measures likely to meet the criteria are illustrated. A classification is developed which incorporates those with and without the ability to cope with personal symptomatology and/or personality deviance. Some uses of the classificatory scheme and the measurements are suggested.

A new method for the measurement of alienation is proposed. It is based upon the conceptual distance between people. For each subject, the observed distances between all possible pairs of elements were calculated and compared with the expected distance between two elements drawn at random. The ratios derived in this way were used to examine intra-self alienation and actual self isolation. The obsessional patient is self alienated and isolated. The normal control subject is self and socially integrated.

The general relationship between alcohol and crime is reviewed, and five central methodological problems are identified relevant to prison population ‘alcoholism prevalence surveys’ as a prelude to a report of an investigation of 500 recidivist prisoners. The prevalence rate is shown to be highly dependent on the particular definition of ‘alcoholism’ which is employed. Long-term and short-term prisoner subgroups are compared, and similarities with a population of non-prisoner homeless men discussed. A ‘dependence score’ derived from an operant conditioning model of alcoholism correlates significantly with various measures of social instability.

A sample of general practitioner referrals to a Psychiatric teaching centre was investigated by means of standard interviews, first with the practitioners and subsequently with the patients. Hospital treatment and disposal were examined in the light of the doctors' reasons for referral, and of the expectations which they and the patients had held of the hospital service. The findings are related to previous work in this field, and the implications for service planning discussed.

The construction and development of an inventory of 69 questions dealing with the subjective assessment of obsessional traits and symptoms is described. A card-sorting procedure requiring supervision is used, which gives rise to information about feelings of resistance and interference with other activities, in addition to the straightforward answers to the questions. The resulting scores are shown to differentiate well between a group of selected obsessional patients and normals. The problem of to what extent replies to apparently specific questions in inventories and questionnaires can be interpreted as having only general significance is discussed.

Specific cortical somatosensory evoked responses were recorded in nine patients suffering from senile dementia and eight elderly depressed patients. The results were as follows. (1) The latencies of each peak were longer in the demented than in the depressed group but this difference was significant only for peak 3 (the second negative deviation). (2) The late negative deviation (peak 5) was either absent or very flat in demented patients. The ratio of the amplitude of this late wave to that of the first peak discriminated between demented and non-demented patients at the 0·5% level. (3) The value of this ratio combined with that of the latency of peak 3 could be used to classify all but one patient into the correct diagnostic group. The results are discussed in the light of the relevant literature. It is suggested that slowing of conduction in the nervous system may be a very basic disturbance associated with cognitive impairment in old age and that measurements of this kind may come to assist in the diagnosis of dementia.

On the Intensity measure of the Grid Test acute and chronic thought disordered schizophrenics were significantly different from controls, and acute non-thought disordered schizophrenics significantly different from acute thought disordered schizophrenics. The difference between chronic thought disordered and non-thought disordered schizophrenics just failed to reach the 10% level of significance. On the Consistency measure results were variable. Only the acute non-thought disordered schizophrenics were significantly different from the acute and chronic thought disordered schizophrenics. The findings are discussed.

Using statistical methods, the hypothesis that suicide occurs either at the beginning or at the end of a spell of treatment is shown to fit the available data.

An inventory of obsessional symptoms and traits was administered to patients with depressive illnesses while they were ill and again after recovery. They obtained higher scores than normals even when well and their scores increased considerably during episodes of depression in proportion to the depth of the depression. In mania, on the other hand, obsessional symptoms are rare.

Fifty consecutive patients suffering from primary depressiv illness, but excluding those who had a distinct episode of mania, were rated for the presence and degree of certain symptomatology, especially agitation and retardation. They were also divided into two groups (‘early’ and ‘late’ onset), according to whether their first-ever attack of depressive illness had occurred before the age of 45. After they had recovered from their illness, aspects of personality were assessed on a battery of self-rating personality tests. There was no evidence from this study that any of the personality traits measured was in any way significantly related to any of the clinical features of the illness.

Folate (RBC, serum, CSF) and B12 (serum and CSF) and 5-HIAA and HVA (CSF) concentrations were measured in patients with senile dementia. Those with RBC folate < 130 ng/ml. were given folate/B12 in a double-blind crossover trial. (1) Amine metabolites and folate were unrelated. (2) CSF folate levels rose significantly but slowly on ward diet only independently of the period of intensive replacement. (3) There was no clinical improvement over the 24 weeks of observation but in view of the biochemical findings the period of study may have been too short.

Probands with schizophrenia of good and poor prognosis were selected according to defined criteria. Families were investigated blindly. The families with poor prognosis contained significantly more schizophrenia, neurosis, and overall illness, but less affective disorder than the families with good prognosis.