An attempt was made to identify background, sociodemographic and clinical variables which are associated with attempted suicide in depression. Within a sample of 308 depressed psychiatric inpatients, suicide attempters were younger than non-attempters and were identified by a pattern of chronic interpersonal maladjustment reflected clinically in withdrawal from social contact and the display of hostility or irritability toward others.

Two experiments concerned with the statistical characteristics of speech in presenile dementia are described. Apart from a lowered rate of production of words under certain conditions no speech abnormalities were detected on the variables examined.

A comparison was made of the mental state of patients with chronic epilepsy and matched controls with locomotor disorders, using a reliable psychiatric interview technique. The symptom profiles of the two groups were similar. The profiles of temporal lobe and other epileptics were also similar. Epileptic patients with a high current psychiatric morbidity were characterized by a raised incidence of previous neurotic illness and raised neuroticism scores on the Eysenck Personality Inventory.

A two-generation study of 46 families of convicted women felons showed that the daughters of sociopathic fathers had a significantly higher prevalence of hysteria than did the daughters of other fathers. The differences were significant both for daughters with hysteria plus sociopathy and for daughters with hysteria without sociopathy. The association was independent of assortative mating between sociopathic men and women with hysteria or sociopathy.

Patients diagnosed on the basis of structured interviews as having affective psychoses were less sensitive in detecting the presence of a transient auditory signal than were schizophrenic patients or non-patients. Patients with affective psychoses also benefited more (their reaction time was more reduced) than the other two groups from the presence of a second auditory transient.

Variable s describing 113 outpatients of a mental health clinic were derived from a Placebo Test, the MMPI, a Symptom Check List, measures of response style, and a questionnaire containing historical and demographic information. Two highly reliable scales, the Placebo Effect Scale (PES) and the Side Effect Scale (SES) were derived from the Placebo Test and served as dependent variables. PES scores were inversely related to reporting symptoms and unrelated to measures of response style. SES scores were directly related to reporting symptoms and with several measures of response style. There was a curvilinear relationship between placebo response and reporting side-effects. Implications of results for further research are presented.

The annual rates of referral to two differently organized comprehensive psychiatric services in separate but demographically similar areas are presented for various demographic social and clinical categories. In Part 1 the rates are examined for similarities both between the two areas and with findings from other studies in order to obtain pointers to factors affecting the inception of psychiatric disorders. In Part 2 an attempt is made to evaluate an aspect of the community service. Differences between the rates in the two areas are discussed with a view to identifying those variables that selectively affect referral to a community service.

A double-blind crossover trial was carried out comparing pimozide with fluphenazine. The effects of the drugs on the activity of 20 chronic inert male schizophrenic patients were measured using nursing observations, psychiatric rating, and an operant conditioning method. When activity was assessed in these different ways, no significant difference was found between the two drugs on any of the measures. It is concluded that pimozide does not effectively increase the activity in such patients. It is considered that the free operant conditioning method used was shown to be a useful measure for comparing therapy in chronic schizophrenic patients.

The characteristics of 64 suicides with a retrospective diagnosis of depression and 128 depressives referred for psychiatric treatment were compared. The following items differentiated the suicide group: male sex, older age in females, single status, living alone, the symptoms of insomnia, impaired memory and self neglect, and a history of suicide attempts. The value of these items in assessing suicide risk in depressive illness is discussed.

Following an earlier report, plasma cortisol-binding capacity (CBC) was estimated in a new series of 11 men with unipolar depression and 11 men with bipolar illness admitted to hospital. The two groups were comparable except that the bipolar group tended to have more frequent episodes of illness and to have more family histories of affective disorder. There was no significant difference between the CBC values in each group.

Withdrawal of drug from a group of chlorpromazine-treated chronic male schizophrenics led to a significant rise in the initially low serum tryptophan concentration, and a rise in the fraction freely diffusible. These changes, which would be expected to lead to an increase in tryptophan influx into the brain, and hence to an increase in cerebral serotonin synthesis, could be related to the clinical effects of drug withdrawal.

A case of Cushing's syndrome in a woman aged 50 years is described, with psychosis of schizophrenic type. The psychosis and endocrine disorder were subsequently cured by adrenalectomy. Twenty-five years previously the patient had a typical schizophrenic psychosis treated in mental hospital with deep insulin therapy and ECT. The possibility is raised that deep insulin therapy could have induced the Cushing's syndrome through its non-specific stressor effect on the pituitary-adrenal axis.

In a double reversal design the potency of thyrotropin releasing hormone (TRH) (500 μg intravenously) as a quick-acting antidepressive agent was evaluated. A first injection did seem to give rise to a very slight short-lasting effect, though this could not be ascertained clearly. There were no visible effects after a second injection. The thyroid stimulating hormone (TSH) response curve after TRH administration in the depressive patients group was blunted in comparison with that in a matched control group of normals.

Depressed patients (unipolar) were given one of the following combinations in an attempt to test aspects of the ‘amine hypothesis’ and to find a preferential therapy: (1) clomipramine; (2) clomipramine and tryptophan; (3) desipramine and clomipramine, and (4) desipramine and tryptophan. Treatment (2) should have given optimal potentiation of 5-HT neurones and (3) and (4) should have acted similarly on both serotoninergic and adrenergic pathways. In no group was there any evidence of accelerated recovery, indicating that the process of conversion to normal mood may be more complex than suggested by most versions of the amine hypothesis.

A sample of 91 new referrals to a community based psychiatric outpatient service was compared with a cross-matched control sample of 107 patients attending the general practitioner's surgery. The subjects in both groups completed the General Health Questionnaire and there was a very marked difference between the scores of the two groups. Seventy-five of the psychiatric group had a high score on the questionnaire, and a large number of these were extremely high, while 74 of the general practice group had a low score. The ‘false’ positives and negatives are discussed. It is considered that the validity of this questionnaire as a screening device for demonstrating psychiatric morbidity and severity in general practice is further established in this study by showing that in matched samples the expected psychiatric morbidity in general practice can be compared with the much greater morbidity in psychiatric outpatient referrals. For the psychiatric sample more patients showed high scores and these tended to be much higher.

Cognitive function was evaluated in 11 patients with Huntington's chorea, using eight subtests of the WAIS, and their performance was compared with that previously reported for a normal aged population. The pattern of impairment was similar in the two groups. Tests of immediate memory were given to nine of these patients, and to 10 healthy but aged subjects. In botḥ groups, there was a significant correlation between the performance of individuals in these tests and their IQ, suggesting that the choreic patients had no selective impairment of immediate memory. The clinical and psychological records of the 11 patients revealed no evidence of focal deficits, and the majority of patients were fully orientated and retained insight to their condition. These observations are discussed in relation to the pattern of intellectual impairment seen in other presenile dementias.

The sulphate and glucuronide conjugates of 4-OH-3-methoxyphenylethyleneglycol (MOPEG) and 4-OH-3-methoxymandelic acid (VMA) have been serially studied in the urine of a manic-depressive patient before and after a therapeutic response to lithium carbonate. Excretion of both conjugates correlates with changes in mood. Some reasons to suggest that the sulphate might be a more useful measure of brain activity are stated.

Depressives responding to initial treatment were maintained on amitriptyline for eight months, withdrawn double-blind to placebo after two months, or withdrawn overtly onto no medication. In each group half the patients received weekly psychotherapy and half were seen, once monthly. Effects on symptom ratings were examined. Maintenance amitriptyline gave a significant advantage over early withdrawal in preventing symptom recrudescence. There were no differences between double-blind or overt withdrawal. There were no interactions between drug withdrawal and psychotherapy. Psychotherapy produced no significant advantages over low contact on symptoms, although it did improve social adjustment ratings reported elsewhere.

Factor analysis was performed on objectively measured and subjectively reported characteristics of 46 nights' sleep in four healthy male subjects. The fragmentation of sleep by awakenings during the night, the delay before falling asleep, the total duration of sleep, and the amount of delta-wave sleep formed the bases of four separate factors.

An experiment is described in which depressed patients were asked to recall pleasant or unpleasant experiences from their past life in response to a standard series of stimulus words. The ratio between the time for recall of pleasant and unpleasant experiences was found to fall progressively with increasing severity of depression or of ‘neuroticism’ and to be significantly related to each. Among patients who scored relatively low on depression or neuroticism pleasant memories were recalled more speedily than unpleasant; among those who scored high this relationship was reversed. Possible mechanisms to account for these findings are discussed.