A hierarchy of classes of personal illness model is proposed and was assessed using a new self-report measure, the Delusions-Symptoms-States Inventory (DSSI). Of 480 psychiatric patients 93.3% had symptom patterns conforming to the model. It was additionally found that single syndrome patterns, within a particular class, occurred significantly more often in those not classifiable in any higher class. Finally, the relationship between each possible pair of the 12 syndromes was examined. Some of the implications of the model and the data are discussed in terms of the development, remission, assessment, and treatment of personal illness.

Fifty-seven patients with primary affective disorder who were in a double-blind outpatient study to evaluate the prophylaxis of lithium were questioned as to whether they believed they were receiving lithium or placebo. Research nurses who were ‘blind’ to the patients' medication and a close relative living with each patient were also questioned. Nearly all patients (96%) said they believed they were receiving lithium, ascribing this belief in 63% of the cases to a perceived improvement in condition. In only 14% of the cases on lithium was the presence of side-effects implicated in the patients' beliefs. One of the three nurses had a correct guess rate in excess of chance expectancy. All nurses tended to be more accurate in their guesses in the cases of patients who had been in prophylactic trials of over 15 months' duration than for patients with briefer periods in the study. Patients' relatives were, as a group, extremely accurate, their correct guess rate exceeding chance expectancy at the 0·001 level.

This study is based on a sample of 35,486 consecutive confinements in Cardiff (1965–72) which gave rise to 67 cases of post partum mental illness. No difference was found between these cases and all resident Cardiff maternities for the same period in respect of social class, maternal parity, weight gain in pregnancy, length of gestation, birth weight, and sex of infant. A statistically significant cyclic variation in month of conception and date of birth was found with a peak frequency among conceptions in the first quarter of the year. The bearing this finding may have on the prevention of post partum mental illness and the implications of the observation that post partum mental illness and the functional psychoses have a remarkably similar temporal behaviour are discussed.

In a prospective study of rheumatoid disease (RD) clinical, serological, radiological, and biochemical factors were assessed on 102 patients and scores obtained on the Middlesex Hospital Questionnaire (MHQ). Patients with early RD had MHQ scores closely resembling those in the normal population. Using a new clinical prognostic index, patients who develop severe RD tended to have low scores at initial testing on the MHQ. Patients whose serum was positive for rheumatoid factor also tended to have low scores on the MHQ. Together these findings suggest a possible subclassification of RD into a less severe form in which psychosocial factors may be important, and a more severe form in which heredity or some other constitutional factor (or factors) may be important, rheumatoid factor acting as a ‘marker’.

Factor analysis was performed on variables used to describe subjectively the sleep habits of three groups of subjects—male patients, female patients, and medical students. Similarities in the six factors from each analysis indicate the existence of dimensions of variation which are common to normal sleep habits and insomnia.

A cross-sectional household survey of drinking patterns, categorized as alcoholism, excessive drinking, moderate drinking, and abstinence, was conducted in a middle and lower-class section of Greater Buenos Aires. Alcoholism and excessive drinking were present almost exclusively among males, and were more prevalent among the lower levels of education, occupation, or residential area, and also among migrants. Prevalence rates for males, aged 15 +, were: alcoholics 4.4% ±2.1 and excessive drinkers 12.2% ± 3.4. Details of the methods, the implication of the findings, and comparisons with other surveys are reported and discussed.

The psychiatric ratings, using the In-Patient Multi-dimensional Psychiatric Scale, of (1) a group of over 200 psychiatrists from the British Isles, (2) third year psychology students, (3) trainee sister tutors, (4) general practitioners attending a postgraduate course in psychiatry, and (5) a group of new registrars at the Maudsley Hospital, were compared. The first hypothesis, that, whereas the non-psychiatrists would rate similar levels of symptoms, the psychiatrists would tend to rate lower than other professional groups, was upheld. The second, that the pattern or profile of symptoms as shown by the IMPS syndromes would differ little between the groups, was also upheld. The third hypothesis, that because of their special training in the recognition of symptoms, psychiatrists would tend to show greater intra-group agreement on the levels of symptoms than the other groups, was not upheld. Some possible reasons for the findings are discussed. The importance for a screening schedule, designed to be used by non-psychiatrists for the detection of psychiatric illness, of the finding that non-psychiatrists rate higher levels of symptoms than psychiatrists, is also discussed.

The study of tryptophan metabolism using compartmental analysis suggested differences between males and females, and between control subjects and patients with affective illness, patients treated with tricyclic drugs, and those established on lithium therapy. The total mass of tryptophan in the body may be reduced in people prone to affective disorder, and in depressed patients (ill and well) turnover of tryptophan seemed to be reduced. The reduction of concentration of tryptophan in compartment S2 in affective illness could affect protein synthesis.

The results of a survey carried out at Rampton and Moss Side Special Hospitals into physical and behavioural incapacity associated with mental handicap are described and compared with the findings of the 1970 National Survey. The Special Hospital patients were found to be less mentally handicapped than similar patients in subnormality hospitals in the National Health Service. The prevalence of physical incapacity associated with mental handicap was also lower in the Special Hospitals but the Special Hospital patients were assessed as more behaviourally disordered. In both surveys the incapacities present were concentrated in the severely mentally handicapped patients. In the Special Hospitals survey the women, when compared with the men, were found to be more behaviourally disordered and to suffer from a greater degree of multiple severe incapacity. All the differences found between the two surveys are consistent with the statutory criteria for admission to a Special Hospital.

Plasma levels of chlorpromazine (CPZ) and prolactin were measured repeatedly in 14 psychiatric patients throughout CPZ treatment. Mean prolactin level was elevated in 11 subjects (all six women and five of eight men). Mean plasma prolactin correlated significantly with mean plasma CPZ but not with the dose of the drug. Only patients with mean plasma prolactin above 35 ng/ml developed Parkinsonian side-effects.

A sample of male prisoners was examined by means of a questionnaire and subsequently by a structured interview. Control subjects who denied heavy drinking were used to study test-retest reliability of a group who admitted that drinking was a problem and a third group who admitted heavy drinking but denied problem drinking. Non-heavy drinkers and the heaviest drinkers are shown to be the most reliable and the intermediate group least reliable.

Fifty new psychiatric outpatients, suffering from minor disorders, were assessed using standardized social and clinical interview schedules. Forty-six were successfully followed-up six months later and their condition was assessed using a specially constructed rating scale. Social dysfunction in the area of the patient's material circumstances was the single most important predictive variable. Clinical predictions of outcome were shown to be closely related to the proportion of time the patient had been ill over the five years before inception.

A case is reported in which platelet monoamine oxidase (MAO) activity fluctuated in the course of a schizophreniform psychosis in a way which suggests a direct relationship between low levels of MAO activity and the psychosis.

In 1967 a proposal was made by the Medical Research Council that a unit be set up to consider the scholastic and behavioural skills of handicapped children and adolescents. In the beginning, three groups of studies were envisaged—those concerned with visual displays and orientation, those concerned with verbal ability and its development, and those concerned with immediate memory and the organization of perception.