The paper describes a one year prospective study of 124 elderly depressed patients. Only one third of the group had a good outcome. Poor outcome was associated with severity of initial illness, those with depressive delusions having a particularly poor outcome. Outcome was also influenced by physical health problems and severe life events in the follow-up year. Social class differences in outcome were thought to be due to class differences in the experience of severe life events. There was no evidence that an intimate relationship protected against relapse in the face of continuing life stress.

Three groups of patients were identified during a study of men who had recently suffered an acute myocardial infarction: those with psychiatric morbidity antedating the infarction, those with psychiatric morbidity immediately following the infarction and those with no significant psychopathology. Compared to the other two groups, patients with psychiatric morbidity before the infarction were more likely to be unmarried, unemployed and to have received previous psychiatric treatment. They also obtained higher scores for neuroticism and psychoticism on personality assessment. Patients whose symptoms have been precipitated by the infarction resembled the psychologically healthy group with regard to their demographic characteristics and personality. Their symptoms tended to be transient, improving without special psychiatric treatment.

In a study of 229 neurotic same-sex adult twins admitted to all psychiatric in- and out-patient clinics and mental hospitals in Norway, a statistically significant, moderately higher concordance was found for MZ than for DZ twins. When the sample was subdivided, this higher concordance for MZ pairs was true only for male twins and for twins admitted to mental hospitals. The results are compared to those from earlier studies; different findings on the importance of genetic factors in the development of neuroses may be due to differences in sample selection.

The 420 first-degree relatives of 14 patients with anorexia nervosa, 55 patients with bulimia, and 20 patients with both disorders were evaluated for the presence of psychiatric illness, using DSM-III criteria, by the family history method. The morbid risk for affective disorder in the families of the eating disorder probands was similar to that found in the families of patients with bipolar disorder; but was significantly greater than that found in the families of patients with schizophrenia or borderline personality disorder. These results add to the growing evidence that anorexia nervosa and bulimia are closely related to affective disorder.

This study examined by questionnaire the prevalence of binge-eating and self-induced vomiting among a sample of 369 consecutive attenders at a family planning clinic. 20.9 per cent reported current episodes of uncontrollable and excessive eating (‘binges’), 2.9 per cent currently induced vomiting as a means of weight control; and 4.9 per cent reported using laxatives. Binge-eating and self-induced vomiting were strongly associated with disturbed attitudes to food, eating, body weight and shape; and with psychiatric disturbance. Menstrual dysfunction was not associated with either body weight or binge-eating; it was however associated with psychiatric state. Applying conservative rules, 1.9 per cent appeared to fulfil diagnostic criteria for the recently described syndrome bulimia nervosa.

In two follow-up studies of a total of 175 patients, carried out approximately eight years after first hospitalization, men were under hospital care more often and for more prolonged periods than women, but used outpatient services less. At the end there were only small differences in clinical condition between the sexes, but social condition, as depicted by social adjustment, psychosexual situation and work adjustment, was clearly poorer in men than in women. This was perhaps a reflection of the men's poorer premorbid psychosocial development and social role. The differences between the sexes in the prognosis for schizophrenia are considered.

Visual evoked potentials (VEP) to different flash intensities were recorded at a central site (Cz) plus at homologous temporal and occipital locations in normal and unmedicated schizophrenic subjects. Schizophrenic patients showed an hemisphere asymmetry of the P100–N120 peak-trough amplitude with smaller left but larger right hemisphere amplitudes than normal. Further, two subgroups of patients were found with abnormalities lateralized to the left hemisphere. One group was found to have abnormal P100 amplitude-intensity patterns at the left temporal site while the other group showed deviant N120 amplitude-intensity patterns at the left occipital location. The clinical significance of these results can be seen in the higher nuclear schizophrenia (PSE-CATEGO) scores in the left temporal subgroup and the higher hypomania and situational anxiety scores in the left occipital group. Patients also showed slower than normal P100 and N120 peak latencies.

The relationship between hand preference, age, and developmental functioning was examined in 70 autistic patients. Unilateral or mixed handedness appeared to be stabilized by the age of five years. Patients with established hand lateralization tended to function better in all developmental areas including intelligence, language, and visuospatial abilities. It is a tenable hypothesis that the presence or absence of hand lateralization by age five may be an important predictor of outcome in autism.

The systematic application of guidelines derived from the British National Formulary resulted in a substantial reduction of the amount and frequency of medication used in two hospitals for the mentally handicapped.

Long-term antiparkinsonian medication given to 20 mentally handicapped patients also on neuroleptics was abruptly withdrawn. Transient extrapyramidal signs developed in most patients during the following four weeks but in 60 per cent had disappeared by 12 weeks. Reintroduction of medication was necessary in only three patients, who developed acute dystonic reactions within one week of withdrawal.

The addiction and conviction status of 60 male patients who presented to a London drug clinic in 1970 was re-examined 10 years later. Eleven of the patients had died. Three-quarters of the survivors had been abstinent for five years and one quarter were still addicted in this time. Ninety-seven per cent had received a court conviction by 1981 and 83 per cent were convicted during follow-up. Neither hospital treatment receipt of a clinic prescription nor imprisonment was associated with eventual abstinence. Poor outcome, in combined terms of continued addiction and re-conviction, related to early parental loss, poor academic achievement, conviction before drug use, longer imprisonment and a high conviction rate. Criminality emerges as the predominant and continuing expression of deviancy in these drug clinic patients.

Eighty-seven people with the symptom of social phobia were compared with 57 people with the symptom of agoraphobia to determine whether these symptoms were part of distinct syndromes. Comparisons were made on demographic, clinical and questionnaire data. Significant differences were found on important variables. The social phobics were younger and more often male, unmarried, and from social classes I and II. The pattern of phobic situations was different in the two groups and so was the pattern of autonomic symptoms experienced in these situations. Symptoms visible to others were more frequent among social phobics. Fainting was more frequent among the agoraphobics.

Of 15 patients with writer's cramp (4 females, 11 males, mean age 36, range 23–50, mean duration 3.6 years), 13 entered a behavioural treatment. Nine received a multimodal treatment, and four EMG feedback alone. Four patients dropped out during the treatment phase. Nine patients were considered as improved at a follow-up between 1 and 9 months. A stress-coping model is put forward to account for the therapeutic effectiveness, and to explain the drop-outs. Writer's cramp seems to be related to stressful situations at work. The existence of personality and biological factors remains to be demonstrated.

We have observed a lesser growth hormone response to intravenous clonidine administration in nine obsessive-compulsive disorder patients meeting research diagnostic criteria than in nine matched controls. The obsessive-compulsive disorder patients had higher plasma free 3-methoxy-4-hydroxyphenylglycol and plasma norepinephrine levels before clonidine than the controls. As blunted growth hormone responses to clonidine are also characteristic of affective disorder patients, these results support other observations of a psychobiologic affinity between these two groups and are also compatible with an association between increased presynaptic noradrenergic activity and decreased post-synaptic receptor responsiveness.

The binding of tritiated imipramine was significantly reduced in the hippocampus and occipital cortex from a series of patients with depressive illness compared with age-matched patients with no psychiatric disorder. In contrast there was no change in imipramine binding in established cases of senile dementia of Alzheimer-type. Scatchard analysis indicated normal binding affinity but a reduction in the number of imipramine binding sites in depression. These observations parallel previous findings of decreased binding sites in platelets from depressed patients and suggest there may be an abnormality in the uptake mechanism for serotonin in depression.

Two female psychiatric patient samples were examined—240 women, aged 20 or over, from North East Scotland; and 44, aged 40 to 49, from Chichester, West Sussex. There was also a Chichester community sample of 230 women of similar age-range.

The N.E. Scotland psychiatric patients with poor marriages broke down significantly earlier, and the delay between marriage and first breakdown was significantly shorter. This group also tended to have a neurotic rather than an endogenous type of depression.

The poor marriages of the Chichester psychiatric patients were, in the main, similar to those of the Chichester non-patients, but the patients demonstrated significantly more disturbance of sexual relationships, and their in-laws were significantly more disapproving.

A psychiatric service was provided to the remote areas of Botswana by means of regular visits from psychiatrists and psychiatric nurses to the primary care facilities in those areas. The service was well used by the local health workers and general populations and encountered a substantial psychiatric morbidity. Studies in one region indicated that by using the primary care staff as case finders a substantial proportion of a total likely population of schizophrenic and epileptic patients could be bought into treatment. The specific conditions that enabled this service to become established are discussed.