Disorders of the skin, either congenital or acquired, associated with nervous disorders and disturbance of normal mental functioning arc numerous. The classification is very wide-ranging and includes: phakomatoses, hamartoses, adenomatoses and neurocutaneous syndromes. In 1972, Liebaldt and Leiber collected 40 titles of the syndromes, and since then many more reports of the new syndromes and their variants have appeared in the world literature.

Much attention has been devoted to the classification of the behaviour disorders of childhood, and various authors have identified what they consider to be clinically homogeneous groups. The alternative to a clinical approach to classification is a multivariate approach in an attempt to identify more scientifically the main dimensions underlying the wide range of behaviour disorders that occur in children. A model for a multivariate classification was pioneered by Hewitt and Jenkins (1946), who delineated three behaviour syndromes:

1. (a) socialized delinquency;

2. (b) unsocialized aggressive behaviour;

3. (c) over-inhibited behaviour.

There is now extensive evidence that autistic children manifest a specific cognitive defect involving language impairment (Rutter, 1974). The presence of such a deficit is demonstrated by the pattern of clinical findings (Rutter, 1968; Rutter, Bartak and Newman, 1971), the long term course of the disorder (Rutter, 1970), and the results of systematic experimental studies (Hermelin and O'Connor, 1970). Nevertheless, basic questions remain concerning the meaning of this deficit for theories on the nature and causation of infantile autism. First, what are the boundaries of the cognitive deficit and in particular does it extend outside language? Second, does it constitute the primary handicap which gives rise to other symptoms? Thirdly, if it does, does the cognitive deficit lead directly to the behavioural syndrome or must there be an interaction with a particular set of environmental or other circumstances for the syndrome to develop?

In his original description of children with early infantile autism, Kanner (1943) commented that the parents were usually highly intelligent and that many were rather obsessive individuals who lacked real warmth. Subsequently he elaborated on these parental features (Kanner, 1949), and together with Eisenberg went on to suggest that autism was the result of an interaction between an innate ‘organic’ defect and a particular family environment (Eisenberg and Kanner, 1956; Eisenberg, 1957).

Although psychiatrists trained in the United States and the British Isles pick out the same areas of psychopathology, American psychiatrists display a tendency, greater than British psychiatrists, to use high ratings of pathology when asked to rate a videotaped clinical interview (Kendell et al., 1971; Sharpe et al., 1974). Within the British Isles Maudsley-trained psychiatrists rated lower than psychiatrists trained at other centres (Copeland et al., 1971).

This paper reports the initial analysis of a series of observations of a number of depressed patients communicating with their spouses and with a third party. This is part of a larger study which arose out of our dissatisfaction with the traditional ways of thinking about depressed patients. By and large there is general agreement about the people who are called ‘depressed’; there are constellations of symptoms and signs which can be evaluated by using one of the many rating scales for depression which have a degree of reliability and consistency. However, we feel that most of the thinking which underlies these efforts is based on presuppositions which would place ‘the depression’ within the patient, that is to say that there is something wrong within the patient which causes the symptoms and gives rise to the signs. These views are reductionist in character and we have by contrast attempted to reexamine certain aspects of depression using non-reductionist ideas.

During 1973 there were 169,362 abortions notified to the Chief Medical Officer at the Department of Health. In a leading article the British Medical Journal (1973) acknowledged that ‘bald statistics cannot help to answer the important question of the nature of the physical and emotional sequelae of termination of pregnancy’. The article called for careful prospective studies to assess such sequelae. This paper is a report of a short-term prospective study of the psychiatric sequelae.

Work in England (Kaldegg, 1956) and America (Wechsler, 1958; and Jones and Parsons, 1972) has suggested that heavy drinking, while in the later stages leading to all-round intellectual deterioration, in the early stages frequently causes deficits in visual/spatial and visual/motor co-ordination and visual memory. Kleinknecht and Goldstein (1972) suggest two general areas of deficit, inability in abstract reasoning and problem solving, and inability in tasks involving speed and perceptual/motor co-ordination. These functions are known to deteriorate with age and so deficits due to alcohol look like premature senescence of intellectual and psychological processes.

IQ, appears to play a major role in the development and course of schizophrenia. Patients with low IQ tend to have an earlier onset (Pollack, 1960; Belmont, Birch, Klein and Pollack, 1964; Offord and Cross, 1971), to stay in hospital longer (Offord and Cross, 1971) and improve less while there (Pollack, 1960), to remit less often (Stotsky, 1952) and to make a poorer post-hospital adjustment (Pollack, Levenstein and Klein, 1968) than patients with normal or high IQ. In addition, schizophrenics, particularly the men, tend to have lower childhood IQs than their siblings (Lane and Albee, 1965; Offord, 1974).

Manic-depressive psychosis is considered to comprise two different clinical entities, bipolar and monopolar. This dichotomy is based mainly on Western clinical material. The present study aimed at eliciting any differences that might exist between monopolar and bipolar manic patients in respect of three factors: (i) occurrence of psychiatric illness in first degree relatives; (ii) parental death before the patient's 15th birthday; and (iii) socio-economic status of the patient. Venkoba Rao (1973) studied the differences between monopolar and bipolar endogenous depressives on three factors: occurrence of affective disorder (including suicide) in first degree relatives; parental loss before the patient's 12th birthday, and the extent of ‘jointness' of the patient's family.

This preliminary communication draws attention to a condition that may adversely affect psychiatric personnel, and to some of its determinants. Personnel working in institutions where meetings are a major occupational activity appear especially at risk. The condition is a pathological response to groups or collections of colleagues met together in circles for professional purposes. Idealization of these groups and their activities leads to a craving to join them and to dependency once membership is achieved; less often rejection symptoms arise.