We have gone far in getting to grips with the nature of the error underlying mental handicap in many conditions. In a number of these, this has given scope, for example, for treatment based on biochemical correction, and for valuable preventive measures. The cause of the condition of many mentally handicapped patients, however, remains mysterious when neither history-taking nor investigations have led to any clues.

Various characteristics of residents of a large hospital for the mentally handicapped were investigated in order to find any associations between these characteristics and the frequency of visiting by parents. The findings suggest that early attachment of the parents to the subjects is of more importance for visiting than present skills and behaviour. The most frequently visited subjects were more likely to recognize people, have some speech and have had a normal appearance as a baby. The unvisited subjects were more likely to have been born with an abnormal appearance and into homes with pre-existing social and emotional problems.

Of a sample of families containing abused and at risk children, in 29 per cent one or both parents had attempted suicide. The rate at which the suicide attempts were repeated within a year was higher than that expected for other attempters of the same age group. A previous history of psychiatric disturbance and marital breakdown was strongly associated with the combination of child abuse and suicidal behaviour. The relationship between child abuse and attempted suicide did not appear in most cases to have been a direct one; often both forms of behaviour seemed to reflect marital difficulties.

A method is described for identifying a genuine boundary between related syndromes, if one exists, by demonstrating a non-linear relationship between symptomatology and outcome. The technique was applied to the putative boundary between schizophrenic and affective psychoses, but a non-linear relationship could not be demonstrated.

This paper describes a patient with an almost 48-hour manic-depressive cycle but with a daily shift of the switching time, the latter having itself a cycle of five days. The mood change always occurred gradually and during the day, never at night. Between manic and depressive phases there was a difference in the frequency of the EEG alpha rhythm. The patient showed a good response to lithium treatment.

Heredity has been shown to be an important factor in the aetiology of manic-depressive psychosis. Recent linkage studies with colour blindness have suggested the presence of an X-linked dominant gene in the transmission of manic-depressive psychosis. We report here positive evidence of a linkage between manic-depressive psychosis and glucose-6-phosphate dehydrogenase deficiency in an informative family assorting for both traits. These results strengthen previous linkage studies in affective illness and support the hypothesis of X-linkage in a subgroup of manic-depressive psychosis.

Erythrocyte membrane adenosine triphosphatase activities were examined in twelve unipolar depressed patients receiving ECT. Eleven patients undergoing diagnostic cystoscopy served as controls for the acute effects of anaesthesia, and sixteen healthy subjects served as non-depressed controls. The unipolar depressed patients had a slight reduction in their (Na++K+)-ATPase activity but effective ECT treatment was not associated with any increase in this activity. This approach is unlikely to cast further light on the membrane phenomenology of depressive illness.

Concentrations of noradrenaline (NA), homovanillic acid, 5-hydroxyindoleacetic acid and cyclic nucleotides were determined in lumbar cerebrospinal fluid (CSF) from acute and chronic schizophrenics and various groups of psychiatric and non-psychiatric control subjects. Statistically significant increases in NA and cyclic adenosine monophosphate were found in CSF from chronic schizophrenics compared to all other groups. These results were shown by statistical analyses to be unrelated to medication. They may be interpreted as evidence for noradrenergic overactivity as a possible primary abnormality in chronic schizophrenia.

The perception by schizophrenic patients of stimuli with more than one feature (dimension) was investigated using psychiatric and non-psychiatric control groups. Indices of the ability (a) to make use of redundant stimulus cues, (b) to ‘screen out’ or filter irrelevant stimulus features, and (c) to scan the perceptual field for relevant stimulus features, indicated that only filtering was consistently poor in schizophrenia. It has been suggested that the schizophrenic patient may tend to perceive his environment in an undifferentiated holistic manner rather than in an analytic manner and the implication for the theory of left hemisphere pathology in schizophrenia is discussed. However, the performance of the schizophrenic subjects did not differ significantly from that of the group of depressed patients, which suggests that the selective attention deficits previously observed in schizophrenia are not specific to the disorder.

The stereotype of the older male homosexual is one of disengagement from the homosexual world, loneliness, rejection, depression and unhappiness. This typical picture of the ageing homosexual is not supported by the findings from 478 homosexual men in Australia with diverse backgrounds. There are no age differences in psychological well-being and involvement in the gay community. The older homosexual does believe he has less control for his sexual orientation and attempts to hide his homosexuality more than his younger counterparts. These latter findings appear to be generational differences. Implications for professionals working with homosexuals and their parents are briefly discussed.

Sichuan is the biggest province of the People's Republic of China, with a broad area of over 560 thousand square km and a population of over 90 million people. The central portion of it is a big basin about 200 thousand square km in area, surrounded by many mountains with average altitude between 1,000 and 3,000 m above sea level. About 90 per cent of the population of the province lives in this area. The west portion of the province, called West Sichuan Plateau with average altitude of over 3,000 m, is relatively unpopulated. According to a census of a district of Zigong in 1973, 39.2 per cent of the population was below age 15 and 4.3 per cent above age 65. [In Britain (1975) the corresponding figures were 25 per cent and 14 per cent—Editor].

Despite the recent proliferation of telephone counselling services, there have been few rigorous studies of their effectiveness. Effectiveness has been assessed in terms of possible changes in suicide rate, caller compliance with counsellor recommendations, counsellor performance, and caller satisfaction, though none of these indices have been entirely satisfactory (Auerbach and Kilmann, 1977; France, 1975; Greer and Anderson, 1979). We have compared counsellors' and callers' perceptions by recontacting callers shortly after their initial call for help.