This article formulates a definition of the term dangerousness, indicates why the commission of dangerous offences cannot be reliably predicted, and then reviews the several factors which have been or might be used by those who have to make decisions about dangerousness in criminals. It suggests that these factors are useful insofar as they help to illuminate the individual's capacity to feel sympathy and to learn by experience. Since the accuracy of prediction varies inversely with time, the maintenance of personal relationships and good communication seems the inescapable requirement in the management of potentially dangerous criminals.

The history of writer's cramp is reviewed, and the study of ten cases described. Nine of the patients were male with obsessional personalities, and involved in a conflict with some bearing on the act of writing. Treatment by psychotherapy and re-education produced either temporary or little improvement; biofeedback, used in six cases, produced some benefit in four, of which only one relapsed. Although no statistical weight can be attached to the results of so short a series, biofeedback appears to offer a promise of response which merits further investigation. The use of the electromyograph is discussed also as a means of discriminating between tension and tremor in such cases, with particular reference to their psychosomatic meaning.

During a nine-month period (1974–75), 1,050 students (846 male, 204 female) at Ain Shams University, Cairo, attended the Student Health Centre. Fifty-two per cent were referred there by their general practitioners, 5 per cent by their families and 3 per cent through their faculties; the remainder (41 per cent) were self-referred.

Male patients represented 2·8 per cent of the male students, but female patients only 0·9 per cent of the female students. In faculties dealing with practical subjects the male-female ratio was higher than in those dealing with more theoretical subjects. The diagnoses included anxiety neurosis (36 per cent of the cases), schizophrenia (18 per cent), depression (15 per cent) and neurotic depression (12 per cent).

Forty-six mentally ill women with radiologically verified hyperostosis frontalis interna (HFI) were compared with 46 matched mentally ill women without HFI in respect of mental morbidity among the full siblings of the two groups. It was found that mental morbidity was lower among the siblings of mentally ill women with HFI than among those of similar mentally ill women without HFI. A reasonable interpretation of these findings is that the combination mental illness-HFI is more often exogenously determined than other forms of mental illness.

A computer-administered ‘interview’ was developed for eliciting evidence relating to alcohol problems. Thirty-six volunteer male patients on their first visits to a specialist alcohol clinic were interviewed three times, by two psychiatrists and by the computer; information was sought about 72 predefined indicants concerning alcohol consumption, drinking behaviour, and symptoms. Each patient was asked to complete an attitude questionnaire anonymously.

The extent of agreement between the evidence elicited by the computer and by the psychiatrists was quite high, and their estimated error rates were very similar, all between 10 per cent and 12 per cent in total. With respects to amounts of alcohol consumed, patients reported significantly greater amounts to the computer than they reported to the psychiatrists. The median amounts of pure ethanol consumed ranged from 1 · 19 kg per week calculated from reports made to one of the psychiatrists, up to 1 · 58 kg per week calculated from reports made to the computer. The results from the attitude questionnaire indicated a high level of acceptability to patients of computer interrogation.

Plasma levels of amitriptyline and nortriptyline were similar in ten depressed patients after administration of amitriptyline hydrochloride in three divided doses or as a single daily dose. Maximum comparability of the plasma levels is achieved by sampling 12 to 16 hours after the single daily dose, or 3 to 7 hours after the morning dose on a thrice-daily schedule. Owing to the long biological half-life of these drugs, therapeutic plasma levels are maintained on a once a day dosage schedule, and the need for sustained release preparations appears questionable.

Nine patients diagnosed as having acute schizophrenic psychosis were treated with chlorpromazine. Their clinical response to drug treatment was measured by the use of a clinical rating scale developed from the Present State Examination, and a nurses rating scale. Plasma levels of chlorpromazine (CPZ), 7-hydroxychlorpromazine (7OHCPZ), monodesmethylchlorpromazine (NOR1CPZ) and chlorpromazine sulphoxide (SOCPZ), were monitored during the period of hospital treatment. Correlations were made between the increase in plasma levels of drug or metabolites and improvement in the different PSE scores. These showed that the most significant correlations occurred when symptoms with high diagnostic significance for schizophrenia (Group 1) and symptoms rating perceptual disorders (P) were correlated with plasma 7OHCPZ levels in plasma samples taken before the first morning dose of CPZ. The ratio of 7OHCPZ to CPZ in these samples increased significantly as clinical ratings improved, this correlation being most highly significant against the Group 1 and P scores. The ratio of 7OHPCZ to SOCPZ increased significantly only in the case of Group 1 and P scores. This indicates a preferential shift of CPZ metabolism towards the formation of the active 7OHCPZ during the period of clinical improvement.

The psychological function of the social network is considered in terms of attachment theory. Social bonds are proposed as essential for obtaining a commodity commonly but unsatisfactorily referred to as support. Requirements for this complex commodity can be discerned in a wide range of contexts. Examples considered are the evolutionary origin of the social network itself, the concept of psychosocial supplies, the distribution of neurosis in Western and non-Western populations, the use of medical consultations, psychotherapy and habitual responses to adversity or disaster. In these and other contexts, it is apparent that individuals have, quite simply, a requirement for affectively positive interaction with others. Under stressful conditions this interaction is called ‘support’. When support is lacking there is evidence that psychiatric and perhaps medical morbidity rates increase. For research, the objective must now be to determine whether depleted primary group interaction is causally related to morbidity, or whether it is only an associated or a secondary factor in aetiology, or indeed wholly unrelated. Elucidating more precisely why people need people constitutes an important new task for social psychiatry.

Junior schoolchildren were screened for high risk of emotional and educational disorder. The information was gathered from the school, using standard and objective tests. The multiple criterion screen employed, comprised: (a) classroom behaviour scale (Rutter B Scale), rated by teachers; (b) sociometric tests; choice of companions by classmates. From these, lack of positive choices was taken as a measure of isolation and a high rate of negative choices, as a measure of rejection; (c) Reading quotient of 75 or below on the Young Reading Test; (d) Absence from school for reasons considered by teachers to be trivial.

The number of cases identified by the screening was found to be 322 children per thousand. They may be seen as representing a high risk rate.

Using extreme scores as indicative of high risk, approximately 17 per cent of children were identified on the basis of the behaviour test; 12 per cent by the reading test; 9 per cent by the isolation test; 8 per cent by the rejection test and 3 per cent by the absenteeism test. Seventy per cent of the identified children were rated clinically as disturbed. Absenteeism identified the smallest percentage of cases and made the smallest independent contribution to identification. Isolation was not impressively related to neurotic or antisocial beha viour. The three important criteria, therefore, were behaviour, rejection and reading.

Corrected disturbance rates for our population of 7-8-year-old children, including those not identified by the screen, were 6-8 per cent markedly maladjusted and 33.7 per cent somewhat maladjusted.