In 42 patients with cognitive dysfunction (senile dementia) significant correlations between immunoglobulins and various tests of intelligence were observed. Serum IgG emerged as the single best predictor of behavioural status. There is need for further research in this field.

Data from interviews with 64 women who were to undergo or already had undergone an augmentation mammaplasty were compared with data from a control group of 28 women. Great differences existed between the groups, mainly with regard to personality test data and childhood milieu. The women operated on were in general less certain of themselves and felt less feminine. These factors seem to be a sufficient basis for the appearance of the problem. Cultural norms are obviously also important but seem to influence all women in the same way.

This is a study of the symptoms and treatment of 61 patients with hysterical conversion. The incidence rate is high and the clinical picture showed different qualities from that seen in other studies. Treatment by suggestion under various procedures produced favourable results. All symptoms were removed, and after twelve months follow-up only 12 patients relapsed. Symptom substitution was minimal. The prognosis is related, among other things, to the duration of the symptoms before treatment.

Kinetic analysis of the transport of 5-HT into the blood platelets of depressed patients and recovered depressive patients has shown that the rate of accumulation of 5-hydroxytryptamine (5-HT) is significantly decreased both before and after recovery from the illness. This abnormality is corrected by both short and long-term lithium treatment. As a corollary to these studies, the effect of lithium in vitro on 5-HT uptake has been studied and the results are opposite to those reported in vivo. These findings suggest that lithium acts indirectly, and possible mechanisms of its action are discussed.

A controlled study comparing salbutamol (6 mg/day) to clomipramine (150 mg/day), both given by intravenous infusion, was performed on depressed inpatients (10 per group). The symptomatology was evaluated by two blind observers at days 0, 5 and 15 using the Hamilton Rating Scale. Both treatments were effective on the overall symptomatology but the onset of action of salbutamol was more rapid.

This 18 month prospective study assessed the time course of sleep disturbances in 85 male psychiatric out-patients and 103 male non-patients. Over one-third of the patients and 5 per cent of the non-patients reported frequent symptoms of insomnia during at least 14 of the 18 months. Frequency and chronicity of insomnia were strongly associated with intensity of psychiatric symptomatology, but not with diagnosis. Minor tranquillizers and hypnotics were used frequently by patients and occasionally by non-patients, but there was little indication that they altered the course of insomnia.

Two samples of newly admitted psychiatric patients were examined. Of 558 patients admitted during one year, 76 (13.7 per cent) came in from transitory accommodation or no fixed abode; of 456 patients discharged 131 (28.7 per cent) either changed address during their stay in hospital or left without known accommodation. Of 102 patients in the wards and day hospital on one day, 29 (28.4 per cent) came in from transitory accommodation or no fixed abode, 66 (64.7 per cent) were unemployed, 51 (50 per cent) were living alone. Of the 74 inpatients 30 (40.5 per cent) were homeless and 27 (36.5 per cent) had no visitors. These results indicate that many patients have lost their community supports by the time they reach hospital.

Causes of death were studied in a cohort of 200 schizophrenic, 100 manic, and 225 depressive patients who were followed in a historical prospective study. These patients were admitted between 1934 and 1944 and were studied 30 to 40 years later. Five cause of death categories were considered in this analysis: (1) unnatural deaths, (2) neoplasms, (3) diseases of the circulatory system, (4) infective and parasitic diseases, and (5) other causes. For each cause of death, the expected number of deaths was calculated from vital statistics for the State of Iowa for the time period of follow-up. Observed numbers of deaths were contrasted with expected numbers of deaths to assess statistical significance for each diagnostic group. There was a significant excess of unnatural deaths in all diagnostic groups in both sexes, with the exception of female manics. This group, however, did show a significant excess of circulatory system deaths. Both male and female schizophrenics showed a substantial excess of infective disorder deaths.

Atkinson (1971), in his chapter studying the role which coroners and research workers play in defining suicide, noted that by 1927 Hans Rost's bibliography of suicide cited nearly 4,000 works on the subject, while 2,000 further publications were listed by Schneidmann and Farberow between 1927 and 1961. He had personally traced another 300 studies subsequently. In the face of this vast output one hesitates to add yet another paper. However, historical surveys of popular views on suicide have received relatively scant attention, much of the most valuable work being carried out by historians.

The brothers of 73 delinquent boys were found themselves to be more antisocial than the brothers of 73 matched control boys. Further, the average antisocial score of the probands’ brothers increased with the number of brothers in the family, holding the number of sisters constant, and decreased with the number of sisters, holding the number of brothers constant. These results are interpreted in terms of male potentiation and female suppression of antisocial behaviour in boys. Results are also reported for 59 pairs of matched delinquent and control girls and their siblings.

A history of life events in the three months before onset of illness was taken in a group of schizophrenic and a group of depressed neurotic in-patients. The Expressed Emotion (EE) of the patients’ key relatives was measured. There was no difference between the schizophrenic and depressed patients in the rate of events in the three month period before onset or in the proportion of undesirable events. However, the two groups exhibited significantly different patterns of interaction between life events and relatives’ EE. Schizophrenic patients living with high EE relatives had a low rate of life events compared with those living with low EE relatives, whereas depressives living with high criticism relatives had a high rate of events compared with those living with low criticism relatives. The implications of these findings are discussed in relation to schizophrenic and depressive patients’ differential vulnerability to environmental stress.

Sixty patients, 30 with depressive neurosis, 15 with anxiety neurosis and 15 with phobic anxiety states, were treated with the monoamine oxidase inhibitor, phenelzine, in two different dosage schedules for four weeks. All patients received an initial dose of 15 mg daily, increasing to 30 mg daily between the third and seventh day, but subsequently, using double-blind procedure, one group took the commonly prescribed dose of 45 mg daily and the other took 90 mg daily. Acetylator status was independently determined before the start of treatment. Each diagnostic group showed a similar response to treatment, but patients taking the higher dose improved significantly more than those taking normal dosage, and the rate of improvement, measured by weekly self-ratings, was also more rapid with higher dosage. Acetylator status did not affect clinical response. The results suggest that dosage is more important in determining clinical response to phenelzine in neurotic disorder than specific diagnosis or acetylator status.

A survey of 14 published studies found no consistent association between specific HLA antigens and schizophrenia. Since these studies lacked diagnostic or biological criteria, an investigation was undertaken using recognized diagnostic criteria and CT scan findings. Typing for HLA antigens at loci A, B and C was carried out on 130 patients. Among 92 black schizophrenic patients there was an increase of HLA-A2 which remained significant even after correcting for the number of antigens studied. When the patients for whom CT scans were available were divided according to the presence or absence of evidence of brain atrophy, there was an increase of A2 in the black schizophrenic patients without evidence of atrophy, which remained significant after multiplying by the number of antigens studied. However, there was no significant increase of A2 in those with evidence of atrophy. Similar trends held for the white population but they failed to reach significance. The need for HLA studies on biologically defined groups of schizophrenic patients is stressed.

The patients discharged from a 24 bed acute psychiatric admission ward over a six-month period after the introduction of a contract admission procedure were compared with a similar group, discharged over the identical six-month period of the preceding year, before the use of the new procedure. The length of stay in hospital was found to be reduced, but preliminary studies suggest that the re-admission rate is not significantly altered. There was no evidence to suggest that shortening the length of stay in hospital increased the likelihood of relapse, nor were increased demands made on the day hospital service.

The study analysed qualitative and quantitative dermatoglyphic features in schizophrenia and manic-depressive psychosis. Differences were found which support the view that these two psychoses are genetically distinct. A possible field for further study is discussed.

Ten chronic schizophrenic in-patients and ten matched normal controls were tested on a cross-hemispheric stereognostic task, using both meaningful objects and non-meaningful shapes of wood, under four different retention intervals. The main finding was that the schizophrenic group but not the control group displayed deficits in intermanual transfer of tactual material, as compared to the same task performed within hands.

The implications of this result are discussed in relation to the possibility that some basic neurological disorder may accompany schizophrenia.

Computed tomographic (CT) and brief psychometric findings on 50 psychiatrically and neurologically healthy community residents over 60 years old are presented. The need for normative CT data is emphasized, and the methodological problems in obtaining them are discussed. Measures of ventricular size were generally found to be greater than those reported by other workers, and variation with age was also found to be less marked than hitherto reported. A reciprocal relationship was found between a global rating of cortical atrophy and a test of memory and orientation. This communication forms the basis for comparison with groups of psychiatric patients to be presented in subsequent articles.

In a double-blind parallel group study, thirty-two patients suffering from a primary affective disorder received either dothiepin or amitriptyline. Serum concentrations of total dothiepin plus northiaden or amitriptyline and nortriptyline were estimated. A similar therapeutic response was seen with both drugs but there was no correlation with serum concentrations of amitriptyline or nortriptyline, whereas serum dothiepin correlated positively with clinical response.

Peptidic neurones may be considered as multisignal integrators and transducers. When formation or release of peptide outstrips genetically determined breakdown capacity, overflow of peptides to the body fluids and urine may be expected. In this paper, pathological urinary chromatographic patterns of peptides are shown for genetic, functional and mixed disorders. Part symptoms of the disorders may be induced with the biologically isolated and purified peptides as well as with chemically synthesized peptides.

The work histories of 75 completed suicides and 150 controls were compared to test Durkheim's theory of the protective nature of work. The suicides showed more unemployment, more absence through illness, had more frequent job changes and held their jobs for shorter periods. They were less likely to retire gradually. There was no difference in social class mobility. Suicides were more likely to come from high risk occupations. The comparatively poor work record of the suicides is attributed to their high level of psychiatric morbidity.