A sample of 190 patients, diagnosed as schizophrenic by the same psychiatrist, have been surveyed in an urban community and their clinical and social status assessed. Compared to the local population as a whole, a significantly greater proportion of the men had never married, and although the women had married at approximately the same rate as those in the general population, 25 per cent of them had been divorced by the time of the interview. Assessments of the subjects' clinical condition by the Present State Examination were analysed into four groups of syndromes. Only 27 patients showed schizophrenic or paranoid symptoms, whereas neurotic symptoms were not only prevalent but seemed to cause most of the reported personal problems. Twenty-eight patients were free of symptoms at the time of interview. The great majority of the sample (72 per cent) were being maintained on long-acting neuroleptics. These data will form the baseline to assess a monitoring system, designed to keep the local psychiatric services in touch with schizophrenic patients who might otherwise drop out of treatment.

A study to test the relationship between body build and mental illness, conducted in Royal Park Psychiatric Hospital, Melbourne, is described. The Rees-Eysenck body index (REBI) and androgyny score (AGS) were determined for 225 male patients and 24 normals. As age increases, there is a decreasing trend in the scores for these two indices. There were no significant differences between the various diagnostic groups and the normal group for the AGS. But the difference between the non-paranoid schizophrenic group and paranoid schizophrenic group in REBI was significant.

Evidence is presented that the incidence of depression among users of oral contraceptives is no higher than that among matched controls not taking such medication. There is an association between high depression scores and high neuroticism scores, more marked in controls than takers. Intensity of depression is related more to age, personality and occupation than to the use of oral contraceptives. A higher proportion of users than of controls experience sexual satisfaction. Past takers include a large number of individuals with a high neuroticism score. The incidence of depressive symptoms in women increases with age. A higher proportion of housewives than of women going out to full-time work show depressive symptoms.

Despite dramatic clinical improvement in about one-third of a group of severely depressed, medication-resistant patients one year after modified leucotomy, their relative decrease in conjugated and free tyramine output after an oral tyramine load remained unchanged and abnormal. Whilst a direct deficit in intestinal tyramine-conjugating ability still needs to be finally ruled out, this appears most compatible with a deficit due to bodily metabolic failure, perhaps a deficit in membrane transport which could be an essential aspect of the depressive illness syndrome. Attention is drawn to a similar defect in migraine. The two illnesses may represent a common predisposition which an appropriate triggering mechanism may transform to the florid disease. Biochemical detection of such vulnerability may have important diagnostic and predictive significance.

In 1961, in collaboration with Dr D. Lindsay Walker, who supplied much information concerning the Association's birthplace, the Gloucester Asylum, I published in the Journal (1961) a detailed account of the origins of the Medico-Psychological Association, or rather of the ‘Association of Medical Officers of Asylums and Hospitals for the Insane’, as it was called for the first 24 years of its existence. This account ended with the 1854 Annual Meeting, the first to be reported in the Association's Journal. I now propose to cover a further instalment of its history.

Patients recently recovered from schizophrenic or manic-depressive psychoses showed larger ear difference scores than normal controls on a dichotic listening test, i.e. when asked to identify dissimilar words fed synchronously to the two ears. The possible significance of the finding is discussed, in relation both to hemispheric organization and to other aspects of cognitive activity which may underlie performance on the task.

Platelet and plasma amine oxidase activity was determined in a group of 99 healthy male (active duty military) alcoholics referred for hospital treatment who had been abstinent from alcohol for 2–10 days, and compared with that of a control military group. Platelet MAO activity was slightly but significantly lower in the alcoholic group. Both groups were significantly lower in MAO activity compared to a group of 42 non-military controls. In the alcoholic group there was no correlation between platelet MAO and severity or chronicity of drinking, nor was there evidence of iron deficiency to account for the lowered MAO activity. When the alcoholic and military control groups were split at the median, the first degree relatives of both the ‘low’ MAO alcoholics and the ‘low’ MAO military controls had a higher incidence of alcoholism than did the relatives of both ‘high’ MAO subgroups. No personal or family history data of alcohol-related problems were available on the non-military control group.

Previous research has suggested that schizophrenic speech is less predictable than normal speech. Two experiments designed to test the suggestion are reported, both of them based on Cloze Procedure. In the first, raters were asked to predict ten passages of schizophrenic speech and ten passages of normal speech under fourth-word deletion. No difference between the two types of passage was found. In the second, a modified form of presentation was introduced which prevented raters making use of the text which follows a blank. Once again, no difference was revealed between the schizophrenic and normal passages, and this was true for both the new and traditional forms of presentation, and for both fourth-word and fifth-word deletion patterns. The investigation is discussed in the light of previous findings, and a number of suggestions concerning methodology and forms of analysis are made for future research.

Erythrocyte catechol-O-methyl transferase (COMT) activity was studied in 65 patients with depressive illness and anxiety states. A hypothesis that measurement of this enzyme might have some value as an aid to diagnosis and as an index of clinical recovery has not been confirmed. In patients with endogenous depression, agitated subjects had COMT levels significantly higher than normal (P < ·01) and retarded subjects had levels significantly lower than normal (P < ·02). These observations are congruent with some reports of high and low urinary MHPG excretion in patients with depression. Further data correlating COMT assays with catecholamine metabolites in depressed patients may reveal homogeneous biochemical subgroups which could serve as a guide to rational therapy.

To bring to light the particular circumstances which from the outset weigh against the prospect of a successful result of sex reassignment the authors describe five male cases of transsexualism all of whom subsequently regretted the measure taken for sex reassignment. The number of factors suspected to be prognostically unfavourable was to a statistically significant degree more common among five ‘repentant’ cases than among nine cases with favourable outcome. It was also evident that the patients with unfavourable outcome were considerably older when they first sought help with the aim of obtaining sex reassignment. The results suggest that the more of such factors there are present in a particular case the stronger are the reasons for restraint in embarking upon a course of active intervention.

The serum and CSF of 66 patients with functional psychoses were tested for immunoglobulins and antibodies to measles, HSV-1, CMV, and rubella viruses. Ten surgical and 80 neurological patients were controls. There were no significant findings in the serum, consistent with most previous studies. In the CSF 6 of 17 multiple admission schizophrenic patients had definite elevations of IgG or measles antibody and differed significantly from the surgical controls. Immunologically this group resembled the seriously ill neurological patients. No previous study has been made of immunoglobulins or viral antibodies in the CSF of psychiatric patients. It is concluded that further work is warranted in a search for biological subgroups of schizophrenia.

Eighty-three consecutive patients with organic mental disorder were studied on their first admission to a psychiatric day hospital assessment unit in a general hospital. They were evaluated medically, psychiatrically and by social work, re-evaluated after 3 months, and again after 12 months or at death. The types of care, and the number of days in each setting, were recorded. Nearly three-quarters were dead or in institutions by 12 months: those initially living with spouses did worst, and those with their children did best, while those on their own became long-stay residents in institutions. Family support seemed the most important factor determining continued life in the community, and increased help to families from social services appeared to be needed. The value of earlier psychiatric diagnosis and earlier treatment of physical ills is also discussed.

A double-blind placebo-controlled trial of L-tryptophan, with pyridoxine and ascorbic acid, was carried out in 10 female patients suffering from mania.

In contrast to earlier studies led by Prange and Murphy, L-tryptophan was found to be no better than placebo.

Forty-five patients with obsessive-compulsive neurosis were given a specially devised structured interview with the aim of elucidating aspects of the phenomenology. Four main kinds of ritual were found to predominate: cleaning, avoiding, repeating and checking. A surprisingly large number of patients had little or no resistance to carrying out their rituals. The recognition of senselessness of a ritual was a more important criterion than that of resistance, but patients with predominantly repeating rituals did demonstrate resistance. It is proposed that a redefinition of obsessive-compulsive neurosis with less emphasis on resistance as a necessary condition may be appropriate.