The matrimonial stability of 142 families where a child with neural tube malformation (mostly spina bifida) was born between 1964 and 1966, including 56 families with a surviving spina bifida child, was examined in January 1976. The divorce rate for families with a surviving child was found to be nine times higher than that for the local population and three times higher than for families experiencing bereavement of their spina bifida child. Marriages which followed a pre-nuptial conception resulting in a spina bifida child were particularly vulnerable and had a divorce or separation risk of 50 per cent. All the divorced fathers had remarried, but only one of the mothers. It is concluded that a handicapped child adds greatly to the strain on a marriage, especially when this has not been cemented before the arrival of a child. This strain is diminished by the child's early death.

Two hundred and seventeen women between the ages of 40 and 55 years referred to a gynaecological out-patient clinic were screened for psychiatric illness by means of the General Health Questionnaire (GHQ) and a brief special questionnaire. Of the 114 women identified as possible psychiatric ‘cases' 104 were interviewed. A standardized psychiatric interview schedule was used. Compared with a general population sample from the same geographical area and in the same age range, women presenting at the gynaecological out-patient clinic were predominantly pre-menopausal and from the lower end of the 15-year age range, and were more likely to be separated or divorced, less likely to be single, and more likely to have had previous or to have subsequent contact with the local psychiatric services. A higher proportion of women were identified as psychiatric ‘cases' in the clinic population than in the general population, and their psychiatric disorder appeared to be more severe and more depressive in nature. The findings for this age group support the view that among women presenting for hysterectomy there is already an excess of psychiatric illness before the operation.

The association of gynaecological complaints and psychiatric morbidity in the pre-menopausal years is discussed.

This paper presents information on a shortened form of the Stockton Geriatric Rating Scale, which is shown to be as effective as the original version in discriminating among the elderly. The results for 400 people in the care of hospital or social services provide provisional normative data for the use of the scale, which should be of value in assessing the behavioural competence of the elderly on an individual and group basis.

In 1975 a long-term follow-up was undertaken on patients collected as in-patients, treated and studied in 1962–64 (Bovill, 1972). Treatment was by didactic group psychotherapy and relaxation. Treatment was for a mean of six months and of 30 sessions, treatment remained available on demand for a mean of two years after discharge from attendance. In 1975 30 treated patients and 24 control patients were traced out of the original 36 in each group. The criterion of success was, as before, the inverse of days spent re-hospitalized. The success ratio fell from 7: 1 in 1962–64 to 2½: 1 in 1965–74 and to 2: 1 in the single year 1974. This fall was expected in view of the known spontaneous recovery rate operating on the controls.