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].

One hundred and two mentally handicapped and severely mentally handicapped patients with behaviour disorders and superadded mental illnesses which, in most cases, had not responded adequately to oral medication, entered a 12-week study of fluphenazine decanoate depot injections. Some of the patients had the additional complications of epilepsy, organic brain damage, and physical handicap. Highly significant overall improvements occurred, irrespective of such factors as the patient's age, sex, degree of mental handicap, or co-existence of epilepsy, or brain damage. Hyperpyrexia was not encountered. Extrapyramidal disturbance in 22 of the patients, were mostly well controlled by antiparkinson medication; eight of the 12 patients with pre-trial extrapyramidal abnormalities lost these during the study. Fluphenazine decanoate injections proved a reliable drug-delivery system, which may improve difficult behaviours and enable the mentally handicapped patient to be more receptive to behaviour-shaping exercises, aimed at improving long-term personality adjustment.

Direct observations were made of patients' behaviour during occupational therapy sessions in a psychogeriatric ward, and were used to suggest changes in the conduct of these sessions, and to evaluate the effectiveness of the changes. The intervention was successful in bringing about situation-specific increases in clients' appropriate behaviour.

Relationship between the psychiatric diagnosis and the side of temporal EEG focus was analysed in 62 temporal lobe epileptics. Neurotics had right temporal foci significantly more frequently, while there was no such laterality effect in other psychiatric diagnostic groups.

The seasonality of births was examined for 4,855 schizophrenic patients born in Ireland between 1921 and 1955. All general births for the same years were used as controls. Schizophrenic births were found to be significantly elevated in the second quarter of the year (P <.001). The excess was 11 per cent higher than for any European country examined to date.

The psychotherapeutic treatment of 15 patients is described. The goals were defined in terms of target problems and target dilemmas, traps and snags, and the outcome was assessed by rating these or with a symptom questionnaire and a dyad repertory grid before and after treatment. Patients who rated dilemmas as resolved showed appropriate changes in construct correlations on the dyad grid.

Several cases of increases in frequency of mood cycling have recently been reported in women as a result of tricyclic antidepressant treatment (Siris et al, 1979; Wehr and Goodwin, 1979). We report here the occurrence of 48-hour rapid cycling in a man with recurrent unipolar depression after treatment with dibenzepin (Noveril), an atypical tricyclic antidepressant. Alterations in urinary cyclic adenosine monophosphate (AMP) have been reported with mood changes and were therefore evaluated at the same time.

The hypothesis that ego states, as defined in Transactional Analysis, are distinct and identifiable phenomena was tested. Ten TA therapists were asked to assess which of the three ego states, Parent, Adult or Child, were present in forty statements extracted from the tape of a family therapy session. The level of agreement reached was statistically highly significant. There was a certain amount of inter-rater variability, and potential sources of disagreement are discussed.

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.

Verbal and nonverbal communication of affect was examined in schizophrenic and control families, using audio tapes and transcripts of family interactions. In Study 1, data were available for parents interacting with their schizophrenic child (index session) or with a well child (well-sibling session), and for two parent-child sessions in normal families. In Study 2, data consisted of index sessions only with schizophrenic, non-schizophrenic psychiatric, and normal families. Audio tapes were electronically filtered, and ratings were obtained on nonverbal (filtered speech) and verbal (transcript) samples. The double-bind hypotheses of different nonverbal expression of affect and greater verbal-nonverbal discrepancy in schizophrenic as compared to normal families were not supported. In both studies no overall differences were found between diagnostic groups in terms of nonverbal ratings, indicating that clinical perceptions of inappropriate and conflicted affect in schizophrenic families are not based on spontaneously produced simultaneous discrepancy between verbal and nonverbal channels of spoken communication.

During recent years there has been considerable controversy concerning the classification of depressive disorders. Investigators disagree as to whether depressive disorders are a single phenomenon with varying degrees of severity or are a group of two or more discrete illnesses with differing courses, prognoses, responses to treatment, familial backgrounds, aetiologies, and clinical pictures (Eysenck, 1970; Kendell, 1976; Foulds and Bedford, 1976; Andreasen and Winokur, 1979). They also disagree about the boundaries between depressive disorders and anxiety disorders, schizophrenia, personality disorders, and normality (Roth et al, 1972; Kay et al, 1976; Kendell and Gourlay, 1970a and b; Tsuang et al, 1976). There is no consensus as to what constitutes adequate validation of a nosological class; a variety of independent validators have been proposed, including genetic factors, outcome, responses to treatment, and neurochemical or neurophysiological markers (Guze, 1978; Blashfield and Draguns, 1976; Kupfer et al, 1975; Reider and Gershon, 1978).

Adult metachromatic leucodystrophy (MLD) is a rare demyelinating disease of the central nervous system caused by a genetic autosomal recessive defect and mediated through a deficiency in the enzyme arylsulphatase A (Peiffer, 1970). The initial manifestation may take the form of symptoms suggestive of schizophrenia or dementia (Sourander et al, 1962; Austin et al, 1968).

Marital interaction appears to be relevant to alcoholism. This study compares two groups of couples, each presenting with sexual dysfunction. One group has an alcoholic member in each couple, one group does not. Data are presented suggesting that alcoholic marriages can be distinguished, in a clinically useful way, from other troubled marriages. Alcoholic husbands feel submissive, but are not being forced by their wives to be so. This suggests a therapeutic approach different from the one that would be taken if the wives were actually dominating.

Electrodermal activity was measured in a group of depressive patients and normal controls. Those patients classified as endogenous on the Newcastle Scale had significantly lower skin conductance levels than either the non-endogenous patients or controls. The endogenous depressives also contained significantly more non-responders to the experimental stimuli. The lack of responsivity to external stimulation in non-responders is associated with a significantly lower rate of blood platelet 5-hydroxytryptamine uptake, suggesting that endogenous depressives have biological characteristics that distinguish them from other depressive groups and that electrodermal measures may be useful in the classification of depressive illness.

This paper describes two women. The first was admitted to hospital having suddenly, and without adequate reason, developed the idea that a senior married colleague at her workplace had fallen deeply in love with her. The second woman is her mother, who had been admitted to the same hospital twenty-two years earlier with a well systematized delusion that her husband was unfaithful. Both syndromes have been described by de Clérambault as two of the three forms of psychose passionnelle. The present report is intended to clarify the concepts of psychose passionnelle and demonstrate the similarities between jealousy and erotomania. We believe these case histories describe the first reported instance of psychose passionnelle in successive generations of one family.

The comparative value of possible therapeutic factors in group psychotherapy was studied by submitting questionnaires regularly to patients and therapists of six long-term out-patient groups. Both patients and therapists attached most importance to self-understanding, self-disclosure and learning from interpersonal actions. They diverged, however, in their overall perception of which factors were important in therapy.