For the past fifteen years we have been studying aspects of relationships between sleep, activity, nutrition and mood. This paper comprises a brief statement of some of this research and our views to date.

One hundred and sixty-six patients who had ECT in either 1971 or 1976 were interviewed. The 1976 sample represented 89 per cent of those available for interview. Their experiences of ECT and their attitudes to it are described. They found ECT a helpful treatment and not particularly frightening, but side-effects, especially memory impairment, were frequent.

Twenty-six subjects who complained of permanent unwanted effects following ECT were compared with two groups of control subjects on a battery of 19 cognitive tests. Many statistically significant differences were found in cognitive functioning, mostly attributable to the level of depression or medication in the complainers. However, after analysis of variance/co-variance some differences still remained, indicating impaired cognitive functioning in the ECT complaining group.

Cognitive function was compared in carefully matched groups of ECT and non-ECT treated depressives and in matched normal volunteer controls on admission, at 4 months and at 7 months. ECT caused little impairment at 4 months and no impairment at 7 months on a comprehensive cognitive test battery. Severity of depression had a marked effect on cognitive function. Within the ECT group bilateral ECT caused more impairment than unilateral ECT one week after a course but 3 months later the differences had disappeared. They were equally antidepressant.

The clinical features shown by 50 psychotic patients were documented by interviews held with the patient and next-of-kin, brief videotaped interviews and nurse rating in addition to the hospital case record. Three raters studied all the available material and made master ratings. Comparison of the ratings made at mental state interview with these master ratings showed that this interview missed a great deal of the pathology agreed to be present. The interview with the next-of-kin was helpful in identifying manic symptoms. Nurse rating based on an 8-hour period of observation was less effective overall, but highly significant associations with the master ratings were achieved in 29/57 areas studied. In four areas (uncooperative behaviour, concern for others, agitation and distractibility) it was superior to either interview.

Formerly anticipatory grief was viewed as a potential coping mechanism for a prospective loss. More recently it has been studied in preventive psychiatry as a determinant of the severity of post-mortem grief. The authors in a critical analysis of methodological and theoretical inconsistencies recommend a reconsideration of the concept within a psychosocial context.

Homosexuality in the male is commonly held to be the product of a specific family constellation consisting of a dominant mother and an ineffectual or hostile father. Prospective studies however, on boys with early effeminate behaviour, the majority of whom subsequently become homosexual, show that their closeness to the mother and distance from the father spring from their own needs. The physician should feel free to relieve parents of guilt for this condition.

A group of outpatients scheduled for hearing evaluation were screened for psychiatric morbidity using the General Health Questionnaire (GHQ-30). There was an association between objective hearing loss and elevated GHQ-30 score. An association was also found between the presence of tinnitus and vestibular symptoms and elevated GHQ-30 score.

The files of a narrowly defined group of schizophrenic patients, admitted to hospital for the first time in their lives in 1963, and who were representative of cases from a large un-selected population, were examined for Schneider's first-rank symptoms. Forty-three such patients were followed-up in 1977. Using stepwise regression, it was found that Schneider's first-rank symptoms relate to outcome such that they can ‘explain’ from 17 per cent to 26 per cent of the variance on four outcome measures. The presence of some first-rank symptoms correlated positively with good outcome, others negatively, whilst some correlated differently with different outcome measures. Thus, assessment of only the presence, absence or number of first-rank symptoms is unlikely to relate to outcome.

Some research indicates that thought-disordered schizophrenics produce language utterances that are less predictable than those of non-thought-disordered schizophrenics and controls. We examined the hypothesis that thought-disordered schizophrenics would have a parallel deficiency in the ability to use the predictabilities provided by contextual constraint to improve recall of heard language passages. Subjects were seventeen schizophrenics, ten normal controls, and twelve psychiatric controls, evaluated by standardized psychiatric interview and diagnosed according to research criteria. The data obtained supported the hypothesis and non-thought-disordered schizophrenics performed similarly to controls in the experimental task.

Failure to classify schizophrenic subjects on the dimension of thought disorder may result in misleading comparisons of general samples of schizophrenics with controls on tasks requiring language perception and production.

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.

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.

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.