Opiate antagonists, such as naloxone, have been employed to indicate the possible involvement of endogenous opioids in a variety of behaviours including the pathogenesis of schizophrenia. This paper describes two experiments which were performed to determine the effects of naloxone on fluid intake and activity in rats. In experiment 1, the administration of 1mg/kg naloxone significantly (p<0.001) reduced water intake. 10mg/kg naloxone considerably reduced water intake, although this result was not significant. This influence was transient, since water intake was restored to control levels at the end of the 4 hours test period, and not dose related. A low dose of naloxone 0.01mg/kg produced no effect. In experiment 2, doses of 1 and 10mg/kg did not influence locomotor activity, rearing or grooming in the open field. These results suggest that naloxone may exert a primary antidipsogenic action that does not depend upon any suppression of concomitant activity. Furthermore, mechanisms controlling water intake and activity appear to be dissociated. A speculative role for the endogenous opioid system is discussed.

The aetiology of dental anxiety is multifactorial. Psychologically traumatising events associated with dental treatment have been shown to be of particular importance. The present investigation examines the role of memory in relation to these traumatic episodes and investigates their influence on the patient's response to dental treatment.

The study has shown that patients with dental anxiety have had more experience of “traumatic dental events” (p<0.001), relate the cause of their dental anxiety to specific dental procedures and report more fear of dental treatment than controls. The memories of such traumatic dental events are important indicators of anxiety in the clinical setting, with dentally anxious patients having significantly higher scores for dental anxiety (p<0.001) compared with controls. Furthermore, the memories of these events have a special relevance to the patient's subjective experience of dental anxiety in the here and now. The past event sensitises the susceptible patient and maintains and intensifies the anxiety through a feed-back mechanism, resulting in a vicious circle of anticipatory dental fear.

In a national representative survey, 1,403 people were interviewed on their attitudes to depression and its sufferers and their understanding of the causes, treatability and treatment of depression. Some two-thirds of the interviewees regarded depressives as being neither mentally ill, weak willed, nor as feeling sorry for themselves. Stress, bereavement and hereditary were considered to be the most frequent causes of depression. Seventy-three per cent said that depression could be successfully treated. While 81 per cent recommended getting professional help, only 17 per cent mentioned their GP as a source of treatment for depression. People who had depression, or who had a friend or relative who had depression and those who had visited a patient in a psychiatric hospital expressed more positive attitudes to depression and its management.

During the course of imprisonment, whether on remand or when serving a sentence, people sometimes need to be transferred to a psychiatric hospital. In the Republic of Ireland the only psychiatric hospital a person can be transferred to is the Central Mental Hospital (C.M.H.).

We describe 99 female prison transfers to the C.M.H. between 1983 and 1988. The mean age of the 70 sentenced prisoners was 26.43 years and that of the 29 remand prisoners was 33 years. The primary diagnoses were Schizophrenia (11), Mania (7), Depression and Stress (23), Personality Disorder (36), Mental Handicap (2) and Drug Addiction (16). The longest average stay at the hospital was for personality disorders (5 weeks). The longest sentences were for drugs offences. There were no cases of homicide or sex offences. We recommend that many of these cases could be handled in their catchment area hospital rather than in a high security Special Hospital.

Twenty-six women who had been sexually abused in childhood were assessed by means of structured interviews as to the nature of the abusive experience and subsequent psychiatric disorder. Nineteen (73.1%) fulfilled the criteria of Post Traumatic Stress Disorder and a comparison was made between PTSD and non-PTSD groups with regard to quantitative abuse variables. The phenomenon of latency or delay in onset in PTSD symptomatology was investigated. The possible implications of those findings were discussed.

Motivation towards learning was assessed in a class of 3rd, 4th and 5th standard, using a self report scale. Results for children identified as behaviourally deviant were compared with those of their non-disturbed peers. The findings show no significant difference on motivational scores between both groups; behaviourally deviant children differing from their non-disturbed peers only on an informational subscale of judgment.

Two cases of prolonged hypersomnia following neuroleptic therapy are described. No previous reports exist in the literature. The implications are briefly discussed.

The effects of a series of 6 ECT treatments were observed on the CSF concentrations of neurotensin and substance-P in eight patients suffering from schizophrenia. Four patients were previously drug free. No significant effects of ECT were observed.

We report a case of the Capgras Syndrome in a 67 year old woman who was found to have a glioma of the left frontal lobe. Our case illustrates the multiplicity of possible aetiological factors which frequently coexist in this condition and make any assessment of possible pathogenetic mechanisms difficult. However, there appears to be a consensus of recent neuro-imaging studies that frontal lobe pathology may be important. The possible relevance of this is discussed together with a suggestion for further elucidation of the origin of the delusion.

A case of unilateral auditory hallucinations with endogenous depression is described. Treatment of depression improved the hallucinations. The relationship of lateralisation phenomena with cerebral hemispheric dys-function and peripheral ear disease is discussed.

The reception of family therapy into a psychiatric profession that during the 50s was inclined to sanctify the individual psyche rather than the system inevitably polarized the profession. Psychiatrists contribute a significant referral imput to family therapy services in public health settings and therefore their knowledge of and disposition towards family therapy are influential elements of the context within which family therapy is practised, (i) This paper, through the use of a questionnaire, addresses qualitatively the prevailing attitudes and conceptualizations of psychiatrists working in the Eastern Health Board, Ireland, regarding family therapy, (ii) It looks at these opinions in the context of recent research findings on the efficacy of family therapy and highlights a famine of concise information regarding specific family treatment modalities, (iii) Finally it looks at the difficult relationship that exists between the old and the new epistemologies, which may be termed the ‘conservative and the impetuous’, and the implications for legitimate research into family therapy in the context of a consumerist-driven health service and at the interface of conflicting ideologies.

Hepatic encephalopathy is a neuropsychiatric disorder usually associated with severe hepatic insufficiency. It may however be divided into clinical and subclinical groupings. Psychometric testing, serial EEG's, EEG spectral analysis and event related potentials are all presently being used to quantify and differentiate between the various stages of hepatic encephalopathy. We review the use of psychometrics in hepatic encephalopathy and discuss evidence that these findings are comparable with the more objective data of electrophysiological studies. An adequate, simple and inexpensive assessment may be carried out using a battery of psychometric tests which include number connection tests and five pointed star construction.

Interest in the process of reminiscence has increased in recent years. This article reviews changing attitudes to reminiscence and the various theories as to its function. Some clinical applications are discussed, in particular its potential therapeutic value in dementia.

A significant minority of cases of Huntington's disease commence before the age of 20 years and these juvenile cases are more likely to demonstrate paternal transmission and a clinical picture dominated by rigidity. Genetic research and positron emission tomography may make early diagnosis easier but predictive testing in childhood is replete with serious problems. There is no specific treatment for this fatal disorder. Juvenile Huntington's disease has a similar pathology and biochemistry to the adult condition despite a shorter course and certain clinical differences, such as rigidity and convulsions. Racial differences are explored.

Anxiety states comprise three components, the subjective, the physiological and the behavioural. Anxiety disorders differ from normal anxiety in that cognitive clues inducing the emotion are covert. Anxiety can be induced by a variety of chemical agents, including the catecholamines, caffeine, lactate and some beta-carbolines. Models can be built up from the standpoints of Schachter, Lader and Matthews, and Clark to provide a cohesive theoretical framework for anxiety and panic disorders. Both pharmacological and psychological treatments are effective in these conditions and the model can incorporate the mode of action of these therapies. The ultimate goal is a holistic concept of anxiety combining the bio-psycho-social approaches.

Lithium treatment, employed in western countries by 1 – 1.5 persons out of every 1,000 in the population, might with advantage be used more for mania and as a supplement to antidepressants in treatment refractory depressions. Prophylactic efficacy is as good in unipolar depressive as in bipolar illness. Start and discontinuation of prophylactic treatment is decided jointly by patient, spouse and psychiatrist. Treatment intensity (dosage, serum level) should be fine-tuned to lowest effective level. Treatment safety is ensured by observation of guidelines and precautions, and again cooperation between the psychiatrist and the carefully instructed patient and family is essential.