Using a sample of 198 depressed patients (145 female, 53 male) retrospective histories of the illnesses were collected during a depression-free interval, based on a catalogue containing 38 symptom items and the course of the depression (including the interval personality). A cluster analysis on persons and items filtered out an endogenous depressive item profile, corresponding with the clinical syndrome of patients diagnosed as endogenous depressives in the clinics, although determined without reference to the clinical diagnoses. Our study supports many results from earlier multivariate statistical studies. We consider our data to be an essential contribution towards the establishment of a multiaxial clinical picture.

Serum samples from psychiatric patients were added to incubations of rat adrenal cortical cells synthesizing aldosterone. A high proportion of sera from patients with bipolar manic-depressive psychosis inhibited aldosterone production, but chronic in-patients without affective disorders gave few inhibitory sera. Inhibition was greatest in depression, lowest during normal affect. In one patient studied through 11 affective cycles the inhibitor score increased during transitions from mania to depression, showing a significant regression on time. The possible relationship of this in vitro phenomenon to the defect of aldosterone regulation in manic-depressive psychosis is discussed.

The study compares 72 female psychiatric patients who had a history of suicide attempt with 122 who had neither attempted nor contemplated suicide. Of these 194 women, 128 had experienced the death of their mothers before the age of 11, but the proportions of early bereaved and not early bereaved who were suicidal were similar. Not even the events which followed bereavement affected suicidal behaviour, but the suicidal patients tended to come from larger sibships. Poor quality of the marriage and, for the early bereaved only, having three or more children related significantly to suicidal behaviour. The suicidal women were significantly more often described as dependent. Suicidal behaviour was not differentiated on the endogenous/neurotic depressive dichotomy but it was significantly related to severity of depression.

The effect of deficiencies in social relationships has been studied prospectively in a community sample. In the half who were exposed to the higher level of adversity, these deficiencies explained 30 per cent of the variance in neurotic symptoms four months later. They explained only 4 per cent in those with lower adversity. Contrary to expectation, it was not the lack of relationships, but perception of these as being inadequate under adversity, which had by far the stronger predictive power. This may mean that actual conditions in the immediate social environment are not important for neurosis. Instead, intrapsychic and personality factors may have a much stronger effect.

The symptoms of premenstrual syndrome should be rated daily, or at frequent intervals throughout the menstrual cycle. Self-rating is usually most feasible and separate rating of differing symptom groups is important, as symptoms differ in their response to therapy. Daily scores should be analysed to assess periodicity, either by subdividing the cycle into phases or by using the least mean square method of fitting sine waves. Standardized scores enable data to be compared across cycles. In a clinical trial it is important to include an untreated cycle to assess whether the subject has premenstrual syndrome and as a baseline with which to compare treated cycles. Allowance should be made for a carry-over effect and for high placebo response. One solution is to use a change-over design balanced for carry-over effects. The criteria used to define a patient should be stated.

A naturalistic study was undertaken of 36 video and audio-taped interviews undertaken by 7 different psychiatric trainees. The interviews studied were those conducted in the ordinary course of clinic work for diagnostic and therapeutic planning purposes by trainees when first seeing the parent or parents of a child newly referred to a psychiatric clinic. It was found that a variety of rather different interview techniques seemed to facilitate emotional expression. These included a low level of interview talk with few interruptions, a high rate of open rather than closed questions, direct requests for feelings, interpretations and expressions of sympathy. The issue of how far these associations reflected causal influences is discussed.

Individual components of cognitive disability were assessed in the siblings of 41 autistic probands and compared with similar measures from a control group of siblings of Down's syndrome individuals. The results showed a significant familial clustering of cognitive disabilities in the siblings of autistic probands. These cognitive impairments included disturbances in expressive and receptive language, specific learning disabilities, and varying degrees of mental subnormality.

Using a standardized behavioural programme, nine in-patients with severe agoraphobia were treated by staff who had minimal training in the theory and practice of behaviour therapy. With one exception patients showed marked reduction in subjective fear and avoidance, both following treatment and at follow-up. The indications for such treatment are considered and compared with those for alternative behavioural approaches that have recently been advocated.

Psychiatry in traditional Chinese medicine had a long evolution, but is now under re-evaluation. Modern psychiatry in China is based on Western psychiatry, and has a history of less than one hundred years since the first lunatic asylum was set up in Guangzhou (Canton) in 1898 (1, 2, 3) and the first generation of Chinese psychiatrists was trained by an American psychiatrist, Dr Lyman, in Peking Union Medical College, in the 1930s. The present paper is a brief introduction to psychiatry in traditional Chinese medicine.