In one of his Cahiers, Paul Valéry has the note. Somatism (heresy of the end of time),

Adoration, cult of the machine for living.† Have we come to the end of time? The heresy anticipated by Valéry has almost become the official religion. Everything is related to the body, as if it had just been rediscovered after being long forgotten; body image, body language, body consciousness, liberation of the body are the passwords. Historians, prey to the same infection, have begun inquiring into what previous cultures have done with the body, in way of tattooing, mutilation, celebration all the rituals related to the various bodily functions.2 Past writers from Rabelais to Flaubert are ransacked for evidence, and immediately it becomes apparent that we are far from being the first discoverers of bodily reality. That reality was the first knowledge to enter human understanding: ‘They knew that they were naked’ (Genesis 3.7). From then on, it has impossible to ignore the body.

The history of neurasthenia is discussed in the light of current interest in chronic fatigue, and in particular the illness called myalgic encephalomyelitis (‘ ME ’). A comparison is made of the symptoms, presumed aetiologies and treatment of both illnesses, as well as their social setting. It is shown that neurasthenia remained popular as long as it was viewed as a non-psychiatric, neurological illness caused by environmental factors which affected successful people and for which the cure was rest. The decline in neurasthenia was related to the changes which occurred in each of these views. It is argued that similar factors are associated with the current interest in myalgic encephalomyelitis. It is further argued that neither neurasthenia nor ‘ ME ’ can be fully understood within a single medical or psychiatric model. Instead both have arisen in the context of contemporary explanations and attitudes involving mental illness. Future understanding, treatment and prevention of these and related illnesses will depend upon both psychosocial and neurobiological explanations of physical and mental fatigability.

CT scans were performed on 72 consecutive patients with a functional psychosis, and compared with 50 community controls. There was a specific difference in lateral ventricular area between these two groups but it accounted for only 11% of the variance in this measure. In contrast, racial and sexual differences in the ventricular-brain ratio (VBR) related to differences in intra-cranial area. It is argued that analysis of variance, using lateral ventricular area and intra-cranial area, is more informative than VBR in examining these structural changes in functional psychoses.

Twenty-five male alcoholic Korsakoff patients were compared with age and sex-matched non-Korsakoff chronic alcoholics and healthy volunteers on clinical and CT brain scan parameters. The scans were assessed by planimetry, visual grading procedures and computerized analysis. Reliable measures of third ventricular size were developed.

The Korsakoff patients had wider third ventricles, larger lateral ventricles and wider interhemispheric fissures than the comparison groups; but sulcal and Sylvian fissure widths were equivalent in Korsakoff and non-Korsakoff alcoholics.

The results suggest that, in addition to their well-established diencephalic lesions, many Korsakoff patients have sustained widespread cerebral damage. Shrinkage in the frontal brain regions appears to be especially pronounced. The implications for a dual aetiology of alcoholic Korsakoff's syndrome involving thiamine deficiency and features associated with alcoholism, probably direct alcohol neurotoxicity, are discussed.

Forty patients with Parkinson's disease underwent a detailed assessment of their psychiatric state using a standardized, semi-structured interview, the Present State Examination. Analysis of the interviews yielded a profile of depressive and neurotic syndromes. Comparing the results with population norms, however, revealed that the patients were distinguished only by high levels of depressed mood and loss of interest and poor concentration. In the majority of patients the range and severity of symptoms fell below the criteria for ‘caseness’. Only four patients could be allocated to an ICD-9 class, two to ‘ neurotic depression’, one to ‘ anxiety state’ and one to ‘ phobic state’. This rate was almost identical to that found in the general population. Broader indices of psychiatric morbidity were related to the patients' levels of disability and cognitive function.

The significance of the excess of obstetric complications which appears to characterize the histories of schizophrenic patients is critically dependent on the validity of the source of obstetric information, especially when this is obtained by maternal recall. Twenty-one biological mothers of 17 schizophrenic and four other patients were interviewed for their recollections of individual events characterizing the pregnancy and delivery relating to each patient. These were then compared with those events documented in maternity hospital records. Only in two of the 21 instances (9·5%) were inconsistencies of detail apparent which would have affected the designation of the relevant patient as having, or as not having, experienced major obstetric complication(s). It is concluded that maternal recall can be a surprisingly accurate source of obstetric information in relation to research on schizophrenia.

P300 responses to emotive words of different hedonic tones were assessed in depressed patients (unipolar major), patients recovered from the same type of depression and normal controls. Depressed patients showed a smaller amplitude of P300 in response to negatively toned words than to positive words; normal controls showed the opposite pattern and recovered patients showed a pattern of response which resembled that of depressed patients. The experimental trials comparing responses to negative and positive stimuli in relation to neutral words showed significant differences for negative as compared with neutral stimuli, but not for positive as compared with neutral stimuli. Latencies of P300 did not differentiate depressed patients from normal controls. The results are discussed within the context of the ‘expectancy’ theory of information processing.

A group of psychiatric in-patients significantly over-estimated the intensity of their depression when asked to recollect how depressed they had been one week earlier. The initial level of depression affected the accuracy of recall. Unexpectedly, patients who were more depressed initially had more accurate recall, particularly for biological and symptomatically negative items of the Zung Self-Rating Depression Scale.

The performance of patients with a presumptive clinical diagnosis of Senile Dementia of the Alzheimer's Type was compared to that of a group of normal elderly on several memory and neuropsychological tasks. The patients were impaired on tasks of free and cued recall, but exhibited normal performance on a word-completion procedure similar to that used by Graf et al. (1984). Reasons for the discrepancy between these findings and those from related research which reports impairment of word completion in patients with Alzheimer's Disease are discussed. Of particular interest is the role the orientating task plays in word-completion performance.

In a retrospective case note study, 73 young females with anorexia nervosa were compared with 88 young females with affective psychosis. These groups of patients did not differ in terms of place of residence, birth order or social class. They differed very significantly, however, in terms of age at onset of symptoms, marital status, educational attainments and in the pattern of family histories of psychiatric illness. It is concluded that anorexics and young females with affective disorders are two quite distinct groups of patients.

In this study gender differences in coping were explored, using the Ways of Coping Checklist (WCC; Folkman & Lazarus, 1980). In addition, the focus was on sex differences in the predictive value of coping strategies in relation to psychosomatic symptoms. Males preferred problem-focused coping strategies, planned and rational actions, positive thinking, personal growth and humour, day-dreaming and fantasies. Women preferred emotion-focused coping solutions, self-blame, expression of emotions/seeking of social support, and wishful thinking/emotionality. In spite of the gender differences the results of multiple regression analyses indicated congruous relationships between coping and complaints for both sexes. Stressors and coping factors contributed in much the same way to the explained variance of symptoms and the results were generally similar for males and females. The present data also emphasize the bidirectionality of the coping–symptoms link. This holds especially for self-blame, day-dreaming and fantasizing, and wishful thinking/emotionality. In contrast, distancing was found to be associated with self-reported psychosocial load. Future prospective studies should explicitly pay attention to this bidirectional relationship.

The steps to setting up a population register of elderly residents are described. Based upon this, 87·2% of the elderly residents of an inner-city electoral area were screened for memory disorder, depression and activity limitation using the Short CARE. Contact with medical and social agencies was also recorded; 4·7% were classed as cases by the dementia diagnostic scale, sufferers being older and not living alone. Of the residents 15·9% were classed as depressed, this state being more prevalent in those not currently married. The depresse were, in contrast to the demented residents, likely to be in recent contact with hospital and general practitioner. Thirty-two per cent of the population showed impairment in daily activity, these individuals were usually older, not married and receiving hospital care. Sleep disorder and compliant of many somatic symptoms were associated with a diagnosis of depression. In contrast, most respondents with a subjective complaint of memory disorder, which was common in this population, were neither suffering from depression nor dementia.

With this accurate sampling frame and a good response rate, the prevalence rate of clinical depression must be seen as disturbingly high. The prevalence rate of dementia approximated to that of other surveys. This study also indicated that general practitioners' lists may be inaccurate and that non-responders to first approaches for interview, although similar in demographic features to those responding, may contain among them many suffering from dementia.

One hundred and thirty men and women attending psychiatric hospitals with depressive disorders were interviewed at the time of their initial contact. After a mean four month interval, 119 were reassessed in order to test the hypothesis that initial levels of social support predict clinical improvement even when other potential risk factors such as age, sex, diagnosis and severity of depression are controlled. Severity and duration of the episode emerged as the only significant background predictors of recovery. The explained variance in recovery from depression due to social support was equal in men and women, and was not diminished by the background clinical predictors. According to subset analyses however, the aspects of personal relationships and perceived support that predict recovery in men and in women appear to be different. The available multiple regression models of outcome favoured a main effect of social support and provided persuasive if inconclusive evidence for a statistical interaction effect with sex. The implications for further research and for theory are discussed.

Research on the role of life events in the onset of depression has suggested that certain vulnerability factors can increase the risk of disorder in the face of a threatening event. The role of vulnerability factors to increase the likelihood of severs events occurring in the first place has remained largelu unexplored. The vulnerability factor which has received the most attention is a lack of social support, particularly lack of a confiding relationship with a husband for women. A reanalysis of a number of published studies is undertaken; this shows that there is a positive relationship between lack of intimacy and the occurrence of adversity. The implications of this finding are briefly discussed, with emphasis on the need for a life-span developmental perspective in future life events research.

An autistic young man and a normal control were asked to factorize numbers and to recognize and generate primes. Both subjects made a similar of errors and employed similar strategies, but they differed markedly in the speeds at which the arithmetical operations were carried out.

Interviews were conducted with parents of 100 children taken to a ‘School attendance committee’, because of persistent failture to attend School. Clinical assessmen t of the attendance problem was carried out so that children were categorized as ‘School refusers’ (N = 24), ‘truants’ (N =53), ‘both refusers and truants’ (N =9), or as ‘neither’ (N =14). Any ICD-9 psychiatirc disorder was separately identified. Cluster analysis of information collected in a standard way indicated that there was a group of children with the features of ‘School refusal’ who often had genralized neurotic disorders as well and who were mostly girls, another group with the feature of ‘truancy’ all of whom had conduct disorders who were mainly boys, and a third cluster of childrsen who were usually ‘truants’ but less often psychiatrically disturbed. The study provided evidence for the existence of School refusal with and without generalized neurotic disturbance in a non-clinical population.