Goodwin Wharton (1653–1704) was a nobleman's son and a Whig MP who played no small part in English public life. His manuscript journal shows, however, that he also lived a bizarre secret life of the mind of a kind which, in later generations, would have led to his confinement as suffering from mental illness. Above all, through the offices of his medium and lover, Mary Parish, he entered into elaborate relations both with the fairy world and with God and His Angels. This paper examines our records of Wharton's consciousness

Among the most notable features of the religious revival in western Europe in the early thirteenth century was the development of mysticism among the nuns and religious women of the lowlands. As scholarly attention becomes increasingly focused on this group of remarkable women, the question arises whether a psychiatric viewpoint has something of value to offer to the understanding of such individuals and the culture in which they struggled. The methodological and intellectual problems inherent in examining the life of a thirteenth-century mystic with a twentieth-century empirical frame of reference are illustrated in this study of the adolescence of Beatrice of Nazareth. Beatrice's stormy asceticism, ecstatic states and mood swings lend themselves to potentially competing hypotheses regarding the spiritual and psychopathological significance of her adolescent development and eventual life-course. Common grounds for reconciling these alternative models are discussed.

The standard technical vocabulary used to define placebo therapies and experimental placebo controls in medicine and psychiatry is both confusing and obscure. To achieve conceptual clarity in the theory of placebogenic phenomena, this paper offers (1) a rigorous articulation of the placebo notion, (2) a lucid new terminology that obviates the defects intrinsic to the traditional locutions employed in the placebo literature, and (3) a substantial revamping of A. K. Shapiro's influential prior definition of‘placebo’. This paper supersedes an earlier version (Grünbaum, 1981).

The development over the last 60 years of the concept of bradyphrenia, a syndrome including slowing of cognitive processing in parkinsonism, is described. Psychic akinesia and subcortical dementia are seen as more recent synonyms for this syndrome. Its relations to akinesia and the psychomotor retardation of depression are considered in a historical context, as are its implications for the relation of neurological and psychiatric disorder.

Data on the history of cannabis use and a spot urine test for cannabinoids were obtained for 137 schizophrenics in treatment. Subjects who were using cannabis during the 6-month observation period presented with a significantly higher degree of delusional and hallucinatory activity than those who did not. Moreover, the group using cannabis made a higher average number of visits to the hospital during the same period. The status of cannabis use appeared to contribute to such variance more than did other relevant factors (age, stage of the illness, amount of medication prescribed, occasional use of other psychoactive substances).

The history of the concept of presbyophrenia is traced from its inception in 1863 to the present day. Early in the twentieth century it was used to refer to a subtype of dementia characterized by confabulations, marked memory impairment, hyperactivity, disorientation, elevated mood and preserved social graces. At the time it was considered to be either a form of Korsakoff's psychosis or a subtype of senile dementia. The decline of the concept started in the 1920s and was precipitated by the redefinition of dementia in terms of impaired cognition, cortical symptomatology and specific neuropathological changes.

Three explanations for the curious combination of symptoms characterizing presbyophrenia were then suggested: toxic-delirious states, manic illness in late life, or a combination of cerebrovascular disease and senile dementia. It is suggested that the dismissal of presbyophrenia could have been premature as it may capture a behavioural phenocopy of relevance to clinical practice.

By means of a National Case Register of patients admitted to psychiatric hospitals in Norway it was possible to study the case-histories of the 199 patients admitted from 1916 to 1975 with a diagnosis of Huntington's chorea. Ascertainment is likely to have been most complete for the years 1930–50, when the prevalence rates ranged between 6 and 7 per 100000 population. The social adjustment of the patients was found to be more favourable than expected up to the onset of serious psychiatric and neurological symptoms. The marriage rate and the rate of reproduction were not lowered. Occupational distribution and the pattern of migration were normal. Depression and suicide were remarkably rare. The age of onset among single patients was nearly 10 years lower than among the married, and more than 13 years lower on admission to hospital, indicating selection for marriage. With a marriage rate of about 70% and the late manifestation of the disease, predictive tests without prospects of treatment are apt to increase significantly the burden on the carriers.

Serum antibody titres to herpes-simplex (HSV-1, 2), cytomegalovirus (CMV), and Epstein–Barr virus capsid antigen (EBV-VCA) were determined in 38 unrelated chronic schizophrenic patients, 11 nuclear families with at least 2 schizophrenic members, and 2 control groups. The distributions of antibody titres to herpes simplex and cytomegalovirus were similar among all groups. Patients had higher anti-EBV-VCA titres than non-hospitalized controls; however, hospital staff members in contact with the patients also had significantly higher antibody titres to EBV-VCA. Antibodies to EBV early antigen (EBV-EA) were also determined for 27 unrelated patients and 24 mental hospital employees. The schizophrenic patients had significantly higher antibody titres to EBV-EA than the hospital worker control group. These data do not support the hypothesis that herpes viruses are associated with the aetiology of schizophrenia. Although elevated anti-EBV early antigen titres may suggest persistent active EBV infection, it is unlikely to be related to the aetiology of the disorder, since discordance for EBV seropositivity was present among sibling pairs concordant for schizophrenia.