A community sample of elderly married couples completed the 60-item General Health Questionnaire and the Leeds General Scales for the Self-Assessment of Depression and Anxiety. Significant concordance was demonstrated between the spouses' scores on these scales. Concordance was higher for depression than for anxiety. There was little to support previous findings that wives are more likely than husbands to be concordant with an ill spouse. The spouse concordance rates for psychiatric morbidity were similar to those found in studies of younger married couples.

The evidence for an association between hostility and deliberate self-poisoning is reviewed. Although the concept of hostility is poorly defined and different measuring instruments may not measure the same entity, self-poisoning subjects as a group appear to have very high levels of hostility. However, depression is also associated with hostility and when studies have taken into account the psychiatric diagnosis of overdose patients it is outwardly-directed hostility which distinguishes these individuals from other psychiatric patients or normals. A model is proposed to show the inter-relationships of hostility, depression and self-poisoning.

The response to the dexamethasone suppression test (DST) was examined in 543 patients suffering from major depressive illness and 246 healthy controls, from 13 research centres, representing 12 different countries, in a World Health Organization Collaborative Study. In almost all the centres, the post-dexamethasone plasma Cortisol concentration was significantly higher in the patients than in the controls. Although there is variation between centres, this abnormal response to the DST was shown to be frequent in patients from widely different geographical areas.

Thirty-two chemically dependent alcoholics with significant levels of anxiety or depression were admitted to a double-blind randomised study in which the effect of the substituted benzamide tiapride was compared with that of placebo over a 6-month period. Twenty patients completed the study. Assessments included relevant biochemical and haematological tests, drinking levels and associated behaviour, expressed satisfaction with various areas of life, the Crown-Crisp Experiential Index of neurotic symptoms and questionnaires on self-esteem and alcohol dependence. The results indicated that in comparison with the placebo group, patients treated with tiapride drank less and had longer periods of abstinence. This was associated with improvements in laboratory tests, reduction in neurotic symptoms, gains in self-esteem and increased levels of expressed satisfaction with life situation. The drug was well tolerated and no deleterious effects were noted, suggesting its potential usefulness for this patient group.

In a structured sample of 100 male and 100 female minimally impaired patients, aged 60 years and over, females were more depressed. Varimax factor analysis demonstrated four factor groupings which have clinical relevance - Depression, Anxiety, Cognitive impairment, and Psychosomatic disorder; their relative importance is different in males and females. Analysis of variance of the scores of clusters generated by cluster analysis demonstrated four groups of subjects - normal, mildly depressed, moderately depressed with borderline dementia and disability, and severely depressed with moderate dementia and frank disability. In the mildly and moderately depressed, symptoms of anxiety predominated.

An investigation of the suicide rate in the decade 1975–1984 in England and Wales revealed an increase in rate for males of all ages, and a small decrease for young females. The increase for males has been greatest in the 25–54 years group. There has been a decrease in the number of suicides by poisoning with solids and liquids (including overdoses) for both sexes. Rates for poisoning by vehicle exhaust gas and by hanging, strangulation and suffocation have increased substantially during this period. In males, suicides by these methods now exceed those due to poisoning by solids and liquids.

A prevalence of depression of 13% was found among 139 coloured persons aged 65 years and over, living in the community in Cape Town, which accords with figures elsewhere. A high rate of hypochondriasis was found, but there was a low rate of suicidal intent, which could be explained by good social support. Observed depression and a depressed mood occurred in almost all depressed patients; as defined in the Present State Examination, these items appear to be an excellent screen for depression.

A prospective study of 400 largely working-class women with children living at home has once again demonstrated the major importance of long-term severe threatening life events in provoking caseness of depression. However, it again shows that only about one out of five women experiencing such an event go on to develop depression at a case level. This paper demonstrates that more sensitive characterisation of severe events can greatly increase the size of this association. This is done both by improving the description of the event itself and by taking into account various ways in which the event can ‘match’ characteristics of the women present at the first interview, well before the occurrence of the event or any onset of depression.

The phenomenology of solvent inhalation was investigated comparing a group of young people who misused toluene (n = 31) with a group misusing butane (n=12). Marked changes of mental state were invariable. Most users reported elevation of mood and hallucinations but a rich variety of phenomena was elicited. Nearly one-quarter of subjects had the potentially dangerous delusion of believing they were able to fly or swim. In the toluene group thoughts were more likely to be slowed, time appeared to pass more quickly and tactile hallucinations were more commonly reported than in the butane group. Withdrawal phenomena and tolerance were also looked at.

Information on 19 women convicted of indecency and 62 women convicted of other sex offences was examined. Those convicted of indecency offences often had poor social skills and had a high incidence of mental illness, mental handicap and alcoholism. Two were convicted of indecent exposure, a rare offence in women. In 39 (63%) of the sex offences with individual victims, the victims were children and in 9 cases the offender was the mother or step-mother. In 25 cases the women were convicted of aiding and abetting a male offender. Of those convicted of indecent assault on persons under 16 and of gross indecency with children, 48% had a previous history of psychiatric disorder.

Patients suffering from unipolar and bipolar affective illness, who began treatment with prophylactic lithium carbonate during a 5-year period, were followed up and 59 out of 101 interviewed. Most had been taking lithium for at least 13 years: 49% had a complete remission, 41% a partial but significant response, and 10% no response. No specific individual or illness factor was found to correlate with favourable outcome, and no correlation between average serum lithium level and outcome. No side-effects could be associated specifically with the long-term use of lithium, but there was a surprisingly high incidence of clinical hypothyroidism.

Twenty-six in-patients satisfying DSM-III criteria for major depressive episode were assessed using the Newcastle Diagnostic and ECT Predictor Scales and the dexamethasone suppression test (DST), prior to commencing a course of electroconvulsive therapy (ECT). The Newcastle ECT Predictor Scale was successful in predicting both immediate outcome and outcome over the 6 months following ECT; the DST was unsuccessful in predicting either immediate or 6-month outcome.

The patterns of use and related harm of solvent inhalation were investigated in a group of young people who misused toluene (n = 31) and a group misusing butane (n= 12). The two groups were similar in terms of patterns of use and solvent related harm. The toluene users were more likely to sniff only in a group setting, probably because of the long duration of intoxication. The toluene group were more approving in their attitudes towards taking other drugs.

The Newcastle scores of a group of 64 and subsample of 52 severely depressed inpatients were not normally distributed. Evidence for discontinuity in these distributions was adduced from the contrast in outcome between the endogenous and neurotic patients thus defined, the endogenous consistently doing better than the neurotic group. The unipolar/bipolar system failed to predict different results for endogenous and neurotic patients unless unipolar was subdivided into endogenous and neurotic subgroups. The DSM-III criteria for major depression and melancholia failed to identify subgroups of differing prognoses.

DSM-III personality disorder clusters had not previously been tested for their ability to distinguish between different population groups. A major obstacle - different demographic characteristics of different populations - was overcome by using logistic regression. Three out-patient psychiatric referral groups (chronic pain, disability applicants and competency to stand trial) provided subjects; adjustments were made for age, race, sex and education. The groups were significantly different in the adjusted prevalence of DSM-III personality disorder clusters. Clinical association between personality disorder and drug or alcohol abuse was again confirmed.

There is little information available on psychiatric disorder in homeless women. This study compares clinical casenote information of all homeless women admitted to an East London psychiatric hospital from 1971–1980 inclusive, with information on a cohort of homeless men admitted during the same period. The results show that the women appear to have been socially more stable than the men prior to admission and yet they have less satisfactory admissions to hospital. Possible reasons for these apparent inconsistencies are discussed.

Symptom rating sheets completed by psychiatrists over a 9-year period on 2602 intellectually normal child and adolescent clinic attenders were subjected to factor analysis (principal components). Two types of factor sets were derived, one for younger subjects (3–11 years) and another for older subjects (12–18). Both had three factors in common: conduct disturbance, relationship problems and emotionality, but differed on the fourth – developmental immaturity for the younger group, depression for the older. A factor solution was also derived for the whole clinic sample with three scales: conduct, emotionality and immaturity. Both types of factor solutions were subjected to MANOVA for age and sex effects, both of which proved to be of significant influence. Good correspondence was found between the symptom factors identified and conceptually similar clinical diagnoses.

The limited literature on the pedigrees of tiqueurs, including those with Gilles de la Tourette's syndrome, is reviewed. Most statistical analyses have been restricted to affected family members without specifying the unaffected ones. The present statistical analysis of a series of child tiqueurs, including 91 probands and 1293 first- and second-degree relatives, 46 of whom were tiqueurs, predicts the odds on being a tiqueur for individuals, and establishes how those odds are affected by certain explanatory variables using log-linear models. The data do not confirm a familial pattern beyond reasonable doubt, but if the suggested prevalence of tics in the population is 10% then the figure for parents is large enough to support a familial hypothesis. The pedigrees do not indicate a simple mode of genetic transmission. Further research is needed to confirm that there is a connection between childhood tics and Gilles de la Tourette's syndrome, to establish that the predisposition to tics is familial, and, if so, whether there is a complex genetic mechanism involved, or some other environmental aetiology so far undisclosed.

The autosomal dominant mode of inheritance of Huntington's Chorea (HC) has been established for over 100 years. Strong psychological defences against the acceptance of this knowledge are commonly found both in professionals and in Huntington families and relatives who are at risk. One consequence of maintaining these defences is the continuing transmission of the gene, and therefore the disease, to succeeding generations. The defences of professional persons protect them from the difficult and unsettling task of providing genetic counselling to healthy relatives at risk. An increase in awareness of the psychodynamics involved may lead to constructive thinking about the current deficiencies in care and counselling services provided for these families.

Times in remission from affective illness were prolonged during treatment with lithium carbonate and carbamazepine, but lithium was the more effective. Similar global scores for the two drugs suggested that other factors may determine their acceptability.