The relapse and admission histories revealed a positive correlation between number of schizophrenic episodes and time on maintenance medication, probably reflecting severity of illness. Relapse rates after drug discontinuation rose to 45% within 13 months. There were no differences of predictive value between those relapsing on or off medication. The relationship between relapse rates, drug treatment, and social outcome is complex; antipsychotic drugs may postpone relapse, and frequent relapses might inhibit improvement in social performance long after florid symptoms have been controlled by medication.

The term ‘dementia praecox’ was used by Kraepelin to emphasise the tendency towards deterioration to a state of impairment resembling a dementia. Early studies looked for structural brain lesions post mortem, and later using pneumoencephalography; there were positive findings (Haug, 1962), but they were not always replicated (Storey, 1966). The risks and limitations of pneumoencephalography gradually led to its being abandoned. However, studies showing minor neurological abnormalities (Rochford et al, 1970) and cognitive impairment (Malec, 1978) continued to suggest an organic component to schizophrenia.

Thirty five claimants with accident neurosis, in which there were gross perplexing somatic symptoms without demonstrable organic pathology were traced and followed-up in their homes, from one to seven years after compensation was received. Few claimants recovered and such recovery as did take place was unrelated to the time of compensation. Family processes leading to over-protection by relatives were examined and appeared to be vitally important in the prolongation of symptoms. The legal process and the delays involved caused great distress.

The two-year follow-up results are reported of a trial of social intervention in families of schizophrenic patients in high social contact with high-expressed emotion (EE) relatives. For those patients who remained on antipsychotic medication throughout the two years, the social intervention significantly reduced the relapse rate. In those experimental families where relatives' EE and/or face-to-face contact was lowered, the relapse rate was 14%, compared with 78% for control patients on regular medication (P = 0.02).

Several studies have commented upon the false negatives which can result when the General Health Questionnaire (GHQ) is employed as a community screening device for psychological distress. It would appear that some false negatives are the result of individual or cultural factors, whilst others result from the phrasing of the GHQ questions, which may mislead patients suffering from chronic disorders. This paper reports the use of additional questions, designed to detect such chronicity.

Marked differences were found between the reasons chosen to explain overdoses by the closest relatives or friends (the ‘significant others’) of 34 self-poisoners and those reasons chosen by the self-poisoners themselves. Whilst 41% of the latter claimed suicidal intent, in only one case was the significant other in agreement. The significant others were more likely to attribute manipulative reasons, commonly viewing the overdoses as directed at themselves, but the two groups agreed that the overdoses were often a means of alleviating distress. As well as evoking sympathy, the overdoses often caused the significant others to feel considerable guilt and anger. Discrepancies in the way self-poisoners and significant others interpret overdoses, and the strong feelings that overdoses evoke in the latter, should be considered during assessment and treatment of overdose patients.

Agoraphobia is believed to run in families, but this belief is not well supported by the literature. Data were gathered on the risk of agoraphobia in parents and siblings of 60 agoraphobic probands; 12½% of the relatives were reported to have or have had agoraphobia. This risk is significantly greater than estimates of the population incidence, and requires explanation. The details of the pedigrees do not directly support simple genetic models while investigations into environmental factors in agoraphobia by other workers have been inconclusive. As a putative case has been established for the familial occurrence of agoraphobia, further work is required to shed light on whether genetic or cultural factors are paramount

Nuclear magnetic resonance (NMR) imaging of hydrogen in body water and fat is proving valuable in clinical investigation of the brain. An introduction to the technique and to the biological significance of the images is presented here. The ‘multi-parameter’ nature of these images is stressed, and the individual parameters described. NMR imaging may well be of value in investigating the pathology of organic and functional psychoses.

Seventy-nine patients with a diagnosis of hysteria were compared, on a number of variables, with a control group of neurological patients without psychiatric morbidity, and with psychiatric patients free from somatic complaints. Demographic information was obtained, and rating scales for the assessment of personality and mood, were administered, as well as Pilowsky's Illness Behaviour Questionnaire. The data confirm the high incidence of affective disturbance in particular, depression and anxiety in patients with hysteria. There was no link between hysteria and early hospitalisation, although associations were found with sexual disturbances, a past history of vague or undiagnosed illness, affective inhibition, and denial. Relationships between personality and illness behaviour reveal links between personality dimensions and the reporting of illness.

A survey was made of academic difficulties among undergraduate students at Ain Shams University, Cairo, during the academic year 1979–1980. Almost 6% of students dropped out before graduating and a further 8% required substantial extra time to complete their course of study: these figures were almost identical for both sexes. Psychiatric disorders were diagnosed in 42% of male students with academic problems (compared with 9% among the academically successful), with neuroses accounting for nearly half of the cases and schizophrenia for a quarter. Serious psychiatric illness was nearly four times as frequent among 3rd-year students as among 1st-year students.

Proton NMR imaging of the brain is rapidly becoming established as a useful investigative tool in medicine. This paper examines the usefulness of the NMR parameters—spin-lattice relaxation time (T1) and proton density (PD)—in differentiating groups of patients with senile dementia of Alzheimer type (SDAT) and multi-infarct dementia (MID) from each other, and from elderly controls. T1 values increase with severity of dementia. NMR parameters may also be of use in localising regions of brain damage.

The association between parental attempted suicide and child abuse was investigated in 114 mothers with children aged five years and under, referred to a general hospital following suicide attempts. The risk was greatly increased in the attempted suicide mothers, compared with both similar mothers at risk for depression and general population control mothers; well-documented risk of child abuse was identified in 29.8% of those who attempted suicide. No major differences were found between the attempted suicide mothers whose children were at risk and those whose children were not at risk. During the general hospital assessment of mothers with young children who attempt suicide, careful enquiry concerning the relationship with the children is essential

Retrospective questionnaire information was sought from 175 Royal Air Force officers who had survived ejection from an aircraft and 88% replied. A profile of risk factors, both objective and subjective, was found in the 40% who subsequently experienced prolonged emotional disturbances. Confidential counselling of ejection survivors should therefore be routine. Consultation between involved medical staff and a Service psychiatrist can increase awareness that surviving aircrew may not be as composed and unaffected as they seem, while appropriate counselling can reduce prolonged emotional morbidity.

We compared 178 students with academic problems with 77 academically successful students. Academic difficulty showed highly significant associations with low socio-economic status, over-crowded housing, paternal behaviour problems and a poor relationship between the parents; also significant associations with family history of psychiatric disorder and living away from home. Academic achievement at school was no guide to university performance. Failed students had fewer friendships, especially with women, amd more limited recreational activities. They also scored significantly lower on tests of verbal and non-verbal IQ, and worse on the Bender Gestalt and trail-making tests. EPQ results suggested that university students, particularly those with academic difficulties, are more neurotic and introverted than the general Egyptian population.

The two-threshold multifactorial polygenic (MFP) model was applied to blind family study data, collected in a long-term follow-up and family study of major affective disorders. This model tested whether bipolar and unipolar disorders are manifestations of the same underlying factors or if they are independently caused disorders. The hypothesis that bipolar and unipolar disorders are, respectively, severe and mild forms of the same disorder was supported. There was little evidence for different familial aetiologies for bipolar and unipolar disorders in our sample.

Diagnostic patterns for schizophrenia and affective psychosis were examined for all admissions to psychiatric facilities in New South Wales over a ten-year (1967–1977) period, before, during, and after lithium carbonate had been established as an accepted treatment. While the proportion of functional psychoses to total admissions remained relatively constant over the study, there was a relative decrease in schizophrenia, and a relative increase in the affective psychosis group. Analyses of sub-groups suggested, after controlling for the effects of time, that the introduction of lithium has been associated with an increase in diagnoses of mania and a decrease in diagnoses of paranoid schizophrenia, both for first admissions and for readmissions.

Forty agoraphobics had individual exposure treatment over a period of 28 weeks and were followed up for two years. Outcome in the 27 married patients was as favourable as that in the 13 single patients. However, among the married patients greater improvement occurred in those with better initial marital and sexual adjustment although even those with poor initial marital adjustment improved significantly during treatment and maintained that improvement during follow-up. Good initial work adjustment and social adjustment were also predictive of particularly good outcome. Reduction of phobias was accompanied by stable or improved marital, sexual, social and work adjustment.

The outcome in patients receiving long-term in-patient care for manic-depressive psychosis was compared with that in long-stay schizophrenic in-patients and discharged schizophrenic patients. The manic-depressive and schizophrenic in-patients differed in terms of positive and negative features and in the pattern of behaviour, but were equally cognitively impaired. The pattern of behaviour in both schizophrenic groups was the same. The results offer some support for the use of outcome as a validating criterion for the diagnosis of schizophrenia.

The controversial literature about the biological antagonism between schizophrenia and epilepsy involves at least two areas of clinical interest. Firstly, it is frequently stated that convulsive treatment was introduced into psychiatry for the management of psychosis because of this antagonism, and secondly, it has a bearing on the topics of ‘alternative psychosis' and ‘forced normalisation’, as reported in the epilepsy literature. In addition to these, the subject is of theoretical interest in its relationship to other biological antagonisms that may be found in nature, but closer examination of the literature suggests that some of the discussions and controversies surrounding this problem are based on assumptions that may be incorrect. One possible reason for this may be the fact that much of the original work was written in German, and we propose therefore to give a brief account of the origins of the theories, as derived from their original sources.

Both mates of schizophrenic mothers and a control group consisting of mates of non-schizophrenic mothers were diagnostically examined. The former were more frequently psychiatrically deviant than their controls, both with respect to a life-time syndrome diagnosis and a personality diagnosis. Mating between a schizophrenic mother and a father who suffered from schizophrenia spectrum disorder significantly increased the offspring's risk of developing a schizophrenia spectrum disorder himself. Assortative mating was negatively correlated with age of onset of maternal schizophrenia. It is proposed that defective emotional rapport or sub-psychotic features constitute the phenotypic traits by which assortative mating operates in schizophrenia.