In his monumental work on the history of dynamic psychiatry (1970), Henri Ellenberger has traced the origin of the modern depth psychologies back into the mists of time. Both ills of the body and ills of the mind were originally handled by the priest-physician of primitive societies along much the same lines. But there came a parting of the ways. Glimmerings of an empirical approach to the external world led to some degree of objectivity and to the primordial elements of science. Some physical illnesses could be traced to physical causes, and an understanding of causation led in course of time to rational therapy along physical lines. But mental illnesses remained refractory. It was only in a small area of their vast extent that their causes could be attributed to bodily conditions and thereby to physical causes. Over a great reach of time up to the present day, or at least till yesterday, it was generally believed that, as bodily illnesses had physical causes, the illnesses of the mind must have psychological causes. It proved beyond the powers of priests or physicians to identify them; and there was no way of accounting for the variable course, outcome and responsiveness to treatment of mental disorders.

In recent years there has been a resurgence of interest in pornography, particularly in Great Britain and the U.S.A. There have been many more publications on the subject, as well as various surveys and enquiries; some of these have been officially sponsored. Well-publicized prosecutions have helped to keep the topic in the public eye, but at the same time have drawn attention to uncertainties and ambiguities in present-day legislation (Tribe, 1973). Underlying all this is a continuing concern about the possible harmful effects of pornography, its implications for mental health and the need for more research and informed psychological guidance.

The increasing involvement of psychiatrists in the general hospital presents opportunities for teaching medical students about the psychological evaluation and management of patients. We have found it useful to introduce this topic during the first year, by collaborating with colleagues from medicine and surgery in an interdepartmental course on patient care.

Multivariate analyses are an aid to, not a substitute for critical thinking in the area of data analysis. Meaningful results can only be produced by these methods if careful consideration is given to questions of sample size, variable type, variable distribution etc., and accusations of subjectivity in interpretation can only be overcome by replication.

The computer revolution has produced many problems for statisticians, not least of which is the ease with which experimenters may access packages of programs for multivariate analysis, and so bypass a ‘difficult’ (by which is meant one who will not do simply as he is told) statistician. Of course there are many abuses of univariate statistical methods. Here, however, the abuses are not likely to lead to such seriously misleading results as in the multivariate case.

Perhaps a major cause of the continuing misuse of statistical methods is the insistence of many journal editors in psychology and related areas, on articles being laced with multivariate analyses, and on encouraging the pedantic use of significance levels, i.e. the inevitable p < —, as if such inclusions lent an air of respectability to their journal which it might not otherwise have had. Research workers in these fields would be better encouraged to devote more time to an initial screening of their data using simple graphical techniques, to ensure that their data are at least approximately suitable for more complicated multivariate analyses.

For the past decade there has been extensive interest in the hypothesized association between brain amine function and disturbances in mood (either depression or mania). The more influential theories have postulated that clinical depression is associated with a decrease in aminergic function (either norepinephrine, dopamine or serotonin) while mania is associated with increased activity of these amines. This essentially ‘bipolar’ approach has tended to dominate most studies in this area. Evidence supporting these theories has been extensively reviewed (11, 61, 70) and need not be detailed here.

Those interested in the family backgrounds of delinquents have paid a good deal of attention to family size and position in family (see Mannheim, 1965, for a review), but little to the ratio of brothers to sisters. This is surprising, since it can be argued that boys who come from families with a preponderance of brothers may be particularly at risk of delinquency; for example, their parents might find it difficult to control them; they might be more likely to play out on the streets and thus have greater opportunities for delinquency; and, since delinquency is a predominantly male activity, they might have a greater chance of being set a bad example through the behaviour of their brothers.

The technique of measuring penile erection is the most valid assessment of sexual arousal in males (Zuckerman, 1971). The stimuli used during assessments of sexual preference with this technique have for the most part, been still or moving pictures of nude single females and males (Freund, 1963; McConaghy, 1967; Barlow, Becker, Leitenberg and Agras, 1970). Recently Abel, Barlow, Blanchard and Mavissakalian (in press) have shown that erotic films produce significantly greater penile circumference changes than either slides or audiotaped descriptions in homosexual males. Similarly, Sandford (1974) showed the superiority of films over slides in heterosexual males and suggested that sexual activity rather than nakedness per se may be the more important in producing sexual arousal. The main purpose of this study was to determine what sexual activities produce significantly different sexual responses in homosexual and heterosexual males.

The patient undergoing rehabilitation is expected to do more than passively accept care and treatment. He is also expected to learn. The doctor or nurse purveying rehabilitation finds that the job increasingly includes teaching as well as treating patients. Most but not all of the transactions between teachers and taught are conducted by means of the spoken word. The extent to which messages are conveyed intact by this means (and without this no learning will occur) will depend among other things upon the speaker's clarity of expression and the listener's ability to understand.

In a previous study, macrocytosis was found in non-anaemic mentally retarded epileptic patients treated with anticonvulsants, and a direct relationship was found between drug dose and the degree of macrocytosis, when the sole anticonvulsant given was phenobarbitone (Eastham and Jancar, 1970a and b). An attempt to use the measurement of red cell size to detect folate deficiency during anticonvulsant therapy before the development of overt anaemia was unsuccessful. Following these findings, yeast tablets were given as a natural source of folate to both epileptic and non-epileptic mentally retarded patients, and preliminary results showed that folate deficiency associated with long-term anticonvulsant therapy could be corrected within three months, without increasing either the frequency or the severity of convulsions in epileptic patients (Eastham and Jancar, 1971). Supplementary yeast tablets were therefore given routinely to all epileptic patients on anticonvulsant therapy in the hospital; there were no side effects from this medication.

Pierce-James (1967), has shown that British heroin addicts have a very much higher mortality rate than the general population. The same applies to American narcotic addicts; a 20-year follow-up study of a group of narcotic dependents showed the very high death rate of 23 per cent over this period (Vaillant, 1973). Pierce-James (1967), distinguished between suicidal, accidental, and other causes of death, and also demonstrated a higher rate of successful suicide attempts among heroin addicts than in the general population. Connell (1965) suggested that the incidence of suicidal threats and attempts in childhood and adolescence is higher than is generally recognized, and in both adolescents (Gould, 1965) and intravenous narcotic addicts (Frederick et al., 1973) suicidal and self-destructive behaviour is more common than successful suicide. The distinction between suicidal attempts and self-destructive behaviour is unclear. Stengel (1964) defined as suicidal attempts, ‘all cases of potentially dangerous self-poisoning or self-inflicted injury.’ The present study, however, does not assume that self-poisoning or self-inflicted injury necessarily implies suicidal intent.

There is accumulating evidence of the clinical effectiveness of selective stereotactic psychosurgery in some severely disabled psychiatric patients who have not responded to other forms of treatment (Ström-Olsen and Carlisle, 1971; Bridges, Göktepe and Maratos, 1973; Kelly et al., 1973). The risks of adverse effects resulting from operation are now small, and their significance is further diminished when related to the distress over long periods of those patients who are suitable for psychosurgery. The criteria for selection have been considered by Bridges and Bartlett (1973).

Evidence continues to accumulate for the proposition that lithium salts have a marked prophylactic effect on recurrent affective disorders. An earlier paper (1), together with reports from Baastrup et al. (2) and Coppen et al. (3) indicate that this effect is a strong one. This paper reports the current position regarding a trial in one centre which has been in progress for eight years, in which the effect of lithium was investigated on the frequency of admission to and time spent in psychiatric hospitals.

An ergot alkaloid, 2-br-alpha-ergocryptine (CB 154), referred to hereafter as brom-ergocryptine, has been reported to inhibit puerperal lactation (Varga, Lutterbeck et al., 1972), and to terminate breast secretion in patients with inappropriate lactation (Lutterbeck, Pryor et al., 1971). Besser, Park et al. (1972) found that the drug suppressed elevated levels of plasma prolactin in five patients whose inappropriate lactation was due to a variety of causes. This hormonal effect was accompanied by clinical changes such as the disappearance of galactorrhoea, return of menstruation, and an increase in sexual potency.

The Merseyside Council on Alcoholism (M.C.A.) is the first operative regional council on alcoholism in the United Kingdom; it is a voluntary organization employing full-time staff (Kenyon, 1972). In its first ten years it has counselled over 4,000 alcoholics; about one third of these needed admission to hospital, so arrangements for admission were early established with general and psychiatric hospitals and with the regional addiction unit. After individual counselling by the M.C.A. (aided when necessary by detoxification at home, or in a medical or psychiatric ward) the alcoholics usually return to work.