In 1966 a census was carried out of the epileptic population in prisons and borstals in England and Wales (1). This indicated that there are at least 7.1 epileptics/1,000 men in these institutions, a figure higher than that expected from general population estimates. The present paper reports an attempt to explain this higher prevalence using an interview study of a representative sample of epileptic prisoners together with a similar study of non-epileptic prisoners matched for institution and date of reception into prison.

Mortality rates in psychiatric patients have been reported as higher than those of the general population in Scandinavia (Odegaard, 1952), the United States (Gorwitz et al., 1966; Babigian and Odoroff, 1968), and Scotland (Innes and Millar, 1970). These findings may be related both to a greater prevalence of physical disease amongst psychiatric patients (Kay and Roth, 1955; Culpan et al., 1960; Shepherd et al., 1964; Kay and Bergman, 1966; Eastwood and Trevelyan, 1972) and to a greater frequency of suicide (Stenstedt, 1952; Stenstedt, 1959; Pokorny, 1964).

The accurate classification of causes of death is fundamental to progress in preventive medicine. Classifying death by poisoning may be specially difficult because the exact distinction between deliberate and accidental poisoning is inherently difficult for the coroner to make. Thus figures for suicidal poisoning are likely to be under-estimated because of ambiguous evidence and because of the stringent legal definition of suicide which coroners must apply. An examination of the drugs involved in poisoning cases, comparing their frequencies in the suicide and accident categories, may throw some light on the validity of coroners' present methods of classifying and provide evidence about the limits of error of under-estimation of the suicide rate.

Stammering has been defined as an interruption in the normal rhythm of speech of such a frequency and abnormality as to attract attention, interfere with communication or cause distress to a stammerer or his audience (Bloodstein, 1960).

Stammering has been and still is one of the most challenging disorders in psychiatry. It may be the result of constitutional or neurological differences (Karlin, 1950; Boland, 1951), of delayed auditory feed-back (Lee, 1951), of neurosis or of a learned response (Wischuer, 1950, 1952). Schmoigl et al. (1967) studied 50 cases of stammering and found abnormalities in 70 per cent of cases. The possibility of organicity in stammering tempted us to make EEG studies in Egyptian stammerers.

In recent years reports have shown that in psychiatric practice in this country short treatments with relatively brief interviews and much reliance on drugs are the rule (Carstairs and Bruhn, 1962; Sargant and Slater, 1964). That this is also true of general practice has been demonstrated (Cooper, 1965; Shepherd et al., 1966).

Investigations into possible relationships between EEG and personality traits began in 1935 (Lemere, 1935), and have continued sporadically (Saul et al., 1937; Gottlober, 1938; Lindsley, 1938; Henry and Knott, 1941). More recently there has been a controversial British exchange (Savage, 1964; Fenton and Scotton, 1967; Broadhurst and Glass, 1969; Young et al., 1971).

The occurrence of psychiatric complications following the administration of ACTH and corticosteroids is well recognized. Psychiatric disturbances usually take the form of euphoria or elation in mood. Depression is less likely, and irritability or aggressiveness may occur. In about 5 per cent of cases the alteration in mood may be accompanied by clouding of consciousness, delusions, hallucinations and disorientation. This picture of an organic confusional state is said to result from high doses and prolonged therapy with corticosteroids and ACTH. The latter is recognized to cause psychiatric sequelae more often than the corticosteroids (Truelove and Witts, 1959). Disturbances may appear within six to seven hours of initial therapy (Goolker and Schein, 1953), after prolonged administration, or even after complete withdrawal of the hormone therapy.

Almost all sleep-promoting drugs distort the natural pattern of sleep by suppressing rapid eye movement (REM) sleep, and cause a rebound to above-normal values on withdrawal which typically lasts about six weeks (Oswald, 1968, 1969). Furthermore, barbiturates reduce the number of eye movements per unit time in REM sleep (Oswald et al., 1963; Baekeland, 1967; Lester et al., 1968; Feinberg et al., 1969), with a rebound in eye movement (EM) profusion on withdrawal (Oswald, 1970). Non-barbiturate hypnotics do likewise, also with a rebound in EM profusion on withdrawal (Allen et al., 1968; Lewis, 1968).

The purpose of this short paper is to draw attention to the higher scores on neurotic scales found by the authors in Irish female subjects in three separate comparative studies of different categories of Irish and British hospital patients, using three different instruments for enquiry.

The tendency of adult and child psychiatrists to go their separate ways has led to neglect of the common ground which exists between the psychopathology of childhood and that of the psychoses of adult life. The purpose of this paper is to rekindle interest in what once was regarded as an important field for research into the psychoses. In this paper the phenomena which are to be found in children who suffer from neurotic disorders, ‘borderline’ states and psychoses will be compared with the signs and symptoms of adult psychoses and the significance of the similarities assessed. In both children and adults the data to be presented consists of the symptomatology observable at the onset of the illness and the phenomena which appear during the course of the illness and during psychotherapy.

Older people in institutions are often disabled by physical disease (Wilson et al., 1962). Psychiatric patients, in general, have more somatic disorders than mentally healthy people (Westrin, 1961; Shepherd et al., 1964; Maguire and Granville-Grossman, 1968). In fact, most elderly long-term psychiatric patients in hospital suffer from one or more somatic disorders (Ask, 1962). Even a small improvement in the general health of these patients may be of importance for their daily life activities, and also reduce the requirements for assistance. An established regular somatic screening of these patients will help to detect disease which otherwise may be over-looked.

Between 1962 and 1970, the male parasuicide (attempted suicide) rate in Edinburgh has doubled, and the rate for women shows a 70 per cent increase (Kreitman, 1972). Of those who are admitted following a parasuicidal act a substantial proportion are readmitted—approximately 15 per cent within 12 months and 25 per cent within three years. Parasuicide is a sign of severe distress, and repetition indicates that the distress has not been adequately alleviated. A means of early identification of the potential repeaters would be valuable.

The success of an in-patient therapeutic programme depends, in many instances, on the willingness of the patient to co-operate with medical and nursing staff, and to react positively to the permissive regime characteristic of the modern psychiatric hospital.

Exposure treatments such as flooding are being used increasingly for phobic and obsessive-compulsive disorders (reviewed by Marks, 1972). The shortage of treatment personnel has led to a search for ways to save therapist time. An obvious way of economizing is to expose a number of patients simultaneously in groups, instead of individually, to the real life situation which they fear.

This case is reported in the absence of any documented evidence of the systematic and successful treatment of blepharospasm. A flexible behaviour therapy approach, guided by behavioural analysis and experimental psychology was used (Sharpe and Meyer, 1973).