Although the belief that primitive man might be free from schizophrenia has joined the rest of the golden age myths, there is still a serious question respecting the severity or chronicity of the disease in many tropical peoples. In such peoples typical cases of schizophrenia are proportionately uncommon, and in their place one often meets an acute short-lasting psychosis, which may be indistinguishable from classical schizophrenia in its initial stages but which runs a much shorter course and carries a better prognosis.

The difficulties of organizing mental health services in developing countries are made all the greater by inadequacy of information about the extent of illness and disability. Some beginnings have been made in India, particularly under the sponsorship of the All India Institute of Mental Health, Bangalore. The Mental Health Advisory Committee of the Government of India (1966) suggested a probable prevalence of mental illness of 20 per 1,000 population in general, 18 per mille for semi-rural and 14 per mille for rural areas. These figures are much lower than the 72 per 1,000 suggested by Sethi et al. (1967). Ganguli (1968) estimated a prevalence rate of 140 per 1,000 in industrial workers near Delhi. Incidence rates have been much less studied than prevalences (Lin and Standley, 1962). A WHO Expert Committee on mental health convened in 1960 suggested as a working definition of a case of mental illness:

It has been estimated (Zellweger, 1961) that less than 5 per cent of all cases of mental subnormality have a hereditary metabolic defect. This is a figure which requires confirmation, and is one that is likely to vary in different parts of the world. We have accordingly carried out a systematic clinical and biochemical screening of the cases of mental subnormality (IQ lower than 70) attending the out-patient department of the Mental Hospital, Bangalore. A total of 729 patients (439 males and 290 females) were available for this study.

Motor disorders occurring in association with phenothiazine therapy have been widely appreciated and investigated since the advent of these drugs in the early nineteen-fifties. Published works have indicated that between 20 and 40 per cent of patients treated with phenothiazines exhibit signs of extrapyramidal dysfunction (Denham, 1961; Ayd, 1961). However, the relationship between treatment variables and the frequency of these motor disorders is not a simple one. Many factors are likely to have aetiological significance, and it seems that their occurrence is more a reflection of personal idiosyncrasy than of chemical structure, dosage or duration of treatment (Lancet, 1964).

The elctrical resistance of the palmar skin, and the naturally-occurring difference in electrical potential between the palm and the dorsal surface of the forearm show simultaneous changes in response to sudden or emotionally-laden sensory stimuli (the ‘galvanic skin response’ or GSR). Spontaneous GSRs occur during wakefulness, especially in anxiety states, but they are reduced by general relaxation and it might be supposed that they would be absent during sleep of uniform EEG appearance. However, Oswald et al. (1959) reported that this was not so and that in sleep with very high voltage slow waves (today generally called Stage 4 sleep) there could be present random spontaneous GSR activity, measured by the potential difference technique. Since these electrical phenomena cannot be related to any known stimulus, to call them galvanic skin responses is inappropriate, and they may better be termed electrodermogram (EDG) activity.

Dibenzepin hydrochloride is a new tricyclic antidepressant drug with pharmacological properties midway between those of imipramine and amitriptyline. In a double-blind comparative trial, J. M. Fielding (Med. J. Australia, 1969, 1, 614) found no significant difference in the speed of the effect of the two drugs in depressed patients. He reported that side-effects rated subjectively by patients were maximal before starting on the drugs and tended to decrease with time. The following trial was accordingly staged.

In a previous study we presented preliminary evidence indicating that there may be two types of alcoholism in women (Schuckit, Pitts, Reich, King and Winokur, 1969). These types were called primary alcoholism and affective-disorder-alcoholism. The affective-disorder-alcoholic woman showed evidence that she had had a clear-cut affective episode which was either independent of the alcoholic intake or had occurred prior to the time alcohol had become a problem. Suicide attempts were significantly more frequently seen among the affective-disorder-alcoholic women than among the primary alcoholic women. As regards the family history there was significantly more affective disorder in the families of affective-disorder-alcoholic women than in those of the primary alcoholics. It appeared, then, that there were two types of alcoholism among women hospitalized for alcoholic abuse.

The patient in the case presented below lacerated his wrists under conditions which have been used experimentally (8) and observed in man (7, 9) to produce alcohol amnesia. His family history is typical of those seen frequently in suicidal attempts (2).

Self-injury is a frequent occurrence in both mentally subnormal and mentally ill patients. The aim of this study was to determine its prevalence and nature in hospital populations of such individuals.

The first descriptions of anorexia nervosa, categorized in various ways, date back to the sixteenth and seventeenth centuries (Rudolph, 1970; Schadewaldt, 1965; Thomä, 1961). It seems clear that the condition has become more frequent in recent years, even though we must allow for the fact that such patients were formerly seldom seen by the psychiatrist, but were treated in general or paediatric hospitals as subjects of an endocrine disorder. It has been suggested that the recent increase in the incidence is related to the emancipation of women (von Baeyer, 1965), and to the increasing number of professional women who are mothers.

Hypnagogic hallucinations are well established in text books of psychiatry, as also are hypnopompic hallucinations. Hypnagogic hallucinations are those which occur as the subject falls asleep and prevent him falling into a sound sleep, whereas hypnopompic hallucinations occur when the subject is waking up. Since by definition hypnagogic hallucinations actually waken the subject, the distinction between these two types of mental phenomena may be artificial. Psychiatric texts vary in their assessment of the significance of these hallucinations, and, with some exceptions, they have generally been considered as ‘normal’ phenomena.

Religions mysticism (hereinafter referred to as R.M.) is defined as (alleged) direct experience of ultimate reality seen as personal or hyper-personal. It may take any one of three forms: nature mysticism, theistic mysticism, and monist mysticism. In nature mysticism, the percipient feels the whole of Nature, including man, to be pervaded and directed by Mind (the capital letters are used deliberately). Wordsworth's Prelude and Tintern Abbey provide classical examples. In theistic mysticism, the percipient feels himself to be aware of the God of religion in a purely spiritual manner, which in respect of its immediacy is felt to be analogous to sensory perception. Thomas Aquinas, in fact, defines this kind of experience as ‘direct awareness of God, analogous to sensory perception.’ In monist mysticism, the percipient feels himself to be the One-and-Only Mind. The Yogi mystic, Swami Vivekananda, provides the classical example of this latter type of experience, proclaiming ‘I am the Blissful One’.

A neurotic patient is like a traveller in unfamiliar country forced to rely upon a deficient or systematically falsified map. The joint explorations undertaken with the therapist can enable the patient to revise this map. One condition which must be met for this to occur is for the therapist to recognize clearly how the patient sees his relationships with others, including the therapist. The present paper reports a method of investigating how far this condition is met, using a dyad grid test completed by the patient and by the therapist.

This is a report on offenders recommended for psychiatric treatment at the Royal Edinburgh Hospital during the three years 1966 to 1968.

The term regression as used in psychiatry may be defined as the re-living by an individual of his past, or part of it, in the present. Thus, in psychoanalytic therapy the patient may treat the analyst as he did one of his parents in his childhood, while in the dream of the normal person primitive tendencies and mechanisms of thought are revived. It should be noted, however, that regression is rarely or ever clear-cut or total. Although the patient reacts towards the psychoanalyst as he did in his childhood towards his father, yet at the same time he remains well aware of the analyst's true identity. Again, in the dream, although the underlying thoughts and feelings are related to childhood they are disguised and distorted by being mixed up with experiences of much later origin. In both the transference situation and the dream there is a ‘telescoping’ of the past into the present, a fusing of chronological levels, and a ‘condensation’ of experience.

In Great Britain the majority of terminations are carried out under Clause 2 of the new Abortion Act—a threat to the physical or mental health of the mother. It is understood that the majority of such abortions are performed on mental rather than physical grounds. Little is known about the degree of psychiatric illness displayed by these subjects, and practically no studies so far published have attempted to quantify this.

In many psychiatric units nurses now wear ordinary clothes instead of uniforms. The rationale underlying such changes has usually been that uniforms inappropriately emphasize the medical role of the nurse in physical treatment and interfere with her therapeutic role. The aim of the present study was to assess the effects of such a change on the attitudes of both nurses and patients.