In a recent book, Sargant (1957) has discussed many examples of human beings who, after brief or prolonged mental tension, including terror, underwent a sort of reactive collapse into a state which, in its extreme form, was one of stupor. Sargant interpreted these reactions in terms of a physiology derived from Pavlov, particular emphasis being laid on “transmarginal inhibition“—a variety of the “internal inhibition”, or “hypnosis” which Pavlov identified with sleep, and which was manifested by motor inertia and unresponsiveness to stimuli. Pavlov's dogs exhibited internal inhibition in response to monotonous stimulation of any kind (including repeated electric shocks); repeated non-reinforcement, disappointment, or non-fulfilment of the dog's expectations; delay in reinforcement; and, in experienced dogs, in response to being placed in the experimental situation (or having the stimulating electrode attached to the leg in the case of those given electric shocks).

The object of the experiment to be described in this paper, was to find out if it was possible to develop a systematic experimental investigation of paranoid delusions.

The problems of diagnosis, pathogenesis, aetiology and successful treatment of the idiopathic schizophrenias is one of the most urgent and formidable ones which psychiatry has still to tackle. It is most urgent because of the large number of sufferers struck by the disease, made unfit for a successful life at an early age, and the distress imposed on them and their relatives. It is most formidable because our essential knowledge of the nature of this disease, or possibly group of diseases, is scanty and disorderly and opinions are conflicting and contradictory. This unsatisfactory state is made worse by the fact that there is quite an amount of disagreement on diagnosis, so that often the findings of different workers do not refer to comparable groups of patients (and conditions in which they are examined) which must add to the confusion, particularly when metabolic examinations are carried out. Too often “marginal psychoses“, and also not rarely, paranoid hallucinatory states with and without changes of the personality are called “schizophrenia”. The last-named states are not infrequently schizophrenoid reactions (or reactions of a schizoid person) to psychogenic causes or to potentially diagnosable physical disorders. On close clinical examination one would also find that the symptomatology of such cases is not that of idiopathic schizophrenia. In the “classical” schizophrenias of Kraepelin, Bleuler and Kleist, despite some discrepancies, the typical para-functions of feeling, willing, thinking and activity, usually accompanied by hallucinations, mainly auditory, and paranoid delusions are present and also a disturbance of the albumin/globulin ratio in C.S.F. and serum. In the absence of this mental and physical symptomatology the diagnosis of idiopathic schizophrenia should not be made (Fleischhacker et al. (7, 8)).

In Norway, the refugee problem has not been quantitatively significant. On the other hand, we have many examples to show that refugee work and interest for the fate of refugees has had an important position in the awareness and interest of the Norwegian people. The fact that the Nobel peace prize has twice been awarded to the High Commissioner for refugee organizations also speaks for itself. After the Russian revolution and its suppression in 1905 a small wave of emigrants came to Norway, and likewise after the 1917 revolution. Moreover we note a very limited and controlled immigration of victims of Nazi oppression from Germany and the occupied territories until World War II. After the war Norway was faced with a series of problems in connection with the refugees. In the first place it was a question of repatriation of Norwegian prisoners in Germany and refugees in Sweden, there were the forced evacuees from Finmark to be sent home, and then, last but not least, all the foreigners who had involuntarily landed in Norway during the war. Of these 140,000 were “displaced persons“. These had been brought to the country by the Germans either as civil workers or forced labourers in “Organization Todt”, “Organization Speer” or as prisoners of war, mainly Serbs (Jugoslavs), Russians and Poles. According to a list published in the annual report of the Ministry of Labour for 1947 (1948) the following figures are given:

A recent court case (16) exposed many of the problems that confront the psychiatrist called upon to perform electroplexy.

In particular it revealed that in 1957, nearly 20 years after E.C.T. had first been used for the treatment of mental disorder, no uniform technique had yet been evolved. The medical witnesses were unable to agree on the use of muscle relaxants or mechanical restraint, but were agreed that there were certain risks attendant upon the use of electroplexy, especially the risk of fractures and the risk to life. It was argued that had the plaintiff received a relaxant drug he might not have sustained bilateral acetabular fractures, but might have suffered an even worse disaster, namely death.

Tranquillizing drugs have become widely accepted as a major form of treatment in psychiatry. However, reports in the literature on these drugs have frequently been conflicting, with a marked tendency for the results of uncontrolled studies to be much more favourable than those obtained in studies where some method of control has been adopted. Sargant (1956) has emphasized many of the social, economic, and moral implications inherent in the extravagant and indiscriminate use of tranquillizers in general and has stressed the need for the proper evaluation of their therapeutic effects. In view of this need, we undertook a controlled comparative study of the effects of two of the phenothiazine compounds, promazine (“Sparine”) and chlorpromazine (“Largactil”), in the treatment of chronic psychosis.

An examination of recent catalogues of tests published by the Australian Council for Educational Research, the Psychological Corporation of America and the National Foundation for Educational Research, has shown that few well-standardized and validated tests of personality are available for use with children.

Control of micturition by day should ordinarily be acquired in the second year of life and by night in the third, and enuresis comprises repeated involuntary micturition after this age if not due to organic disease. If the latter is responsible the symptom is termed incontinence of urine (Hubble, 1950).

Certain drugs apparently alter the focus of attention. This paper deals with attempts to confirm and extend knowledge about drug influences on the focus of attention, and to relate the concept of the focus of attention to the concepts of extraversion and introversion used by Eysenck and his co-workers.

In Oxford, all psychiatric cases among undergraduates are referred by their general practitioners and therefore tend to be selected by them. There is no group they are more ready to pass on to the psychiatrist than the student complaining, in whatever guise, of homosexuality. It is not therefore surprising that homosexuals form a high proportion of the 100 Oxford students referred on psychiatric grounds and studied in the research underlying this paper (the mode of selection is described in Davidson et al., 1955 and Spencer, 1957, p. 93). Opportunity was afforded also for the examination of 100 freshman controls from three Oxford Colleges (for mode of selection, see loc. cit.). These students agreed to answer questions about their sexual development, including possible homosexual practices or interests.

Clinical conditions simulating various degrees of intellectual handicap have been described quite frequently in the past. Individuals with such a deficiency have been observed in increasing numbers by psychiatrists, pediatricians, psychologists and social workers in schools for the mentally defective as well as in psychiatric hospitals and mental hygiene clinics.

Phenylketonuria is an inborn metabolic disorder affecting the body's ability to hydroxylate phenylalanine to tyrosine.

Its incidence in the general population has been estimated at 0.004 per cent. and its institutional frequency at approximately 0.2 to 0.9 per cent.

In 1956 the Henderson Research Trust awarded the writer a scholarship which enabled him to spend a year in Scandinavia, studying the care and treatment of psychopathic offenders. This paper is based on observations and enquiries by the writer during that year.

In his examination of elderly patients the psychiatrist is commonly concerned to obtain some indication of the individual's “memory function“. When the psychologist is asked to help in such assessment there are at least two factors which may handicap his ability to do so. Firstly, the conception of “memory”. as popularly used, even in the clinic, is rather narrow in its connotation, having come to refer almost exclusively to the reproduction of learned material. It would seem more satisfactory, from the psychologist's point of view, to substitute instead the notion of “learning ability” since this expression has a wider meaning. It admits of the discussion of separate aspects and takes into account, for example, the two broad phases of “acquisition” and “retention“. Secondly, those tests which the psychologist may have by him which purport to assess “memory” usually suffer from a number of disadvantages. For example, as Williams (12) has recently pointed out, they are seldom so constructed as to ensure that every subject has a standard opportunity to acquire what the test requires him to reproduce; in any case few of the tests available have ever been given to elderly people, so that “normal” performance in such age groups is unknown. A more important, and less often emphasized, disadvantage, however, is that performance on such tests is commonly closely related to performance on intelligence tests, so that although the ostensible content of the material used seems to be related to “memory”, in the popular sense, what the psychologist in fact gets from them is another measure of general intellectual ability. A study by Hall (1) has shown that, for a young population at least (mean age 29.11, sd 2.77), the results of the Wechsler Memory Scale (10) correlate with results on the Wechsler Bellevue Intelligence Scale (9) almost to the degree (r=0.77) to which the intelligence measure correlates with itself (r=0.94).

In the past thirty years a great deal of attention has been paid to the problems of differentiating mental deficiency from psychosis, and recognizing the distorting effects of mental defect and deprivation upon supervening mental illnesses. The incidence of psychotic syndromes in mental deficiency hospitals has been variously estimated as 5 per cent (Greene 1933), 8 per cent (Vanuxem 1935), and 11 per cent (James 1939), while a survey made by Hackbush (1935) on a very large number of patients on the waiting list for admission to mental deficiency hospitals, suggested a figure of 10 per cent. James considered that three-quarters of his psychotic group were schizophrenic, and Bergman et al. (1951) agreed that schizophrenic illnesses were very common in mental defectives. Whereas the incidence of schizophrenia in the general population is 0.85 per cent (Mayer-Gross et al. 1954), it occurs as much as nine times more frequently in certain mentally defective groups.

Derivatives of glutarimide are known to exert an effect upon the central nervous system. To name only two which are widely used for clinical purposes: Glutethimide (“Doriden”) is a sedative, Bemigride (“Megimide”) a stimulant. Preparation 16038 (Ciba) α-(p-aminophenyl)-α-ethyl glutarimide, in animal experiments had shown properties which suggested its use as an anticonvulsant, and this paper is an account of a clinical trial with the substance on in- and out-patients suffering from epilepsy.

There have been a few studies of the nature and frequency of mental disorder in the offspring of marriages in which both parents were known to have been mentally ill (Schulz, 1940; 1941, Elsaesser, 1952; Lewis, 1957). A number of psychoses affecting both husband and wife have also been described as examples of folie à deux. Gralnick (1942) reviewed the literature, and found altogether 118 cases of folie à deux, but Ascher (1949) has concluded that such cases are commoner than would appear. The majority of those reported have involved blood relatives, in whom the implications of a “psychosis of association” are questionable, because of similarities in their genetic endowment (Kallmann and Mickey, 1946). However, Gralnick recorded 26 cases of folie à deux involving husband and wife.

It is natural for psychiatrists and others dealing with mental patients to enquire what the prognosis is for a patient showing certain symptoms or syndromes of symptoms—taking age and the history of the patient's illness into account. The very fact that the symptoms generally form syndromes points to their interdependence to a greater or lesser degree, but this interdependence may not be a straightforward linear relationship such as is revealed by an ordinary correlation coefficient for the symptoms may interact with each other in a complicated way. When this is the case the problem of prediction is difficult from a statistical as well as from a psychiatric point of view. In this paper an effort is made to clarify the statistical problem by describing briefly and by comparing two statistical models which may be used for predictive purposes. The models are introduced by means of an example using data for patients who have attended this hospital. For reasons of clarity the number of variables included in the study is a bare minimum.

In a previous investigation (Foulds and Caine, 1958) a series of consecutive admissions (women) admitted to Runwell Hospital and diagnosed as psychoneurotic were found to divide into four groups in terms of presenting syndrome (hysteria or dysthymia) and of personality type (hysteroid or obsessive). When psychological tests were administered to these groups it was found that some measurements were related to diagnostic category whilst others were related to personality type.

Since disulfiram (tetraethylthiuram disulphide) was first reported to cause intolerance to alcoholic beverages (Hald et al., 1948) it has been used extensively as an adjunct in the treatment of alcoholism. Impressions of most therapists have been favourable (e.g. Martensen-Larsen, 1953; Wallerstein et al., 1957). At Warlingham Park Hospital the drug has been administered over the past five years to more than 250 alcoholics (as part of a fairly comprehensive therapeutic programme—Glatt, 1955) and has been found by a great many patients very helpful after discharge from hospital.