A detailed account is given of the historical background and current status of the concepts of transitory delusional state (bouffée délirante) and chronic delusional state in French psychiatry. Their relations with other nosological systems are discussed.

A brief review of post-war developments indicates the course of research into psychiatric morbidity at the level of primary care in the United Kingdom. The theoretical and practical importance of such work has now been demonstrated and some major lines of future enquiry are outlined.

The relationship between psychological and biological processes is examined. Criteria for the distinction between reasons and causes are described. These provide a basis for a separation of those mental states and behaviour that can be explained in a reductionist fashion, and those that are not reducible. The proposed conceptual framework has clinical and research implications.

A case is reported in which mercury intoxication produced visual symptoms with an unusual compensation. The similarity of this patient to Schn., a much reported neuropsychiatric case, was striking and prompted correlation of the two cases. Experimental psychological studies performed on the present case provide a basis for an understanding of both cases.

133 samples of plasma taken from 9 normal control and 8 manic-depressive subjects were analysed for vanadium by atomic absorption spectrometry. Mean plasma vanadium concentrations were 0·15 μM in normal control, 0·34 μM in manic and 0·28 μM in depressed subjects, and 0·23 μM in manic-depressive subjects after recovery. The differences between normal subjects and manic and recovered subjects were statistically significant. Significant negative correlations were found between plasma vanadium concentration and the ratio of Na–K–Mg ATPase to Mg–ATPase in 2 manic-depressive subjects, but not in normal subjects. The results suggest that vanadium may be a cause of the variations in Na–K–Mg ATPase and sodium pump activity which are associated with manic-depressive illness.

Little is known about the effects of non-MAOI antidepressants on cognitive functions, despite their wide application to ambulant patients. Evidence from studies involving healthy volunteers suggests that differences exist between drugs, with imipramine, amitriptyline and mianserin being associated with the most marked detrimental effects. However, these findings have generally not been supported by the few studies using clinical populations, for which improvements in cognitive functions are often recorded following treatment. The reasons for this discrepancy are discussed, and the need for further research suggested.

Thirty-four women who had vaginal deliveries of live infants completed behavioural ratings and supplied blood and 24-hour urine samples on three occasions during pregnancy and on three occasions after delivery. Approximately one third of the women indicated a distinct upswing in mood between Days 2 and 4 following delivery. These ‘positive mood change’ subjects showed changes in urinary cyclic AMP (adenosine 3′5′ cyclic monophosphate), plasma cyclic AMP, whole blood cell cyclic AMP, whole blood cell ATP (adenosine triphosphate), haematocrit and urinary 11 OHCS (11-hydroxycortisol steroids) following delivery which were different from those observed in the rest of the subjects and comparable with the biochemical changes described during upswings in mood in short-cycle manic-depressive subjects. There was also an indication that the women showing this upswing in mood following delivery were distinct in some respects on both behavioural ratings and biochemical findings during pregnancy.

The Southampton case register and maternity records were used to identify all Southampton women who had babies in 1976 and 1977 and who had been in psychiatric care in the 2 years before and after the birth date. 127 such women were identified out of a total of 5200 having babies. An analysis of the timing of referral and the total number in care at various stages of the study period confirmed an increased rate of psychosis following childbirth. Rates for other diagnoses showed no such clear relationship. Obstetric and social factors were not related to postpartum morbidity. These results are discussed.

An increasing interest in the psychological concomitants of neoplastic diseases has led to a burgeoning literature in recent years. The present review identifies five major areas of psychiatric research, documents the current state of knowledge, and indicates fruitful avenues for further study.

Skin conductance habituation was measured in schizophrenic patients (N = 41) during an acute episode and compared with neurotic patients (N = 86) who were either predominantly anxious or predominantly depressed. All patients were tested before the onset of drug treatment. Between the 14th and 15th tone of the 17 tone simple habituation series a loud ‘dishabituating’ tone was inserted.

In terms of traditional measures based on response frequency, non-habituation was most frequent in the anxious patients and least frequent in the depressed patients, with schizophrenic patients being intermediate. However, in terms of response amplitude the schizophrenic patients showed significantly faster habituation than either neurotic group. This paradox seems to be a consequence of the frequency of spontaneous fluctuations which was highly related to habituation status in the schizophrenic group, but not in the neurotic groups. When habituation was defined in terms of response amplitudes falling below spontaneous fluctuation amplitudes (rather than zero) the schizophrenic group showed the lowest frequency of non-habituation.

None of the groups showed any evidence of dishabituation after the loud tone, but the schizophrenics showed a significantly smaller response to the loud tone itself. Following Groves & Thompson (1970), this is interpreted as showing that the loud tone induced a greater response because of its perceived difference from the other tones rather than a sensitization effect because of its loudness. In these terms the schizophrenic patients showed greater response generalization than the neurotic patients.

Three experiments are reported in which schizophrenics are compared with other psychiatric patients on (i) the imagery value of words in their speech, (ii) their memory for words differing in imagery value, and (iii) their ability to distinguish the imagery value of two words. The study was designed to evaluate a neglected interpretation of Goldstein's ideas that schizophrenics are more concrete, in that their ‘action is determined by momentary sense impressions’. The results gave no support for this interpretation and it is suggested that an abnormal way of categorizing the world is more likely to be a useful way of formulating Goldstein's ideas.

Social and demographic characteristics were examined retrospectively in a sample of 475 hospitalized schizophrenics to test the hypothesis that they can be meaningfully distinguished by the presence or abesence of psychiatric disorders in their relatives. Cases with a positive family history of psychiatric disorders (FHP cases) were significantly more likely to have been born in the United Kingdom and to have had mothers. Those who had relatives with psychiatric disorders other than schizophrenia were significantly more likely to have been diagnosed as schizo-affective. The findings are thought to reflect a constitutional trait in parents of FHP cases leading to delayed child bearing. They also support the ‘environmental stress’ theory of immigrant psychosis and the hypothesized genetic link between schizo-affective and affective disorders.

First admissions for schizophrenia in Northern Ireland are significantly higher for the Roman Catholics than for the rest of the population, although not as high as in the Irish Republic. The excess of Catholic cases affects only the never-married, and derives much more from the rural west of the territory than from the industrial east. It does not appear to be accounted for by geography per se, by the differential use of services, diagnostic bias, social class distribution, or mean age at marriage. There are indications that some conflict around sex and marriage and, more doubtfully, a sense of relative deprivation may be contributing factors.

Electrodermal measures, psychiatric ratings (Brief Psychiatric Rating Scale, Clinical Global Impressions) and several Wechsler subtest scores were obtained for 26 hospitalized chronic schizophrenics during drug ‘washout’. The psychiatric ratings and Wechsler scores were obtained again after 6 months' treatment with thiothixene or thioridazine. Results revealed that those patients who displayed therapeutic benefit from the neuroleptic treatment displayed greater pre-treatment electrodermal activity and higher skin conductance levels, compared with schizophrenics who did not benefit. No effect for laterality was noted.

At discharge, a significantly larger percentage of unipolar patients treated with electroconvulsive therapy (ECT) respond with marked improvement as compared with those receiving antidepressants or other treatment. No treatment appears to be more efficacious in the bipolar group. In studying the covariables related to the length of time between hospitalizations, we found that the type of treatment is not important for the unipolar patient, whereas a combination of ECT and antidepressants lengthens the time to rehospitalization of the bipolar patient. Previous hospitalization is an important predictor variable for all patients.

Thirty-two patients who complained of episodes of ravenous overeating which they felt unable to control (bulimia) were asked to describe their behaviour and symptoms. There was considerable variation both between and within individuals, but a number of factors were defined which appeared to be common to all with the complaint. It is difficult to set up strict criteria for the recognition of bulimia, and those that have recently been proposed are criticized in the light of our present findings.