Sydenham's reputation rests in part on his self-deceptive assertion that he allowed clinical observation to speak for itself. In fact, however, his mind was steeped in philosophical world-views that went back via the Scholastics and Galen to Plato and Aristotle. A brief survey of these views is presented to clarify Sydenham's message. The basic formula of logical set theory is then used to put in perspective Sydenham's disease postulates and later views on the nature of disease. The point is made that, in the case of cryptogenic diseases, we sometimes tend to revert unwittingly to ideas akin to those of Sydenham.

The clinical condition occurring in the elderly with preserved intellectual functions, characterized by vivid, elaborate and dynamic recurrent visual pseudo-hallucinatory phenomena of a pleasant or neutral nature and often associated with ocular pathology – the Charles Bonnet Syndrome – is described. Its main clinical features are illustrated and the aetiology discussed. Two new cases are presented and areas for future research are outlined.

LH, FSH, PRL and testosterone were estimated by radioimmunoassay in serial venous samples from 20 male chronic schizophrenic patients, 17 age-matched controls, 3 patients in remission from acute schizophrenia, and in single samples from age–sex matched populations. LH and FSH, but not testosterone or PRL, were significantly reduced in patients with chronic schizophrenia. There was an associated reduction in the frequency, but not amplitude, of LH secretory episodes in patients with chronic schizophrenia. No abnormalities of LH secretion were detected in those patients in remission from acute schizophrenia. Fourteen of the chronic schizophrenic patients were retested at a later date with similar results, except in the case of the few patients who had been started on neuroleptic medication. Some relationships were established between hormonal secretion and the clinical features of these patients. The possible significance of these findings is discussed in the context of the complex control of gonadotrophin secretion from the anterior pituitary and the natural history and nature of chronic schizophrenia.

HLA types studied in 113 patients with manic-depressive psychosis did not confirm the previously suggested association with HLA Bw16. No difference was found between unipolar and bipolar manifestations. A possible excess of A10 in patients is of interest, since this antigen binds with psychotropic drugs.

The Lundby cohort consists of all inhabitants in a delimited area in Sweden studied in 1947 by Essen-Möller, then by Hagnell in 1957, and by Hagnell & Öjesjöin 1975. It has been claimed that depressive disorders have increased during the sixties and seventies. In order to examine this hypothesis on a normal population (the Lundby Study), comparisons were made of the incidence figures for depression during the periods 1947–57 and 1957–72, and during the five 5-year intervals within the period.

This investigation aimed to ascertain the levels of anxiety, depression and religious attitude, by means of rating scales, in a group of physically sick men and women planning to go on a pilgrimage to Lourdes. These levels were reassessed one month and ten months after the pilgrims had returned. There was a statistically significant decrease in anxiety and depression which was sustained. The possible reasons for these findings are discussed.

Rates and methods of suicide during 1961–70 of migrants in Australia were compared with native born Australians. Large differences in both rates and methods of suicide were found in individual migrant groups. The rates were more akin to those in the country of origin than of the Australian-born, no matter how long the migrants had lived in Australia. By contrast, methods of suicide used by migrants approached more closely those of the Australian-born the longer they had lived in Australia. The change in methods used was greatest in those migrant groups coming from countries with a language and culture more akin to those in Australia. A discussion follows of various possible sociological and cultural factors, both within the countries of origin and within Australia, which could have contributed to these results.

Disturbed behaviour and dissatisfaction were studied in relation to two contrasting ward environments, one representing the ‘medical model’ of psychiatry and the other being a modified form of ‘therapeutic community’. Specially designed forms were used for 18 months to obtain daily and weekly measures of behavioural disturbance from the nurses and of dissatisfaction with various aspects of the ward environment from the patients. The results suggested that the ‘therapeutic community’ ward was significantly more disturbed, and that disturbance on that ward varied according to the day of the week, something which did not happen on the ‘medical model’ ward. Differences in disturbance between diagnoses were also found. Disturbance was significantly correlated with, and tended to precede, dissatisfaction only in the ‘therapeutic community’ ward.

The effect of childhood experiences on adult psychiatric morbidity was examined in a community psychiatric survey. The Present State Examination was used to assess psychiatric morbidity. Childhood experiences assessed included childhood demographic factors and ‘loss and deprivation’ variables. The latter group comprised maternal and paternal deaths and separations and other disruptions in parental care. ‘Loss and deprivation’ in combination accounted for between 4·5 and 5·5% of the variance in adult psychiatric morbidity

A procedural replication of the Camberwell retrospective community study of depression in women (Brown et al. 1975; Brown & Harris, 1978 a) was conducted in Calgary, Alberta. A random sample of 449 women between the ages of 18 and 65 were interviewed. The shorter form of the Present State Examination (PSE) and Brown's Interview Schedules for Life Events and Difficulties were used.

By contrast to the findings of Brown, none of the following factors was associated with the onset of depression in the 12 months prior to interview: social class, employment status, number of children at home, loss of mother before age 11. In agreement with Brown, a lack of intimacy with spouse/cohabitant/boyfriend increased the risk of depression. Also in agreement with Brown, severe life events and difficulties were associated with depression. The association was particularly strong for ‘possibly independent’ events and difficulties, i.e. events (and difficulties) that may or may not have been caused in part by the woman herself. It was concluded that the role of social factors is community-specific and that the causal roles of events and difficulties in relation to depression remain uncertain. The implications of the findings in relation to the locus of vulnerability to depression are briefly discussed

The use of a standard intelligence test for detecting cognitive impairment has been re-examined in a cohort of 506 hospitalized alcoholics. The value of Vocabulary scores as indicators of original intelligence was tested by formulating the hypothesis that Vocabulary scores would remain constant despite increasing degrees of alcohol-induced cerebral dysfunction. Subjects were assigned to non-dysfunctional, minimal, moderate and severe dysfunctional groups on the basis of psychometric testing and their Wechsler Vocabulary scores categorized as either ‘abstract’, ‘concrete’ or ‘wrong’. Significant linear deficits in Vocabulary score and loss of abstract ability correlated with increasing dysfunction, irrespective of age but with greater frequency in females.

The relationships between smoking, reasons for smoking and personality were investigated in 98 cigarette smokers. Contrary to the usual findings, smoking did not relate to extraversion (E) but related instead to psychoticism (P). It is suggested that this relation is the true one, and previous findings have been due to a contaminated measure of E. Neuroticism (N) was related to the amount smoked, and particularly to a willingness to give reasons for smoking. There was no relation between the Reasons for Smoking Questionnaire, and attempts or success at giving up smoking. Smokers who rolled their own cigarettes were more introverted than others. No measures showed significant relations with the nicotine content of cigarettes

The parents of 24 physically handicapped children were grouped according to their responses to a Primary Mood Factors grid and comparisons were made with their children's responses to a self-concept scale. It was found that parents who were close together in their primary mood reactions had handicapped children who were more positive in self-esteem than those dyads who were divided in their primary mood reaction.

The clinician has no objective criteria of good health; he is likely to identify its presence only in the absence of disease and dysfunction. Yet the layman is able to give a global assessment of his own health as good, average or poor. The present paper explores the correlates of self-assessment of health in a large community sample and, by the use of two linear models, describes the effects of age, sex, reported symptoms, and long-standing illness on self-rated health status. It is suggested that global ratings are influenced by age and sex and by the experience of both physical and psychological symptoms, and that there are no interactive effects between symptoms and the demographic variables.

Primiparae were randomly assigned to two conditions of routine ultrasound examination at their first antenatal clinic visit: (a) high feedback ultrasound where the monitor screen was visible and the patient was shown the foetal size, shape and movement (N = 67); (b) low feedback ultrasound where the screen was not seen and specific verbal feedback was denied (N = 62). Women were interviewed at 16 weeks gestation. Those receiving high feedback were more likely to report that they had acted on health advice given at the first antenatal visit to reduce their smoking and drinking.

Coping is action directed at the resolution or mitigation of a problematic situation. There are a number of ways in which this may be attempted, and a number of ways of classifying coping strategies. This paper presents a simple schema of six coping themes, ordered in terms of their defensiveness and the degree of attempted personal control which they imply. They comprise rejection, control, resignation, dependency, avoidance and minimization, and characterize the meaning or qualitative ‘style’ of the individual's response, rather than the formal characteristics of the strategies employed. Data from studies of breast cancer and surgical patients are cited to illustrate the substance of the themes.