The historical accounts of religious stigmatization occurring during the past 750 years have been surveyed, with more detailed attention being given to late nineteenth- and twentieth-century medical investigations of some well-known cases. A case showing some features of religious stigmatization is described. The possible relationship of the phenomena of religious stigmatization to disease and psychophysiological processes in the subject is examined.

A series of in-patients, a series of out-patients and a series of women from a general population sample, all aged under 65, and all living in the same area of south-east London, were examined using the ninth edition of the Present State Examination (PSE). An ‘index of definition’ (ID), based on number, type and severity of PSE symptoms, was constructed in order to define a threshold point above which sufficient information was available to allow classification into one of the functional psychoses or neuroses. The index specified 8 levels of definition of disorder; the threshold point for a ‘case’ lying between levels 4 and 5. The identification of ‘cases’ by this means in the general population series was highly concordant with global clinical judgement.

When the 3 series were compared, the in-patient series contained the most definite cases, the out-patient series was intermediate, and the general population series was characterized mainly by below-threshold conditions.

Disorders above the threshold point were classified using the CATEGO program. The clinical severity of the depressive disorders and anxiety states identified in this way in the 3 series was compared on the basis of symptom and syndrome profiles and PSE scores. As expected, the inpatients had the most severe, and the general population ‘cases’ the least severe disorders.

It is suggested that the PSE-ID-CATEGO techniques can be used to help standardize certain aspects of case-finding and case-description in both referred and non-referred populations and thereby make the results of surveys more comparable.

Results of the investigation of a sample of size N = 200, half of whom live in the vicinity of a main airport, are reported. Three health indicators were examined: (1) annoyance reactions measured with a scale which did not include symptoms; (2) a symptom score, obtained with a screening instrument which identifies possible psychiatric cases; and (3) confirmed psychiatric cases identified with a traditional diagnosis after an interview by a psychiatrist. Noise was undoubtedly associated with annoyance. An association between noise and psychiatric measures was only present in a subgroup of respondents of high education. There was a marked association between annoyance and psychiatric measures. An attempt was made to clarify the nature of this relationship. Hypersensitivity to noise was associated with a high frequency of psychiatric symptoms and should be considered among the high risk factors for psychiatric illness.

In a 5-year follow-up of 32 patients identified during a survey of a Dutch village in 1969, approximately two-thirds were found to have recovered. This result was reflected in the scores on a self-reporting questionnaire. A control group showed little change over those years. The persistence of psychiatric problems was related to life experience, as measured by a life-event interview.

This paper discusses the magnitude of the effect of life events in the causation of psychiatric illness. It is argued that an established epidemiological concept, relative risk, provides a useful measure of association which can be approximately adapted for retrospective controlled studies. Examination of studies employing general population controls consistently indicates effects of some importance, with risks of illness increased by factors of between 2 and 7 in the 6 months after an event. Risks are greater for the more stressful types of events, greater for depression and neuroses than schizophrenia, and even greater for suicide attempts. However, similar events occur commonly and a large proportion of event occurrences are not followed by illness. Events must interact with a wide variety of background factors, and the appropriate model is one of multifactorial causation.

The death risk for psychiatric patients has decreased over the last 30 years but still remains higher than that of the general population. The death risk for patients with a diagnosis of neurosis is higher than that for the general population. Previous studies are enlisted to investigate this mortality for socio-economic characteristics, alcohol and drug abuse, psychopathy and accident proneness. Possible psychosomatic aetiology of disease and subsequent death is examined. Psychological theories for premature death are discussed and some recommendations made for future areas of enquiry.

A blind social assessment at home was carried out twice during a year's follow-up of 41 patients on continuation therapy, 21 randomly allocated to pimozide tablets and 20 to fluphenazine decanoate injections. Patients on pimozide were significantly more favourably rated on aspects of sociability, use of leisure, warmth of personal relationships, household tasks and child-rearing. The mode of production of this result is discussed.

Eighty-nine new referral hypertensive out-patients and 46 new referral non-hypertensive chronically physically ill out-patients completed a mood rating scale at regular intervals for one year. The results showed a high prevalence of depression in both groups of patients, with no preponderance in the hypertensive group. Hypertensive patients with psychiatric histories had a higher prevalence of depression than the comparison patients. This was accounted for by a significant number of depressions occurring in methyl dopa treated patients with psychiatric histories.

A retrospective study of alcoholic psychoses is reported. The phenomena of the illnesses corresponded poorly with classical descriptions of alcoholic hallucinosis, delirium tremens and alcoholic paranoia. Alternative diagnostic approaches were tried (Catego, restrictive definition of alcoholic hallucinosis). The problems of distinguishing psychoses with associated organic factors from ‘idiopathic’ forms are discussed.

Twenty female anxious neurotic patients were compared with 25 normal female volunteers, divided into a low anxious normal and a high anxious group, with respect to dream report content. Dream reports were analysed using an objective and reliable method and were correlated with the day-time attitudes of the subjects measured by Semantic Differential techniques.

Anxiety levels influenced both dream reporting and dream content. In particular, aggression towards the dreamer was more common in the anxious patients. Significant correlations were found in all groups between dream content and daytime attitudes. The results were consistent with the ‘continuity’ hypothesis of dream function.

Recent work has shown that the hypothalamic peptides commonly associated with the control of pituitary function have important behavioural actions of possible psychiatric significance. Thus, vasopressin, ACTH and like peptides may influence memory processes, and ACTH and MSH given intracranially induce a peculiar stretching and yawning syndrome accompanied by penile erection and ejaculation. Thyrotrophic hormone-releasing factor potentiates behavioural excitation, somatostatin is depressive, while luteinizing hormone-releasing hormone facilitates sexual behaviour and the newly identified endorphins are markedly opioid in character. These and other activities of the hypothalamic peptides are reviewed and assessed alongside the clinical information available.

The estimation of body dimensions in a group of 31 patients with anorexia nervosa and a control group of 20 psychoneurotic females has been studied with different techniques, including a visual size estimation apparatus and the marking of indicated body points on a paper attached to the wall. The results confirm the previously described tendency by patients with anorexia nervosa to overestimate body size in the stage before their treatment in hospital. Various differences between the two groups were found and the anorexic patients were more inconsistent in the estimation of the different body measures. On the basis of correlations with the results of an internal-external control questionnaire, it is suggested that overestimation and variability in visual size estimation could be promoted by an orientation towards external control.

A self-completion sleep evaluation questionnaire (SEQ), consisting of 10 cm line analogue rating scale questions, was constructed to investigate subjects' responses to aspects of sleep and early morning behaviour. The questions were grouped into 4 chronological areas: the ease of getting to sleep (GTS), the perceived quality of sleep (QOS), the ease of awakening from sleep (AFS), and the integrity of early morning behaviour following wakefulness (BFW). Five hundred and one SEQs were completed during several investigations into the comparative effectiveness of hypnotic drugs. The classical factor analysis produced 4 factors which corresponded to the 4 aspects of sleep and early morning behaviour listed above. The GTS and QOS factors were positively correlated (+ 0·57), as were the AFS and BFW factors (+ 0·48). The 2 sleeping state factors (GTS and QOS) were orthogonal to the 2 waking state factors (AFS and BFW).

Plasma chlorpromazine measured by a gas chromatographic procedure was found to disappear rapidly during the first week after withdrawal of chlorpromazine treatment in a group of 17 chronically hospitalized patients. The drug or its metabolites were no longer measurable in plasma after 8 days.

A group of 49 patients with depressive illness were treated in an uncontrolled study by the intravenous administration of the beta-adrenergic stimulant, salbutamol. The results suggested a rapid antidepressant action in the majority of cases without significant adverse effects.

A preliminary survey of 10 married couples was carried out to test the hypothesis that women express greater dissatisfaction with their health and other personal life domains than men. Although the women made more use of medical facilities for minor complaints than their husbands, no difference was found in expressed satisfaction, or in number or severity of symptoms reported at interview. However, there was a discrepancy between husbands' and wives' perception of their spouses' satisfaction levels and experience of illness-symptoms, in the direction of wives being perceived by their husbands as considerably less healthy and more dissatisfied than the husbands were rated by their wives. Some evidence was also found for greater emotionality in women. The results are regarded as indicating that illness is more socially acceptable in women than in men.