How well do we really know Thomas More? Directed to one of the most familiar figures of the sixteenth century, the question must appear absurd. Even without the aid of stage and screen, surely everyone has a clear idea of England's leading humanist, great wit, friend of Erasmus and other Continental humanists, author of Utopia, family man, man of convictions, ultimately martyr. The familiar Holbein portrait seems to sum it all up, as does at greater length the much admired biography of R. W. Chambers. Chambers, in fact, completed the picture when, to his own satisfaction and that of others, he disposed of ‘inconsistencies’ discerned by earlier observers between the cheerful reformer and ‘liberal’ of 1516 on the one hand, and the fierce opponent of Lutheran reform and savage polemicist of 1528–33 on the other. No man's personality in that age, not even King Henry's, seems more fully explored and more generally agreed than More's.

The crucial importance of economic, social and political factors in the definition and incidence of crime is undeniable, as is the need for socio-political change, but the part played by individual characteristics in determining who becomes labelled a criminal should not be neglected. Clinical criminology studies offenders as individuals, examines their peculiarities and their social problems and seeks ways to help them to lead less troubled lives. A wide range of treatment interventions is required, the psychiatric approach is not always the most appropriate.

In view of the lack of success in reducing recidivism by means of treatment, penologists see little justification for continuing to try. More successes might be recognized if treatment schemes were applied with greater realism and discrimination, and if proper evaluations were made more often. In any event, some offenders need treatment regardless of the effect upon their offending behaviour.

The main unresolved issues with respect to the psychological sequelae of brain damage in childhood are noted, and the previous studies of children suffering head injury are critically reviewed. A new prospective study is described. Three groups of children were studied: (a) 31 children with ‘severe’ head injuries resulting in a post-traumatic amnesia of at least 7 days; (b) an individually matched control group of 28 children with hospital-treated orthopaedic injuries; and (c) 29 children with ‘mild’ head injuries resulting in a post-traumatic amnesia exceeding 1 hour but less than 1 week. The children were studied as soon as possible after the accident and then again 4 months, 1 year, and 2¼ years after the injury. The parents were interviewed, using systematic and standardized interview techniques; both parents and teachers completed behavioural questionnaires; and the children were seen for individual psychological testing using the WISC, the Neale Analysis of Reading Ability and a battery of tests of more specific cognitive functions. At the final follow-up, the severe head injury group (but not the other 2 groups) received a systematic neurological examination and the school teacher who knew the child best was personally interviewed. The findings are given on physical handicap, neurological abnormality, school placement and psychiatric referrals. All types of disabilities were both more frequent and more persistent in the children with severe head injuries.

A population of professional dance (N = 183) and modelling (N = 56) students, who by career choice must focus increased attention and control over their body shapes, was studied. Height and weight data were obtained on all subjects. In addition, a questionnaire that is useful in assessing the symptoms of anorexia nervosa, the Eating Attitudes Test (EAT), was administered. Results of these tests were compared with those of normal female university students (N = 59), patients with anorexia nervosa (N = 68), and music students (N = 35).

Anorexia nervosa and excessive dieting concerns were overrepresented in the dance and modelling students. Twelve cases (6·5%) of primary anexoria nervosa were detected in the dance group. All but one case developed the disorder while studying dance. Within the dance group those from the most competitive environments had the greatest frequency of anorexia nervosa. These data suggest that both pressures to be slim and achievement expectations are risk factors in the development of anorexia nervosa. The influence of socio-cultural determinants are discussed within the context of anorexia nervosa as a multidetermined disorder.

The application of Piaget's genetic psychology tests to schizophrenic patients yielded the following findings. The intelligence quotient of schizophrenics, although within the normal range, is slightly lower than that of a control population of similar age. This is due not to a loss of the operations of the intellect, but to a difficulty experienced by the patients in actualizing the operations. The difficulty is seen particularly in operations dealing with specific objects which require a constant maintenance of the equilibrium between assimilation and accommodation. The thought processes of hebephrenic patients oscillate between excessive assimilation, resulting in a distortion of observable data, and excessive accommodation which by adhering to the observable data distorts the reasoning process. The thought processes of paranoid schizophrenics are dominated by excessive assimilation. This predominance explains their tendency to distort observable data and their difficulty in the generalization of reasoning; it also has an impact on the assimilation/accommodation equilibrium of their logical operations, leading to (a) difficulties in delimiting reflecting abstractions, and therefore the comprehension and extension of concepts, and (b) loss of proof based on logico-mathematical reasoning and, as a result, a propensity to resort to magical thinking and subjective explanations.

Family history, response to treatment and outcome are reported in a series of 76 patients presenting with both depression and schizophrenic or paranoid symptoms. About 10% of psychotic admissions to the Maudsley and Bethlem Royal Hospitals met a study definition of ‘schizodepressive’ illness. The patients were highly heterogeneous in history, clinical picture and outcome. Many followed a typical schizophrenic course, and others a typical course for affective disorders, but only 4 were given a final diagnosis of manic depressive disease. The best predictors of poor outcome were a mode of onset as an exacerbation of previous psychotic symptoms and the presence of schizophrenic symptoms at some time without depression. The best predictors of good outcome were Stephens' criteria of good prognosis schizophrenia and Kasanin's concept of ‘acute schizo-affective psychosis’. These findings are not easily reconciled with Kraepelin's two entities principle but suggest a continuum of outcome between schizophrenia and unipolar depressive psychosis.

A family of 6 affectively ill siblings is described. Two suffered from bipolar illnesses, 2 from recurrent unipolar illness, and the remainder showed alcoholism, depression and schizo-affective disorder. HLA typing revealed that all the tested members shared the antigens A3 and B7. Because only ill members were available for testing, there was insufficient information in the family to draw any definite conclusion as to whether these antigens were linked to the illness. However, the observation is of some interest in the light of other recent reports which have suggested that these 2 antigens are associated with affective disorder.

A domiciliary survey (sample size circa 6000) was conducted in areas of different aircraft exposure affected by London (Heathrow) Airport. Respondents were urban dwellers age 16+. Since no differences were found in the prevalence of manifest psychiatric disorders, the frequency of 27 individual acute and chronic symptoms was investigated. Many acute symptoms showed an increase with noise, and this was particularly evident for waking at night, irritability, depression, difficulty in getting to sleep, swollen ankles, burns/cuts/minor accidents, and skin troubles. Two chronic symptoms, tinnitus and ear problems, showed evidence of an increase with noise, while most chronic symptoms were more common in low noise conditions. Results are controlled for the effects of age, sex and other standard epidemiological variables. Irrespective of their association with noise, most symptoms, chronic and acute, were more frequent among those respondents who also reported high annoyance. Suggestions for the analysis of surveys of health effects by noise are put forward.

The incidence of psychiatric symptoms in a community sample of mother-bereaved women was not excessive. No differences emerged when a series of 160 female psychiatric patients whose mothers died before age 11 were compared with 80 female controls. Fifty bereaved women who had bad relationships with their mother replacements had specific clinical characteristics.

It is argued that people who are predisposed to mistake a vivid imagination image for a genuine percept (i.e. hallucinators) should show an impaired ability to make clear perceptual–conceptual distinctions (i.e. boundary confusion) and should lack familiarity with internal sources of information. A test of these hypotheses was undertaken by comparing a group of ‘alcoholic’ hallucinators with a group of ‘alcoholic’ non-hallucinators. Some support is claimed for the ‘boundary confusion’ hypothesis but not for the ‘lack of familiarity’ hypothesis. Specifically, it was found that hallucinators performed significantly worse than non-hallucinators on the Embedded Figures Test (a measure of perceptual boundary confusion) and on the Intersensory Time Judgement Test (a measure of conceptual boundary confusion). These results are discussed in relation to other aspects of the predisposition to hallucinate. Some specific research needs are described.

It is generally recognized that social relationships occupy a central position in psychiatry. To examine the role of social relationships in the onset of minor psychiatric morbidity it is necessary to construct an instrument which will meet the need for a valid, reliable and comprehensive index of social relationships. Such an instrument has now been developed and used in a sample of the general population.

The Interview Schedule for Social Interaction arose from a research need, and was constructed to assess the availability and perceived adequacy for any individual of a number of facets of social relationships. These consist both of persons and of the provisions obtained through them. Data from a general population sample suggest this instrument to be sufficiently valid and reliable, and also sensitive to predictable variations between sociodemographic groups, to justify its use in clinical and epidemiological studies, both in psychiatry and general medicine.

The effects of social desirability and defensiveness on scores on 2 self-report psychiatric inventories, the General Health Questionnaire (GHQ) and the Middlesex Hospital Questionnaire (MHQ) were investigated in a female subject group assessed for research purposes in an occupational setting. It was found that defensiveness did not affect the reporting of somatic symptoms, but it significantly affected the reporting of all psychological distress. The effect of social desirability was more specific, only the GHQ social dysfunction subscale showing a significant correlation, an effect attributable to the influence of the setting in which the data were obtained.

In the context of an ongoing WHO research programme in depression, a total of 573 patients consulting psychiatrists in Canada, Iran, Japan and Switzerland were assessed with the WHO/SADD schedule which proved to be a simple and reliable instrument for standardized recording of clinical data. The results indicated that the ‘average’ depressive patients seeking care in culturally different settings have many clinical features in common. A screening instrument, developed in the same study, has been shown to be effective in selecting depressive patients among in- and out-patient populations.

A pilot study is described on 41 men and women of similar age, social and educational backgrounds, in 2 working environments. The use of psychiatric interviews in such occupational settings is demonstrated to be acceptable to both management and employees. Preliminary coefficients of validity for the General Health Questionnaire are found to compare favourably with those in clinical or community settings. Though the prevalence of minor psychiatric morbidity in these small samples did not differ between the sexes, the women had twice as many spells of absence as the men. Considering women separately, minor psychiatric morbidity was found to be significantly correlated with absence. However, psychiatric illness was a less important predictor of absence in men.

There are many reports which suggest that patients with affective illness (mania and/or depression) have abnormalities in the functioning of one or more neurobiological systems. At a conference convened by the Clinical Research Branch, Division of Extramural Research Programs, National Institute of Mental Health, these findings were reviewed and some of the factors impeding movement towards a more complete and integrated view of the functioning of neurobiological systems in patients with mania or depression were identified. As a result, a multi-research centre, collaborative approach to the study of the psychobiology of affective disorders was developed. In this collaborative programme, which has now been underway for several years, the focus has been upon: (a) the assessment of the functioning of several different types of biological systems in the same patient, both before and during treatment; (b) obtaining a reasonably large number of patients and comparison subjects; and (c) the use within and across centres of standardized diagnostic categories and behavioural rating methodologies. In this paper the history, background, and rationale for this collaborative effort are reviewed. Those biological systems chosen for study are noted, and issues such as reliability and validity of diagnoses, measurement of state variables, assessment of change with treatment, and logistical and coordinating problems are discussed.

A preceding paper has reviewed the history, background, and rationale for this collaborative effort exploring the biologic basis of the affective disorders. This paper details the ‘flow’ of a subject through the experimental protocol, the instrumentation used to obtain the clinical and behavioural data, and the biologic methodologies employed in the analysis of the body fluids. Data management and analysis techniques developed for this study are also examined.