Late nineteenth-century medico-psychological approaches to the mind–body problem are discussed in relation to psychiatry's theoretical constitution as a distinct ‘mind–body’ science and practice, and to John Hughlings Jackson's ‘doctrine of concomitance’. Psychiatric ‘explanations’ of the mind–body relation are interpreted as expressions of psychiatry's independent professional interests vis-à-vis neurology and general medicine.

In experiments designed to investigate transmission, cerebrospinal fluid (CSF) from patients with schizophrenia and neurological disease (Huntington's chorea and multiple sclerosis) which had been found to induce cytopathic effects in human embryonic fibroblast cell culture was injected intracerebrally into mice, hamsters and marmosets (small New World primates). No evidence was obtained of transmission to mice or hamsters. A total of 15 marmosets (Callithrix jacchus) was injected intracerebrally with CSF [8 with samples from 4 patients with schizophrenia. 3 with samples from patients with neurological disease (2 with Huntington's chorea and 1 with multiple sclerosis) and 4 with samples from 3 patients without neurological or psychiatric disease] and was observed over a period of 2½ years.

Analysis of variance on data obtained from behavioural observations averaged over 6-month periods revealed that animals injected with CSF from patients with schizophrenia and neurological disease became progressively more inactive when compared with animals injected with CSF from control patients. The change detected by behavioural observation was confirmed as a difference 2 and 2½ years after injection by automated activity monitoring.

There was an incidence of reproductive anomalies (including two occipital encephalocoeles) in the females in the experimental group, but the numbers are too small to draw firm conclusions from this observation.

Many reported differences in biological samples from schizophrenic patients and normal controls have subsequently been found to be due to factors unrelated to the disease state. This may prove to be the case with the changes observed in this experiment. Nevertheless, the fact that marmosets injected with CSF from patients suffering from neuropsychiatric disease, including schizophrenia, subsequently differed in their behaviour from those injected with control CSF warrants further investigation.

In a series of 36 patients with acute schizophrenia flupenthixol dosage was blindly adjusted to give a fixed level of sedation. Patients were then randomly allocated to procyclidine or placebo. The patients receiving procyclidine experienced more positive schizophrenic symptoms and less severe extrapyramidal features by comparison with placebo patients. Blood levels of prolactin and flupenthixol estimated by radloimmunoassay were not significantly changed by the addition of procyclidine. Flupenthixol dosage and levels and prolactin levels were significantly related. There was no significant association between clinical and laboratory measures, with the exception that a curvilinear (inverted U) relationship was demonstrated between flupenthixol levels and antipsychotic and extrapyramidal effects. This relationship may be due to the fact that, in a study of this design, patients resistant to the effects of neuroleptic medication are likely to be given the highest doses. The findings support earlier claims that anticholinergic medication has adverse effects on schizophrenic symptoms.

Memory functions were examined in a group of 53 patients with affective disorders before commencing prophylactic lithium therapy and then after 4 and 12 months of lithium treatment. The memory tests administered were the 30 Figure Test, the 30 Word-Pair Test, the 30 Person-Data Test (these tests are included in the Cronhoim–Molander test battery) and the 30 Face Test. Three scores were obtained: immediate memory score, delayed memory score and forgetting score. There were no statistical significant differences between these scores before lithium therapy or after 4 and 12 months, except for immediate and delayed memory on the Person-Data Test and the 30 Face Test which showed an increased score of memory functions. The results of this study support the view that long-term lithium treatment with serum levels of about 0·6 mmol/1 does not induce memory disturbances.

Major affective disorder clinically similar to the disorder found in conditions other than Huntington's Disease (HD) was found in 41% of patients with HD in a consecutive case series ascertained through multiple sources in a defined geographical area. The association appears to be confined to certain families, and affective disorder may appear as long as 20 years before the onset of chorea and dementia. The association may represent genetic heterogeneity in HD.

Within a sample of 141 female anorexia nervosa patients comparative investigations were carried out between three subgroups: dieters, binge-eaters, and vomiters/purgers. A number of significant differences were found, especially with respect to age and duration of illness, previous treatment failures, and long-term outcome. The results appear to support the authors' view that the staic idea of anorexia nervosa as a unitary illness should be abandoned and replaced by a dynamic dimensional model according to which, in the course of time, changes may occur in the clinical picture of dysorectic patients.

On the evidence of long-term follow-up studies of cohorts of patients in Europe the outcome of schizophrenia appears to be changing from chronicity to an episodic course with a more favourable outlook. While the reasons for this change are unclear it is suggested that schizophrenia is characterized essentially by a state of vulnerability to the disorder. This vulnerability may or may not give rise to an episode of illness, depending on the incidence of triggering life event stressors and on the moderating influences of social networks, ecological factors, and premorbid personality. The traditional view of schizophrenia as an essentially chronic condition reflects not so much the natural history of the disorder as iatrogenic influences, lack of satisfactory extra-mural care, the accumulation of a relatively small proportion of truly chronic illnesses and the failure to recognize the termination of an episode of illness in patients with poor premorbid personalities. Evidence for the episodic nature of schizophrenia is presented.

The Eating Attitudes Test (EAT) and General Health Questionnaire (GHQ) have been validated in an unselected population of 15-year-old South London schoolgirls. Scores on the questionnaires were compared with the results of standard interview. The EAT was found to be an efficient screening instrument for abnormal eating attitudes and behaviour, whereas the GHQ was less satisfactory in its ability to screen for psychiatric morbidity in this age group than in adults. At the optimal cutting points, 6·9% of this population gave a positive response to the EAT and 19·3% gave a positive response to the GHQ. There was a statistically significant positive correlation between the two sets of scores

Six hundred people diagnosed as schizophrenic by the specialist psychiatric services in Oxfordshire, between 1971 and 1973, were identified from the Oxford Psychiatric Case Register (OPCR). The person records of deaths and hospital discharges held by the Oxford Record Linkage Study (ORLS) were used to examine the following items of information for members of this group: details of discharges from and surgical operations performed in Oxfordshire non-psychiatric hospitals in a 6-year period before and a 4-year period after the date of first inclusion in the OPCR, and details of deaths in a 4-year period after the date of first inclusion in the OPCR.

The numbers of deaths, discharges and operations so observed in the study group were compared in age, sex and major diagnostic groups with the expected numbers derived from rates prevailing in the Oxfordshire population over the same periods. Observed deaths were twice as numerous as expected in both sexes, and the numbers of general hospital discharges were also higher than expected. Ischaemic heart disease was the commonest cause of death in both sexes, but did not account for the excessive numbers of hospital discharges. Trauma and poisoning accounted for the excess both of deaths in younger members of the study group and of general hospital discharges overall. Social and environmental difficulties associated with the diagnosis schizophrenia are likely to have contributed more than any inherent biological disadvantage to this excess.

This is an introductory report for the Brief Symptom Inventory (BSI), a brief psychological self-report symptom scale. The BSI was developed from its longer parent instrument, the SCL-90-R, and psychometric evaluation reveals it to be an acceptable short alternative to the complete scale. Both test-retest and internal consistency reliabilities are shown to be very good for the primary symptom dimensions of the BSI, and its correlations with the comparable dimensions of the SCL-90-R are quite high. In terms of validation, high convergence between BSI scales and like dimensions of the MMPI provide good evidence of convergent validity, and factor analytic studies of the internal structure of the scale contribute evidence of construct validity. Several criterion-oriented validity studies have also been completed with this instrument

This paper describes a study to assess the validity of a brief household survey measure of psychic distress (PSYDIS). The measure classifies persons according to their pattern of scores on four dimensions, including anxiety and depression. Study subjects were interviewed first respondents from the general population in a cross-sectional household survey. Then, according their ratings on PSYDIS, subsamples were selected for psychiatric evaluation in a clinic a few weeks later. The survey ratings of 287 persons were compared with evaluations of the same persons experienced psychiatrists. Overall levels of concordance ranged from 76% to 80%, depending the psychiatric criterion used. Concordance was very high for women; it was lower for men for persons classified as High on PSYDIS

We then applied two analytic strategies for increasing agreement between the clinical judgements and the clinical ratings. Strategy number I augmented the symptom checklist data with additional survey data on the subject's history of episodes of distress. Strategy II revised procedures for constructing the PSYDIS typology by (1) using more rigorous cutting point scores on the component scales, and (2) using a non-typological method of classification. The first strategy improved agreement between the clinic and survey measures; the second did not. The paper also compares PSYDIS with other brief symptom checklist measures.

There have been few previous attempts to study factors which affect the duration of treatment with psychiatric drugs in general practice. In the present study ‘duration of treatment’ was regarded as analogous to ‘survival time’, and techniques of survival analysis were applied to data from a previously published study of psychotropic drug use in general practice (Williams et al. 1982). Methods of logistic modelling were used in an attempt to construct a comprehensive and parsimonious model to describe and predict the duration of psychotropic use. Such a model was found to include the effects of previous psychotropic treatment, social problems, duration of treatment and general practitioner behaviour. The implications of the findings, vis à vis the prevention of unnecessary long-term psychotropic drug use, are discussed.

The presence and severity of Minor Psychiatric Morbidity (MPM) as measured by the 60-item General Health Questionnaire (GHQ), and being female rather than male, increases the consulting rate of people in the community to their general practitioner. The rate of increase of consulting decreases as the severity of MPM increases. There is an interaction between age and MPM, giving progressively increased consulting rates in the older age groups in males but not females. The possibility of a biological difference between males and females in the interaction of MPM and physical, and of age and physical illness, is raised.

In anglophonic countries erotomania has traditionally been regarded as a female disorder of little more than curiosity value. The French literature recognizes the disorder in males, but as a rarity. In a recently collected group of violent male offenders the syndrome proved to be fairly common. The offending behaviour was invariably triggered by the core symptom. A description is provided of four cases whose level of aggression was low but appeared to be directly related to the firmness with which the delusion of being loved was held. The disorder of these men can be regarded as a variant of one of the major functional psychoses, but for the purposes of predicting behaviour and management there may be advantages in treating it as a syndrome in a similar taxonomic category as that of morbid jealousy.

The phenomenon of a Doppelgänger (the double autoscopy; heautoscopy) and its resolution in a psychotic patient is presented. A comparison is made between this experience and the phenomenon as it is described and defined in the literature. The themes of death and disintegration so commonly associated with the Doppelgänger in folklore and literature are highlighted by this patient's experience.

The significantly favourable changes in medical students' general attitude to psychiatry and intention to specialize in the subject, which we found after an 8-week psychiatric clerkship, were maintained one year later, at the time of the students' M.B., B.S. examinations. However, of 18 specific attitudes to psychiatry, only one changed significantly overall – fewer students agreed that ‘psychiatrists are held in poor regard by most other doctors’. Contrary to other reports, these preliminary findings suggest that a psychiatric clerkship may be followed by stable attitudes and intent towards the specialty.