The case of a sixteen-year-old youth is presented on the basis of correspondence over the years 1806 to 1813. His initial breakdown was probably due to hebephrenic schizophrenia, but clinical detail is defective and the evidence is chiefly about the difficulties of recovery and rehabilitation. The case is discussed in relation to the treatment he received and against the background of provision for insanity and psychiatric methods and ideas in Ireland during the period.

Dangerous and even fatal interactions can occur in man following combinations of antidepressants which include non-selective MAO inhibitors. To ascertain the causation, interactions reproducing the clinical phenomena have been elicited in animals with these combinations, and the mechanisms involved have been explored by various pharmacological strategies; 5-HT re-uptake inhibitors proved especially hazardous in combination. Interactions could, however, be avoided even with the 5-HT re-uptake inhibitors, by combination with relatively selective MAO A or B inhibitors, an approach with potential clinical value.

When amphetamines are administered to humans every few hours for several days, either during the ‘speed runs’ of addicts or in controlled laboratory settings, the psychosis which reliably results is similar to paranoid schizophrenia in a number of important aspects. This unique regimen of drug intake, which involves the continuous presence of stimulants over a prolonged period of time, can be simulated in animals using subcutaneously implanted slow-release silicone pellets containing d-amphetamine base. Monkeys and rats implanted with these pellets develop stages of behavioural alterations which are somewhat similar in sequence to those observed in humans who have received frequent doses of amphetamine. An initial period of hyperactivity and exploratory behaviour is followed by the gradual development of motor stereotypies which become virtually incessant. A period of relative inactivity then appears which is followed, at 4–5 days after pellet implantation, by a late stage. This final stage is characterized by ‘wet-dog’ shakes, parasitotic-like grooming episodes, and a variety of other forms of hallucinatory-like behaviour. At about the same time there are distinctive and partially irreversible alterations in dopaminergic innervations of the caudate nucleus, but not in mesolimbic dopamine innervation of the nucleus accumbens or in several other neurotransmitter systems. Continuous amphetamine administration may reproduce some aspects of the prolonged excitation which accompanies an acute psychotic episode and may be a fruitful model for the clarification of the dopamine theory of schizophrenia.

The study explored associations between the cerebral event-related slow potentials (ERSP) and psychiatric symptoms and syndromes as reflected by the Present State Examination (PSE) in 36 randomly selected psychiatric in-patients. Independent raters measured the readiness potential (RP), contingent negative variation (CNV) and post-imperative negative variation (PINV) in terms of their amplitude and duration. The 360 individual PSE items were grouped into units of analysis (UA) and further collapsed into groups of units of analysis (GUA). Canonical correlations were computed between two sets of variables (psychological and electrophysiological). Kendall's rank-order correlation was used as the main statistical approach. Some psychotic signs were associated with increased PINV amplitude. Obsessive thoughts, ideas of reference and verbal hallucinations correlated with longer PINV duration. Hopelessness and suicidal thoughts (affect-laden thoughts) as well as first-rank Schneiderian symptoms (FRS) were negatively correlated with CNV amplitude. The results support the hypothesis that CNV and PINV, alone or in combination, can be used to indicate the presence or absence of identifiable psychiatric symptoms and syndromes. The implications of electrophysiological correlates of psychopathology for psychiatric nosology and for the validity of psychiatric symptoms and syndromes were discussed

Bouffée délirante is an historic and unique French diagnostic term for a short-lived psychosis. The key diagnostic features are acute, floridly psychotic symptoms with complete remission. Its use in a Paris hospital has been examined, and it appears that the term is declining in popularity. A case-controlled study indicated that the diagnosis is likely to be given to migrants on first admission. A re-diagnosis of case summaries indicated no particular correspondence of bouffée délirante to any one lCD category. However, the usefulness of having a special diagnostic term for psychosis with a good outcome is discussed.

On each of a sequence of trials subjects had to guess whether a cross would appear on the left or the right side of a computer screen. The sequence of cross positions was random. Normal controls, manic-depressive patients and patients with senile dementia produced relatively random sequences of responses, as did acute schizophrenic patients with positive symptoms. Acute schizophrenic patients with negative symptoms and chronic patients produced more stereotyped sequences with many response alternations (LRLR). Chronic schizophrenic patients with negative symptoms and intellectual deterioration (defect state) produced very stereotyped sequences with many preservations (LLLL). This severe restriction of response sequences is similar to that shown by animals after treatment with amphetamine. It is suggested that it is due to an impairment of a higher order control process which normally inhibits the repetition of sequences of behaviour when these have proved inappropriate.

The present study examined a prominent symptom subtype conception of the psychopathology of schizophrenia. It analysed the presumed dichotomy between hallucinations, delusions and formal thought disorder as positive symptoms and flattening of affect and poverty of speech as negative symptoms, and tested predictions concerning the nature of the mediating processes of positive and negative symptoms. Four different analyses were applied to the transcripts of speech produced by 9 normals, 10 chronic schizophrenics with only positive symptoms of whom 7 had incoherence of speech, and 9 chronic schizophrenics with only negative symptoms of whom 4 had poverty of speech. The conception of the nature of the mediating processes of positive and negative symptoms was not supported by the results. Further, a clear dichotomy between positive and negative symptom groups was not shown to exist, because positive speech disorder and negative speech disorder did not follow the presupposed dichotomy. Thus, contrary to existing conceptions of speech disorder in schizophrenia, both positive and negative speech disorder are marked by poverty of thought, as measured by the production of fewer and shorter ideas and lower speech variability.

Data from two studies, one naturalistic and the other a controlled trial, were analysed to clarify the relationships between independent life events, Expressed Emotion of a key relative, maintenance neuroleptics and the relapse of schizophrenia. It was found that patients in the community who are unprotected by medication are vulnerable either to acute stress in the form of life events or to chronic stress in the form of living with a high Expressed Emotion relative. Patients on regular medication are protected against one or other stress, but are very likely to relapse if the two forms of stress occur together. A model of schizophrenic susceptibility to environmental stress is constructed to incorporate these observations.

Family histories obtained from 27 patients with obsessive-compulsive disorder failed to find a single parent with the disorder. To augment the family history data the Leyton Obsessional Inventory was completed by a subset of 10 patients and by their 20 parents. Although as a group parents showed lower Leyton Obsessional Inventory symptom scores than their obsessional offspring, 3 parents who had not been identified by family history were distinguished by high symptom scores in the absence of significant resistance or interference.

The literature on the place of hostile emotion in obsessional neurosis is reviewed. In the main study 11 obsessional neurotic and 11 depressive patients matched for severity of illness were given questionnaires to measure experienced hostility and anger, and a repertory grid of standard form. The obsessional group showed a qualitatively distinct correlational pattern of measured aspects of hostility–anger, including a high correlation between outwardly directed aspects of hostility and anger; this pattern was replicated in a validation study. In contrast, the obsessional group was not differentiated by a negative cognitive set. Treatment implications for obsessional neurosis are briefly discussed.

The present study compared families of patients with anorexia nervosa with families of non-anorexic adolescent daughters of a similar social class. All anorexics and adolescent comparison girls and their parents were studied using a variety of psychometric measures. Body size estimation and physical anhedonia were also measured. Family characteristics were assessed using the Family Assessment Measure (FAM). Contrary to the hypotheses, no abnormalities were found in terms of parental attitudes to weight control or dieting. The mothers of anorexics displayed no increase in psychopathology on any of the measures. The fathers scored very similarly to controls but with higher degrees of conscientiousness. Neither fathers nor mothers displayed abnormalities of their own body size estimates or body satisfaction. On the FAM the anorexic families reported an increased pathology on several sub-scales. It is not possible to say whether these disturbances are part of the pathogenesis or are sequelae to the illness.

Whereas in Western societies there is an inverse relationship between high social class and low body weight, the inverse is true of less developed, non-Western societies. It has also been shown that the longer immigrants have been in Western societies, the less obese they tend to be. This study examined how Kenyan Asian, British and Kenyan British females from similar backgrounds perceived female body shapes. As predicted, the Kenyans rated larger figures more favourably and smaller figures less favourably than the British. Also, as predicted, it was found that the Kenyan Asian British were more similar to the British group in their perceptions. The results support the view that social and cultural factors play dominant role in the perception of one's own and others' body shapes. In addition, the results reveal that in Britain preferences for small body shapes to the point of being anorexic are not uncommon.

It is well established that a diagnosis of cancer and the subsequent treatment can cause a great deal of stress, and the need for psychosocial support is increasingly being advocated. The data for the efficacy of intervention programmes are reviewed. The evidence relating to the benefits gained by patients is equivocal. The indication is that a selective rather than a blanket service is needed, with the target for intervention being patients at high risk for psychological morbidity. The advantages of one type of support over another remain unproven.

Eighty–one children previously treated for congenital dislocation of the hip (CDH) before the age of 5 were followed up several years after their treatment, and their psychological adjustment was compared with that of 3 other groups; (i) 44 children who had experienced a single hospital admission of less than a week before the age of 5; (ii) 26 children who had experienced 2 or more hospital admissions, the first being before the age of 5; and (iii) 51 children who had no experience of hospital admission. All 4 groups were similar in composition in terms of sex ratio, age at follow-up, family size, birth order, parental age and social situation. Psychological adjustment was measured by means of Rutter's questionnaires for parents and teachers. In addition, the children completed a Schonell reading test. Both the parental and the teacher's questionnaires selected more disordered children in the CDH group. The CDH group also had a higher total score and more health and behaviour problems than did the single admission group on the parental questionnaire. On the teacher's questionnaire they were more antisocial than the single and no admission groups combined. No significant differences were found on the reading test. While the overall impression is that the CDH group are poorly adjusted, there is some suggestion that it is the younger children who are contributing to this effect.

A comparison of the homicide rate of mentally abnormal offenders and murderers who subsequently commit suicide, from a range of different populations, shows a uniform consistency when compared with the overall rates. ‘Laws’ are proposed which govern the rates within these subgroups in comparison with the population as a whole and which determine fluctuations. Qualitatively different psychiatric and sociological factors are thought to account for these findings and require further elucidation.

In a matched controlled clinical study of 300 neurotic depressives collected over 6 years, 13% had experienced parental death before 17 years of age compared with 10·7% of the controls; this difference was not significant. There were no significant differences between the two groups when maternal or paternal death was examined separately either before 11 or 17 years of age. Thus the experience of parental death as a child is not in itself a risk factor for neurotic depression as seen in psychiatric patients.