The modern stereotype that in the Middle Ages there was a general belief that mental illness was caused by sin is reviewed. The authors examined 57 descriptions of mental illness (madness, possession, alcoholism, epilepsy, and combinations thereof) from pre-Crusade chronicles and saints' lives. In only 9 (16%) of these descriptions did the sources attribute the mental illness to sin or wrongdoing, and in these cases the medieval authors appeared to use this attribution for its propaganda value against an enemy of their patron saints, their monastery lands, or their religious values. The medieval sources indicate that the authors were well aware of the proximate causes of mental illness, such as humoral imbalance, intemperate diet and alcohol intake, overwork, and grief. The banality that, since God causes all things he also causes mental illness, was only used by medieval authors under special circumstances and in a minority of cases. It does not constitute evidence of superstitious and primitive notions about mental illness in the early Middle Ages.

Histocompatibility antigens were examined in 124 patients with Alzheimer's disease (AD), and the frequency of HLA-B15 was found to be significantly increased over controls. Pooling of data from the present and similar studies suggests that AD is not strongly associated with any particular HLA antigen, although there may be a weak association with HLA-A2, B15 and Cw3. In a family study of 34 patients with AD, secondary cases of AD were identified in 9·7% of the first-degree relatives, and cases of presenile dementia and senile dementia of the Alzheimer type were found to occur within individual families.

The gastric emptying rate of 8 heroin-dependent males was measured by means of a radioactive isotope method. A simultaneous oral glucose tolerance test was carried out. The glucose response showed a low, flat curve with a delayed peak, and increased secretion of insulin and growth hormone occurred. As the gastric emptying rate proved to be normal the observed metabolic abnormalities are not due to the effect of heroin on the gastro-intestinal tract, but must be attributed to some other effect of chronic heroin administration.

Assessment was made of the behavioural development of 3 monkeys whose levels of thyroxine were reduced by being given 131I and another 3 monkeys given a thyroxine depressant (TCAP) during the first weeks of life and maintained with low thyroxine levels for 3 months. When subsequently tested at normal thyroxine levels, these experimental subjects showed less positive social behaviour when compared with controls. When confronted with unfamiliar monkeys, the two experimental groups were less fearful than controls and also showed a lack of differential responsiveness in varying social situations, suggesting a low level of emotion. A foetal athyreotic group is also described.

The effect of ascorbic acid and ethylene diamine tetra acetic acid (EDTA) in the treatment of manic-depressive psychosis was compared, using double-blind procedures, with recognized treatment regimes. There was no significant difference between the response of depressed patients to amitriptyline or ascorbic acid and EDTA. Manic patients responded significantly better to lithium than to ascorbic acid and EDTA. These results are in keeping with the suggestion that vanadium may be of aetiological importance in depressive psychosis, but do not support such a suggestion for mania.

This review of the data on bilinguals in relation to hypnosis, psychotherapy and psychotic disorders presents evidence for the bilateral representation of language in the cerebral hemispheres of bilinguals, and outlines possible links between the neuropsychology of psychotic disorders and the lateralization of language in these patients. The relationship between affective states and the retrieval of memories and language is also explored.

The relationship was examined between symptoms rated in a sample of out-patient depressives, and measures of life stress derived from a separate interview. There was an association between symptoms reflecting the endogenous–neurotic distinction and life stress. However, the association was relatively weak, and was mainly with total social problems at the time of presentation, rather than with life events at onset. These findings are consistent with other studies which indicate that the absence of prior life events and the presence of the endogenous symptom pattern are only weakly related.

A retrospective survey was undertaken of the clinical EEG in a series of consecutive admissions to Broadmoor Special Hospital (N = 265). Following reporting of the records by visual inspection, the EEGs were classified according to 4 descriptive categories: predominantly monorhythmic; low voltage fast, ‘choppy’ dysrhythmic with excess theta; and dysrhythmic with paroxysmal features. The last 3 categories constituted EEG patterns with atypical or anomalous features. The EEGs of patients with high scores on Welsh's MMPI Anxiety scale (‘withdrawers’) were compared with those of patients with low scores (‘approachers’). Lateralization of paroxysmal EEG features was studied with reference to MMPI personality measures (Blackburn's Impulsivity and Sociability and Welsh's Anxiety), legal diagnosis, type of offence, and relationship to victim. The EEGs were studied in a further sample of 29 admissions who had been assessed, using Hare's Research Scale for the Assessment of Psychopathy (Hare, 1980). While the overall incidence of atypical EEG features reported in the present study (around 60% of cases) was comparable with that reported previously for offender populations, they occurred significantly more frequently in ‘withdrawers’ than in ‘approachers’. This suggests that the high frequency of atypical EEG features in abnormal offenders may be due to the preponderance of ‘withdrawers’ in this population. Patients who had committed violent offences against strangers, as opposed to people known to them, tended to have bilateral paroxysmal features in their EEG. High scores on Hare's Psychopathy scale were significantly associated with prominent Posterior Temporal Slow Activity. The study offers some prospect that the combined use of EEG and personality assessments may be of potential value in the assessment of dangerousness.

Nearly 10% of a sample of men charged with a variety of offences claimed amnesia for their offence. The amnesia occurred only among those who had committed violence and was most frequent following homicide. All the amnesics had a psychiatric disorder, four having a primary depressive illness and the remainder being almost equally divided between schizophrenia and alcohol abuse. None of the amnesias had any legal implications. The circumstances of the offences suggested a variety of mechanisms to account for the amnesia, including repression, dissociation and alcoholic black-outs. Psychological defence mechanisms were probably of some importance, even when alcohol was an important factor.

In a retrospective study, children referred to the Maudsley Hospital with conduct or emotional disorders who also suffered from hallucinations were found to be older than other children seen with similar diagnoses, more of them had below-average IQs and they were more frequently admitted as in-patients. In most cases hallucinations were auditory. When compared with a group of 20 controls matched on these differentiating features, the 20 children with hallucinations had more precipitants of illness, a shorter duration of the disorder, symptoms of depression, and a family history of mood changes. They also had more symptoms suggestive of cognitive–perceptual dysfunction.

In a controlled study, 20 children with hallucinations and emotional or conduct disorders were followed up into adulthood. The mean follow-up time was 17 years and the mean age at follow-up was 30 years. Hallucinations in childhood did not carry an increased risk for psychoses, depressive illness, organic brain damage or other psychiatric disorders. The continuation of hallucinations and episodes of altered awareness in some of the subjects may indicate a special predisposition to hallucinate.

The relationship between length of unemployment and psychological ill-health was examined in a sample of 954 unemployed working-class men, selected to cover all levels of age and several levels of duration of unemployment. The association between length of unemployment and psychological ill-health was found to be strongest in the middle age groups, with greater ill-health among those with a longer duration since job loss. No association between duration and ill-health was found for those who had recently entered the labour market or who were close to the end of their working lives. Desire for a job and financial stress were shown to be additional mediators of psychological ill-health during employment. A cumulative stress model is proposed to account for these findings.

This paper examines a comprehensive set of data on the prevalence and correlates of psychological distress in a sample of 1038 adolescent students in a major urban area of a Canadian prairie province. About 27% of the students reported 6 or more symptoms of psychological distress on the GHQ-30. The frequency of symptoms varied with age, grade level and average marks, with sex being the most significant variation. ‘Anxiety’ and ‘social dysfunction’ were the most frequent symptom dimensions reported. More detailed analysis of possible predictors of mental health showed that the nature and quality of family life strongly affected adolescent mental health. Adolescents' positive evaluation of their school atmosphere and peer group life and their locus of control orientation also positively influenced their psychological well-being.

Recent interest in the way social factors influence the course of schizophrenia has led to attempts to monitor and manipulate these factors. The work on the Expressed Emotion of the relative has been especially influential in this area. A number of studies have now been conducted in which a psychosocial intervention has been employed in an attempt to prevent relapse after discharge from hospital. These studies are reviewed with an emphasis on their methodological adequacy and on the nature of the intervention used. Recent studies have demonstrated a positive result for psychosocial interventions used in combination with neuroleptic medication. However, analysis of these studies does not allow us to conclude that we can identify the ‘active ingredients’ in these psychosocial treatment regimes. Although there is cause for optimism, further investigation is required.

The present study examined sensitivity to noise in subjects with Type A and Type B behaviour patterns as a function of the type of task being performed. Twenty Type A and 20 Type B subjects, selected by means of Bortner's scale (French version), were exposed to steadily increasing noise levels (68–110 dBA) while performing two tasks. The first was simple (crossing out) and the second was more complex (memorizing nonsense syllables). There was no difference between the groups on the simple task, but on the more complex task Type A and Type B subjects reacted differently, the former maintaining their level of tolerance while the latter lowered theirs. High investment and the desire to succeed may lead Type A subjects to ignore the acoustic environment and/or to deny the aversive aspects of noise as cognitive strategies for coping with stress.

In order to evaluate Foulds' hierarchical model of psychiatric illness, a study was carried out using data from a 3-year follow-up of patients suffering from functional non-affective psychoses. Of the 177 Present State Examinations carried out 86% yielded symptom patterns compatible with the model. It was shown that failures to fit the hierarchy can be explained either by measurement error or by the masking of major symptoms by the simultaneous presence of minor ones. A one-dimensional scale to measure the severity of psychiatric illness was constructed. Patients' scores were compared with ratings on the Index of Definition and the diagnosis of current mental state. The results of these comparisons were considered to be supportive validatory evidence. Some of the implications of the model and the data are discussed.