This study validates the GHQ-28 on a sample of paralysed, spinally injured outpatients under the care of the West Midlands Spinal Injuries Unit. The validity of the GHQ-28 was 0·83 (95% confidence interval: 0·70 to 0·93) using the Clinical Interview Schedule (CIS) as the validating criterion. The effectiveness of the GHQ-28 as a screening instrument using CIS 11/12 as case criterion, and thus a prevalence rate of 0·18, was judged by relative operating characteristic (ROC) analysis. The area under the ROC curve was 0·91±0·03. “Optimum’ discrimination occurred near GHQ 3/4 (0011 scoring scheme) giving a sensitivity of 0·81, a specificity of 0·82 and a misclassification rate of 18%.

This study describes the occurrence of self-reported perceptual phenomena in students experiencing anxiety. Phenomena like hypersensitivity to touch, hyposensitivity to taste and smell, and unusual tastes and smells appear to be non-specific and to be closely related to the level of anxiety. They emphasize the need for the development of techniques to elicit perceptual phenomena, and to investigate their occurrence and the intensity of their phenomena in variously defined groups. These also have implications for the assessment of benzodiazepine withdrawal syndromes.

LHRH was administered by continuous 4-hour intravenous infusion to 14 anorexia nervosa patients on a refeeding programme. Infusions were repeated in 7 patients following weight gain and in 4 after a course of bromocriptine. Five healthy female volunteers in the early or midfollicular phase of the menstrual cycle served as controls.

The LH response was diminished in patients at 65% standard weight, but was of progressively increasing magnitude in patients at 80% and 95% standard weight. The pattern of LH response to the 4-hour infusion was suggestive of a deficient stimulation by endogenous LHRH in patients at extremely low weights, and of an impaired oestrogen feedback mechanism in patients at intermediate weights. Bromocriptine enhanced the LH response on one occasion in a patient with moderately elevated plasma HPR values, but failed to produce a similar effect when given to 3 patients with normal HPR levels. The mean FSH response did not differ significantly between patients in different weight categories, although those at 65% standard weight had a markedly greater variance of response. Plasma oestradiol values were lower in patients at 65% standard weight than in those at higher weights.

The difficulties of developing a classification of the non-psychotic disorders of early childhood are discussed. A cluster analysis technique is described for determining whether the pattern of behavioural items in 3 year olds could be used as a basis for such a classification. Among the clusters found were two suggesting conduct and neurotic disorders. Two pieces of evidence suggest that the clusters produced are clinically meaningful and have prognostic significance: (1) a group of children with a high risk for later psychiatrie disorder (children in local authority care) are over-represented in the ‘pathological’ clusters, and (2) the mothers of the children in these latter ‘clusters’ have significantly higher scores than mothers of children in the remaining clusters on an index of mental health one year later. It is suggested that evidence for the psychiatrie syndromes of early life is sufficiently strong to warrant further investigation.

Smooth pursuit eye movements to a sinusoidally moving target were recorded using the electro-oculogram in 49 subjects with bipolar disorder, 19 with major depressive disorder and 61 with definite schizophrenia, and compared with 145 normal controls. The signals were analysed in the frequency domain to yield a signal to noise ratio that is known to relate to accuracy of smooth pursuit. Smooth pursuit was found to be significantly poorer in schizophrenics than in bipolars, major depressed or controls. Eye-tracking performance was independent of the effects of neuroleptics, tricyclic antidepressants or lithium, and was not altered by the severity of depression in the affective psychoses. There was a small, but significant worsening of smooth pursuit with age in controls and schizophrenics, but this did not account for the group differences. The results support the view that among the major psychoses eye-tracking dysfunction is specific to schizophrenia.

Two samples of Special Hospital patients who had posterior temporal slow wave foci were selected and matched for age, sex, and duration of stay with patients from the same hospital who had normal EEG records. A high prevalence of between 20 and 31% was found. No significant differences were found between the index and control groups with regard to a number of developmental, forensic, psychiatric, behavioural, and psychometric variables. A striking feature was the high average age of almost 30 years of the posterior temporal slow wave patients. This finding suggests that the current maturation defect hypothesis in relation to cerebral function in psychopaths requires revision. The possible role of early social and environmental factors in the genesis of these EEG anomalies is discussed.

Skin conductance habituation was measured in schizophrenic patients (N = 41) during an acute episode and compared with neurotic patients (N = 86) who were either predominantly anxious or predominantly depressed. All patients were tested before the onset of drug treatment. Between the 14th and 15th tone of the 17 tone simple habituation series a loud ‘dishabituating’ tone was inserted.

In terms of traditional measures based on response frequency, non-habituation was most frequent in the anxious patients and least frequent in the depressed patients, with schizophrenic patients being intermediate. However, in terms of response amplitude the schizophrenic patients showed significantly faster habituation than either neurotic group. This paradox seems to be a consequence of the frequency of spontaneous fluctuations which was highly related to habituation status in the schizophrenic group, but not in the neurotic groups. When habituation was defined in terms of response amplitudes falling below spontaneous fluctuation amplitudes (rather than zero) the schizophrenic group showed the lowest frequency of non-habituation.

None of the groups showed any evidence of dishabituation after the loud tone, but the schizophrenics showed a significantly smaller response to the loud tone itself. Following Groves & Thompson (1970), this is interpreted as showing that the loud tone induced a greater response because of its perceived difference from the other tones rather than a sensitization effect because of its loudness. In these terms the schizophrenic patients showed greater response generalization than the neurotic patients.

Forty-two patients attending a Huntington's Disease Research project at Johns Hopkins Hospital, Baltimore, were screened for alcohol abuse and alcohol-related problems. Prevalence of current or past alcohol abuse was 24% for males, 5.9% for females or 16.7% overall. When alcohol abuse occurred in HD probands it was often concurrent with depressive symptoms, and may have been associated with the threat of the disease. There was no evidence that HD patients had an increased rate of alcohol abuse above that of the local Baltimore community.

Background. Recognition can be normalized in schizophrenia by providing patients with semantic organizational strategies through a levels-of-processing (LOP) framework. However, patients may rely primarily on familiarity effects, making recognition less sensitive than source monitoring to the strength of the episodic memory trace. The current study investigates whether providing semantic organizational strategies can also normalize patients' internal source-monitoring performance.

Method. Sixteen clinically stable medicated patients with schizophrenia and 15 demographically matched healthy controls were asked to identify the source of remembered words following an LOP-encoding paradigm in which they alternated between processing words on a ‘shallow’ perceptual versus a ‘deep’ semantic level. A multinomial analysis provided orthogonal measures of item recognition and source discrimination, and bootstrapping generated variance to allow for parametric analyses. LOP and group effects were tested by contrasting recognition and source-monitoring parameters for words that had been encoded during deep versus shallow processing conditions.

Results. As in a previous study there were no group differences in LOP effects on recognition performance, with patients and controls benefiting equally from deep versus shallow processing. Although there were no group differences in internal source monitoring, only controls had significantly better performance for words processed during the deep encoding condition. Patient performance did not correlate with clinical symptoms or medication dose.

Conclusions. Providing a deep processing semantic encoding strategy significantly improved patients' recognition performance only. The lack of a significant LOP effect on internal source monitoring in patients may reflect subtle problems in the relational binding of semantic information that are independent of strategic memory processes.

In a 5-week study of 22 depressed patients treated with nortriptyline, significant changes in plasma levels, both elevated and reduced, were deliberately produced in the third and fourth weeks of each patient's treatment. Correlation of plasma nortriptyline levels and changes in the severity of depression, as measured by the Hamilton Depression Scale, showed no significant relationships. The implications of the study are discussed.

Enuresis is a disorder of micturition occurring in the absence of an organic urinary tract lesion. To understand its possible causation, the mechanisms controlling micturition are described together with the possible sites of action of various anti-enuretic agents, particularly imipramine. It is concluded that further research into the central control of micturition is required before the precise actions of centrally-acting anti-enuretic agents can be elucidated. Knowledge of these may give insight into the nature of the defect causing enuresis.

Computerized axial tomography was used to compare sex and age-matched groups of controls and long-term benzodiazepine users for evidence of cerebral atrophy. No statistically significant differences were found.

Antibodies to a variety of foods, and in particular cereals, were measured in serum from 100 patients with acute psychoses and 100 elective surgical patients. For 13 out of 14 foods to which non-IgE antibodies were detected the schizophrenics had slightly more antibodies than the controls. There was an association between a possible secondary mania and the presence of IgE antibodies to wheat or rye. However, neither the schizophrenia nor the mania findings can be regarded as evidence for food allergy causing psychiatric disorder, since the immunological findings in both cases may represent consequences of the illnesses or their treatment, rather than causes of the illness.

Background. Many people who develop schizophrenia have impairments in intellectual and social functioning that are detectable from early childhood. However, some patients do not exhibit such deficits, and this suggests that they may have suffered less neurodevelopmental damage. We hypothesized that the aetiology and form of schizophrenia may differ in such patients. We therefore studied a group of schizophrenic patients who were functioning well enough to enter university prior to illness onset.

Methods. The casenotes of 46 university-educated patients and 48 non-university-educated patients were rated on several schedules including the OPCRIT checklist, and the two groups were compared using univariate statistical techniques. Principal components analysis was then performed using data from all patients, and the factor scores for each principal component were compared between groups.

Results. Univariate analyses showed the university-educated patients had an excess of depressive symptoms, and a paucity of core schizophrenic symptoms. Four principal components emerged in the principal components analysis: mania, biological depression, schizophrenic symptoms, and a reactive depression. University-educated patients scored significantly higher on the reactive depression principal component, and lower on the schizophrenic symptoms principal component, than the non-university-educated patients.

Conclusions. University-educated patients may have a non-developmental subtype of schizophrenia.