The history of the words paranoia and paranoid is traced from the Greeks to the present day and their fluctuations of usage and concept are explored.

Historical analysis can contribute to the study of suicide as a form of human behaviour by providing perspective. Examining suicide in relation to changing social conditions, value systems, institutions and ideologies at different periods and in various societies may suggest ways of looking at suicide in our society. Materials presented here also indicate possibilities for further investigation.

Theories of symbolic logic are used in an attempt to clarify the medico-psychological concept of disease. It is argued that the class concept of diseased persons has as its extension the universal class of patients, and as its intension the attribute concept of patienthood (or disease in general). It is proposed that the diagnosis of patienthood has as its sufficient and necessary condition the experience of therapeutic concern by a person for himself and/or the arousal of therapeutic concern for him in his social environment. The experience of therapeutic concern has as its necessary condition, and also as its specific psychological cause, the observation of clinical symptoms and/or other pathological manifestations. The general domain of patients and its various subdivisions are empirical classes which are logically inexact—that is, contain neutral members in the form of dubious patients—and are polythetically characterized—that is, by a loose cluster of pathological attributes of which only a substantial proportion need be exhibited by a class member. The division of the domain of patients (and therefore the classification of patients) is commonly achieved by the addition to the intension of the domain of pathological attributes. These must, of course, be attributes which are not universally or predominantly shared by the domain members. Endopathological and exopathological abnormalities have proved themselves as the most useful classifying criteria. Their addition to the intension of the domain of patients separates particular classes from the rest of the domain. The intensions of these classes correspond to particular diseases, and list all the relevant clinical, endopathological, and exopathological data, if available. When a particular endopathological abnormality is by definition established as the specific cause of its clinical symptoms, then the intension in question corresponds to an aetiologically homogeneous disease entity.

The nature of the episodes of severe mental disorder which Strindberg suffered after the age of 45 has led to considerable discussion, much of which must remain inconclusive until all the relevant documents, some still awaiting publication, can be assessed. On the basis of present evidence, the diagnosis of an affective, schizophrenic, or toxic state is considered, and the views of earlier psychiatrists are discussed.

Within a few years of their introduction into psychiatry in 1893 the terms ‘endogenous’ and ‘exogenous’ were widely used. The development of the two words and the semantic uncertainty which surrounded them is traced in this article.

The alpha attenuation response (AAR) and its habituation rate during the course of 60 serially presented paired flash stimuli was measured in a small but homogeneous group of male identical and fraternal twins, all within the age range 19 to 40 years. Comparison of the intraclass correlation coefficients for each of the recorded AAR parameters between the two twin series and a constructed series of genetically unrelated individuals indicated that individual differences in the variables measured were significantly influenced by heredity. The findings are discussed in relation to previously reported studies of the genetic aspects of the normal spontaneous EEG.

Disordered amine metabolism is frequently suggested as being of aetiological significance in schizophrenia. The present study investigates the effects of loading doses of the cate-cholamine precursor L-tyrosine in this illness. Groups of schizophrenic and control subjects were given loading doses of L-tyrosine after which plasma tyrosine levels and excretion of some tyrosine metabolities were measured. In only one parameter, excretion of free p-hydroxyphenylacetic acid, was any significant difference observed between the groups. The study is discussed in relation to some of the biochemical theories advanced from time to time for schizophrenia.

A carefully controlled comparison of communication defects and deviances in parents of schizophrenics and neurotics was undertaken using the 41-category Rorschach manual of Singer and Wynne. Subjects were tested and scored blindly and scoring was shown to be reliable. Although a statistically significant difference was found between the two groups, the marked overlap of the distribution of scores found in this study is not compatible with theories advanced by other authors concerning communication abnormality in parents of schizophrenics. Evidence is presented which provides a more parsimonious explanation of the difference between groups and leads to a hypothesis which would explain the failure of this study to confirm the striking differences between groups reported by previous workers.

Early work on the reticular formation has been largely overlooked, and this article traces back to the beginning of the 19th century the roots of modern developments in this field.

A cohort of patients from Camberwell, who had been in psychiatric hospital for one year or more on 31 December 1964, is described. The attrition rate for this group, and the accumulation of ‘new’ long-stay patients from the area since that date, are analysed, and compared with published data from other studies. In the light of the resulting overall decrease in the long-stay population with time, possible trends in the future can be considered.

A case of Klinefelter's syndrome with XXY karyotype and a dementing neuropsychiatric illness associated with a diffuse degeneration of the deep cerebral white matter and adrenal cortical atrophy is presented. The possible relationships between genetic abnormalities and disordered function and structure of the brain are discussed in the light of the clinical and pathological observations.

Four patients with ‘developmental dyscalculia’ are described who were initially identified on the basis of clinical tests, reports of longstanding and severe difficulties in arithmetic, and psychological test results. Descriptive psychological testing indicated (1) that the arithmetical deficits could not be accounted for on the basis of a generally low level of intellectual functioning; (2) that of the four basic arithmetical processes that of multiplication was relatively more deficient; (3) that this relative deficiency in multiplication stemmed from a faulty grasp of basic multiplication tables; that this was a real difficulty, experienced subjectively by the patient, and one that could not be accounted for simply by carelessness; and finally, that the degree of difficulty experienced varied with the multiplication table involved. Two kinds of attempt were made to improve arithmetical functioning. The first involved brief remedial coaching programmes directed at the basic multiplication tables: relatively little success was obtained with this method. The second kind of attempt involved methods of bypassing the necessity for learning multiplication tables: some success was obtained with these methods. The discussion concentrates on some of the features which may provide possibly useful cues for identifying ‘developmental dyscalculia’: these are classified in terms of: (1) pattern of deficit displayed; (2) qualitative features of arithmetical performance; and (3) response to remedial teaching. Some suggestions are made concerning further lines of investigation.

Salivary secretion was measured in 34 depressed inpatients who were also assessed clinically and psychometrically. Thirty-one of the patients were reassessed two weeks after a course of ECT. Before ECT, diminished salivation was associated with retardation and gastrointestinal somatic symptoms. Overall, the patients' salivary secretion did not change after ECT. More detailed analysis showed that the salivary secretion of the more retarded patients was low before ECT and increased subsequently, whereas that of the least retarded patients was high before ECT and diminished subsequently. It is suggested that the relationship between retardation and salivation may explain some of the divergent results of previous studies.

The concept of screening, and in particular multiphasic screening, is being introduced into medical practice. The subject is controversial and doubts have been expressed as to ils present applicability. This article is concerned with whether screening is appropriate for psychiatric disorder and is subdivided into a review of screening in general, the distribution of psychiatric disorder, psychiatric screening instruments, an outline of a psychiatric screening survey, and, finally, the evaluation of psychiatric screening.