The problems which arise in the use of a psychiatric screening instrument in a language and culture other than that in which it was designed and developed are considered. An account is given of the development of a psychiatric screening questionnaire suitable for use in Chinese community samples. The questionnaire was derived from a Chinese translation of the General Health Questionnaire, with the addition of specially designed, culturally-relevant items. Discriminant function analysis was then used to select a subset of 12 items which discriminated well between ‘cases’ and ‘normals’ in the community.

Studies employing psychiatric rating instruments administered by lay interviewers need to demonstrate the reliability and validity of subject classification. In a national population study utilizing the short form of the Present State Examination, audiotapes of interviews were used to demonstrate the reliability of ratings. The classification of ‘cases’ was found to be related to self-reports of nervous trouble and help–seeking for such problems. Associations between the rate of psychiatric disorder and demographic factors were similar to those found in previous community surveys. In general, the method of psychiatric assessment was considered to be satisfactory. Recommendations are made for the monitoring of interviews in similar large-scale investigations.

Differences in response criterion and sensory sensitivity to visual flicker among major depressive patients, dysthymic patients, and normal controls were investigated. Also, signal detection confidence ratings and response times were compared. The results indicated that major depressive patients responded more conservatively (i.e. were less willing to respond ‘flicker’) than either of the other groups. The groups did not differ significantly on a criterion free measure of flicker sensitivity. The major conclusions are: (1) previously reported visual flicker differences between depressed patients and normal controls were probably due to the more conservative response criterion of the patients and not to flicker sensitivity differences between groups; and (2) confidence ratings and response times yield similar conclusions with respect to visual flicker sensitivity and response criterion. Therefore, interpretations concerning a sensory or perceptual deficit in depression must take into account the differences in response criterion between depressed patients and normal controls.

Parental questionnaires identified 22% of children aged 7–12 years attending 8 general practices as psychologically deviant. Most attended for physical complaints. A comparison with general population rates showed that deviant children were over-represented among surgery attenders, particularly in the more socially advantaged areas. This finding may be explained through (1) an excess of somatic symptoms in deviant children; (2) increased parental concern about the child's health as an extension of concern about his behaviour; (3) family stress. These possibilities are discussed.

In only a few cases is transmissible dementia known to have been acquired by infection from a source outside the individual; the remaining cases can be classified as sporadic, loosely familial, or autosomal dominant. Each group has a characteristic mean age of onset. A range of neurodegenerative diseases (including Alzheimer-type dementia and amyotrophic lateral sclerosis) can also be classified in this way, with similar characteristic mean ages of onset. The emergence of these diseases in later middle age, and the interdependence of age of onset and the type of familial occurrence suggest that these pathological processes are related to those genetic mechanisms which determine senescence. It is argued that the majority of cases of transmissible dementia arise, not from infection, but from the expression of endogenous virogene sequences as part of the aging processes.

A survey to analyse patients' characteristics and the care delivered to them was conducted in several psychiatric facilities, covering the whole range of care offered in the public sector in two regions of Southern Italy. A case–control method of analysis was chosen, and the relative risk estimates (RR), together with their 95% confidence intervals (CI), of being in custodial facilities were computed, comparing patients treated in custodial institutions (‘cases’) with those in community-based services (‘controls’) in respect of social and clinical vairables. Factors more stongly associated with custodial treatment were: illiteracy (RR = 2·4), unmarried status (RR =2·4), a history of prolonged illness (RR = 7·6), organic diagnosis (RR = 2·6), previous custodial treatment (RR = 3·9), and expected poor social functioning (RR =2·4). The suitability and advantages of the case–control method of analysis in the field of psychiatric care evaluation are discussed.

Severely handicapped psychiatric patients in long-term day care were questioned about their perceptions of their skills, motivation to perform a range of everyday tasks, current problems and coping strategies. Patients were found to respond reliably and consistently to these questions. It is argued that effective service planning must take account of patients' views of their difficulties and, in particular, of their subjective priorities.

The present investigation demonstrates relatively high antibody titres against an E. coli O-antigen in sera from somatically healthy male schizophrenic patients. This observation supports the suggestion that abnormal portasystemic collaterals are relevant to the manifestation of schizophrenia.

Synopsis A case of a 37-year-old patient, 10 years after bilateral amygdalotomy and subcaudate tractotomy for chronic self-mutilation, is described. The clinical picture revealed a complex mental state, including disorders of facial recognition, social behaviour, affect and elements of the Kluver–Bucy syndrome. Mild selective deficits were demonstrated psychometrically in the recognition of familiar and unfamiliar faces. Certain features have been described in rhesus monkeys, but have not previously been reported in humans. Primate studies are discussed, with particular reference to the role of the amygdala in facial recognition.

Synopsis The CAGE questionnaire was used to screen for at risk drinking among attenders to an inner London health centre. The CAGE functioned most effectively at a cut-off point of two or more affirmative replies, with a sensitivity of 84%, a specificity of 95% and a positive predictive value of 45%. The usefulness of this instrument for screening in general practice is discussed.

Thirty patients who fulfilled DSM–III criteria for schizophrenia but who were within 2 years of presentation were compared with 26 age–matched normal volunteers with respect to CT scan appearances. In the index group the ventricle–brain ratio (VBR) was significantly greater. The VBR values were positively correlated with average alcohol intake and with early physical trauma, and negatively correlated with a family history of schizophrenia. The implications of these findings are discussed in the context of the present uncertainty about the meaning of CT scan findings in schizophrenia.

A woman with a 5-year history of frequently recurrent depressions responded poorly to the usual antidepressants. She had a raised plasma cortisol and was made worse by progesterone or by ACTH. An oestradiol/testosterone implant every 4 months abolished all symptoms for at least 8 years, and plasma cortisol returned to normal. This case is relevant to an understanding of premenstrual syndromes and the genesis of depressive illness.