Twenty schizophrenic patients with tardive dyskinesia and an equal number of matched controls were tested on a novel cognitive task. The task had two components: cued response and spatial memory. Relative to controls, the dyskinetic subjects showed a superior cued response performance but an equal spatial memory ability. We speculate that this selective facilitation may reflect dopaminergic hyperactivity in the dyskinetic group.

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.

There is a need for a method, useful both to the clinician and to the research worker which can assess both the ‘quantity’ and the ‘quality’ of daily life. In this paper two ‘diary’ methods are described for obtaining accounts of daily activities, social contacts and patterns of interaction from people diagnosed as having multiple sclerosis. The information obtained is compared with that derived from a major decennial national survey of the population aged over 4 years and from a selected group of matched non-patient controls. The paper is divided into two parts, each concentrating on one of the techniques. The first is a postal 24-hour written account; the second a detailed tape-recorded interview known as the ‘Standard Day Interview’. Difficulties and advantages in using these approaches to assess both the quantitative and the qualitative changes during disabling illness are discussed and proposals for developing the methods are presented. Indications of substantive variation in the use of time by samples drawn from the ‘healthy’ and from populations with multiple sclerosis are reported.

A computer programme (DPAX) was constructed for a longitudinal study of psychiatric epidemiology in Stirling County (Canada). It identifies disorders involving the syndromes of depression and anxiety based on responses given in structured questionnaire interviews. The programme follows a diagnostic algorithm that uses criteria for: (1) essential features; (2) number, frequency, and pattern of associated symptoms; (3) impairment; and (4) duration. The programme reproduces case evaluations provided by psychiatrists, as conveyed by a sensitivity of 92% and a specificity of 98%.

Depressed patients commonly complain of concentration problems, yet these have seldom been the focus of systematic investigation. A structured interview about concentration problems was administered to a group of relatively severely depressed patients. Problems in reading and watching television were the most common, and were highly correlated with each other. Direct report of the number of concentration lapses on a reading task was the most generally satisfactory task-performance correlate of complaints of reading/TV concentration problems. Evidence both from this task and from the interview suggests that depressive concentration problems may often be due to ‘mind-wandering’. The correlations with concentration problems with the severity and endogeneity of depression and with state anxiety were generally similar.

The data for this cross-sectional survey were obtained from a stratified probability sample of 510 residents in South-Verona during the period May–June 1980. The two-week prevalence of psychotropic drug consumption was found to be 13%. The prevalence was higher in women (18%) than in men (9%). The most commonly consumed category of psychotropic drugs were the benzodiazepines, which accounted for 70% of all the psychotropic drugs consumed by women and 85% of those consumed by men. Using a logistic analysis, a strong association between drug consumption and minor psychiatric morbidity, as indicated by the GHQ scores, was found for both sexes, a finding not significantly different from that found in the West London study by Murray et al. (1981). Alcohol abuse in men was less prevalent in the youngest age-group. Thirty-three (19%) of the male GHQ low scorers were alcohol abusers, compared with 12 (40%) of the high scorers. No significant association was found between psychotropic drug consumption and alcohol abuse in men.

The Type A behaviour pattern and other measures of psychological traits and symptom states were assessed in 92 subjects (predominantly male) presenting for coronary angiography. These measures were correlated with three angiographic indices of coronary heart disease (CHD) severity and two clinical indices (angina and the duration of CHD). The only psychological measures associated with atherosclerosis (assessed by angiography) were indices of personality: Type A (the Jenkins Activity Survey), trait tension, trait anxiety and suppression of anger. It was concluded that these traits may have some role in the pathogenesis of coronary atherosclerosis. None of the measures of psychological symptoms showed a significant association with angiography indices. However, depressive symptoms and expressed hostility were associated with the severity of angina and duration of heart disease. It was concluded that these affects are the consequences of the physical disability of CHD.

The ecological association between unemployment and parasuicide rates among males in Edinburgh over the period 1968–82 was positive and highly significant (r = 0·77). Similarly, the two rates were found to be correlated across the city wards in 1971 (r = 0·76) and even more strongly in 1981 (r = 0·95). Throughout the period the parasuicide rate among the unemployed was nearly always more than 10 times higher than that among the employed. The long-term unemployed were at much higher risk than those out of work for lesser periods, although the impact of recent job loss was marked. Population attributable risk has shown a tendency to rise in line with the upward trend in the unemployment rate, despite the decline in relative risk over the period. The findings were considered consistent with the view that unemployment increases the parasuicide rate.

The 60-item General Health Questionnaire (GHQ) and the Clinical Interview Schedule (CIS) were administered to a consecutive series of 194 patients with established or presumptive coronary heart disease (CHD) attending an out-patient cardiology unit. The GHQ proved to be a valid instrument for the routine screening of this population. The presence of organic anginal pain was associated with high scores on the GHQ, but with a lower specificity and a higher percentage of false positives. This was not found in patients with atypical or non-cardiac chest pain. These findings suggest a need for an upward revision of the cut-off score on the GHQ in patients with organic anginal pain. False negatives were found predominantly among patients with personality disorders, and in those characterized by the longstanding nature of their symptomatology and by higher levels of defensiveness.

The individual's response to the occurrence of symptoms is conditioned by a variety of non-medical factors, of both an enduring (e.g. personality attributes) and a changing nature (e.g. social support). The health diary provides a particularly appropriate method of studying the daily variations in health and illness behaviour which make up so much of the clinical content of general practice.

In a recent study Turner et al. (1983) employed Bell & Byrne's (1978) Repression-Sensitization (R–S) scale to test the hypothesis that agoraphobics utilize repression as a method of avoiding anxiety-arousing forms of cognition. However, no support was found for this view. Rather, the R–S scores indicated general sensitization and attention to negative affect. In this paper it is argued that, on both theoretical and psychometric grounds, the R–S scale cannot be considered a suitable measure of the repression–sensitization process. A study was carried out in which a number of other defensivity measures were used in addition to the R–S scale. Weak support was found for Goldstein & Chambless’ (1978) view that a defensive cognitive style is characteristic of agoraphobic patients when compared with non-phobic psychiatric controls.

A study was made of the smoking habits of an unselected series of 1129 18-year-old men from the general population. Their smoking habits were related to personality traits, intellectual level and platelet monoamine oxidase (MAO). Regular smokers were found to be extraverts, sensation seekers who were easily bored and with a strong tendency to avoid monotony. They also had a lower than average intellectual level, and were more prone to the abuse of alcohol, glue, cannabis, amphetamine and morphine. Furthermore, they had a low platelet MAO.

The results are discussed in relation to the pharmacological reasons for smoking and favour the hypothesis that tobacco smoking is related to arousal-seeking behaviour. Ex-smokers had personality traits, intellectual levels and platelet MAO of the same magnitude as non-smokers: this may be the reason why they were able to give up smoking.

This paper is a preliminary investigation into the application of Q-analysis in clinical psychiatry, Q-analysis is used to describe the interrelationships of attitudes that two groups of patients were observed to hold towards ECT. The data were collected as part of the Leicestershire ECT trial. One group comprised 96 patients who consented to enter the trial. The other group was formed by 23 patients who refused to participate in the trial, but who agreed to be interviewed so that their attitudes could be assessed.

The method of applying Q-analysis is described, and the resultant outputs for the two groups are discussed. The presence of insight, a subjective need for treatment and trust in ECT were significant features in the 96 patients who agreed to enter the trial. However, among this group there was a subset of patients who were very anxious and who had little desire to receive ECT or trust in it. Among the 23 patients who refused to participate in the trial two main viewpoints could be discerned. First, there was a subgroup who seemed accurately to assess their need for treatment, had insight and trust in ECT as well as specifically wanting to receive it. The second was composed of patients who were very apprehensive, did not want ECT and generally were unhappy about being in hospital. In both groups it was considered that level of knowledge was relatively unimportant in the formation of attitudes.

Issues surrounding the collection of accurate information about the life events of girls aged 15–20 were tested on 67 mother/daughter pairs in a community sample. The Bedford system of classifying and rating the events was modified to accommodate the perspective of an adolescent. Mothers recalled fewer events than their daughters, but the difference was most marked for the ‘severe’ events of girls aged over 17. There was a marked fall-off in the reporting of severe and non-severe events after the 30th week, and a significant difference between the rate of events in the furthest 6 months, compared with the proximal 6 months.

The case histories of 72 women admitted to prison for contempt of court in 1979–83 were reviewed. The sample included 45% of all women imprisoned for contempt in England and Wales over the 5-year period. The contemnors were significantly older than other sentenced prisoners, one third were foreign born and 37–5% were suffering from psychiatric disorder. Two thirds of the mentally disordered group had a paranoid disorder, litigiousness was a prominent feature of their illness, and 52% committed contempt in the context of a matrimonial dispute or a dispute with neighbours. Recent legislation may help to prevent the imprisonment of mentally ill contemnors.

The monoamine metabolites 5-hydroxindoleacetic acid (5-HIAA), homovanillic acid (HVA) and 3-methoxy-4-hydroxyphenylethyleneglycol (MHPG) were measured in the lumbar cerebrospinal fluid (CSF) of 27 chronic schizophrenic patients who at some time had attempted suicide, and were compared with values from 27 chronic schizophrenic patients without a history of attempted suicide. There were no significant differences between either the violent or non-violent attempters and those without a history of attempted suicide in the mean lumbar CSF concentrations of the serotonin metabolite 5-HIAA, the dopamine metabolite HVA, or the norepinephrine metabolite MHPG. Significantly more of the suicide attempters had a previous major depressive episode, had received a course of ECT, and had significantly more psychiatric admissions than those who had never attempted suicide.

In a group of 20 patients who were to undergo endarterectomy for atherosclerotic occlusive disease of the internal carotid artery, the stenosis did not appear to have resulted in cognitive or motor deficits. Consistent with this finding, surgery could not be shown to have a beneficial effect on cognitive or motor functioning. Control data were supplied by 20 patients who underwent peripheral vascular surgery and 20 healthy subjects. The test-retest interval was 10 weeks.

The weekly distribution of deaths for myocardial infarction was studied, using mortality data for Lower Saxony for the years 1968–77. In accordance with hypotheses derived from Holmes & Rahe's stress model, an increase of deaths was found on Saturdays and Mondays only in men aged between 25 and 55 years.

National statistics for railway fatalities in England and Wales show a reduction of train crashes and a fluctuating level of deaths, of which an increasing proportion is from suicide. A closer examination of a two-year sample from the South of England revealed a large proportion of probable suicides and a small proportion of pure accidents. The remainder appeared to have medical, mainly psychiatric, contributions to their death, of which alcohol was an important factor in single young men. Rail suicides appear to be younger, the men less often married, the women more often married, and both sexes less often widowed than other suicides. They included more cases of major psychosis and neurosis, but fewer and less severe alcoholics. Characteristic patterns of this method of suicide are described with examples. Hypotheses to explain the choice of method suggest that it is not related to either volume of traffic, or residence in a rail-dense area or in an area with a high suicide rate, or the proximity of a psychiatric hospital.

The 40-item Eating Attitudes Test (EAT-40) was administered to teenage schoolgirls. Factor analysis (N = 749) yielded a major dieting factor almost identical to that found by Garner et al. (1982) with anorexics. Although this factor clearly measures pathology in underweight girls, its interpretation is ambiguous for normal and overweight girls. Two other factors found in all analyses were food preoccupation and social pressure to eat.