Evidence is presented that the incidence of depression among users of oral contraceptives is no higher than that among matched controls not taking such medication. There is an association between high depression scores and high neuroticism scores, more marked in controls than takers. Intensity of depression is related more to age, personality and occupation than to the use of oral contraceptives. A higher proportion of users than of controls experience sexual satisfaction. Past takers include a large number of individuals with a high neuroticism score. The incidence of depressive symptoms in women increases with age. A higher proportion of housewives than of women going out to full-time work show depressive symptoms.

Eighty-three consecutive patients with organic mental disorder were studied on their first admission to a psychiatric day hospital assessment unit in a general hospital. They were evaluated medically, psychiatrically and by social work, re-evaluated after 3 months, and again after 12 months or at death. The types of care, and the number of days in each setting, were recorded. Nearly three-quarters were dead or in institutions by 12 months: those initially living with spouses did worst, and those with their children did best, while those on their own became long-stay residents in institutions. Family support seemed the most important factor determining continued life in the community, and increased help to families from social services appeared to be needed. The value of earlier psychiatric diagnosis and earlier treatment of physical ills is also discussed.

Using successive analyses of hospitalized mentally handicapped people from a geographically defined Welsh catchment area, this article attempts to evaluate changes in cohorts of such patients. It suggests the likelihood that the level of hospital accommodation predicted in the White Paper ‘Better Services for the Mentally Handicapped’ will be sufficient.

A search was made of records available for 65 non-psychotic patients referred to a psychiatric day hospital. Assessments were made of whether they had shown various specified types of deviant social conduct, such detailed objective surveys of social conduct being regarded as superior to the use of concepts such as ‘psychopathic personality’. The correlational structures of the areas of deviance produced four factors, i.e. deviant family roles, poor social integration, violence, and a more heterogeneous antisocial behaviour factor.

The relationship was examined between areas of deviance and indices of the course and outcome of day hospital admission. The prognostic significance of social deviance was different for men and women; for example, only men showed a correlation between the number of areas of social deviance and the outcome of day hospital admissions. Violence and poor social integration showed no relation to outcome at all. It is suggested that there is no basis for excluding such patients from day hospitals on the assumption that they are less likely to be helped than other non-psychotic patients.

In a random sample of the general population (N = 142) a strong inverse relationship was found between social bonds and the presence of neurotic symptoms. This association was strongest in the case of close affectional ties. Together, measures of social bonds accounted for 47 per cent of the variance in neurotic symptoms. While there is likely to be contamination between the two sets of variables, and while the data do not indicate the direction of causality, these findings constitute an aetiological lead which should be pursued.

A survey of patients with drug-related problems seen in London casualty departments during the course of one month revealed 1,706 separate incidents. In 477 cases the patients were dependent on drugs, and more than 40 per cent were dealt with by only five hospitals, all in the West End of London. The remaining 1,229 incidents involved non-dependent patients who had taken a drug overdose, and these cases were distributed more evenly between hospitals all over the Greater London area. The implications of this study for service planning and for further monitoring of the patterns of drug misuse are discussed.

Various benefits claimed for methadone maintenance in the treatment of opioid drug takers are reviewed. It is said to stop illicit drug use, maintain treatment contact, reduce morbidity, mortality and crime, and improve social adjustment. Little firm evidence is found to support these claims. Results are reported comparing 26 drug takers on methadone prescriptions with 16 illicit opioid takers. The measures used are Stimson's (1972) ‘Patterns of Behaviour’ questionnaire, and direct behavioural measures of social functioning. The groups are found not to differ in terms of treatment contact, work status and involvement with other drug takers. There is some evidence that the methadone group is involved in less criminal activity. However, no association is found between amounts of drugs prescribed and numbers of local pharmacy thefts. It is concluded that the benefits of methadone maintenance have been exaggerated.

Fifty persons who had all been heavy cannabis users for a long time were given psychological tests measuring psychomotor, perceptual and other variables. Half of these persons were ‘Charas' smokers, half ‘Bhang’ drinkers. The duration of cannabis use was 4–10 years, with an average daily dose of 150 mg tetrahydrocannabinol. A matched control group of twenty-five persons were given the same tests. Compared with this group, the cannabis users were found to react more slowly, to be poorer in concentration and time estimation, to have higher neuroticism and greater perceptuo-motor disturbance. The Charas smokers were the poorest performers and also showed poor memory, lowered psychomotor activity, and poor size estimation.

The conviction rates for the first 61 admissions to a therapeutic community for drug dependence were obtained for a period two years prior to admission and two years after discharge, by searching in the Criminal Records Office at Scotland Yard.

A long-stay group (n = 20) which had remained in residence more than six months was compared with a medium-stay group (n = 20) which had remained from one to six months and a short stay group (n = 21) which had remained less than one month.

The long-stay group had a pre-admission conviction rate of 60 per cent, which was significantly reduced to 10 per cent during the follow-up period. The conviction rate of the medium-stay group was reduced from 70 per cent before treatment to 45 per cent after treatment; that of the short stay group remained constant at 57 per cent before and after treatment. It is suggested that periods of more than six months treatment in the community are effective in reducing subsequent criminality.

Ninety-nine cases of school phobia seen at a child guidance clinic over a period of twelve years were divided into acute and chronic groups and investigated in several ways. The results indicate that the children of both groups are more likely to be the eldest or youngest in the family. Acute school phobia is more likely to occur in youngest children with two or fewer siblings, and mothers tend to be older. It is most common in adolescence and seems often to be precipitated by stress. Chronic school phobia is likely to occur in a child from a larger family and with a younger mother. It is more common in social class V and in children of mentally ill parents. Implications for treatment are discussed.

Thirty-two school-phobic youngsters of mean age 13 years were randomly allocated to two treatment groups after stratifying for sex. Length of in-patient management in a psychiatric hospital unit for young adolescents was evaluated. One group was admitted for three months and the other for six. Care was taken to ensure that cases had been fairly distributed between the groups by comparing them on a variety of clinical features. Follow-up assessments were carried out in a reliable fashion at six months, one year and two years after discharge. Outcome, overall, was similar to that found in a previous follow-up study for the same unit, in that symptoms of emotional disturbance and social impairment tended to persist in a considerable proportion of cases over the period of review. Length of stay in hospital did not affect outcome as far as the boys were concerned; the findings in relation to the girls was less certain and it seems likely that longer in-patient treatment improves outcome in school-phobic girls.

A lower incidence of attempted suicide was found for Oxford University students than for other persons of the same age in Oxford City. This may be due to social class differences. Characteristics of the student attempters are reported. On the other hand, the rates for completed suicides of students, over a recent ten-year period, were in excess of those for the rest of their age group.

This case report augments a paper published in 1971 (Gunn and Fenton) in which it was indicated that automatic behaviour is a rare explanation for the crimes of epileptic patients. It was claimed that although two possible ‘automatic’ crimes were committed by two epileptic patients among the 46 male epileptics at Broadmoor there were no such crimes committed by any of the 158 male epileptic prisoners who came into a national sample. Since then it has become clear that one man serving life imprisonment, excluded from the epileptic prisoner sample in 1967 because of a doubt about his diagnosis, is definitely epileptic and probably killed his wife during an epileptic attack or its immediate sequela.

People working in the field of social psychiatry concern themselves with social factors which may affect the onset, duration or outcome of psychiatric disorders. This concern encompasses the full range of psychiatric conditions and virtually every aspect of the structure of society, so that in this short review we can only attempt to convey the flavour of the subject and to highlight some salient contributions.