We interviewed 128 women regularly during pregnancy and the first postnatal year. Psychiatric interviews identified eight ‘cases' of psychiatric disorder (6 per cent) in early pregnancy and twenty ‘cases' (16 per cent) at six weeks after birth. Postnatal affective disorder, which accounted for 15 of these cases, was significantly associated with dissatisfaction with the marital relationship and also with previous psychiatric history. The implications of the term ‘postnatal depression’ are considered in terms of the course of the disorder in the 29 women (23 per cent) who had episodes of affective disorder at some time during pregnancy and the postnatal year. We found that the majority of episodes of affective disorder could be understood in terms of previous psychiatric history and/or reaction to life-events, including the stress of childbirth itself.

Using a classical click/flash paradigm the contingent negative variation (CNV) was recorded from 60 consecutive male admissions to Broadmoor Hospital. Clinical and psychometric Minnesota Multiphasic Personality Inventory (MMPI) assessments were made independently of the electroencephalography (EEG) data. A trend for higher amplitude CNV's to be recorded from patients with a clinical diagnosis of antisocial (psychopathic) personality was observed. Patients with a Mental Health Act diagnosis of psychopathic disorder had significantly higher voltage CNV's than those in the mental illness category. These CNV differences were only found in the primary (non-anxious, sociable) psychopaths. Secondary (neurotic, unsociable) psychopaths did not differ from staff controls. A positive association between CNV voltage and the personality factor of sociability(sociable-shy dimension) was observed. A weak, negative correlation between CNV amplitude and impulsivity (impulsive-controlled dimension) was also apparent. All subjects showed an habituation effect across trials. No difference in response variability between successive series of trials was apparent in any of the patient groups.

This study was undertaken in a society without psychiatric services to assess the economic losses associated there with major mental disorder. Such data are important in assessing the cost/benefit of services for major mental disorders.

A survey was conducted in 27 representative villages of Laos, each containing about 200–300 people; 35 mentally ill subjects were identified. Data were obtained on expenditure for treatment, loss of productivity, and other economic losses (eg., destruction of property); demographic data and clinical rating scales were also obtained, and compared with economic variables.

The data show wide variability in expenditures for treatment, but losses of productivity were consistently high; acute losses, while impressive due to their suddeness and obvious wastefulness, were comparatively small relative to others. Demographic data were not associated with loss in productivity. Certain psychopathological parameters, ie., more psychopathology, less productivity, were inversely correlated with productivity. Psychosocial function scales were strongly and directly correlated with productivity.

Measures of intrafamilial expressed emotion (EE) predict relapse in schizophrenic patients, but previous research has not investigated whether EE scores are representative of ongoing family transactions. Parents of 42 hospitalized schizophrenic patients were rated for level and type of EE. Following the patient's discharge, families participated in two 10-minute direct interaction tasks. Transcripts from these interactions were coded on dimensions of affective communication.

High-EE parents exhibited more negatively charged emotional verbal behaviour in direct transaction with their schizophrenic offspring than did low-EE parents. Some parents rated high-EE were distinguished by their frequent usage of critical comments during the interactions, whereas high-EE overinvolved parents used more intrusive, invasive statements. These findings support the construct validity of expressed emotion.

Eighteen patients fulfilling DSM-III criteria for both major depression and dementia were matched by age and sex to patients with a diagnosis of irreversible dementia and patients with a diagnosis of major depression. A past history of depression, self reports of depressed mood, self blaming, hopeless and somatic delusions, an appetite disturbance and subacute onset identified the patients suffering from dementia caused by depression. Two year follow-up confirmed the initial diagnosis and demonstrated that coexisting cognitive impairment and major depression are not usually precursory to a progressive dementing illness.

Much of what is known about the psychological response to amputation is derived from studies of veterans. Most recent amputees come from a different group; they are typically older and have experienced medical problems prior to their amputation. In order to investigate the effects of age and time since amputation on psychological response, 66 amputees were assessed by the Symptom Checklist-90, Beck Depression Inventory and interviewed. When classified by time since amputation and by age, the results indicate that older amputees exhibited less depression and fewer psychological symptoms: in contrast, younger amputees evidenced increased depression and psychological symptomatology the longer the time since their amputation.

Tardive dyskinesia (TD) is usually described as fluctuating in its clinical manifestations. We attempted to quantify fluctuations in TD using the Abnormal Involuntary Movement Scale (AIMS). Three psychiatrists rated multiple video-recorded examinations of four outpatients with mild TD. The unexpected finding was that within-rater variability dominated within-patient variability.

The effects of inhaling a mixture of 35 per cent carbon dioxide and 65 per cent oxygen on the occurrence of panic symptoms defined by the DSM III, was investigated. Compared to a placebo (air), carbon dioxide produced more panic symptoms. If carbon dioxide inhalation was preceded by intake of a beta-blocker (60 mg propranolol), less symptoms occurred than if preceded by a placebo. The results are compared with earlier reports on the effects of lactate infusion. It is argued that panic disorders can be conceptualized as a fear of internal (panic) sensations and that inhalation of a mixture of carbon dioxide and oxygen may constitute an effective exposure treatment.

Forty-four psychiatric patients were separated into four groups on the basis of presence/absence of hallucinations and reactive/process status. Reactive hallucinators were found to be singularly impaired in two aspects of cognitive processing: (1) tolerance of ambiguity; and (2) availability of alternative meanings. The perceptual errors produced by premature judgment and limited consideration of alternative meanings for misperceptions are discussed as factors predisposing to auditory hallucination.

Dysmorphophobia is an uncommon psychiatric syndrome characterized by a subjective feeling of ugliness or physical defect. Although appearance is within normal limits, the patient feels that this is noticeable to others. Views on the nature of this condition are illustrated by two case histories. It is proposed that dysmorphophobia is a discrete psychiatric illness. The symptoms arise in individuals with schizoid, narcissistic, or obsessional personality traits and should be distinguished from those phenomena which are secondary to morbid psychological processes.

The present paper compares a lenient and a strict operant conditioning programme in refeeding patients with anorexia nervosa. Sixty-five consecutive in-patients participated in the study. We found no significant difference in the rate of weight-gain between the two treatments. There were, however, a number of practical advantages in using the more lenient programme: it was more economical of nursing time, and patients were more accessible to psychotherapy. The programme was also more acceptable to the patients.

Thirty alcoholic patients were investigated for evidence of impaired hepatic function and deficits in cognitive functioning, to see if there was any significant relationship between these two complications of alcoholism. Forty-seven per cent had abnormal γ-glutamyl transpeptidase levels, and 63 per cent had abnormal results on the Category test. Only one significant correlation coefficient was found, between one parameter of hepatic function and one of cognitive function. Possible explanations for this (negative) correlation are discussed, and the value of further study is suggested.

Brain-type creatine phosphokinase isoenzyme (CPK BB) was measured by radioimmunoassay in the serum of 31 depressed patients undergoing bilateral ECT. Samples were taken shortly before and at one hour, two hours, and six hours following ECT. ECT did not cause a significant alteration in serum CPK BB concentration during the six hours following the treatment. Similarly, there was no difference in mean pre-ECT concentration of serum CPK BB between patients receiving the first ECT of their current admission and those receiving subsequent treatments. These findings do not support suggestions that ECT causes alteration in permeability of the blood-brain barrier, nor that it causes detectable brain injury.

The extraversion–introversion dimension of personality is believed to have an inverse relationship with cortical arousal. Brain capillary perfusion is a well established index of brain function and arousal. Regional cerebral blood flow was measured in 51 right-handed females whose personality structure was examined with the Eysenck Personality Inventory (EPI). Significant inverse correlations were found between the brain blood flow and the extraversion–introversion score of EPI.

Several studies have suggested that schizophrenics have a deficit in their ability to recognize the affect expressed in photos of human faces. In this study, the performance of 17 chronic schizophrenics was compared to that of 17 controls on both a test of facial affect recognition and a control task involving facial recognition. Compared with controls, chronic schizophrenics tended to perform more poorly on the test of facial affect recognition, but this difference was eliminated when facial recognition was entered as a covariate. When all test items, including those with poor reliability and discriminatory power, were included in the analysis the schizophrenics showed a significant deficit in facial affect recognition which persisted even when facial recognition was used as a covariate.

Neuropathological examination of the brain of eight adult mentally handicapped patients showed mesial temporal sclerosis. Three patients had cerebral palsy, one had Down's syndrome, three were retarded, and one had an unspecific mental handicap. Although there was a suspicion of fits in most patients, temporal lobe epilepsy was not diagnosed in life.

The new American psychiatric classification (DSM–III) features a radically new approach to organic mental disorders. The concept of organicity has been liberalised to allow inclusion of psychiatric correlates of cerebral disorders which not only fail to involve cognitive impairment but in some cases also resemble affective, paranoid, and schizophrenic disorders. The highlights, and implications of the new approach are discussed.

The Social Adjustment Scale Self-report (SAS-SR) was completed by chronic schizophrenics (N = 82) living in Nithsdale, in Dumfries and Galloway region. Relatives also assessed patients' adjustment. The questionnaire response indicated that scrutiny of the form by a professional immediately after completion is necessary. Patients' and relatives' assessment of the patients' overall adjustment correlated very closely, thus suggesting a schizophrenic can satisfactorily describe his own adjustment. The patients were less well adjusted than a normal community population in all areas except the parental role. The SAS-SR highlights for each individual where many of his problems lie, and therefore may act as a guide to specific rehabilitative measures.