In view of the considerable importance attached to sexual adjustment by many psychologists and psychiatrists, it is disappointing that very little work seems in fact to have been done in this field. There are, it is true, surveys of ‘normal’ sexual behaviour, such as those associated with Kinsey, but these are characterized on the whole by the serious limitation of using entirely descriptive statistics; these are useful in a limited sense, but are not very informative. The value of a mean of 2 · 34 for the number of times that members of a given sample indulge in intercourse during the week is doubtful when it is realized that some members of the sample have intercourse once or twice a year, while others have it several times a night; even if one could take the unaided recall of such events very seriously, and even if the rate for a given person were less fluctuating than it probably is, nevertheless when variances are as large as these means have little meaning or relevance. Clearly the important question centres on quite a different problem, namely that of personality traits and other factors giving rise to these very marked individual differences in sexual behaviour and adjustment. Kinsey and his followers have concentrated on the factors of social class and age, perhaps because these are relatively easy to ascertain; it is not so easy to ascertain the psychological factors involved, as many critics of Kinsey's work have pointed out. Nor have psychiatrists, in spite of their professional interest in this field, been more forthcoming; apart from isolated statements about the lower fertility of psychotics, the loss of libido in depression, its excess in manic states, and the widespread sexual troubles of neurotics, little serious and detailed work appears to have been done to relate personality traits, or even descriptive diagnostic labels, to specific types of sexual behaviour. Psychologists have been equally remiss; apart from a few undistinguished and not very meaningful studies reviewed by the writer (Eysenck, 1971) little use has been made of the well-established research methodologies and psychometric tests available to them for use in such a situation.

Little has been published about psychiatric out-patient work, and even less about the relationship between in-patient and out-patient psychiatric facilities in service requirements for a given population. The reasons for this are partly general to the whole field of medicine —a preoccupation with severe illness and the hospital bed to which it inevitably leads— and partly particular to psychiatry. The growth of out-patient psychiatric work is relatively recent, and its existence outside teaching hospitals is largely a National Health Service development. With in-patients concentrated in large mental hospitals serving an extensive area, the psychiatrist's connection with any individual general hospital was necessarily limited and the out-patients a small and peripheral part of his work.

The Department of Health carried out a complete census of the resident patient population of local authority and private psychiatric hospitals in the Republic of Ireland on 31 March, 1963. This paper analyses the Irish census returns and compares them with those of the similar psychiatric hospital census carried out in England and Wales on 31 December, 1963 (Brooke, 1967).

Psychoanalytic literature has a number of references to suicidal acts taking place on the anniversary of the death of a loved person. Anniversaries of significant bereavements have been seen as likely to reactivate a depressive syndrome and as possible precipitants of suicide. Zilboorg (7) suggested that suicides might take their lives on the anniversary of a parent's death as though to expiate the death which they unconsciously perceived as the result of their own wishes. Others have seen the meaning of the suicide's act as a fantasied rebirth or new beginning with a lost love object, and the supposed occurrence of suicides on the anniversary of a death has again been instanced as support (Jackson (3)).

It has often been stated that there is a seasonal variation in suicidal deaths, with more occurring in the spring than at other times of the year. The analysis of this phenomenon has, however, remained at a relatively crude level. For example: (1) Recent data (Dublin, 1963) indicate that the pattern is not simple. There appears to be a subsidiary peak in suicidal deaths in the early winter in the U.S.A. (2) Investigators have not investigated whether the seasonal variation is found more strongly in some subgroups of the population than in others. (3) Investigators frequently omit to carry out statistical tests of significance on their data. The present study sought to investigate the seasonal variation in suicidal deaths, taking these considerations into account.

This paper examines the differences in diagnostic practice and rating behaviour between groups of psychiatrists trained in different centres in the British Isles, using their observations on three video-taped psychiatric interviews. The findings are also briefly compared with similar data obtained in the United States.

Despite the popularity of group psychotherapy in its many different forms over several decades, we seem to be little nearer to an understanding of how it works and how effective it is. This lack in our understanding stems largely from deficiencies in research in this field. Bennis (1960) found that research on group psychotherapy was more often based on descriptions, anecdotes and clinical observations than on systematic collection and analysis of data. Slavson (1962) found that many of the papers which he dealt with as the editor of International Journal of Group Psychotherapy ‘lacked in scientific discipline, and often drew conclusions from inadequate evidence’. Luchins (1947) felt that there was ‘a decided deficiency in the use of objective methods of establishing outcome of group psychotherapy programmes', and Burchard et at. (1948), in their comparative evaluation of fifteen reported programmes of group psychotherapy, concluded that failure to consider pertinent variables, the lack of operational definitions, and the absence of any frame of reference, made comparison of methods or evaluation of outcome almost impossible.

It is frequently the case in investigations in the behaviour sciences that a number of independent raters are asked to rate the same sample of subjects with regard to certain signs, symptoms or characteristics of these subjects, and the question of comparing the results given by the raters then arises.

Payne and Hewlett (1960) found that the schizophrenics having the highest factor scores on their dimension of overinclusion were diagnosed paranoid schizophrenic. Payne (1966) has suggested that if overinclusive thinking is construed as an inability to disregard irrelevant stimulation it is conceivable that overinclusive thought-disordered schizophrenics will come to hold delusions of reference and persecution as a consequence of their giving these irrelevances personal significance. In this way the paranoid schizophrenic's thought disorder is seen as the basis of his delusional symptomatology. A number of studies have lent support to this contention (Payne, Caird and Laverty, 1964; Lloyd, 1967). On the other hand several studies have failed to find the predicted relationship between overinclusive test performance and delusional symptomatology (Hawks, 1964; Chapman and McGhie, 1962).

It can be difficult to make a confident diagnosis and one that will stand the test of time when a person without a family history or previous history of psychosis presents as psychotic with overactivity, pressure of talk, loose association of ideas and perhaps some paranoid ideation. He may be schizophrenic or manic. The nature of the disturbance of speech, and by inference thought, may assist in making the clinical diagnosis, but standard textbooks (Slater and Roth, 1969; Freedman and Kaplan, 1967) state that pressure of speech, flight of ideas, clang associations, distractibility and inability to adhere to a line of thought are common to both conditions.

The relative contribution of genetic and environmental factors to the development of homosexual behaviour is a controversial subject. The original suggestion that homosexuality is a purely inherited trait has been attributed to Krafft-Ebing (Kallmann, 1952). Perhaps the strongest support for this view was Kallmann's series of 40 male monozygotic twin pairs showing 100 per cent concordance for the overt practice and quantitative rating of homosexual behaviour (Kallmann, 1952). This report has been criticized, and Kallmann later conceded that the 100 per cent concordance was possibly a statistical artefact (Kallmann, 1960). Habel (1950), who obtained the index twins from a prison population, found concordant homosexuality in 3 out of 5 monozygotic pairs (60 per cent), but none of 5 dizygotic pairs. In a more recent study, Heston and Shields (1968) found concordant homosexuality in 2 out of 5 monozygotic pairs (40 per cent) and 1 out of 7 dizygotic pairs (14 per cent). Heston and Shields (1968) also report a family with a sibship of 14 which included 3 pairs of male monozygotic twins, in two of which both twins were homosexual and in the third both heterosexual; no environmental factors which differentiated the homosexual from the heterosexual sibs could be detected. These workers also refute the suggestion that the tendency for monozygotic twins to be more alike with regard to homosexuality than dizygotic twins is related not to genetic factors but to problems of sexual identification which predispose to homosexuality (Money, 1962) by pointing out that there is no evidence that monozygotic twins per se are especially prone to become homosexual.

In recent years several workers have followed-up the status of patients with phobic disorders after treatment (Terhune, 1949; Friedman, 1950; Tucker, 1956; Roberts, 1964; Sim and Houghton, 1966; Marks and Gelder, 1965; Marks, Birley and Gelder, 1966). These studies were retrospective in that evaluation was largely based on past records, and systematic interviews did not provide the main source of data. Some patients were included with phobias of duration ranging from three days to 32 years, while follow-up results were usually reported at varying durations after treatment, so that it was not possible to evaluate serial change in a cohort.

A prospective study of mood changes through pregnancy and puerperium was undertaken by a research group centred on the North Middlesex Hospital, Edmonton, London. Data collected from 189 women revealed an evolution of mood changes in those who later developed puerperal depression, which was characterized by anxiety at the first ante-natal visit, elation during later pregnancy and depression in the puerperium. The findings were in agreement with other workers in this field. The arguments in favour of a hormonal aetiology of puerperal depression are presented.