This article presents the results of a study in which a number of social, familial and demographic aspects of primary depressive illness were examined under carefully-controlled conditions. The following factors are particularly considered:

1. 1. The size of the sibship in the depressive's family of upbringing;

2. 2. the ordinal position of the depressive in that sibship;

3. 3. the depressive's position in the sibship relative to the other sibs;

4. 4. the age of the parents at the time of the depressive individual's birth;

5. 5. the presence of a family history of severe mental illness;

6. 6. celibacy and marriage in depressive individuals;

7. 7. the fertility of depressives;

8. 8. the social class distribution of depressive illness.

Since in most cultures it is normal practice for children to be reared by their parents, there is a general consensus of opinion that it is undesirable to be deprived of one's parents in childhood. This can scarcely be disputed, but to assert, as many authorities do, that a variety of severe psychological abnormalities may arise in the child as a result of such deprivation is to make an assumption of some magnitude. It requires an even greater assumption to postulate a causal connection between a long-past occurrence like childhood bereavement and a psychiatric illness which develops in adult life. It will be contended here that, with some exceptions, the evidence for such a connection is meagre. In particular, it will be shown that there is no apparent justification for regarding parental deprivation as an aetiological factor in depressive illness.

There have been many reports of the high incidence of early parental loss among groups of patients suffering from various psycho-pathological disorders. Bowlby (1951) cited numerous relevant studies in his influential monograph, and Gregory (1958) has critically reviewed a dozen others. More recently Brown (1961) reported a significantly higher incidence of parental loss in childhood among depressed patients than among the general population, and Beck et al. (1963) found that the incidence among highly depressed psychiatric patients was higher than among non-depressed patients. Both these writers aver that their findings provide evidence that parental loss in childhood is a significant factor in the development of a depressive illness in adult life.

A study of the relationship between attempted suicide and parental loss in childhood has been described in a previous publication (13).

As currently used, the diagnosis of depression includes a wide range of clinical phenomena. This has not always been the case. Near the end of the 19th century, when the term depression began to evolve the meanings that it has today it was applied primarily to psychotics. The formulations of Freud in Mourning and Melancholia (1917), and of Kraepelin in Manic Depressive Insanity (1921) were based upon observations of patients who were both depressed and psychotic. In their work the contrast was between psychotic depression (or “melancholia”) on one hand, and normal sadness on the other. In the succeeding half-century, however, as psychiatry has extended its boundaries, increasing attention has been focused on non-psychotic depressions, often called “neurotic” or “reactive.” As these “neurotic” or “reactive” depressions reached public attention, a debate began over the way in which the depressive population should be described and the extent to which it should be subdivided. Critical and often sarcastic written battles were fought between the separatists and the unifiers during the 1920's and 1930's. These debates have been informatively chronicled by Partridge (1949). We have found it useful to divide these theorists into unifiers, dualists, and pluralists.

The experience of hearing a “voice” or “loud thoughts” within the head or some other part of the body is not infrequently reported by psychiatric patients. Schneider (1959) has stipulated that “certain modes of hearing voices are of special diagnostic importance for assuming a schizophrenia: hearing one's own thoughts (or thoughts being audible), voices conversing with one another, and voices that keep up a running commentary on the patient's behaviour”. This paper is primarily concerned with the phenomena of “loud” or “audible” thoughts, “inner voices” and similar experiences. It attempts to show that various phenomena superficially resemble the schizophrenic experience of “thoughts becoming audible”, but that distinction is possible on phenomenological grounds.

The number of married schizophrenic women living at home may be expected to increase owing to the effectiveness of modern pharmacotherapeutic methods and the trend towards social rehabilitation. Hospital admissions will be limited to short periods, thus providing greater opportunity for the schizophrenic patient to become pregnant. As each additional attack of the illness may result in further deterioration, which will increase the mother's inability to care for her children, the relationship between the schizophrenic disease process and the stresses of pregnancy and childbirth needs investigation and evaluation. The practical clinical significance of this question is mainly relevant to married women suffering from schizophrenia of an acute onset or schizophrenia which follows a more benign course, which would allow them to function at home at various intervals.

In this investigation, the subjects were 180 female patients with pure endogenous depressions. These were divided into six different groups of 30 each. Of these groups, four were treated with nortriptyline, amitriptyline, imipramine and MAO-inhibitors respectively, and the results were compared with those obtained in the fifth group of patients who had been given electroplexy only, and finally with those obtained in the sixth group of patients who had received treatment before 1937.

This report is based on a study of 21 cases of anorexia nervosa treated and followed-up for a mean period of 1½ years.

Obesity, one of the major threats to health and longevity in Western society, is usually treated with some form of weight-reducing regime. However, in recent years several authors have cautioned against the widespread prescription of reducing diets for obese patients because of the danger of inducing severe depression. The present investigation was undertaken to determine the actual risk of such severe depressive illness occurring among a group of obese dieters attempting weight reduction under the supervision of their general practitioner.