Fifty-five patients with presenile dementia were examined. There were 28 women and 27 men, and the mean age was 59 and 56 years respectively at the time of the study. A large series of psychometric tests was used, and with the aid of age-matched non-demented controls five significantly different cognitive reduction groups could be identified. In the demented patients the regional cerebral blood flow (rCBF) was determined with an eight-detector or 32-detector equipment. There was a rough proportionality between the cognitive reduction and a decrease of the cerebral blood flow (especially the flow in the grey matter). In addition, certain regional flow abnormalities correlated with specific cognitive functions in a manner resembling the cognitive defects found in focal brain lesions in the same region. Thus, patients who showed only memory disturbances demonstrated a focal flow reduction in the temporal region. More severely affected patients, with reduction of verbal abilities and signs of agnosia, showed very low flows in occipitotemporo-parietal parts of the hemisphere. The results offer a principal confirmation of the dynamic field theory concerning the functional organization of the cerebral cortex (Luria, 1966).

The welcome visit of the Royal College of Psychiatrists brings to mind the close links which exist between the University of Padua and Britain.

Sixty-six patients were assessed clinically, psychologically and physiologically before operation, at six weeks and at a mean of 16 months following stereotactic limbic leucotomy. Seventy-three per cent were clinically improved at six weeks and 76 per cent at 16 months. In obsessional neurosis, 89 per cent of patients showed definite clinical improvement at 16 months; in chronic anxiety, 66 per cent were improved; in depression, 78 per cent; and in the small number of schizophrenics treated the improvement rate was over 80 per cent. Self-assessment and observer-assessment questionnaires and scales measuring Depression, Anxiety, Neuroticism, Hysterical symptoms and Obsessional symptoms and traits all showed highly significant reductions of mean scores at 16 months. There was no fall-off in intelligence, and adverse effects were minimal. Limbic leucotomy, with its enhanced accuracy and safety, compares very favourably with similarly assessed, more extensive ‘free-hand’ procedures, and in obsessional neurosis and chronic anxiety the results are superior.

During the fiscal year 1 April 1972 to 31 March 1973, 22,210 ECT treatments in 3,438 series were given in Denmark (6.46 treatments per series). Indications for treatment were: endogenous depression, acute delirium, mania, hysterical psychosis, reactive depression and schizophrenia. Unilateral ECT was used in more than half of the departments concerned. Two treatments were given weekly. The types of apparatus and anaesthesia techniques used are described. One death, which had questionable relation to the ECT, was reported, and other complications were few and mild. The advantages of ECT compared to tricyclic antidepressants are described, including the higher percentage of remissions or improvements in the treatment of endogenous depressions (about 80 per cent for ECT compared to about 60 per cent for tricyclic antidepressants). Little risk was found in out-patient administration of ECT. With present techniques and unilateral placement of electrodes out-patient ECT may be recommended for wider use than before.

The results from a prospective follow-up study of a group of schizophrenic patients suggest that a significant proportion (41 per cent) are likely to relapse during a two-year period despite the prescription of long-acting injectable neuroleptic drugs. Some will relapse because of a failure of the regime, but others (32–37 per cent) because the pharmacological protection of these drugs would appear to be less effective in certain patients. Even with the major advantages of the long-acting injectable neuroleptics over oral medication, the schizophrenic patient population remains a group with a high incidence of psychiatric and social morbidity which continues to require the full resources of both the hospital and community services.

It is suggested that a clearer distinction should be made between the statistical validity and the clinical utility of the Grid Test of schizophrenic thought disorder. The results of three published studies are examined, and in each case the Grid Test is found to have appreciable statistical validity in terms of correlations between grid predictions and clinical judgements of thought disorder. Two criteria are proposed for assessing the usefulness of the Grid Test as a diagnostic instrument, and from an examination of the results of three published studies it is concluded that, despite its statistical validity, the test, at least in its present form, has no appreciable clinical utility.

Total and free plasma tryptophan levels were measured in depressive and manic patients before and after recovery. No change was found in total or free plasma tryptophan concentration on recovery from depressive illness. Free plasma tryptophan levels were higher in recovered manics than in active manics, and a group of four manic patients tested before and after recovery showed a significant increase in free plasma tryptophan concentration on recovery.

The proportion of persons with neurotic personalities in flats was not significantly greater than that in houses. Extraversion was not correlated with psychiatric illness or with the tendency to consult a doctor. Flat dwelling, but not house dwelling, was sufficient stress for neurotic personalities to cause, among them, an increase in clinical psychiatric illness. The resulting increase in the overall level of psychiatric illness of all flat dwellers was too small to be significantly greater than that of all house dwellers.

A psychiatric condition disabling to persons in the fifth and sixth decades is described. Approximately 51 per cent of nearly 1,000 Social Security Disability applicants sampled presented a wide variety of somatic and psychological complaints, but no severe psychiatric disorder. This group is characterized by inability to continue gainful employment. Commencement of full-time employment before age 16 years (59 per cent) and level of education were the only significant differences between this group and psychotic applicants; another 33 per cent began full-time work before age 20 years. 88.5 per cent of the families of these persons remained intact until after they began work. Apparently, being thrust into the responsibilities of adulthood earlier than their peers contributed to the early disability.

A retrospective study of the records of 17,571 psychiatric patients who attended the out-patients department of Eginition Hospital in Athens during three two-year periods (1948–50, 1958–60 and 1969–71) revealed a statistically significant decrease in the frequency of patients diagnosed as suffering from hysteria, a statistically significant decrease in the relative frequency of patients with hysterical fits and with mental conversion symptoms, and a statistically significant increase in the relative frequency of patients with mixed conversion symptoms. The findings confirm the notion that hysteria is still a ‘woman's disease’, although a statistically significant increase in male participation was noted. The significance of the above findings for the understanding of certain aspects of hysteria is discussed.

An analysis of recently published family history data on rapid eye movement (REM) narcolepsy was undertaken to determine the goodness-of-fit of a multifactorial (MF) model of inheritance. The analysis revealed that a two-threshold MF model can successfully account for the prevalence of REM narcolepsy and other disorders of excessive sleep (DES) observed in the first-degree relatives of the REM narcoleptic probands studied.

The present investigation was intended principally as a concurrent validation study for a new self-report symptom inventory: the SCL-90. A sample of 209 ‘symptomatic volunteers' served as subjects and were administered both the SCL-90 and the MMPI prior to participation in clinical therapeutic drug trials. The MMPI was scored for the Wiggins content scales and the Tryon cluster scales in addition to the standard clinical scales. Comparisons of the nine primary symptom dimensions of the SCL-90 with the set of MMPI scales reflected very high convergent validity for the SCL-90. Peak correlations were observed with like constructs on eight of the nine scales, with secondary patterns of correlations showing high interpretative consistency.

A postal inquiry of all senior registrars in general psychiatry in the United Kingdom gave a nearly 90 per cent response rate. Between a quarter and a fifth of the respondents will not be pursuing general psychiatry at consultant level in this country, most of these opting for a psychiatric specialty. Nearly all the overseas graduates will probably remain in this country. Slightly fewer women than men are aiming for a consultancy in general psychiatry, the rest of the women proposing to switch to one of the specialties. Some of the implications of these findings are discussed, including a proposal for a yearly follow-up of the respondents.