For the purposes of the present report we will include under the generic term of Latin America a group of 20 countries with geographic, historical, political and cultural common links, which because of being former colonies of Spain and Portugal might better be called Iberoamerica. Tied together in regional groups during colonial days, they became independent at the beginning of last century and initiated their republican life as separate countries. In almost all of them Spanish is spoken as the exclusive or major language, the two exceptions being Brazil and Haiti.

The Ganda are the most numerous tribe in Uganda. They live around the capital, Kampala, along the north-west shore of Lake Victoria and up to 50 to 100 miles inland. They are a Bantu-speaking people, surrounded by other Bantu to the east, west and south, with Nilotic people to the north.

Thirty-four first admissions between the years 1964 and 1970 into the Department of Psychiatry, Erskine Hospital, Madurai, South India, who were diagnosed as general paresis formed the material for this prospective study. Diagnosis was based on clinical and positive blood and CSF serology, and on Lange's paretic reaction in the CSF.

Disorders in which anxiety or depression is the predominant feature constitute a large part of contemporary psychiatric practice. They are also being increasingly recognized as the underlying causes of many conditions in general medicine and family practice for which, even after prolonged investigation, no physical basis can be discovered.

This is the second of two papers dealing with the classification of affective disorders in which the relationship between anxiety states and depressive illnesses is examined. The question at issue is whether a line of demarcation may be drawn between the two disorders or whether they are more appropriately regarded as merging insensibly along a continuum of affective disturbance.

While detailed and systematic studies have been carried out on the course and outcome of manic-depressive psychoses (Kraepelin, 1921; Rennie, 1942; Poort, 1945; Lundquist, 1945; Astrup et al., 1959; Olsen, 1961; Bratfos and Haug, 1968), depressive illnesses (Lewis, 1936; Kay et al, 1969) and anxiety states (Miles et al., 1951; Eitinger, 1955; Greer and Cawley, 1966), there is little information concerning the prognosis of affective disorders as a whole.

That a distinction may be made on clinical grounds between anxiety states and depressive illnesses has been affirmed by some authors (Garmany, 1956, 1958; Stenbäck, 1963), and rejected by others (Mapother, 1926; Conrad, 1958; Ey, 1963; Lewis, 1950–1966). This problem is also of interest from a biological point of view in that anxiety neuroses represent in an exaggerated form an emotion that is ‘directly serviceable’ (Cannon, 1928) and one which has potential survival value for the organism. Moreover, analogous conditions can be reproduced experimentally in animals, while no convincing models have so far been described of states akin to depressive illnesses (McKinney and Bunney, 1969).

The classification of depressive illness continues to be a subject for dispute. Studies in many areas support the view that there are two distinct forms of depression, but until techniques of multivariate analysis became available it was difficult to obtain definite support for either the unitary or the binary view.

Obsessional neurosis, inasfar as it comes to the attention of the psychiatrist, is a comparatively rare disorder, comprising not more than about 3 per cent of all cases of neurosis. Its rarity is reflected in the fact that the largest series so far described, that of Pollitt (1957), consisted of only 150 cases, though a limited amount of information has been available from the somewhat larger series of the Bethlem-Maudsley Hospital (Blacker and Gore, 1955) and of the Registrar General (1964).

To demonstrate how 'senile dementia emerged as an important psychiatric concept is not an easy task. Although the history of general psychiatry can be satisfactorily traced to the spirited endeavours of Hippocrates (460–375 B.C.), Celsus (circa 30 a.d.), Soranus the elder (circa 100 a.d.), and Aretaeus (circa 150 a.d.), the psychiatry of old age unfortunately lacks such a clear and well-defined genealogy. The term 'senile dementia’ itself seems to have been first used by Aretaeus, the physician of Cappadocia, but exactly how it had evolved and how it was differentiated, if at all, from normal senescence is not at all clear. Certainly modern psychiatry has inherited a wealth of graphic description of old age in general, and for a detailed account of the relevant ethnographic literature the reader is referred to the excellent article by Rosen (1961). From a scientific point of view, however, it is unfortunate that the spirit of enquiry and the descriptive contributions of the early writers seem to have been tempered more by the degree of optimism or pessimism with which they anticipated the intellectual and behavioural foibles of old age, than by a desire to explore and evaluate systematically its possible deviations.