To achieve a successful marital partnership is probably the most difficult of life's social requirements, whether successful is defined biologically as the production of healthy offspring or in the more human terms as achieving a relationship which allows each partner to lead a satisfying life. To be successful each marital partner must often defer to the other, especially if there are dependent children present. Failure to show this capacity to defer or to be unselfish inevitably leads to conflict, and conflict can easily build up to the point of violence. The ethological study of animal reproduction, including that of primates, shows how universally true this is and what a wealth of convention and ritual is developed to reduce such dangerous confrontation.

Ferenczi (1927, orig. 1911) thought that on clinical grounds he had clearly established two types of homosexual males. One type combined masculinity and a preference for pubescents, and the other type combined femininity with a preference for physically mature partners. However, Hirschfeld (1920, p. 267, 277, orig. 1914), who had examined a very large number of homosexual males, doubted the existence of any relationship between femininity and age preference.

Most studies on the personality of homosexuals have been based on patients or prisoners (e.g. Cattell and Morony, 1962), and much less is known about those who do not fall into these categories. This report summarizes a comparison of the personalities of a sample of normal British homosexuals with a patient group who sought treatment. It was hoped through this investigation, an offshoot study of a major treatment programme for homosexuals, to determine the relationship between personality characteristics and referral for treatment; also to obtain further information about the personalities of non-treatment-seeking homosexuals.

While there is general agreement that deafness, either congenital or acquired in early childhood, is psychologically damaging (Oléron, 1953; Furth, 1961; and Vernon, 1966), opinions are divided on the adverse effects that deafness beginning in adolescence or in adult life may have on mental health. For example, Furth (1966) has reported that the way of life of the adult deaf should not be all that different from people with normal hearing, although it has been generally held that deafness in adults predisposes to the development of irascibility and paranoid attitudes (Kraepelin, 1915; Slater et al., 1969). The relationship between deafness and paranoid illness has been investigated by Houston et al. (1964) and Kay et al. (1961).

Beginning with the work of Cameron (1944), the concept of overinclusive thinking has been used to describe or account for the thought disorder observed in schizophrenic patients. This is usually defined as an inability to preserve conceptual boundaries, perhaps based on a cerebral input dysfunction which causes difficulty in filtering stimuli (Payne et al., 1959; McGhie, 1970; Epstein, 1953; Broadbent, 1958). This leads the schizophrenic to make remote associations and to overgeneralize or overabstract.

Various reports have suggested that the urinary excretion of adenosine cyclic 3'5’ monophosphate (cyclic AMP) is increased in mania and decreased in depression. However, our own serial studies from short-cycle bipolar manic-depressive patients showed no correlation between mood and cyclic AMP excretion (2). Jenner et al. (4) confirmed our findings, except in the case of a patient with a regular 48-hour mood cycle who did show a correlation between his mood changes and changes in cyclic AMP excretion. Paul et al. (5) also reported a general lack of correlation between these variables, but found a transient increase of urinary cyclic AMP during the rapid switch from depression to mania. We have investigated the situation in a bipolar patient who shows such a rapid switch in mood but have been unable to demonstrate any increase in cyclic AMP excretion during the switch period.

In Orthomolecular Psychiatry; Treatment of Schizophrenia, edited by David Hawkins and Linus Pauling (1973), Beebe and Wendel (pp. 278–302) report a high correlation coefficient of r = 0.99 (which we calculate gives N = 42, p very much lower than 0.001) between whole blood glucose and adenosine triphosphate (ATP). This relationship they claim is no longer maintained in schizophrenics with anxiety, r = 0.16 (N = 62, p > 0.1). Erban and Hanzlicek (1966), Hansen (1972) and Hansen and Dimitrakoudi (1974) have suggested a possible significance of whole blood ATP in psychoses, and Naylor, Dick, Dick, Le Poidevin and Whyte (1973) have implicated red cell Na/K ATPases. The mechanisms involved in controlling blood ATP seemed therefore worthy of study especially if they are so dependent on glucose.

The systematic search of aetiological agents from a variety of slowly progressing or subacute neurological diseases has revealed causative viruses or virus-like agents from kuru, Creutzfeldt-Jacob disease and other forms of presenile dementias, subacute sclerosing panencephalitis, progressive multifocal encephalopathy, and from many similar neurological diseases in animals (Gajdusek and Gibbs, 1973; Gajdusek, 1973). The first two diseases called subacute spongiform virus encephalopathies (Gajdusek and Gibbs, 1971) have many interesting features including heredo-familial occurrence and totally non-inflammatory neuropathology. Thus the epidemiology of these diseases is not typical for diseases with infectious aetiology, and the histopathological studies do not suggest the presence of extremely high-titred infectious material in brain cells.

This paper reports a study of maternal psychiatric illness in school-phobic adolescents admitted to a psychiatric in-patient unit. These cases have been previously described and studied in various ways (Berg, Nichols and Pritchard, 1969; Berg, 1970; Berg and McGuire, 1971; Berg, Butler and McGuire, 1972; Berg and McGuire, 1974).

School-phobic youngsters have sometimes been described as wilful and stubborn in the family situation (Hersov, 1960), and this tendency has been invoked to explain the particular occurrence of school phobia in early adolescence (Leventhal and Sills, 1964). The emotional upset shown by these young people when faced with the prospect of going to school (Berg, Nichols and Pritchard, 1969), may occasionally appear to be more in the nature of anger, defiance and temper than either fearfulness or misery (Smith, 1970). The fact that in the general population dislike of school is reflected in actual absence only during the secondary school years (Mitchell and Shepherd, 1967) supports the view that assertiveness, which presumably becomes more effective as the child reaches the teens, plays some part in school refusal.

Since the implementation in April 1968 of the 1967 Dangerous Drugs Act, it has been illegal for any doctors except those working in drug centres to prescribe heroin. With the consequent introduction of the methadone maintenance clinics there has been a definite change in the overall pattern of addiction, largely governed by drug availability. It is difficult to estimate the extent of dependence on, or misuse of, barbiturates, but it is likely that the figure for the United Kingdom may be in the order of 150 to 250 per 100,000 (Bewley, 1970). In a recent study of sedative abuse, Mitcheson et al. (1970) found that 95 per cent of the heroin addicts interviewed had used sedatives.

The object of this paper is to consider the proposition that some kinds of critical change in a person's life experience bring about a change in his sense of identity which is not subjectively recognized and acknowledged until between one and two years after the critical event or initiation of the critical change.

Hoenig (1967) has recently and comprehensively summarized the extensive literature on the prognosis of schizophrenia. In a section on existing prognostic tests he criticizes the vagueness of the items to be scored, the variety of prognostic criteria and the low validity of the resulting scales. The present paper describes an attempt to devise a new prognostic test, using material which was originally collected in order to study the cost of rehabilitation.

Since the beginning of the century, group methods have played an increasingly important role in the treatment of patients suffering from psychological or physical disorders.

Although there have been reports of psychotic reactions to benzhexol hydrochloride in adults we have not found any reports of adverse reactions in children. Recently, at the in-patient psychiatric unit of the Hospital for Sick Children, Great Ormond Street, London, we have seen two children who developed acute psychotic reactions when treated with benzhexol hydrochloride given to prevent extra-pyramidal side effects. In both cases, complete recovery occurred rapidly when benzhexol was discontinued.

A previous paper (Malcolm and Madden, 1973) has described the use of disulfiram implantation as a method of treatment for some alcoholics. The results obtained were satisfactory, measured in terms of duration of abstinence and social improvements made in the post-implant period. However, it was suggested that the success of the implant might be due to psychological rather than pharmacological factors. In an effort to clarify the nature of any deterrent effect of the implant, further clinical and biochemical evidence has been collected.

The memory loss that follows a series of electroconvulsive therapy (ECT) treatments has been well documented. The amnesia appears to involve an impairment in the ability to acquire new memories, an impairment of memory for events that occurred shortly before ECT (Dornbush, 1972; Williams, 1966), and an impairment in the ability to recall material from remote memory (Janis, 1950; Squire, 1974a). Several characteristics of the anterograde amnesia produced by ECT have been the subject of contradictory reports. For example, it has been reported that memory functions can improve markedly or even return to pre-ECT levels within hours after the last of a short series of treatments (Brengelmann, 1959; Zinkin and Birtchnell, 1968; Zirkle, 1956). Yet, it has also been found that amnesic effects of a short series of treatments can be detected for weeks (Cronin, Bodley, Mather, Gardner and Tobin, 1970; Halliday, Davison, Browne and Krieger, 1968). Moreover, some reports suggest that memory recovers at the same rate following each of the first few treatments in a series (Brengelmann, 1959; Zinkin and Birtchnell, 1968), whereas other reports demonstrate that the effects of the first few treatments on memory can be cumulative (Bidder, Strain and Brunschwig, 1970). One explanation for such variant findings is that different memory tests have been employed in these studies. To obtain accurate estimates of the effects of ECT on memory, tests used to assess memory should be as sensitive as they can be to memory impairment. This point is particularly relevant, of course, to the evaluation of long-term effects of ECT on memory. Patients who had sustained partial temporal lobectomy could perform normally in tests of immediate reproduction from memory, but were markedly impaired in tests that imposed long delays between learning and retention (Milner, 1958). Apparently tests involving delayed reproduction from memory are a more sensitive index of organic memory dysfunction than tests that involve immediate reproduction. The present study assessed the ability of patients receiving ECT to retain newly learned material for 30 minutes and 24 hours. The results of these delayed retention tests demonstrate that recovery from anterograde amnesia is quite gradual and that the effects of the first few ECT treatments on memory are cumulative; and underscore the value of such tests as sensitive indicators of possible long-term effects of ECT on memory.

In 1959, J. M. Roberts claimed that in 50 depressed women aged 40–60 years the response to the intravenous injection of 15 mg. methylamphetamine differentiated significantly between those diagnosed as ‘psychotic’ and those diagnosed as ‘neurotic’. Following the injection each patient was observed closely for two to three hours, and in the great majority one of two responses occurred. Either the patient experienced a ‘sustained period of general uplift of mood and a feeling of greater well-being'—the ‘normalization’ response; or the patient showed ‘an immediate, or almost immediate, intensification of symptoms, particularly a worsening of any agitation present, often together with a deepening of the depressive affect'—the ‘intensification’ response. In only two patients, both with neurotic depression, was it not possible to classify the response.

All the papers about flat dwelling (Central Housing Advisory Committee, 1952; Hopper, 1962; Hird, 1966; Fanning, 1967; Gunn, 1968; Gilloran, 1968 and Stewart, 1970) except one (Sheerboom, 1962) state that it has an adverse effect on mental health. They are almost unanimous in naming the care of children as a cause. The best study from a scientific point of view (Fanning, 1967) showed a significantly higher rate of psychiatric consultations among those living in the same flats as in the present study. This was thought to be due to social isolation caused by the nature of the flats and being confined in them by children. A widely held belief that bad housing can cause or aggravate mental illness is not justified by the evidence. Three investigations (Martin, Brotherston and Chave, 1957; Wilner, Walkley, Schram, Pinkerton and Tayback, 1960 and Hare and Shaw, 1965) failed to show any benefit to mental health from new housing. The only one (Taylor and Chave, 1964) to find an improvement studied new housing which was socially planned. All four studies failed to allow for two other variables. One was the adverse effect of the move itself (Maule and Martin, 1956; Hall, 1964 and Shepherd, Cooper, Brown and Kalton, 1966) on those in new housing. The other was moving to better old housing among controls (Wilner et al., 1960).