For a social group to develop, two opposing adaptive processes must be reconciled—mechanisms for developing cohesion and mechanisms for establishing a dominance hierarchy. The formation of stable groups provides significant evolutionary advantages: a source of protection, increased reproductive opportunities, and a larger store of survival strategies than any one individual could encompass. A recent theory of human evolution (Reynolds, 1981) stresses that social behaviour would seem to be the most likely single cause of the origin of human intelligence, if one origin must be isolated. Current interest in the biological basis of behaviour has been focused particularly on specific diagnostic categories and biochemical mechanisms. This paper reviews a different research tradition, based on ethological principles, and applies the findings to an understanding of human group behaviour.

In the spring of 1985, a party of psychiatrists from Great Britain and Ireland visited four major Chinese cities—Beijing (Peking), Shanghai, Nanjing (Nanking) and Guangzhou (Canton), as a study tour of the Royal College of Psychiatrists, under the auspices of the Chinese Medical Association. A number of psychiatric hospitals were visited and there was opportunity for many discussions with psychiatrists and other professional staff. This paper records some impressions of the psychiatric services and practices that were observed, together with material obtained in discussions. It is hoped that it will update and complement previous reports by Western visitors to China, and thus increase understanding of mental health in China.

The relationship between spouses' levels of expressed emotion (EE) and relapse was examined in a sample of 39 depressed psychiatric hospital patients. Over a nine-month follow-up, 59% of patients with high-EE spouses relapsed, although no patients living with low-EE spouses did so. The results replicate the association found by Vaughn & Left between EE and depression, and suggest that the EE construct has predictive validity in both schizophrenic and depressed populations.

Nineteen patients with an episode of major depressive disorder who did not recover within two years of prospective follow-up were compared with an equal number who recovered within a year of the initial evaluation and remained well through the two-year follow-up date. The groups were individually matched for age, sex, primary/secondary status, and prior duration of episode. The only psycho-social variable that predicted chronicity was increased neuroticism on self-report personality inventories administered during the index evaluation. Early loss, recent life events, and recent social supports were not predictive of outcome.

In an investigation to find the prevalence of the fragile X (Martin Bell) syndrome in a mental handicap hospital, chromosomal investigations were carried out in 196 males selected out of a total of 512, and also in 20 female patients who were related to some of the selected males. Fragile X cells were found in 41 of the males and two of the females; in 21 of the males it was associated with macro-orchidism. The overall prevalence in the hospital for males (8.0%) ranks this syndrome next in importance to Down's syndrome as a known cause for mental handicap.

Drug-related incidents dealt with by ten Accident and Emergency departments in Greater London during July 1982 were compared with those obtained from an identical survey in 1975. The number of incidents remained high, but there was a significant reduction in them and in the number of drug dependent attenders, compared with 1975: hynotic drugs were used in a significantly smaller percentage of drug overdoses, but there was increased use of minor tranquillisers. The possibility of using A & E departments to monitor drug misuse on a Regional basis is discussed.

The outcome of 30 new psychiatric outpatient consultations at which the psychiatrist decided to see the patient once only was examined after 3 months. Patients were referred from general practice, and evaluation was primarily from the viewpoint of practitioners; the majority were satisfied with a single consultation. However, only about half the patients were seen again by their GPs within the 3-month period, and most of the treatments recommended by the psychiatrists were not carried out by the GPs. Suggestions are offered to ameliorate this disturbing state of affairs.

Evidence for an organic component in patients with delusional misidentification syndromes is reviewed and three described who developed the Capgras symptom after a course of ECT which produced a mild organic psychosyndrome. The delusion was a complicating factor during treatment, but remitted in all cases as the organic brain syndrome cleared and the underlying condition improved.

A prime objective in teaching psychotherapy to medical students is to convey a practical understanding of what happens and a sense of the pleasure and responsibility of working with another person to improve the quality of their relationships. In Nottingham an experiential day was developed during the psychiatry clerkship; the teaching is by doing rather than describing, while spontaneity and individual expression are encouraged; the experience is valued by most and forgotten by none; it would be improved by a second experiential day or by a weekly forum for discussion of the personal and patient-care issues raised.

ECG parameters in elderly depressed in-patients were assessed during routine despramine treatment. Significant changes (prolonged PR and PRS intervals and a decreased QTc interval) were found, related only to steady state concentrations of desipramine's major metabolite—2-hydroxy-desipramine. Potentially clinically significant changes developed in 40% of the patients. All serum drug concentrations were within therapeutic limits. Previous assurances about despiramines's cardiac safety in the elderly may need to be re-evaluated.

In a study of cases of recent onset of schizophrenia, schizophreniform psychosis and hypomania (DSM-III criteria), threatening life events were significantly related to the onset of schizophreniform psychosis but not schizophrenia. The results also suggest that threatening events may precipitate hypomanic episodes.

A total of 576 women aged 18–65, drawn from an area in Edinburgh, were interviewed. Data on life events and long-term difficulties over a six-month period prior to interview were gathered and classified according to area of life, the Bedford system, the Edinburgh system, and the independence of the event or difficulty from the subject's own actions. The highest rates of Bedford system ‘provoking’ situations were found in the working class, among those not employed, among women with three or more children under 14, and in the separated, divorced, widowed or cohabitating group. Similar findings emerged for hopeless situations involving choice or loss. Dependent situations were four times more common in the youngest group than the oldest, and showed a high rate among those divorced, separated, widowed, or cohabiting. It is suggested that both dependent and independent life situations should be studied.

Fifty-three urban general practitioners were questioned about alcoholism. They mostly had reasonably good, if sometimes muddled knowledge of the condition, when to suspect it, and how to confirm its presence. Social harms were seen as predominant over somatic ones. The majority had had postgraduate instruction supplemented by reading. Most were prepared to treat alcoholics, and revealed tolerant and sympathetic attitudes towards them and their families. The survey negates the general impression of unwillingness by general practitioners to engage with alcoholism.

Thirty-six acute schizophrenics were randomly assigned to dextro (d)-propranolol or placebo in a double blind trial lasting four weeks. All patients had a fixed dose of haloperidol during the first week, which resulted in an initial improvement in both groups. Thereafter, a deterioration towards base-line was seen. Six patients on placebo, but none on propranolol were treatment failures at the end of three weeks (P < 0.001). Comparison of change in scores from week 2 to 4 showed significantly greater deterioration in the placebo group; d-propranolol thus had a better effect than placebo in sustaining the initial improvement with haloperidol. The overall magnitude of clinical change from pre-treatment scores is small, the majority of the patients showing little or no overall improvement. It is concluded that d-propranolol has a detectable therapeutic effect, which by inference must have a novel pharmacological basis, but this is not as potent as standard neuroleptics.

The characteristics of Asian patients admitted to a Birmingham hospital following deliberate self-poisoning were compared with those of British-born white self-poisoners. Asian patients were more likely to be young, female, and married. They were less likely to have previously self-poisoned, received previous psychiatric treatment, be diagnosed psychiatrically ill, or suffer from a personality disorder. Culture conflict was common among the Asian patients and was present in the majority of unmarried Asian females. The rate of self-poisoning for Asian females was higher than for white females, but for Asian males was lower than for white males.

The nature of causal explanation remains a conceptual difficulty for psychiatric research. Most research workers and clinicians can describe their processes of causal inference with reference to some empirical example close at hand. Yet such demonstrations are themselves based on more fundamental abstract models that are themselves left unstated. Psychiatric classificatory schemata presently used in research possess unwritten, underlying assumptions regarding causality, and these assumptions need examination.

Clovoxamine, an inhibitor of neuronal uptake of both serotin and noradrenaline, was compared with doxepin in depressed patients over four weeks. Antidepressant efficacy was comparable for both drugs, but clovoxamine might have a special degree of efficacy for patients with more severe depressive illnesses.

The prolactin response after ECT in ten female melancholic patients correlated significantly to their prolactin response to i.v. TRH. These findings may suggest an underlying common mechanism between TRH and ECT regarding their PRL releasing properties.

A double-blind cross-over trial of depot flupenthixol in recurrent manic depressive psychosis was carried out. Ail patients continued on lithium. Eleven patients completed the two-year trial. Flupenthixol appeared to have no prophylactic effect.

Bilateral parietal lobe atrophy was revealed by CT scan in a 48 year-old man, with a history of learning difficulties since childhood, encopretic up to the age of eight, and left-handedness. Nevertheless, he earned his living as a skilled potter, though unable to cope with the administration of the business.