This paper presents findings related to the measure of stress in 641 schizophrenics (125 acutes and 516 chronics) and 95 comparable normals. Stress was defined as an imbalance between environmental demands and the respondent's ability to meet that demand successfully, and was measured in terms of level of stress experienced in relation to specific problem situations. Twenty-one dimensions of stress were measured, subsumed under the following four general areas: social performance, family interaction, social interpersonal interaction, and social maladaptive activities.

Results indicated that, in general, normals experience significantly less stress in dealing with life events than do schizophrenics. Within the schizophrenic group, the pseudo ambulatory chronic patients evidenced more stress than did their acute counterparts, a finding not previously described in the literature.

Implications of these findings do not support the present community after-care concepts. Discharged chronic schizophrenics appear unable to remain in the community for any reasonable period of time because of the high level of stress under which they function.

25-year-old female patient with a psychotic illness lasting three months in which schizophrenia and depressive episodes occurred was studied by serial EEGs. These were coded, masked and rated in a set way without knowledge of the clinical state. It was found that the schizophrenic state was characterized by a decrease in the amount and poor organization of alpha activity, as well as the occurrence of paroxysmal phenomena in particular atypical spike and wave. In the depressive episode, alpha activity was prominent and only scanty paroxysmal features were seen. Using these criteria a series of EEGs from psychiatric patients were assessed ‘blind’ with a view to separating them into either a schizophrenic or a depressive category. This proved possible in 17 cases (9 depressive and 8 schizophrenic). In only two was the categorization completely misjudged. These results suggest that further detailed study of the EEG, possibly with computer analysis, combined with assessment of the behavioural state might not only yield useful diagnostic information but also lead to a better understanding of the underlying neurophysiological basis of certain mental disorders.

The brain stems of 24 mental hospital patients and 10 control patients were examined. Ten mental hospital patients were either deluded or auditorily hallucinated in clear consciousness, and of this group 8 presented with a diagnosis of schizophrenic syndrome. The nature and significance of lesions found in the midline reticular nuclei and the trigeminal n. are discussed. The results, and the dearth of other published material on this subject, indicate the need for further work in this field.

Psychiatric diagnosis in the elderly has been examined in order to extract the information which leads to later modification of the diagnosis. Initial diagnoses of neuroses and toxic states were least stable, 14 out of 29 changing to a different category. Information from relatives and further interviews contributed most to the modification of the initial diagnosis, though affective and neurotic syndromes were particularly susceptible to change resulting from conceptual differences, and dementia to change consequent on physical examination.

It is concluded that an adequate initial interview of a patient and his next of kin will achieve a diagnosiswhich iscorrectin itsmajor categoryon 95 per cent ofoccasions.

Premenstrual tension (PMT) has hitherto not been accurately defined. The term refers to a cluster of symptoms, both psychological and physical, which appear episodically in relation to the phases of the menstrual cycle—either strictly in the premenstruum (Rees, 1953), or also at other times, such as at ovulation (Dalton, 1964). Most previous studies of the syndrome have been ‘retrospective’, i.e. women have been asked to report the presence of PMT during a previous cycle. McCance, Luff and Widdowson (1937) and Altman, Knowles and Bull (1941), who required their subjects to chart mood state daily, pointed to a discrepancy between the frequency of the condition as reported in studies using retrospective questioning and in their own findings. It is hardly surprising that there is controversy concerning the prevalence of a condition which is so poorly defined as is PMT.

The educational attainment of 100 school-phobic youngsters was compared to that of 100 other psychiatric patients, using the reading quotient as the main measure. Age and IQ were allowed for. RQs were, on average, higher in the school phobic group than in the other subjects, except in a small number of younger children of high IQ. Additional comparisons with another group of psychiatric patients and with the general population, using regression equations, failed to provide any evidence of poor educational attainment in school phobia.

The stability of sleep was examined in two kinds of induced insomnia, namely after caffeine administration and after hypnotic drug withdrawal. The duration of each episode of any one sleep stage or any episode of intervening wakefulness plus drowsiness was determined.

After caffeine mere was an increase in longer episodes of intervening wakefulness plus drowsiness, but no significant change in the episode duration of any of the sleep stages. In the case of drug withdrawal there was no change in the episode duration of intervening wakefulness plus drowsiness, but there was a significant shortening of episode duration in sleep stages 2 and 3 +4, with a similar trend for REM sleep episodes.

Caffeine ‘insomnia’ thus seems characterized by increased stability of wakefulness, and hypnotic withdrawal ‘insomnia’ by decreased stability of sleep. The type of analysis undertaken in this study could increase understanding of other types of insomnia.

The subject of impotence has hardly been approached in the Arab countries though sexual dysfunction of a functional nature is of no less importance there than elsewhere.

A group of 46 bipolar probands and their first degree relatives were studied. A high rate of affective disorder (19.6 per cent) was found, including both unipolar (13.2 per cent) and bipolar (6.4 per cent) types, with females predominating (3: 1). The presence of four father-son pairs suffering from affective disorder made the hypothesis of X-linked dominance untenable. Results compatible with polygenic inheritance were found, using both Slater's and Falconer's methods. There was no evidence for assortative mating or for increased total number of females (both well and ill) among first degree relatives. The probands and affectively ill first degree relatives who have died show an alarmingly high rate of suicide (46 per cent). Other forms of mental disorder, including alcoholism, were no more common than in the rest of the community.

An analysis of the drug regimes prescribed to two separate groups of unselected schizophrenic patients indicates certain trends of clinical importance. The results demonstrate a need for the adoption of a personalized dose regime. The scatter of dose regimes found effective is too great to recommend a standardized approach to the prescription of L.A.P. injections.

Two other results of particular significance are that the dose of drug required to control symptoms can be gradually reduced in nearly half of patients, and that helpful trends in prescribing were identified that will help the clinician to abolish side-effects.

A survey of 351 accidents occurring in a two-year period in a psychiatric hospital showed that 77 per cent of the accidents involved female patients and 48 per cent involved patients with organic psychoses; 236 accidents were falls and 280 occurred in the ward setting.

In 277 instances adequate controls were available. Seventy-five per cent of the accident patients had received a psychotropic drug on the day of the accident as opposed to 61 per cent of the controls. The possibility that the side-effects of psychotropic drugs may have contributed to some of these accidents is discussed.

Lithium was given to eight aggressive, non-manic-depressive female defectives in a double-blind placebo-controlled study. The group as a whole showed a reduction in aggression scores while on lithium (p < 0.01): three patients became less aggressive, one became worse and two were unchanged. Both affective and predatory aggression seemed to be reduced. Two patients had to be withdrawn from the trial at an early stage because of the development of neurotoxicity.

R.B.C./plasma lithium ratios showed a wide inter-patient variation in this group of non-manic-depressives.

The study adds further weight to evidence that lithium has an antiaggressive effect at normal therapeutic dosage in non-manic-depressives. The implications of this for hypotheses about the mode of action of lithium and its putative specificity for manic-depressive psychosis are discussed.

A technique of psychotherapy seemingly compatible with psychoanalytical knowledge is described, and compared and contrasted with psychoanalysis. Its mode of action, efficacy, advantages and difficulties, and its suitability for once-a-week individual or group psychotherapy and therefore for Health Service use is discussed.

An attempt to compare observers’ evaluations of aspects of group psychotherapy with the patients’ assessments of the same selected variables (i.e. ‘acceptance’, ‘abreaction’ and ‘improvement’) is described.

Correlation coefficients between the observers’ and clients’ rankings of these factors were obtained, and the implications of the findings are discussed in relation to each group.

The anatomical distribution of 25 stereotactic tractotomy lesions is described. The posterior half of these lesions lie in a subcaudate position and the anterior half, for the most part, lies beneath the central segment of frontal white matter.