Schizophrenia research embodies a microcosm of the vexing problems that confront the behavioural sciences, but particularly those disciplines concerned with psychopathology. We are ignorant of the means to prevent schizophrenia because we continue to be ignorant about its aetiology. Despite recognizable descriptions of the syndrome in ancient Hindu treatises (c. 1400 b.c.) and 76 years after its designation as dementia praecox by Kraepelin (1896), we are still grappling with such basic issues as when and how to diagnose Eugen Bleuler's (1911) ‘group of schizophrenias' (cf. Katz, Cole, and Barton, 1968). Despite brilliant advances in molecular biology, neurochemistry, and brain-behaviour phenomena generally, we cannot pinpoint any necessary biological defect in all or most schizophrenics. Despite selfless expenditures of time and energy by gifted psychotherapists and sophisticated social science efforts, we cannot specify any necessary life experience, either at the level of the family or of a culture, common to all or most schizophrenics. While there is obvious merit in casting the problem in an interactionist framework, aetiology still defies an easy solution because we must then isolate what element(s) in the genotype interact with what element(s) in the internal and/or external environment (as well as when and how) to produce the phenotype we recognize as a schizophrenic one.

Recent family studies of manic-depressive psychosis have emphasized the role of genetics in the aetiology of this bipolar illness (3, 8). However, the mode of genetic transmission is still unknown, the main controversy being between major gene and polygenic inheritance. Furthermore, it is not yet evident whether bipolar illness constitutes a homogeneous entity or whether it may be subdivided into different genetic subgroups. Mendlewicz, Fieve, Rainer, and Fleiss (1) recently produced some evidence that bipolar psychosis can be differentiated into two subgroups on the basis of family history data. Two matched samples of 30 patients each were studied, distinguished by the presence or absence of bipolar illness in their first degree relatives. The patients with a positive family history (FH+) in first degree relatives showed earlier onset of illness and more psychotic symptoms occurring in the manic phase. Alcoholism, if present, was of an episodic pattern. In patients with a negative family history (FH—), there was a later onset of illness; psychotic symptoms occurred usually in the depressive phase; and alcoholism, when present, tended to be chronic.

Several researchers, among them Penrose (1944), Slater and Woodside (1951), Pond et al. (1963), Kreitman (1962, 1968) and others, have found that psychiatric disturbance occurs in both members of marital pairs more often than can be expected by chance. It appears that symptoms in the spouse are more evident when it is the husband who is the patient, and that neurosis rather than psychosis is associated with higher levels of disturbance in the spouse (Kreitman, 1962, 1964).

Lindemann (6) first used the term ‘anticipatory grief’. It referred to the separation of two people with one anticipating the death of the other and preparing for it to such an extent that on the return of the other there is rejection rather than happy acceptance. In his example a soldier returning from combat complained that his wife no longer loved him and was seeking a divorce. After seeing the man, Lindemann attributed the problem to the wife's ‘anticipatory grief. It seems there could be other explanations to his example.

In a previous paper (Kniveton and Stephenson, 1970) we suggested that children with few interests of their own are likely to be more susceptible to the influence of filmed or television models than children with more extensive interests. However, neither we nor any other workers in this field have demonstrated that the tendency to imitate is a consistent behavioural characteristic. In fact, examination of the within-group scores for the subjects in the above-mentioned experiment reveals exceptionally large standard deviations for the amount of time spent imitating. These characterize both middle-class and working-class groups (Kniveton and Stephenson, 1972), although such groups differ consistently in their susceptibility to the filmed model used by the authors.

On 13 May 1969, intercommunal rioting broke out between the Malay and Chinese sections of the population of Kuala Lumpur and continued for a full week. Subsequently a state of emergency was proclaimed, parliamentary government was suspended and the country was placed under the rule of the National Operations Council (a council of top ministers, civil servants and the chiefs of the armed forces and police) which ruled by edict.

The dangers of transcribed drug lists were emphasized in the Aitken Report (1) and by Trillwood (2). Subsequent work by Crooks (3) and by Wallace (4) has demonstrated the disturbingly high level of transcription errors in other centres.

To rely on a system of drug administration based on a transcribed drug list is to court disaster. The high incidence of errors of transcription has been documented by Crooks (1964) (1), Wallace (1965) (2), Watt et al. (in press) (3).

Lindsten (5), Mellbin (7), and Pitts and Guze (8) have described a total of three cases of anorexia nervosa occurring in conjunction with gonosomal aneuploidy (Turner's syndrome or gonadal dysgenesis with XO sex chromosome pattern). The incidence of both conditions is low, and the small likelihood of their concurrent appearance in one individual by chance can be estimated from the following figures. According to Maclean et al. (6), the XO chromosome abnormality occurs in four out of 10,000 live births. Baikie et al. (1) have found that the incidence of the XO gonosome pattern in the general population is not significantly different from that at birth. Anorexia nervosa has an average annual incidence of 45 (Theander (9)) or 61 (Kidd and Wood (4)) cases per 10,000,000 people. On the assumption that the two conditions are independent, the probability of their occurring together would therefore be 0.18 to 0.24/100,000,000. Since the incidence data for the XO anomaly and for anorexia nervosa were obtained from different populations, it must be recognized that these figures are only order of magnitude estimates. Nevertheless, we considered it of interest to examine the available case records of anorexia nervosa patients seen at the University of Iowa Hospitals from 1920 to 1972 for Turner's syndrome and other anomalies of the urogenital tract.

The successful investigation and development of effective treatment programmes for any disorder is closely dependent on the development of reliable and valid assessment procedures. Anorexia nervosa would seem to be no exception in this respect. At present, while the diagnosis of anorexia nervosa seems fairly easy to establish, the assessment of severity, response to various treatment regimes, and prognosis pose rather more of a problem. Reliance on criteria such as weight status and gain, return of menstruation, psychosexual adjustment, etc., is inadequate, especially in the assessment of short-term effects of various therapeutic conditions. Recently Slade and Russell (1972) have described an objective technique for measuring ‘perception of body size‘, an area in which they found anorexia nervosa patients to be defective. Clearly, however, other reliable, objective assessment techniques are needed as well.

Goldstein (1962) and Frank (1963) have emphasized the importance in the treatment process of the patient's and therapist's assumptive world. A number of authors have related certain personality variables, such as thinking introversion, to choice of medical specialty and orientation to treatment on the part of the doctor. The immediate fore-runners of the present investigation are the reports of Caine (1970), Smail (1970) and Caine and Leigh (1972), in which a test of ‘direction of interest‘, in terms of an interest in the external world rather than in the internal world of thoughts and feelings, and a test of ‘conservatism’ were found to relate to nurses' attitudes to patient care and patients' symptomatology and treatment expectancies. This report is an extension of the search for the personality variables underlying patient and therapist expectancies. A third variable, namely convergent-divergent thinking, as defined by Hudson (1966), has been added. Convergent-divergent thinking has to do with whether one prefers to converge on a single solution to a problem or whether one prefers to investigate several possible solutions. Personality variables similar to the ones with which we have been working have been described in association with these thinking types.

It has frequently been argued that requests for cosmetic rhinoplasty, particularly in patients with minimal disfigurements, may be indicative of psychological disturbance. Authors such as Meerloo (1956) and Roubichek (1960) have further argued that corrective operations in these minimally disfigured patients are contra-indicated, as the patients are always dissatisfied by surgery, sometimes demanding restoration to the original state.

Renal dialysis has been a life-saving miracle for the ‘chosen few‘, but has created major moral, social, financial, psychological and interpersonal problems.

Acute alcohol intoxication is commonly followed by partial or total amnesia† for events occurring during the drinking period (Goodwin et al., 1969a). Individuals observed during the ‘blackout’ period have been noted to have a specific short term memory deficit, with remote and immediate memory largely intact (Ryback, 1970; Goodwin et al., 1970; Tamerin et al., 1971). The amnesia appears to be anterograde rather than retrograde, resembling the characteristic memory deficit in Korsakov's syndrome. Speculation has ensued that blackouts and Korsakov's syndrome may share common pathophysiological elements, though there is no direct evidence for this (Goodwin et al., 1969b).

Durkheim directed attention to the suicide rate seen not merely as the sum of individual acts of suicide but as the product of factors which affect the group or society as a whole. The study of suicide rates of different societies thus involves the study of their social structures and leads to inferences about the effects of differences in their cultural, social, psychological and religious composition. Such inferences are based on the assumption that differences in suicide rates are valid and not merely artefacts resulting from differing ascertainment procedures.