In recent years there has been an increasing interest in the observation that rates of psychiatric disorder and of educational problems in children may vary considerably according to area and to types of living conditions. However, very little is known concerning the extent to which rates actually differ, and even less about how particular area characteristics co-vary with the rates of different types of child disorder. Gath et al. (1972) found that child psychiatric referral rates were higher in areas of low social status, but data were not available to determine whether the difference lay in the preyalence of disorder or in the likelihood of detection or referral. Reading backwardness has also been associated with low social class areas (Miller et al., 1957; Eisenberg, 1966). In addition, it has been found that reading standards are lower in England than in Scotland (Davie et al., 1972). None of the studies of reading have taken IQ, into account, and it is not known whether the correlates are mainly with IQ or with a specific disability in reading. The present investigation was designed to examine these issues by determining if there were differences in the rates of child psychiatric disorder and of specific reading retardation between an inner London borough and the Isle of Wight. If differences were found, it also sought to examine the reasons for them, in order to elucidate possible causal or precipitating factors.

It is generally thought that there is considerable regional variation in rates of educational retardation. American studies have shown that reading difficulties are considerably more prevalent in areas of low social status (Miller et al., 1957; Eisenberg, 1966), and Eisenberg (1966) found that inner city children had the lowest reading attainments. The National Child Development study (Davie et al., 1972) showed that reading standards were higher in Scotland than in England, and the Inner London Education Authority (1970) has shown that London primary school children have an average reading level below national norms. In south-east England, Morris (1959 and 1966) showed that levels of reading skills varied according to the characteristics of the schools the children attended. In Japan, a survey using teacher judgements has suggested that the prevalence of reading disability is greatly below that in Western countries (Makita, 1968).

Large differences have been found between the Isle of Wight (IOW) and a (former) inner London borough (ILB) with respect to the rates of emotional (neurotic) disorders, conduct disorders and specific reading retardation in ten-year-old boys and girls (Rutter et al., 1975; Berger et al., 1975). This paper presents preliminary considerations on possible reasons for these differences. Any explanation must account for the fact that the differences in the rates apply to three rather disparate disorders. The epidemiological characteristics and psychosocial correlates of emotional disorders in childhood differ quite markedly from those of conduct disorders, and it appears highly likely that the causes of the two disorders are different (Rutter, 1965, 1970a; Rutter, Tizard and Whitmore, 1970). Although specific reading retardation overlaps markedly with conduct disorders, to a considerable extent it seems to have a separate set of aetiological influences (Rutter and Yule, 1973). Furthermore, there is little association between specific reading retardation and emotional disorder in childhood. It is also notable that the higher rates of disorder in London compared with the Isle of Wight apply just as much to girls as to boys, in spite of the marked differences between the two sexes in the correlates of psychiatric disorder (Rutter, 1970b).

Psychiatric problems were assessed in two groups of adoptees by interviewing the adopting parents. One group of 59 adoptees, the ‘experimental’, were born of psychiatrically disturbed biological parents; the other group, the ‘control’ of 54 adoptees, had psychiatrically ‘normal’ biological parents. Both groups had been separated from biological parents at birth.

The incidence of psychiatric conditions requiring professional care was significantly higher in the experimentais than in the controls (37 per cent vs. 14 per cent). In the experimental group more males than females were disturbed (59 per cent vs. 30 per cent). Most of the excess of disordered males were diagnosed hyperactive. There was some evidence of correlation of the type of psychiatric diagnosis of the biological parent with that of the adoptee.

The recommendations on postgraduate training made by the World Health Organization, the Nuffield Provincial Hospitals Trust and the Royal Medico-Psychological Association are examined in the light of modern concepts of educational objectives. In this country no well defined, specific, assessable and detailed objectives have yet been formulated for postgraduate training in psychiatry.

The function of religion in human society is complex. The part played by religion in psychiatric disorders is even more obscure. Previous literature and theories are divided into two groups: one school believes that intense religiosity is a symptom-complex indicative of psychiatric disorder, while the opposing view is that religious belief in some way acts as a defence mechanism protecting the individual and his psyche.

The present study of 50 Jehovah's Witnesses admitted to the Mental Health Service facilities of Western Australia suggests that members of this section of the community are more likely to be admitted to a psychiatric hospital than the general population. Furthermore, followers of the sect are three times more likely to be diagnosed as suffering from schizophrenia and nearly four times more likely from paranoid schizophrenia than the rest of the population at risk.

These findings suggest that being a member of the Jehovah's Witnesses faith may be a risk factor predisposing to a schizophrenic illness. Further studies would be interesting in investigating whether pre-psychotic people are more likely to join the sect than normal people and what part (if any) membership has in bringing about such a breakdown.

In a cross-national comparison of the frequency of occurrence of various diagnoses among elderly psychiatric patients admitted to public mental hospitals in London and New York, a short battery of psychological tests was administered to all patients independently of psychiatric examination. The psychological assessment was focused on the differentiation between dementing and affective disorders. The test performance showed a highly significant difference between the two groups as diagnosed, and when patients were allocated to groups on the basis of tests alone these allocations showed a high rate of agreement with initial psychiatric diagnosis. There was a similar high rate of agreement between test allocation and hospital diagnosis in the U.K., but this was not so in the U.S.

No significant differences were found between the test performance of U.K. and U.S. patients, except on the WAIS Vocabulary and the Angles Error measurement of the Bender-Gestalt test. When the effects of age and Vocabulary score were eliminated these differences disappeared.

The hypothesis that the diagnosis of affective disorder would be confirmed by a relatively greater improvement in test performance over time in this group of patients was not upheld by the non-parametric analysis of change scores. However, an analysis of covariance utilizing age and initial score did indicate the expected differential improvement.

Previous research suggests, though by no means consistently, that schizophrenic patients may be less able than normals to predict the speech of other people, and that schizophrenic speech is less predictable than normal speech. The present experiment tests these two suggestions and also a third possibility, that the difference between schizophrenic and normal speech is less marked for schizophrenics asked to make the predictions than for normals. Twelve schizophrenic patients recently admitted to hospital, and twelve comparable, psychiatrically normal, orthopaedic patients, were asked to predict both schizophrenic and normal speech, using Cloze Procedure, under both fourth-word and fifth-word deletion. The first hypothesis was upheld, but the second and third received only very limited support. The findings are discussed in the light of previous work, and suggestions are made for future research.

In 1972 three old hospitals were closed and patients transferred to a new hospital for the mentally handicapped. Four to six weeks before transfer, disturbed and a sample of non-disturbed patients were rated on a selected scale; they were again rated four to six weeks after transfer. The disturbed patients numbered 39 per cent of the total and both men and women shared a significant improvement, though the men did not improve to the same extent as the women. There was also a significant improvement among the non-disturbed patients, though this did not apply to the epileptic patients.