Animal studies of alcohol intake can be divided into two groups based on the methodology. General findings of each group will be reviewed especially as they relate to current areas of research interest. Some implications of research findings for theories of alcoholism and drug addiction will be mentioned.

A study is reported of a controlled trial of social intervention in the families of schizophrenic patients at high risk of relapse. The patients were selected for being in high contact with high Expressed Emotion relatives. All patients were maintained on neuroleptic drugs. One half of the 24 families were randomly assigned to routine out-patient care, while the other half received a package of social interventions. This comprised a programme of education about schizophrenia, a group for the relatives, and family sessions for relatives and patients.

The relapse rate in the control group was 50 per cent compared with nine per cent in the experimental group (P = 0.04). The stated aims of the therapeutic interventions were achieved in 73 per cent of experimental families. In these families, no patient relapsed. The results provide evidence for the causal role of relatives' expressed emotion (EE) in schizophrenic relapse, as well as for the therapeutic effectiveness of social intervention combined with drug treatment.

In a comparison between elderly depressed subjects and normal elderly people in the general population, an association was found between severe life events, major social difficulties, poor physical health and the onset of depression. Working class subjects within the general population had a higher incidence of depression and this appeared to be explained by their poorer health and greater social difficulties. Those elderly people who lacked a confiding relationship were more vulnerable to depression. Evidence is presented that the lack of a confidant was a reflection of life-long personality traits.

Language, conceptual, and cultural factors are discussed in relation to a Xhosa translation of the Present State Examination which was administered to a series of 120 consecutive new admissions to a psychiatric hospital.

The experiential events of psychiatric disturbance as defined by the PSE exist in Xhosa-speaking patients and it is a valid instrument.

In a behavioural clinic, over a period of nine years, trainee nurse-therapists treated 65 unusual referrals (8 per cent) out of a total of 800 patients. The remainder had phobic, obsessive-compulsive, sexual and social disorders, which responded encouragingly to behavioural treatment. Of the unusual referrals, useful results were obtained by behavioural treatment for stuttering, hairpulling, tics, and writer's cramp; bulimia is worth further study. Unresponsive conditions included compulsive gambling and obesity.

The responsiveness of eccrine sweat glands to local intradermal injections of carbachol and phenylephrine was studied in six male and six female healthy volunteers and six female patients suffering from anxiety neurosis, using a plastic paint impression method. Carbachol evoked consistently greater responses than phenylephrine. The response to carbachol attained a peak approximately two minutes after injection, whereas the response to phenylephrine attained a peak within fifteen seconds of the injection. Males showed greater responsiveness to both drugs than females, this being reflected in significantly higher maxima of the dose-response curves for the males. The anxious females showed a higher level of spontaneous sweat gland activity and greater responsiveness to both drugs (reflected in higher maxima of the dose-response curves) than the normal females.

The incidence of vegetative symptoms was found to be higher in 61 medication-free patients with anxiety compared to an equal number of age and sex-matched normal controls. Multiple regression analysis identified depression, as rated by Beck Depression Inventory (BDI), as the most highly predictive factor associated with these symptoms. Twenty-two anxious patients who obtained scores less than 5 on BDI (absent or minimal depression) were compared with an equal number of age and sex-matched patients with depression. The depressed patients reported a higher incidence of sleep disturbances, weight loss and appetite loss.

Hospital statistics for episodes coded as ‘adverse effects of medicinal agents' were used to study deliberate self-poisoning among people aged 12–20 years in the Oxford Region. Admission rates rose sharply from the age of 12 years, more so for females than males, up to the age of 16 years in females and 18 years in males. Analgesics, antipyretics and psychotropic drugs were the agents most commonly used by both sexes and accounted for three-quarters of all admissions. Admission rates varied from year to year, but increased overall between 1974 and 1979, notably among people under 16 years of age. Admissions for ‘adverse effects of medicinal agents' accounted for 4.7 per cent of all general hospital admissions among people aged 12–20 years.

A matched controlled study of 30 chronic schizophrenic suicides is presented. Eighty per cent were male and committed suicide at a mean age of 25.8 years after a mean duration of illness of 4.8 years. Significantly more of the suicides had a chronic relapsing schizophrenic illness; 23.3 per cent committed suicide while in-patients, and 50 per cent of the out-patients committed suicide within three months of discharge from in-patient care. Significantly more of the suicides had a past history of depression (56.6 per cent), were depressed in the last episode of contact (53.3 per cent), had their last admission for depression or suicidal ideation (55.2 per cent) and were unemployed (80 per cent).

In a replication study three performance variables measured at the beginning of 200 patients' rehabilitation courses were combined to form an Index to quantify the degree of initial disability. The Index score was significantly associated with the ten-year outcome, and hence has predictive value. With it a level of disability can be specified beyond which a patients' prospect of resettlement is predictably hopeless from the outset despite prolonged and intensive rehabilitative efforts. On the other hand, many less disabled patients cannot achieve resettlement unless such efforts are made. There are, therefore, humanitarian and economic reasons for seeking to distinguish these two groups.

Two repertory grids relating to body image and interpersonal relationships were administered to dysmorphophobic, psoriatic and control subjects. Both dysmorphophobics and psoriatics expressed dissatisfaction with their body image and, in addition, dysmorphophobics were dissatisfied with their interpersonal relationships. The dysmorphophobic group were also less happy with their self-concept than the other two groups.

The quarter of birth of 536 schizophrenic, 1,991 neurotic and 12,085 psychiatrically normal twin pairs from the National Academy of Sciences-National Research Council Twin Registry was compared. When either all twin pairs, or only monozygotic or dizygotic twin pairs, were considered, no significant differences were found in the quarter of birth between the 3 groups. No difference in quarter of birth was found for twin pairs concordant versus discordant for schizophrenia. Despite the increased risk for intrauterine and perinatal complications in twin births, schizophrenic twins appear (at least) to be no more vulnerable than schizophrenic singletons to the seasonal gestation and birth-related insults which probably underlie the seasonality in schizophrenic births. Controlling for season of birth probably has little effect on the results of twin studies of schizophrenia.

Tourette syndrome is a disorder of chronic multiple motor and vocal tics with an age of onset between 2 and 15 years. Clicks, grunts, barks, coughs and yelps are common vocal manifestations, while coprolalia eventually occurs in 60 per cent of cases (Shapiro et al, 1978). Nine years or more (Bruun and Shapiro, 1972) may pass between the onset of the disorder and its diagnosis. Although mental and mood changes are not an intrinsic part of the syndrome, suicide may occur secondary to the profound social disruption produced by the disorder.

Within the past 15 years, it has become clear that the continuing administration of neuroleptics can produce several long term side effects, the two most important being tardive dyskinesia (TD) and skin pigmentation. In mental hospital surveys, the proportion of patients with TD has been described as about 30 to 40 per cent. At this point, there is no recognized treatment although some cases improve if the drug is discontinued (Jeste et al, 1979). In addition, TD may increase mortality (Mehta et al, 1978).

Describing the occurrence of pseudocyesis and its treatment in a 15-year-old girl, Hardwick and Fitzpatrick (1981) pose the question whether there is any association between pseudocyesis and child stealing. They comment that such an association has not so far been reported. However, cases of presumed pseudocyesis have previously been noted among child stealers (d'Orbán, 1972; 1976; 1981) (based on patients' accounts which could not be verified) and three characteristic offence patterns were described:

Established social ritual and practice such as exist to help one cope with illness or death are not available for coping with the experience of one's child being accused of murder.

Of the 1863 women who first gained a registrable qualification from a UK medical school during 1949 to 1951 (early cohort) and in 1965 (late cohort) and believed to be living on 1st October 1977, 74 per cent responded to a postal questionnaire. It was found that 9 per cent of these were not in current practice, and of the remainder, 9 per cent (111) were practising psychiatry. Their participation in medicine was as high or higher than their contemporaries in other branches of medicine. A higher but non-significant proportion (57 per cent) had achieved career posts than other practitioners (54 per cent). Psychiatry was the tenth (early) and sixth (late) most popular choice of specialty on graduation. Psychiatrists resembled other hospital practitioners but not non-hospital practitioners in citing interest, liking, or aptitude as their reason for choosing their current specialty. Of the practising psychiatrists, 37 per cent held the diploma of membership of the Royal College of Psychiatrists; these were engaged in more sessions per week and more often held career posts than the remainder.

Truancy is the term commonly used to describe unjustifiable absence from school. Persistent truancy occurs in approximately 1 per cent of primary school children. It increases considerably over the secondary school years to affect about 10 per cent of 15-year-olds. It is often associated with evidence of other antisocial activity. Educational attainment is inclined to be low. And children who truant often come from disadvantaged homes (Fogelman et al, 1980). Truancy in cases referred to child psychiatrists is usually just one manifestation of a conduct disorder characterized by a whole variety of antisocial behaviour (Hersov, 1960).