In an effort at replication of the original report (Rosenthal and Bigelow, 1972) of increased callosal thickness in schizophrenic brains, the corpus callosum was measured in a blind study of 64 brains autopsied between the years 1972 and 1976. Diagnosis was established by independent chart review. The mean corpus callosum mid sections of 21 early onset chronic schizophrenic brains were found to have a significantly greater thickness when compared with 8 subjects with late onset schizophrenia, 13 patients with neurological diagnoses, or 14 patients with other psychiatric diagnoses. These studies, if independently confirmed, should provide an impetus for testing the hypothesis that some chronic schizophrenic patients have an illness associated with a pathological process in the corpus callosum.

As is well known, there has been a good deal of discussion about the unitary or binary nature of depression. Mapother (1926) and Lewis (1934) made a strong case for the unitary view on clinical grounds, Curran (1937) concurring. Kendell (1968) has reviewed the history of this argument; it is marred by confusion which has persisted through recent attempts to use statistical techniques of factor analysis and discriminant function analysis in an effort to find a more objective and empirical solution. It is the purpose of this brief note to draw attention to this confusion, to show how it has affected arguments of both adherents and opponents of the binary position, and to argue that the data are in fact in sufficient agreement to make possible a valid answer to both problems. It is suggested that the apparent disagreement between workers such as those of the Newcastle group (Kiloh and Garside, 1963; Carney, Roth and Garside, 1965) and the London (Maudsley) group (Kendell, 1968) is in fact quite irrelevant and is based on a misunderstanding of the statistical properties of factors, a misunderstanding apparently introduced in one of the first studies of this kind to be concerned with the problem of the classification of depressive illness, that by Hamilton and White (1959).

The Maudsley Personality Inventory (M.P.I.) is now established as one of the most widely used personality tests in the investigation of a variety of clinical, psychosomatic and genetical problems. When the M.P.I. is employed for such purposes it is most important to know how constant are the scores and how much they are altered by the changes in mental state which often occur in psychiatric patients over a period of days or weeks.

Forty-one subjects from an earlier study, who had undergone computed tomography (CT) during their in-patient care for affective disorder, were followed up clinically for a minimum of one year. Mortality at two years was also determined, and comparisons made with 50 age-matched controls. Those with affective disorder showed a higher mortality than controls, but the difference just failed to reach significance. Within the affective group, however, mortality was significantly higher in patients who had previously shown ventricular enlargement on CT, confirming our earlier suggestion that these patients might have constituted a distinct subgroup. Failure of the affective group to improve performance on a simple cognitive test at follow-up was related to persisting depression. These and other findings are discussed.

We contacted and interviewed 150 cocaine users in south London community settings. Most were taking cocaine regularly, but not daily, and in substantial doses. Three main routes of administration were used: smoking (40%), intranasal (32%), and injecting (24%). Injectors reported having used cocaine more frequently, in higher doses and for longer periods of time. Despite their frequent and extensive use of cocaine, the overall level of dependence was low for the great majority of the sample. Two-thirds (66%) of the full sample (and two-thirds (65%) of the crack smokers) reported only minor signs of dependence during the year prior to interview. Route of drug administration was related to severity of dependence. Cocaine taken by injection was associated with the highest levels of dependence; intranasal use was associated with the lowest levels, and crack smoking was intermediate between the two. There had been substantial changes in the initial route by which cocaine was used, with a clear trend away from injection on the first occasion of use. Those who first used cocaine before 1986 were more likely to have used the drug either intranasally or by injection. Cocaine users who first tried the drug after 1987 were increasingly likely to take it by smoking crack. Women and black (predominantly Afro-Caribbean) subjects were more evident in this sample of cocaine users than has previously been reported in many UK studies.

Speech has been called a socio-economic device for saving effort in the attainment of objectives (Whitehorn and Zipf, 1943). One of its earliest and most fundamental purposes is to orientate the individual within the community. This socializing effect operates early in childhood, and in a phylogenetic sense it was perhaps one of the greatest factors in the origin of speech in primitive man. As maturity is slowly achieved in the individual as in the genus, the use of language becomes inextricably interwoven within the warp and woof of the organism, as exemplified not only by thinking processes, but also by the complicated structure of personality. The development of speech during the pre-hominoid stage synchronizes with the gradual elaboration of communal life: with cries and calls serving as a “sound-tool”: and with the beginnings of delegation of labour. Thus language is primarily a vocal actualization of the tendency to see reality symbolically (Sapir). The same is true ontogenetically. As the child gradually acquires speech, the organization of his thinking slowly changes; it evolves by intricate steps from ego-centric to socialized activity; and as he begins more and more to employ pronouns of the second and third person, he also utters fewer “action words”. We readily agree with Fillmore Sanford (1942) that “there are many indications that language is a vehicle of personality as well as of thought, for when a person speaks, he tells us not only about the world, but also, through both form and content, about himself”. The same author quoted Ben Jonson: “Language most showeth a man; speak that I may see thee.”

Many prenatal risk factors are known to have adverse consequences on fetal development and there is increasing interest in effects on the mental health of offspring. However, associations with prenatal risk factors may arise because of postnatal risk or through confounders, including inherited ones. As a result, caution is required in assuming causation.

Among 307 adults with OCD, early onset (age 5–15 years) was more common in men and later onset (age 26–35 years) in women. Early onset was associated with more checking, and late onset with more washing. More women than men had a history of treated depression; 12% of the women but none of the men had a history of anorexia. More women than men were married. Gender-divergent features may reflect differential aetiological factors. Our sample resembled others in the literature in its slight overall female preponderance, low rate of marriage and low fertility, onset mainly before age 35 years, chronicity, and common present and past depression.

Fifty cases of Korsakov's syndrome and 13 of ‘alcoholic dementia’ were identified from hospital records with the aim of examining the claim of each to be regarded as a clinical entity. Korsakov's syndrome, as diagnosed, was not homogeneous and comprised two groups. One resembled cases labelled as ‘alcoholic dementia’: the onset was gradual, the patients were older women with poorer intellectual functioning and there was a better outcome. The other group conformed to the conventional notion of Korsakov's syndrome, with preservation of intellect and a poor outcome. The combined group of gradual-onset cases and ‘alcoholic dementia’ was not entirely homogeneous. Within it were patients with ‘accelerated psychological deterioration’, others with Korsakov's syndrome superimposed on this pre-existing psychological deficit, and some with subacute confusional states.

Depression following childbirth is associated with poor child growth in developing countries. We describe the association between psychological morbidity during pregnancy and low birth weight (<2.5 kg). A cohort of 270 mothers was recruited from a district hospital in Goa, India; all mothers were interviewed with a screening questionnaire for psychological morbidity. Babies of 250 mothers were reviewed at birth to measure their weight. Excluding 5 premature babies, we found that maternal psychological morbidity was independently associated with low birth weight (odds ratio 1.44, 95% CI 1.00–2.07). We conclude that maternal psychological morbidity has an adverse impact on foetal growth.

Hysteria (Briquet's Syndrome) and sociopathy cluster in the same families instead of segregating as independent traits. Assortative mating between hysterics and sociopaths increases the observed similarity between relatives, but the familial association between sociopathy and hysteria remains after taking assortative mating into account. The Multifactorial Model of Disease Transmission with three thresholds related to severity and sex accounts for population and family data about sociopathic men, sociopathic women, and women with hysteria. The data were obtained for 227 first-degree relatives and for 800 subjects in the general population.

Depending on the sex of the individual and its severity, the same aetiological process may lead to different, sometimes overlapping, clinical pictures. Specifically, analysis indicates that hysteria in women is a more prevalent and less deviant manifestation of the same process that causes sociopathy in women.