Trieste mental health service is considered as one of the best mental healthcare systems in the world. This service is now under threat from right-wing politicians in the local region. We argue that this is a threat to progressive community psychiatry beyond Trieste and Italy. It is important for us to join forces with international colleagues and organisations in the campaign to defend and preserve the current service model in Trieste.

Wing and Freudenberg (1961) assessed the response of schizophrenic subjects to regimes of active and passive encouragement. Their findings suggest that a subgroup of very inactive patients exists and that this group responds dramatically to incentives. The purpose of this study is to re-examine the behaviour and attempt to define this subgroup. Such an examination may provide information which could be applied to treatment programmes. It may also contribute to a better understanding of the nature of the schizophrenic's volitional defect.

Before addressing you, I have formally, however imperfectly, to express my full appreciation of the high honour conferred upon me at your hands in thus placing me in the Presidential Chair of your beneficent Association. I say beneficent advisedly, for when men have banded themselves together for the cultivation of science and the improvement of the condition of the insane, they associate to fulfil these functions as practical philanthropists. These good intentions have been realised in fruitful performance in words and deeds, and we hold our Annual Meeting to-day with a desire, an ability for good work that cannot fail to mark the year as one of humane progress.

The first clinical histories of this condition were reported in Norway by Stengel (1826). Batten (1903) described changes in the macula in two members of a family who had undergone progressive mental deterioration with loss of visual and motor functions. Vogt (1906) published similar cases and attempted to delimit them as a juvenile form of Tay Sachs disease. It differed from the infantile form in that it occurred in childhood after a period of normal development; the rate of progression was slower; it was not limited to Jewish children and the ophthalmological appearances were those of optic atrophy. The following year Spielmeyer described the pathological changes in juvenile Tay Sachs disease as essentially similar to the infantile form. Further detailed pathological studies were made by Greenfield and Holmes (1925).

Reports on adrenocortical function in mental illness have been conflicting, and there has been a failure to replicate results, especially with plasma Cortisol measurements (Gibbons, 1968; Segraves, 1970; and Franzen, 1971). Also, the study of particular diagnostic categories of patients appears to introduce a sampling bias, whilst isolated measurements usually fail to assess hypothalamo-pituitaryadrenal function. We have therefore undertaken a blind assessment study of the nyctohemeral rhythm of plasma Cortisol in Nigerian inmates of the Aro Neuropsychiatric Hospital and Lantoro Institution in Abeokuta, which operate respectively as open and closed treatment centres (Asuni, 1967).