Epimenides, a Cretan poet of the 6th century b.c., withdrew into a cave where he fell asleep; he awoke 57 years later (7). This anecdote is probably the first recorded case of hypersomnia. Sleeping Beauty, Rip Van Winkle and other personalities of folklore and literature followed. Clinically valid contributions, however, first appeared around the turn of this century.

Obsessional neurosis is generally considered to have a poor prognosis (Farr and Stewart, 1942; Müller, 1953; Rüdin, 1953; Ingram, 1961; Noyes and Kolb, 1963; Kringlen, 1965). Factors adversely affecting prognosis include early onset of symptoms, premorbid obsessional personality and the emergence of complications.

The purpose of this drug trial was to compare various methods of assessing changes in anxiety and to determine which would discriminate most effectively between the effects of treatment.

The need for an acceptable, effective non-barbiturate hypnotic has long been recognized. Nitrazepam (Mogadon), an analogue of chlordiazepoxide with a chemical formula: 1,3-dihydro-7-nitro-5-phenyl-2H-1,4-benzodiazepin-2-one recently became available for trial. It has been reported to be a safe and effective hypnotic (General Practitioner Research Group, Report No. 79, 1965). Peck and Shervington (1966) found 10 mg. of nitrazepam as effective as 200 mg. of amylobarbitone in general hospital patients. In a previous investigation (Haider, 1967) I reported the efficacy of nitrazepam as an hypnotic agent, in comparison to a placebo, in a group of elderly psychiatric inpatients.

It is a common clinical observation that emotional disturbance can influence a patient's response to sedative drugs. In recent years these effects have been studied in both normal and emotionally ill subjects. Kornetsky and Humphries (1957) found that in ten healthy adults the response to small doses of secobarbital sodium correlated with the scores on the depression and psychasthenia scales of the MMPI. Von Felsinger et al. (1955), in a study of the effect of a variety of psychotropic drugs, including pentobarbitone, on “normal” subjects, observed that those who responded in an atypical fashion tended to have abnormal personalities and to suffer from depressive episodes. Beecher (1955) has pointed out that the degree of placebo effect on post-operative analgesia varies with the severity of the stress to which the patient is exposed.

While the importance of psychological factors in attempted suicide has long been acknowledged, the use of standardized psychological techniques has been neglected. The paper by Vinoda (1966) is the first in Britain to describe the personality characteristics of attempted suicides using a battery of objective tests. She tested and compared a group of female attempted suicides, who had been admitted to the psychiatric ward of a general hospital, with a group of psychiatric patients and a group of non-psychiatric patients from the same hospital. Where differences on testing occurred it was usually the case that the attempted suicide and psychiatric groups were discriminated from the normal controls but not from each other.

Although there have been various studies of the treatment of schizophrenia and articles on it are numerous, hardly any work has been done on the subject in Pakistan.

The need for increased services for the treatment of alcoholism has been officially accepted and indeed emphasized in recent years (15, 20). The following evaluation of an Alcoholic Unit is based on the response to treatment over the course of one year shown by a cohort of 100 patients, half of whom were admitted to the Unit while the remainder were out-patients. The study aimed at describing the patients referred to the unit and at ascertaining what attributes of the patient and his treatment appeared to influence the prognosis.

Jenner, Gjessing, Cox, Davies-Jones, Hullin, and Hanna (1967) have presented some biochemical and clinical studies of a patient who showed a remarkably precisely timed manic-depressive psychosis. For the last eleven years the patient has been alternately depressed and lethargic for 24 hours, then elated for 24 hours, and so on almost without fail. Harding, Jeavons, Jenner, Drummond, Sheridan and Howells (1966) published electroencephalographic studies showing the 48-hour rhythm in the patient's electroencephalogram. The harmonic mean, the mean abundance and variability of the alpha rhythm all showed a striking 48-hour cycle. A number of similar patients have been described and are conveniently listed by Menninger-Lerchenthal (1960), Richter (1960), and Bunney and Hartmann (1965). Jenner (1965) made some suggestions about possibly heuristically helpful electronic analogues which might appropriately represent some of the underlying mechanisms of the 48-hour syndromes.

The psychogalvanic reflex (P.G.R.) is a decrease in the electrical resistance of the skin which occurs in response to a wide variety of stimuli.

The Coloured people of the Cape Peninsula have evolved over three hundred years as a demarcated ethnic group with recognizable physical features and characteristic cultural and social conditions. As such they constitute a very satisfactory population for epidemiological and transcultural studies, and when the need arose to plan for improved psychiatric services, a large-scale field survey of the prevalence and types of mental illness was set afoot. Since socio-economic circumstances appear to be very relevant to the amount and type of mental illness in a community, special estimations of these were also made. Random sampling of the entire population of Coloured persons over 20 years of age in the magisterial area of the Cape Peninsula was done and 500 of a total population of 200,365 people were interviewed about their mental and physical health, as well as a variety of economic and social circumstances, by a team of three psychiatrists and 14 specially trained social workers. In addition, interviews were held with reliable persons who knew each respondent, such as ministers of religion, social workers, housing managers, nurses, doctors, friends, relations, and employers. Hospital records were consulted as necessary, and the information was evaluated for each respondent by a team of three psychiatrists. The data were coded and finally exposed to an extensive computer and statistical analysis.

This paper reviews and reports on the frequencies of qualitative dermatoglyphic characters in schizophrenia. Dermatoglyphics is the name given by Cummins and Midlo (1943) to the study of the ridged skin found on the fingers, palms and soles. The biological value of dermatoglyphic investigation lies in the morphological constancy, from the time of formation until death, of the dermal ridge arrangements. The dermal ridges are fully formed by the fourteenth week of foetal development, therefore only genetic and prenatal environmental factors can influence ridge formation.

The aim of this study was to examine the factors leading to prolonged stay in hospital of patients admitted with mental disorder. It is part of a larger investigation on the interaction between the services provided for the same area by the psychiatric hospital and the psychiatric unit in the general hospital.

A patient, S., voiced the opinion that subnormals, the blind, anyone with physical or mental imperfections should be exterminated. This included the psychiatrically ill and consequently himself. He had attempted suicide, and said that when he thought it appropriate he would attempt suicide again. In projective tests and interviews he expressed the wish to kill his father, and showed much sado-sexual fantasy and racial prejudice. Psychological tests showed that he was of average intelligence, non-retarded and abnormally overinclusive. He was diagnosed initially as “paranoid schizophrenic”. Such bizarre and macabre features are not necessarily dangerous, but S. was married with two young children. He believed his children to be highly intelligent. Another baby was expected shortly. This study attempted to predict whether these attitudes were potentially dangerous should the patient discover some imperfection in his family.

The study of a single case, though less conclusive, sometimes heralds methodological advance. Hopefully, other investigators will be able to replicate the findings on a large number of subjects. This report, based on the case history of Bob R., describes in detail how the Organic Integrity Test (OIT) may be used as a daily therapeutic index in the treatment of schizophrenia.

The nutritional disturbance in anorexia nervosa almost invariably leads to striking physiological changes, which include amenorrhoea, bradycardia, hypotension and relative hypothermia with reversal of the usual diurnal temperature rhythm (Bliss and Branch, 1960; Mayer-Gross et al., 1960; Crisp and Roberts, 1962; Crisp, 1967a). Crisp (1965a, 1967a) has commented on the characteristic and excessive alertness, restlessness and insomnia displayed by anorexia nervosa patients, whom he regards as showing a specific type of malnutrition associated with carbohydrate starvation. Russell (1967) has also recently demonstrated that patients with this illness restrict especially their carbohydrate intake.

All male patients above 180 cm. tall who were resident in the Århus State Hospital on 13 April, 1966, were registered: they numbered 42 out of the total of 440 resident males (8 · 1 per cent.). One patient, a 78-year-old man, died before chromosome analysis was made. Sex-chromatin analysis was made on Feulgenstained buccal smears and chromosome analysis was made on leucocyte cultures according to the method described by Moorhead et al. (1960), slightly modified. Not less than 25 metaphases were counted, at least 15 metaphases with the modal figure and all metaphases with a chromosome number deviating from the modal figures were analysed.

Longitudinal EEG studies in primary presenile dementia are conspicuously lacking (Kiloh and Osselton, 1966). Letemendia and Pampiglione (1958) found no changes, over a one year period, in the EEG patterns of several of their patients with Alzheimer's disease. Attention has recently been drawn to the relevance of duration of the particular illness when interpreting EEG data in primary presenile dementia (Gordon and Sim, 1967). The tendency to non-specificity of such data in this group of diseases underlines the importance of chronological variations in the EEGs, with regard to both differential diagnosis and prognosis.

Attention was first drawn to this syndrome by Kleine (1925), who described five patients with periodic somnolence, two of whom also had an excessive appetite. Levin (1929) described a youth aged 19 who had suffered from nine attacks of sleepiness and pathological hunger from the age of 16. The attacks lasted from one to six weeks and recurred at intervals of up to twenty-eight weeks, but he eventually recovered spontaneously.