The new American psychiatric classification (DSM–III) features a radically new approach to organic mental disorders. The concept of organicity has been liberalised to allow inclusion of psychiatric correlates of cerebral disorders which not only fail to involve cognitive impairment but in some cases also resemble affective, paranoid, and schizophrenic disorders. The highlights, and implications of the new approach are discussed.

Hypnosis has never reached a widespread acceptance as a therapeutic technique and psychiatrists, especially, appear to give it a wide berth. Since the time when John Elliotson (1791–1868) was forced to resign from the Chair of Medicine at University College Hospital because of his advocacy of mesmerism, the attitude of the medical profession has been one of frank hostility subsiding, in this century, into a lingering mistrust of medically qualified hypnotists. Hypnotherapy is regarded as a form of ‘alternative medicine’ and a recent survey (British Medical Journal, 1978) found that organized teaching of the subject occurred in two of the 33 medical schools and two of the 18 dental schools in Britain. Although I have no exact figures, in a conversation with Professor Gwynne Jones, we suspected that there was also widespread disregard of the subject in psychology courses at both undergraduate and postgraduate level. “Why” asked Sir William Trethowan (1976), in a somewhat sceptical vein, “if hypnotherapy is so effective as some authors of books claim it to be, is the subject not more widely taught on medical courses?”. He partly answered his own question by pointing to the lack of good quality research, but I would add a more fundamental inhibitor and that is the manner in which the subject is presented; if the interested trainee in psychiatry or clinical psychology picks up any of a number of recommended texts, disillusion will rapidly follow. Hypnotherapy is too frequently presented in terms which seem to be frankly anti-scientific and at variance to all other teaching. The expectation of the dramatic disappearance of symptoms, and even disease, at the authoritative command of the practitioner, is clearly allied to the practice of the fairground rather than accredited healing; psychiatrists, especially, shudder at such frequently repeated statements as that hypnosis enables the therapist to ‘directly converse with the unconscious mind of the patient’.

The Social Adjustment Scale Self-report (SAS-SR) was completed by chronic schizophrenics (N = 82) living in Nithsdale, in Dumfries and Galloway region. Relatives also assessed patients' adjustment. The questionnaire response indicated that scrutiny of the form by a professional immediately after completion is necessary. Patients' and relatives' assessment of the patients' overall adjustment correlated very closely, thus suggesting a schizophrenic can satisfactorily describe his own adjustment. The patients were less well adjusted than a normal community population in all areas except the parental role. The SAS-SR highlights for each individual where many of his problems lie, and therefore may act as a guide to specific rehabilitative measures.