In a study of male addicts attending a London drug dependence unit, it was found that convicted addicts tended to score more highly on measures of hostility than non-convicted subjects. The differences in hostility between the convicted and non-convicted groups were most clearly seen on the violent crimes variable, although addicts convicted of drug-possession and of non-drug crimes were also more hostile than non-convicted subjects. It is suggested that hostility acts as a personality factor which predisposes the individual towards criminal behaviour, and that the more hostile subjects may also be more likely to be apprehended and convicted.

The dopamine hypothesis of schizophrenia proposes that schizophrenia is associated with increased brain dopaminergic function. Because dopamine is thought to stimulate the production of cyclic AMP in the brain, we hypothesized that CSF cyclic AMP would be increased in schizophrenia. Cyclic AMP in the CSF was determined in 19 schizophrenic patients who had not received neuroleptic treatment in the preceding two weeks. No significant difference could be shown between CSF cyclic AMP in these patients and CSF cyclic AMP in 10 psychiatrically normal controls.

The distribution of the plasma cholinesterase variants found in 1,374 mentally ill patients differs from that of a random control sample. The patients are more likely to have a rare phenotype than an individual from the normal population. None of the diagnostic groups have been shown to differ in the distribution of the E1a gene, but there is strong statistical evidence that Group IV (psychosis) patients have a higher frequency of the E1f gene than the other groups. The overall frequency of the electrophoretic variant C5 + did not differ significantly from that observed in a Caucasian population, with the exception of the increase observed in Group IV c2.

Twenty-eight unrelated patients with Huntington's chorea were found to have a significantly altered incidence of the C5+ variant and six patients from this group were found to have the rare E1f gene. Our results indicate that the plasma cholinesterase variants may provide some insight into the inheritance of Huntington's chorea.

A young man was followed-up over three years who had severe obsessive-compulsive rituals and ruminations, interpersonal deficits, complicating depression and a history of childhood autism. Intensive behavioural treatment was given in an operant framework, with exposure in vivo, modelling, response prevention and social skills training. Compulsive rituals improved markedly and lastingly, but ruminations and social defects persisted. When intercurrent depression occurred dothiepin facilitated behavioural treatment. Adjustment remained fragile. Minimum maintenance treatment in the community could not be adequately arranged, so that gains made in hospital were partly lost at follow-up, despite continuing improvement in rituals.

Reported reductions in the activity of platelet monoamine oxidase (MAO) in chronic schizophrenic patients might be contributed to by alterations in hormones, platelet numbers or other non-specific factors thought to affect enzyme activity. In this study, MAO activity in 27 patients with chronic schizophrenia was measured, using benzylamine as the substrate in an assay based on platelet counts instead of platelet protein, and was found to be markedly lower than mean MAO activity in 375 normal controls. These results were similar to those previously reported with tryptamine as a substrate for the enzyme. Serum testosterone, triiodothyronine, iron and iron-binding capacity were within normal ranges in individuals with reduced MAO activity, and none of these measurements was significantly correlated with MAO activities. Platelet MAO activity remained stable over time in patients and controls.

Evidence was found against the hypothesis that heterozygous carriers of a schizophrenic gene have a reproductive advantage through enhanced fertility. In consequence an investigation was made of the possibility that an advantage is gained through diminished early mortality among the offspring of carriers. The results were equivocal. While an observed deficit of infant deaths was attributable to under-reporting, the possibility of a true advantage could not be ruled out, because of the statistical unreliability of the findings in a sample of the size available. A plea is made for a collaborative effort to settle the issue.

Thirty families with a newborn mongol baby were matched with thirty families with a normal baby. Both groups were followed for eighteen months to two years and interviewed six times. Few differences could be found in the mental or physical health of the two groups of parents, but marital breakdown or severe marital disharmony was found in nine of the mongol families and in none of the controls.

A group of alcoholics treated by partially reinforced electrical escape conditioning were found to have a significantly better outcome on follow-up than a selected control group, who showed a parallel level of motivation, and were treated by conventional methods. No sex differences in outcome were found for either group. In the experimental group, better prognosis was associated with higher social class and older age, and poorer prognosis with single marital status. There were no variations in outcome for age in the control group. In the age range 20–40 aversion therapy showed no better results than conventional therapies, but with subjects above this age range it was very significantly superior. The results are discussed with reference to the application of aversion therapy to alcoholism.

Forty depressives and 40 matched controls were compared in terms of a number of self-report variables and in terms of their descriptions and evaluations of both real-life and hypothetical social relationships. Clear differences between the two groups reveal poorer self-ratings in the depressive sample, together with a tendency to describe and to evaluate both real and imaginary relationships more negatively. A retest of the depressed patients at the time of discharge from hospital showed improvement only in the two depression measures and not in any of the other self-rating and perceptual measures used. The possibility is discussed that the perceptual variables are predisposing to depression rather than concomitant with it.

Two cases of Capgras' syndrome in association with coarse brain disease are presented. The authors suggest that prosopagnosia (face non-recognition) may be the primary expression of a specific cerebral dysfunction which forms the basis for a delusional elaboration resulting in Capgras' syndrome.

Groups of subjects were tested on a paced serial reaction-time task in order to study the effect of varying the rate at which information was presented. The groups were: two groups of patients with acute schizophrenia but differentiated on the basis of primary symptoms, a group of institutionalized schizophrenic patients, a group of neurotic patients and a normal group. All groups showed a reduction in efficiency when the presentation rate was increased. The groups most adversely affected were the non-integrated and institutionalized schizophrenic patients. The integrated schizophrenic and the neurotic groups were affected to a lesser degree, the normal groups being least affected. These results favour a dimensional view of personal illness, in which deficits are most marked in patients with non-integrated schizophrenia.

Five suicides in one family, mainly by burning, are reported. The ritualistic manner, closeness of events in time and absence of serious exogenous factors suggest the term ‘family suicide’.

Mortality data are presented from a four-decade follow-up study of 200 schizophrenic, 100 manic, 225 depressive patients, and 160 surgical controls (80 appendicectomy; 80 herniorrhaphy). Data for this analysis were available on 648 (95 per cent) members of the study population. Using sex-age standardized mortality ratios (SMR), the mortality experience of the study population was compared with that of the state of Iowa, the geographical area served by the admitting medical facility for the study group. Results are presented for a four-decade period beginning 1935–44, and ending 1965–74. All three psychiatric groups had a significant increase in mortality risk. This was most pronounced in the first decade following admission, although schizophrenic patients, especially females, continued to show a significant excess of deaths throughout the entire four decades of the follow-up period. During no decade of the follow-up period did the mortality of the surgical controls differ significantly from that of the Iowa population.

A distinctive pattern of clinical change during eight affective episodes is reported in a rapidly cycling manic-depressive patient. After a rapid switch to near maximal intensity of affective symptoms, slow changes in symptomatology were documented by significant slopes and correlation coefficients over the course of each episode. Decreases in depression, anxiety, drowsiness, helplessness/hopelessness, anger, and sadness preceded the switches into mania; decreases in mania, euphoria, seeking others, and talking preceded the switches into depression. Psychologically important events appeared to regularly precede rapid mood switches. It is suggested that the consistent, slow clinical changes which occur during affective episodes may reflect part of an underlying rhythmic biological process and that environmental events may be capable of triggering a final common pathway for the mood switch during a vulnerable period.

Elderly psychiatric patients who were in contact with the hospital one year after in-patient admission were retested on a number of clinical and psychometric measures first done soon after admission. In general, changes were small; and for several measures very high correlations existed between the scores gained on the two occasions. When those patients with uncomplicated chronic brain syndromes were considered separately, increasing impairment was demonstrable.

Although ward behaviour rating scales for use with long-stay psychiatric patients by nurses have been in existence for many years, their content tends to reflect the opinions of psychiatrists and psychologists rather than those of nurses. An analysis of five commonly used rating scales illustrates the lack of agreement on what should be included. The opinions of 76 nurses from four separate hospitals were sought, using a 34-item questionnaire, to establish what areas of content were considered important in nursing practice. Apart from agreement on general content, consideration should also be given to the presentation of individual items of ward rating scales.