Of 390 residents in 12 local-authority homes for the elderly, 93 had evidence of depression on screening and underwent standard clinical assessment. Half had an affective disorder, and a further third had depressive symptoms in the setting of an organic mental disorder. The 93 residents had a high rate of physical illness and disability, undertook little social activity, and were visited infrequently. A range of interventions for depressed residents, the majority social in type, mostly proved difficult to implement. There was no evidence of efficacy of psychiatric intervention at three months; at one-year follow-up a quarter of study participants had died, and 28% of those who were reassessed for depression showed evidence of recovery.

Suicides in England and Wales among immigrants of Indian ethnic origin were analysed for the period 1970–78. There were excess suicides among young Indian women, these being disproportionately more among the married. Burning was a common method of suicide among Indian women. Suicide rates were low in Indian men and the Indian elderly. A large proportion of the male suicides were among doctors and dentists.

Data from a UK national sample showed differences between the sexes in age-specific inception rates for mania. Women had a higher inception rate than men during the middle years. The cumulative admission rates were nearly equal between the sexes.

This study analyses the relationship between contextual processing ability and symptom and social status in schizophrenia. The results showed that current symptom status is related to occupational status, and contextual processing is related to current symptom status and employment history. Current symptom severity in chronic schizophrenics may indicate an increased frequency and/or duration of symptom episodes in the past, and therefore an increase in the periods in which contextual processing was disturbed, which would therefore account for the observed decrease in work achievements.

Elderly patients with depression and Alzheimer-type dementia (ATD) were compared with age-matched control subjects using a protocol which measured Cortisol, adrenocorticotrophic hormone (ACTH) and N-terminal pro-opiomelanocortin (N-POMC) to determine diurnal variation and the effect of dexamethasone administration. Depressed patients had significantly elevated Cortisol concentrations both before and after dexamethasone administration. Basal ACTH and N-POMC concentrations were normal in depressed patients but were both elevated, compared with controls, after dexamethasone. By contrast, in ATD patients, Cortisol was elevated only after dexamethasone, as was ACTH, but not N-POMC. This may imply that the pattern of secretion of POMC-derived peptides underlying increased Cortisol secretion is different in ATD from that in depression.

Hospital-based annual incidence rates for schizophrenia in Croatia over 1965–84 did not change significantly. Rates ranged from 0.21 to 0.22 per 1000 population (0.26–0.29 per 1000 population aged over 15). Factors that could influence these rates were analysed, but it appeared that the rates were a true reflection of the incidence rate of schizophrenia in the Croatian population.

Clusters of phenomena were obtained by two clustering techniques, using the form and content of obsessions and compulsions. Significant clusters which emerged involved washing, checking, thoughts of past, and embarrassing behaviour. Depression occurred as a discrete cluster. Eighty-nine per cent of subjects could be fitted into at least one cluster; over half could be fitted into only one cluster. Washers and checkers made up more than half of the sample studied.

Ninety-nine acute in-patients were interviewed within four days of admission to hospital. The interview included items concerning all 11 first-rank symptoms. Two definitions (wide and narrow) of each first-rank symptom were employed. Three definitions of schizophrenia and a research diagnosis of major affective disorder were used to determine their relationship with first-rank symptoms. Of subjects with schizophrenia, 73% had first-rank symptoms, as had five (14%) of 34 subjects with affective disorder. The results do not support the hypothesis that first-rank symptoms are specific to schizophrenia, although the specificity of first-rank symptoms for schizophrenia increased if a narrow rather than a wide definition of symptoms was employed.

The increase in violent incidents on an acute psychiatric ward over a 15–month period was found to be strongly associated with the increase in use of temporary nursing staff (r = 0.63; P = 0.0005). The change in staffing patterns accounted for 39% of the variance in violence. An examination of the characteristics of all patients admitted to the ward revealed that the violent patients were significantly younger, more likely to have been admitted compulsorily and less likely to be depressed than non-violent ones.

Higher CSF 5-HIAA concentrations and lower CSF HVA concentrations have been associated with various measures of slowed motor behaviour and communication in schizophrenic patients. To derive a single, reliable measure of deficit characteristics in schizophrenic patients, we entered four items of the BPRS reflecting negative symptoms, a work history measure derived from the Strauss-Carpenter scale, and three subscale scores of the WAIS-R into a principal-components analysis to derive a single factor score. The CSF 5-HIAA concentrations were within the normal range of values, and correlated directly with this factor score, but CSF HVA concentrations were not associated with the deficit factor score. These findings add support to the hypothesis that brain serotonin function is associated with deficit schizophrenic characteristics.

Based on information from a case register, patient age and diagnosis at first admission are analysed in a Croatian cohort of schizophrenics first admitted in 1972 and followed up through the register for 12 years. Diagnosis was analysed on the same basis and over the same period. Although the male and female differences in incidence rates for schizophrenia were not large, hospital incidence rates in younger age groups were higher in males. Males were also more commonly diagnosed as schizophrenic at first admission, females more frequently receiving diagnoses of affective psychosis and other organic psychosis, except for alcohol-induced psychosis.

Fifty obsessive–compulsives were treated by behavioural therapy (self-exposure in vivo and response prevention) either with their partner directly involved in all aspects of treatment or without their partner. The two treatment formats were equally effective. Although a substantial number of obsessive–compulsives were found to have marital problems, behavioural treatment directed at the obsessive–compulsive disorder resulted in improvement irrespective of marital quality and partner involvement in the therapy. The effects of treatment led neither to a deterioration of the marriage nor to adjustment problems in the partner.

A computer-assisted analysis of samples of free speech from acute schizophrenics (n = 50), chronic schizophrenics (n = 27) and normal subjects (n = 50) enabled a comparison of the linguistic profiles of the three groups. The chronic group consistently emerged as the most impaired, on measures of complexity, integrity (error) and fluency of speech, with the acute patients performing less well than normal speakers but better than chronic patients. Demographic differences could account for only a small number of the linguistic differences. A comparison of chronic schizophrenics from the community and those from long-stay wards suggested that their poor linguistic performance was in some way related to the illness process and not to institutionalisation. Three possible explanations for these results were considered, particularly the possibility that low complexity of speech, negative symptoms and poor outcome are in some way related.

Desipramine, a monoamine reuptake inhibitor, was used to stimulate release of growth hormone (GH) in 29 DSM-III major depressives and in 10 healthy controls. Eighteen of the depressives showed a blunted response. The GH-stimulation test was unable to distinguish endogenous from non-endogenous patients. The 13 dexamethasone non-suppressors were more likely to have a blunted GH response than the 14 suppressors. The results indicate that at least a subset of non-endogenous depressives have significant neuroendocrine abnormality.

The Stress Profile consists of a number of questionnaires which have been developed to assess the severity of stress in nine areas of life: social habits, social relationships, life events, sexual problems, sleep, psychiatric symptoms, old age, menstrual stresses, and ‘stress and the heart’. The questionnaires have been validated for inter-rater reliability and against the Hamilton anxiety and depression rating scales. Using the Profile, the inter-relationships between different stress areas can be assessed, appropriate treatments advised, and the response to treatment in relation to different components evaluated.

Age at onset was determined in a sample of 360 patients representative of the 8069 schizophrenics hospitalised in SR Croatia. The 95% confidence interval for mean age at onset was 22.9–26.7 years. The difference between males and females was not significant, unlike the age difference between the sexes reported for age at first admission for schizophrenia. Results may be influenced by attrition of the original population of patients.

In any assessment of hospital life, the patients' view is indispensable, but there is no generally accepted way of seeking it. In this study, the views of 258 patients in four ‘traditional’ English psychiatric hospitals were obtained by a questionnaire of 45 items supplemented by freehand comments. Their experience of fellow patients, the staff and the material and institutional aspects of hospital care were explored. Some of the benefits and problems of questionnaire use in this realm are discussed.

Thirty manic in-patients were interviewed in hospital using the LEDS, and 24 were re-interviewed 6–12 months after discharge. Data for life events were analysed by: comparing events before onset of mania and before re-interview; and comparing these manic patients with patients in other studies which examined life events and the onset of schizophrenia and depression. No relationship was found between life events and the onset of mania in this preliminary study. Previous studies reporting a link between events and the onset of mania have serious methodological flaws, and definitive data have yet to be produced.

To investigate whether language in schizophrenia deteriorated progressively, 11 schizophrenic subjects, 9 manic subjects and 9 controls were re-tested after an interval of three years using the computer-assisted syntactical analysis technique of Morice. In 13 of the 16 linguistic variables described as hallmarks of schizophrenic speech decline, deterioration was noted in schizophrenics in the direction predicted and relative to the manic and control groups. The deterioration was most pronounced in complexity and integrity of speech. One variable remained unchanged and two (semantic variables) showed marginal improvement. It was concluded that language, and in particular syntax, does deteriorate in the schizophrenic process.

Two hundred couples referred to a sexual problems clinic were assessed in a standardised way for their suitability for sex therapy. The assessment focused on the nature of the sexual dysfunction, motivation for treatment, marital and relationship problems, psychiatric status, and physical problems. Approximately one-third of the couples were found to have significant marital and relationship problems, and more than 30% were suffering from psychiatric disorders, although these were usually of mild to moderate intensity. A third of males and 18% of females were suffering from physical disorders likely to contribute to the sexual dysfunction. Patients who were offered sex therapy and who completed their course of treatment were more likely to show high levels of motivation and an absence of physical disorders, marital relationship problems and psychiatric disorder. There should be careful assessment of couples suffering from sexual dysfunction before specific treatment is offered.