The possibility that desipramine might prove to be a rapidly acting antidepressant was first raised by laboratory studies. In 1959 desipramine was isolated as a metabolite of imipramine (Hermann et al., 1959; Hermann and Pulver, 1960), and a series of papers then followed (Brodie et al., 1961; Gillette et al., 1961; Sulser et al., 1962) in which it was shown that reserpine-induced inactivity in the rat can be more rapidly reversed by desipramine than by imipramine. This was referred to (Gillette et al., 1961) as an experimental demonstration of the relative rapidity of the “antidepressant” action of the two drugs. Other experimental reports should however warn against incautious interpretation of laboratory findings. Garattini et al. (1962) showed that desipramine is not responsible for all the actions of imipramine: in mice, leptazol convulsions are inhibited by the latter but not by the former drug. Dingell et al. (1964) were able to show considerable species differences in the rate at which imipramine is converted to desipramine and in the rate at which desipramine is then destroyed. Their paper also emphasizes the paucity of information on the metabolism of imipramine in human subjects.

This study has arisen from an almost universal clinical observation that many mothers during the first few days of the puerperium show evidence of disturbed emotion. This has been variously described by such terms as “labile emotional reactions” (Millar, 1962), a hysteroid reaction (Robin, 1962), “an emotional lability and a tendency to a mild depression” (James, 1959). It would appear that obstetricians and midwives view these reactions as a natural phenomenon associated with childbirth.

Transvestism is characterized by a repetitive morbid predilection to dress in the attire of the opposite sex. It is distinguishable from fetishism on the one hand and trans-sexualism on the other.

Short acting barbiturates such as amylobarbitone have long been the standby for relief of anxiety—certainly any new drugs introduced for the relief of such symptoms must stand comparison with these. Furthermore such symptoms are well known to be modifiable by such variables as the attitude of the doctor. For this reason a trial of such a new drug must be carried out under blind conditions.

What happens to schizophrenics after their discharge to the community has been a subject of several recent studies. Most of this work is from the Social Psychiatry Research Unit at the Maudsley Hospital and deals with prospects of rehabilitation and resettlement, morbidity in the community, and the impact which these patients have on their families. Earlier follow-up studies of chronic patients who left certain London hospitals between 1949 and 1956 point to a satisfactory resettlement in two-thirds of cases (Brown et al., 1958). In more recent papers rather cautious conclusions were drawn, especially where morbidity in the community and not just lengths of hospital stay and re-admission rates were ascertained (Wing, 1963; Wing et al., 1964). Whilst the time spent in hospital by schizophrenics is now much shorter, re-admission rates continue to rise, and according to Wing “… in the absence of effective community services the policy of early discharges is based to a large degree on the willingness of relatives to attempt the role of nurse and put up with considerable discomfort and distress”. Furthermore, with existing services so different in various parts of the country, no reliable data exist which would indicate to what extent a fully developed community service could prevent morbidity of discharged schizophrenics. What is needed, according to Wing, would be a combination of the Nottingham community services, the Worthing day-centre and industrial workshops on the Bristol pattern.

The finding of chromosomal mosaicism in mongolism (Clarke et al., 1961) has added a new dimension to the problem of mongolism which has helped to answer some questions, but which has also created some new ones. It has been suggested that mosaicism may explain some of the microsymptoms of mongolism found in the siblings, parents and relatives of mongols. This has particular application to the increased atd angles on the palms of some mothers of mongols (Penrose, 1963).

The thalidomide tragedy in Europe has necessitated a re-examination of the use of tranquillizers and other drugs for the treatment of psychiatric conditions during pregnancy.

Since 1948 a number of papers published in Great Britain have demonstrated the feasibility of studying the incidence and prevalence of both major and minor psychiatric disorders in general practice (3, 4, 7, 8, 10, 11, 14, 16, 17, 18). Few, however, have focused on the health of West Indian immigrants in Great Britain, some 125,000 of whom have entered the country since that time (2, 12, 13, 20). This paper reports on the results of a six-month psychiatric morbidity survey of a group general practice in Brixton, the main purpose of which was to collect and compare data on the illness and consultation patterns of West Indian and English patients attending the same general practice.

Increase in serum gamma globulin concentration with reciprocal reduction in serum albumin concentration is commonly found in patients suffering from Down's syndrome (mongolism) (Carver et al., 1959; Nelson, 1961; Pritham et al., 1963). It is possible that gamma globulin of relatively less effective composition than normal is produced, and that hospitalized living increases production of this faulty protein (Pritham et al., 1963). On the other hand, Polani (1962) suggested that in Down's syndrome there is either exaggerated or diminished response to drugs and hormones, and the raised gamma globulin levels could result from an excessive production of normal gamma globulin, possibly in response to infection.

At the time when this investigation was being considered (June, 1961) the efficacy of the monoamine oxidase inhibitors in the treatment of depressive illnesses was already well recognized. It was also evident from a study of the published papers on this group of drugs that their use was accompanied by a number of side-effects which often raised problems in treatment. The clinical trial of a new drug of this class which, from the pre-clinical toxicity studies in animals, held promise of being less toxic than M.A.O. inhibitors already in clinical use was therefore considered worth while. Such a trial also seemed a useful opportunity to follow up previous observations with phenelzine (Gilmour, 1960) and the suggestion of Sargant (1961) that, given concurrently, M.A.O. inhibitors may potentiate the effect of E.C.T. and reduce the number of exposures necessary, and that their continuance after a course of E.C.T. has been completed may reduce the relapse rate.

Two previous papers (Monro, 1962, 1963) dealt respectively with the Self-Referent and the Social Attitudes of a sample population of neurotic and inadequate personalities. In each previous paper, the sample population was used, and the same technique of correlation (that of Cattell, 1946) applied. After the two papers mentioned had been written, it occurred to me that it should be possible to correlate their findings and demonstrate a relationship between particular self-referent and particular social attitudes. That is the task which this paper sets out to do.

In 1963, one of us reported that serum from schizophrenic patients, applied topically to the cerebral cortex of the rat, produced a large increase in the amplitude of the electrical response evoked in the cortex by cutaneous stimulation (German, 1963). This effect was not observed when serum from non-schizophrenic control subjects was used.

Pregnancy in their wives is known to precipitate mental illness in some husbands (Zilboorg, 1931; Freeman, 1951; Towne and Afterman, 1955). But the fact that it may more commonly cause physical symptoms seems never to have been fully investigated, and has only occasionally been reported in the medical press.

The observations recorded in this paper were made on 72 patients referred to a neurological clinic on account of headache who proved to have no evidence of organic disease and whose symptoms were not migrainous in nature. They were, therefore, suffering from the type of headache described as psychogenic headache, tension headache, stress headache, or common headache.

This investigation was prompted by the work of the late Dr. D. E. Sands and his colleagues on the boys in the Adolescent Unit at St. Ebba's Hospital, Epsom. As a result of a variety of endocrinological investigations and studies on physique they concluded that a substantial proportion of these children showed evidence of physical immaturity. It was consequently decided that certain boys might benefit from a course of injections of Human Chorionic Gonadotrophs (H.C.G.) in order to hasten their physical maturity, as it was felt that this could have a beneficial effect on their psychological development.

Suicide is obviously in part a medical problem and various writers have suggested that action on the part of doctors might reduce its incidence. In particular, attention has been directed towards recognizing and promptly treating depressive illness and in the management of such illness suicide is regarded as a significant risk.

Oxazepam, Wy 3498 (John Wyeth, Brother Ltd.) is a benzodiazepine derivative-7-chloro-1, 3-dihydro-3-hydroxy-5-phenyl-2H-1, 4-ben-zodiazepin-2-one. The structural formula is as follows:Other Benzodiazepin derivatives in current use are chlordiazepoxide (Librium) and diazepam (Valium).

This paper describes a double blind controlled trial of the compound trimipramine ('Surmontil’), which does not appear hitherto to have been reported upon by the English-speaking investigators, though there have been many clinical studies reported by French, and some by Italian authors.

Common observation indicates that phobic patients tend to avoid the stimuli which are related to their phobia. This characteristic has suggested the analysis of traffic phobia in terms of avoidance learning theory. According to this theory, stimuli which have been associated with a noxious event (accidents in the case of traffic phobia) may acquire aversive properties (fear arousal) and responses which appear in an attempt to avoid these stimuli (accident situation) are reinforced by fear reduction (Skinner and Estes, 1941; Wynne and Solomon, 1955; Keehn, 1961). If the analysis of traffic phobia in terms of avoidance learning is correct, however, accidents would be expected to be a major source of such phobic reactions. The present study gives a clear illustration of a traffic phobia acquired through conditioning in accident situations and its satisfactory treatment by application of learning theory.

The urgent need to act and explain one's reasons is less pressing now in connection with witchcraft than in the days when it seemed to present an immediate menace to society. It has however always evoked intense reactions without a corresponding intense examination of the available evidence. The subject seems to invite partisan treatment.