This project tested the association of 12 blood marker systems with the Eysenck Extraversion-Introversion/Neuroticism forms and the Buss-Plomin Temperament forms. The sample was about 400 males and 470 females who were given medical examinations during the Tecumseh Community Health Study (Michigan). ANOVA and Scheffe tests were used to test for significant differences; personality traits were adjusted for age. The Lewis red blood cell phenotypes were significantly associated with Anger and Impulsivity for males and Sensation-seeking (a subscale of Impulsivity) for females. It is suggested that these temperament factors merit further exploration.

Facial expressions provide crucial information about an individual's internal mood state, but are difficult to quantify. We report the development of a mathematical method for measuring facial expressions, using photographs and a specially designed computer programme.

The 60-item GHQ was validated in a community population by comparison with the CIS. The GHQ failed to identify nearly half of the psychiatric ‘cases' in this population. Those missed were similar to those detected except for greater chronicity of illness and more frequent social and interpersonal problems. The GHQ appears to be unsuitable as a screening instrument for mental illness in the community and the possible reasons are discussed. Principal components analysis resulted in a 15-item GHQ factor which, when used with Likert scoring, resulted in considerable improvement and failed to identify only 4 per cent of ‘cases'. It is suggested that this may provide a more satisfactory screening instrument.

Spontaneous eye blink rates, psychiatric symptoms and response to neuroleptic medication may all be mediated by dopamine. Fixed doses of haloperidol, a dopamine blocking agent, were administered for six weeks to 17 chronic schizophrenic patients who had been previously withdrawn from all medications. The change in blink rates caused by haloperidol corresponded to a change in the thought disturbance syndrome which measures positive symptoms (r =.48, P <.05). The relationship was particularly clear in patients with normal cerebral ventricles (r =.74, P <.01).

Sixty-eight depressed out-patients were allocated to treatment with either oral amitriptyline (75–225 mg/day) or intramuscular flupenthixol decanoate (10–30 mg every 14 days) in flexible dosage for 12 weeks under double-blind procedures. Various observer- and self-rating scales were applied before and after 2, 4, 8 and 12 weeks of treatment. Twenty-four patients completed the course of amitriptyline and 20 the course of flupenthixol. All variables improved over time, but there were no significant differences between the two drugs. The Newcastle scores pre-treatment were not related to drug response suggesting that both drugs were similarly effective across a wide spectrum of depressive disorders. Patients on amitriptyline tended to complain of dry mouth; those on flupenthixol had a higher incidence of extrapyramidal signs, the majority receiving anti-parkinsonian drugs at some time during the treatment. Flupenthixol decanoate in low dose is a useful anti-depressant, but should be restricted to short courses of treatment, to patients refractory to other treatments, and to patients suspected of poor compliance.

Demethylation was compared in acute and chronic schizophrenics and in non-schizophrenics by the administration of C14 labelled 2,3,4-trimethoxyphenylethylamine (TMPEA). The results did not show a significant difference in the urinary levels of the monodemethylated catabolites of TMPEA among any groups of patients. However, there was a significant decrease in demethylation in untreated chronic schizophrenics after ten days of L-methionine orally, whereas the non-schizophrenic group similarly given methionine did not change. This suggests the possibility of a biological weakness in schizophrenia.

Ninety-four psychiatric in-patients, receiving regular antipsychotic medication, were videotaped using a standard procedure. The tapes were rated by blind observers using a simple scoring system for the duration of abnormal movements. Using this combined videotape and rating scale assessment technique the re-rating reliability, inter-rater reliability and test-retest reliability were high. In order to demonstrate the validity of the technique the rating scale scores in a sub-sample of 30 patients, were compared with the assessment of three experienced clinicians on the same patients, and AIMS scores. Central (lip, tongue, jaw and neck movements) scores showed close agreement with the clinicians' assessment, suggesting that clinical diagnosis is based principally on the presence and severity of oro-facial dyskinesia. Total rating scale scores were in close accord with total AIMS scores. When the two scales were carried out on the same patients on the same occasion a diagnostic criterion level of 2 or more on the central score produced a tardive dyskinesia prevalence rate identical to that produced by an AIMS criterion level of 2 or more on the global severity rating. The tardive dyskinesia prevalence rate based on the central score criterion level showed an increase with age.

A sample of placebo-controlled tricyclic antidepressant studies was examined retrospectively to determine whether there was any difference in the relative efficacy of the tricyclic when it was compared against an inert placebo as against an active (atropine) placebo with anticholinergic side effects. Fewer studies showed a significant difference between atropine placebo and drug than between inert placebo and drug. The possibilities that atropine has a specific antidepressant effect or that side effects amplify placebo responses are considered.

Melancholia is thought by many investigators to have a biological basis, and biological research, particularly on abnormalities of the neuroendocrine system and of the sleep electroencephalogram, is now beginning to yield results which can help in the differential diagnosis of depressive illness. This review will focus on the most widely studied neuroendocrine disturbance: disinhibition of the hypothalamus-pituitary-adrenal cortex (HPA) system as revealed by the dexamethasone suppression test (DST).

Hypotheses which have been proposed to account for the unusual seasonal birth pattern observed in schizophrenic populations are discussed. These competing hypotheses were tested by retrospectively studying season of birth in 975 schizophrenics divided according to family history of psychiatric illness. Information was obtained from case notes, item sheets, and questionnaires sent to general practitioners. The results were inconclusive, but there was a trend for high genetic risk cases to be born less often in the first quarter of the year. Although no clear support could be provided for one or other season of birth hypothesis, it is tentatively suggested that a seasonal constitutional damage factor may be responsible for the excess of births described in schizophrenic populations in the early months of the year.

Six patients are reported in whom mental illness led to severe cold injury. The main contributory factors were cold surroundings, inactivity and neglect. The additional factor of impaired microcirculation in these patients may also be significant.

In the winter of 1979 two instances of cold injury in patients with mental illness came to our attention. A search of the medical records at the Whittington Hospital revealed a further three cases over a period of 14 years. One patient was seen at the National Hospital for Nervous Diseases, Queen Square.

Six depressed patients were treated routinely with desipramine, a relatively selective noradrenergic uptake blocking drug. After 0, 1 and 3 weeks' treatment pupillary responses to tyramine, phenylephrine and pilocarpine were measured using a photographic technique. Both 1 and 3 weeks' treatment significantly inhibited tyramine and phenylephrine-induced mydriasis, but did not inhibit pilocarpine-induced miosis; in fact the longer treatment enhanced miosis due to pilocarpine. Resting pupil size was significantly increased after 1 and 3 weeks' treatment.

The findings can be explained by the known ability of desipramine to block noradrenaline uptake and α adrenoceptors: they provide no evidence of muscarinic receptor blockade or of a slowly developing adaptation at a adrenoceptors.

To test the hypothesis that schizophrenia can be differentiated on the basis of family history, the authors compared two matched samples of 20 patients each, distinguished by the presence or absence of family history of schizophrenia. Family history was not associated with either onset characteristics, symptom picture, phenomenological subtypes of schizophrenia, prognostic indicators or global assessment score for psychosocial functioning.

In a prospective study of offspring of schizophrenic mothers, perinatal complications reported in midwife protocols were analysed for those offspring who, as adults, were diagnosed as schizophrenic, borderline schizophrenic or as not suffering from mental illness. The schizophrenics were found to have had the most complicated births, and the borderlines, the least complicated births. This difference is interpreted in terms of a ‘diathesis-stress' model. It is proposed that birth complications can decompensate borderline individuals towards schizophrenic breakdown.

Patients receiving prophylactic lithium therapy for primary affective disorder during a four year period were studied for recurrence of affective illness. Patients who had affective episodes during this period did not differ from those who remained well in age, sex or diagnosis. Those with a favourable outcome had spent significantly less time at serum lithium levels above 0.9 mmol/litre than those who had a recurrence of affective episodes.

A comparison of hyperactive boys with and without associated conduct disorder was made to determine the validity of a narrowly defined concept of pure hyperactivity. Although clinical differences between the two sub-groups supported the diagnostic distinction, few differences appeared with respect to various possibly causal background factors. A small group of boys with pure hyperactivity was separated, however, on the basis of subnormal IQ scores. In contrast to the hyperactive boys with normal IQ, these boys showed a more serious history of developmental disturbances which appeared to be linked to organicity. It was concluded that pure hyperactivity is an elusive concept and probably defines a heterogeneous group of children whose primary problems are cognitive in nature.

The effect of long-term lithium treatment on the kidneys has generated concern among psychiatrists, and proposals have been made that routine determinations of serum lithium and serum TSH should be supplemented with control of the kidney function through regular determinations of serum creatinine, glomerular filtration rate, and renal concentrating ability, as well as through kidney biopsy in certain circumstances.

Neurotoxicity is a rare but well recognized unwanted effect of lithium therapy (Moore, 1972; von Hartitzsch et al, 1972; Tyrer and Shopsin, 1980) which tends to be associated with high serum lithium levels. In clinical practice it is normally assumed that once signs of toxicity are detected and treatment stopped, serum levels will return to normal. We report here a patient who developed toxic symptoms while her serum levels were in the therapeutic range but who developed severe neurotoxic sequelae and high serum levels after treatment was stopped.

Forty-six users of the hallucinogen lysergic acid diethylamide were compared with 31 controls on a test of colour discrimination an average of two years after their last exposure to the drug. Controls performed better than users, and LSD users without flashbacks performed better than users with flashbacks. An analysis of variance between the three groups was significant at P <0.001. This study suggests that some users of LSD may have a sustained or irreversible impairment in colour discrimination.