Parental age (at patient's birth) and birth order were studied in 623 male and 89 female patients diagnosed as homosexual, who were born in England and Wales and first attended the Maudsley Hospital between the years 1961–1975. For male patients, mean parental ages were significantly higher than expectation, and mean birth order was significantly later. Regression analysis indicated that the raised fathers' age was probably of more aetiological importance than the raised mothers' age. The results confirm those of previous studies. The female patients did not show a raised parental age or late birth order.

From 1972 to 1976 130 epileptics presented 171 times to the Western Infirmary, Glasgow, as medical emergencies with self-poisoning. They constituted 3.5 per cent of 3,733 patients poisoning themselves on 4,121 occasions. Repetition of self-poisoning was commoner in epileptics (18.5 per cent) than in non-epileptics (7.0 per cent). The 130 epileptics have been compared with a non-epileptic group of self-poisoners matched for age, sex, and number of repetitions and have been found to have less alcohol excess but significantly more psychopathy. Possible explanations and prophylactic measures are discussed. In view of the relative incidence of epilepsy and self-poisoning in the community, and of epilepsy among self-poisoners in this and other studies, it is concluded that self-poisoning is a common complication of epilepsy.

Averaged cortical evoked responses to auditory and somatosensory stimuli were recorded in elderly depressives, dements, patients with a combination of depression and dementia and normal elderly controls. The subjects were also given a battery of cognitive tests and clinical ratings at stated intervals.

The latency of the auditory response was significantly longer in dements than in controls. Depressives had intermediate latencies which did not return to normal after recovery. Although somatosensory stimuli produced the results that pointed in the same direction, the mean response latencies were not statistically significant. Mixed cases were too few for separate statistical analysis but their latencies fell between those of the dements and those of the depressives.

Significant correlations emerged between latencies of auditory responses and some cognitive tests, but not with measures of depressive symptomatology.

The delay in response to auditory stimuli may be a useful adjunct to diagnosis: in depressives it may reflect organic cerebral change playing a part in the emergence of depressive symptoms in old age.

In view of recent findings in Japan, and in England and Wales, data on schizophrenic births in the United States were reexamined to see if seasonal shifts had occurred. In Missouri a progressive shift from February to April and May was noted between 1921 and 1930 and between 1941 and 1950. In five New England states there was no shift over the same period. Data were then obtained to compare the Missouri shift with two hypotheses previously put forward to explain schizophrenic birth seasonality: (1) that it is related to the seasonality of general births, and (2) that it is related to seasonal temperature variation. Neither hypothesis was supported by the data.

The 30-item General Health Questionnaire misclassified 26 per cent of respondents in two samples of women who were interviewed by a psychiatrist using the Present State Examination. False negatives were likely to be women with chronic disorders, particularly anxiety states. False positives were likely to be distressed by severe physical illness, a recent adverse life event, or loneliness. Applying a higher threshold score to their GHQ, responses would help to separate those with a diagnosable psychiatric disorder from those in states of distress.

In three collaborating hospitals, 81 anorexia nervosa patients were randomly assigned to behaviour modification or its absence and followed over 35 days. There was no overall significant difference in weight gain in the two groups except in a subset of patients: those with no prior out-patient treatments.

In spite of a decrease in the number of electroconvulsive treatments (ECT) administered during the decade 1966–1975, ECT is still commonly used in Sweden. About 4 per cent of all patients admitted for psychiatric treatment during 1975 received ECT. Affective disorders and confusional states appear to be the main indications. Treatment is usually unilateral, with general anaesthesia and muscle relaxants, generally using the same type of ECT machine.

Individuals potentially at risk for psychiatric disorders were identified by screening 375 college student volunteers for low platelet monoamine oxidase (MAO) activity levels. The lower and upper 10 per cent in MAO activity were administered a personal and family history interview, psychological tests and average evoked response (AER) electroencephalographic procedures. Results indicated that low MAO males and females were socially more active, had more psychiatric contact, and had relatives who were psychiatric-ally more disturbed than high MAO subjects. Low MAO males had more convictions, experimented more with illegal drugs and had elevated scores on the MMPI. AER criteria further defined a high risk group of low MAO-AER augmenters which had more suicides among their relatives and higher scores on the schizophrenia scale of the MMPI.

Seventy cases each of temporal lobe epilepsy and grand mal epilepsy were studied for their sexual functioning. The two groups were similar as regards age, sex, duration of illness, frequency of seizures and menstrual and marital history.

A significantly greater number of temporal lobe epileptics were found to be hyposexual. They had a global loss of performance and interest in the sexual sphere and showed no concern over it.

One case in the group of temporal lobe epilepsy, as against none in the other group, was hypersexual. There were no cases of sexual deviations in either of the groups.

The findings of the study are discussed in the light of the relevant literature.

An account is given of some of the topics discussed during a small informal weekly open group meeting of chronic schizophrenic patients, based on occasional notes compiled over eleven years. The main feature of the patients' condition as displayed was poverty—clinical, social, behavioural, material and financial—and certain features suggested an organic aetiology. Reasons are given for considering that the patients' condition was predominantly caused by schizophrenia rather than by institutionalism.

Maxwell has proposed the Random Error Coefficient of Agreement (RE), as a measure of agreement for the binary case based upon the assumption of random distribution of questionable cases. The present paper presents a more general formula for RE's computation and shows how the new form is applicable to cases with more than two response categories.

Body image distortion in 79 female anorexia nervosa patients were examined on a visual-size estimation apparatus during the emaciated stage of illness. Both they and an age-matched female control group overestimated their body widths, so this overestimation cannot be considered unique to anorexia nervosa. Among anorexia patients the degree of overestimation was associated with less weight gain during treatment, greater denial of illness, and several other pretreatment characteristics indicative of poor outcome.

The construction of a depression rating scale designed to be particularly sensitive to treatment effects is described. Ratings of 54 English and 52 Swedish patients on a 65 item comprehensive psychopathology scale were used to identify the 17 most commonly occurring symptoms in primary depressive illness in the combined sample.

Ratings on these 17 items for 64 patients participating in studies of four different antidepressant drugs were used to create a depression scale consisting of the 10 items which showed the largest changes with treatment and the highest correlation to overall change.

The inter-rater reliability of the new depression scale was high. Scores on the scale correlated significantly with scores on a standard rating scale for depression, the Hamilton Rating Scale (HRS), indicating its validity as a general severity estimate. Its capacity to differentiate between responders and non-responders to antidepressant treatment was better than the HRS, indicating greater sensitivity to change. The practical and ethical implications in terms of smaller sample sizes in clinical trials are discussed.

A trial was carried out of Reality Orientation (R.O.) in a residential home for the elderly mentally infirm with a ‘social therapy’ control group, receiving the same amount of staff attention as the R.O. group, in addition to an untreated control group. R.O. residents improved more on tests of information and orientation and various aspects of memory than controls. These results support the hypothesis that the nature of staff attention is crucial and that it should encourage and reward appropriate behaviour. No differential effects of treatment were found on rating scale assessments of the residents' functioning in the home.

This study examined the effects of desensitization, flooding and social skills training on social fears. The patients were 30 social phobics. All three treatments were associated with useful therapeutic gains during the period of treatment that were maintained over a six-month follow-up period. No differences were found between treatments.

The 30-item General Health Questionnaire (GHQ) has been validated against the criterion of a standardized psychiatric interview in the community. Used for screening, the GHQ misclassified 25 per cent of 105 respondents, being worse for men. Specificity and sensitivity were above.70. The alternative use of the GHQ as an estimator and as an indicator of morbidity in epidemiological surveys is described and discussed.

The purpose of this study was to examine the validity of assessing pictures produced by acute schizophrenic subjects as a technique in differential diagnosis. It was hypothesized that art productions by schizophrenics differ from those both by other acute psychiatric patients and by ‘normals'. Coloured slides were made from pictures produced in standardized conditions by three samples each of thirty subjects. It was found that repetition of abstract forms was the only factor studied to be associated specifically with schizophrenia; whereas the presence of pictorial imbalance, overelaboration, childlike features, uncovered space, detail and colour variety were found to be associated with psychiatric admission irregardless of diagnosis. Doubt is cast on the use of art as a technique in differential psychiatric diagnosis.

A consecutive series of 46 transsexuals, 35 men and 11 women, showed EEG abnormalities in 48 per cent and borderline abnormalities in another 24 per cent. Women showed the abnormalities in a significantly higher proportion than men. Those with the EEG abnormalities were slightly younger at inception, suggesting that they sought help at an earlier age, and their transsexualism became obvious to their families earlier. Those with personality disorders had EEG abnormalities more frequently, but not significantly so. This group of transsexual patients seemed to have a low sex drive, and those with abnormal EEGs even more so, but again the differences were not significant.

The possible significance of these findings for the understanding of transsexualism is discussed.

Fifty depressed in-patients at two psychiatric units, one in Italy the other in England, were treated with clomipramine, either orally, or intravenously and orally. A comparison of clinical response with plasma levels of clomipramine and its metabolite, desmethylclomipramine, showed clear relationships especially in the case of desmethylclomipramine. In the intravenously-treated group this was linear, in the orally-treated group it was curvilinear. Plasma levels of desmethylclomipramine and administered clomipramine correlate highly.

These findings, together with the fact that significant clinical improvement was observed in only 55 per cent of the patients, suggest that titration of the administered dose to obtain more effective plasma levels of the metabolite might improve the clinical response to the drug in some patients.

In three hospitals 81 female patients satisfying rigorous diagnostic criteria for anorexia nervosa were randomly allocated to one of four treatment combinations of cyproheptadine and placebo with behaviour therapy and no behaviour therapy. Cyproheptadine was found to be effective in inducing weight gain in a subgroup of anorexia nervosa patients who (a) had a history of birth delivery complications, (b) had lost 41–52 per cent weight from norm and (c) had a history of prior outpatient treatment failure. This subgroup may represent a more severe form of anorexia nervosa.