The changes in pituitary gland function in mental illness are under intensive study. This is because the regulation of pituitary function by the brain involves monoamine neurotransmitters, and changes in hormonal secretion may thus reflect general fluctuations in monoamine activity in the brain. Characteristic patterns of change of diagnostic and therapeutic significance may also emerge. Thus, adrenocorticotrophic hormone secretion and adrenal corticosteroid activity are enhanced in depression, largely through the occurrence of additional secretory spikes of ACTH and the lack during the late evening or early morning of the normal fall in Cortisol secretion. Dexamethasone is less able to inhibit ACTH secretion in depression, while a fall in plasma glucose may less readily induce growth hormone secretion (Ettigi and Brown, 1977; Gruen, 1978). Nevertheless, there is no assurance that a monoamine neurotransmitter system concerned with pituitary function is affected in the same way as one influencing psychic outlook.

A series of discriminant function analyses based only on clinical symptomatology suggests that psychotic and neurotic depressives do not differ globally but at a fairly specific level and that the principal, if not only, clinical difference between the groups is one of severity. This interpretation is reinforced by the fact that there are few symptoms more common in the neurotic group. There is suggestive evidence that symptoms generally thought to characterize neurotic depression may conduce to referral to psychiatric services. The neurotic depressive syndrome as classically conceived may therefore be an artificial one, created by selective factors bringing patients with particular symptoms into hospital populations.

A sample of chronic schizophrenic patients from an urban community, living outside hospital, were reassessed on the Present State Examination one year after a first examination. During this time their use of psychiatric hospital services was recorded. One hundred and two patients had satisfactory interviews on both occasions. These could be divided into Heavy, Medium and Light users of services, the numbers being 8, 14 and 63 respectively, while 17 only saw their general practitioners or had no treatment. A ranking of the sample in terms of severity showed no correlation with use of these services; second PSE scores were not significantly different from the first. Heavy and Medium users of hospital services were in contact with Social Services to a significantly greater extent than other patients.

Forty-five in-patients, with primary diagnoses of neurosis or personality disorder, completed the test cards and booklet versions of the Symptom Rating Test—Day (SRT). In order to facilitate retroactive interference the Manifest Anxiety Scale (MAS) and the Maudsley Personality Inventory (MPI) were administered between the two forms of the SRT. On the next day the patients were given the SRT (Week). The initial SRT, MAS and MPI testing was repeated one week later.

On the assumption that positional set is an important consideration predictions were made as to the expected differences between the test cards and booklet modes of SRT administration.

The results add support to the practical use of the SRT in its more recent standardized format.

The predictive value of the NOSIE, a ward behaviour rating scale, was investigated in a group of long-stay patients. After a follow-up period of 3 ½ years, it was found that all NOSIE scales differentiated continuing in-patients from those discharged. Regression analysis showed that age and florid psychoticism carried most predictive weight. These findings and the value of reliable rating scales for rehabilitation purposes are discussed.

In 1929, George W. Henry published a paper on ‘Some Modern Aspects of Psychiatry in General Hospital Practice’ and thus became the founder of what later came to be known as liaison psychiatry. He described his work as a psychiatric consultant at Cornell Medical School and advised that ‘On the staff of every general hospital there should be a psychiatrist who would make regular visits to the wards, who would direct a psychiatric out-patient clinic, who would continue the instruction and organize the psychiatric work of interns and who would attend staff conferences so that there might be a mutual exchange of medical experience and a frank discussion of the more complicated cases'. This quotation spells out the essence of psychiatric liaison with medicine. The work of Henry and a few other pioneers bore fruit: psychiatry was at last brought into general hospitals and the mainstream of twentieth century medicine. This was a development of far-reaching consequence for both clinical disciplines, and a major landmark in the history of modern psychiatry.

Five experimental incentive conditions were compared with a control condition in terms of their effect on work performance. Each of the six groups studied had a standard four-week baseline period (Block 1) consisting of an attendance payment, followed by a four-week experimental period (Block 2). Whereas all patients in the Control and Feedback groups produced less during Block 2, only two patients in the remaining four groups failed to improve. An analysis of variance indicated that Social Reinforcement, Piece Rate, Piece Rate plus Social Reinforcement, and Pay Increase plus Social Reinforcement were significantly superior to the Control and Feedback conditions.

The use of cerebral electrotherapy (CET) in methadone detoxification was studied in 28 patients. Fourteen patients received active CET; the other 14 acted as controls and received either simulated CET or only methadone detoxification therapy. One patient dropped out of the study. The Taylor Manifest Anxiety Scale and the Hamilton Anxiety Scale were administered before and after the study period. Nine of the patients receiving active CET were drug-free by the end of 8 to 10 days, and all experienced a marked reduction of their symptoms; the control group did not show significant changes. CET was clearly beneficial in the treatment of patients undergoing methadone withdrawal.

When asked by the book review editor to write an article discussing some ‘important, memorable, relevant, unusual or informative books (or articles)’ in the field of psychopharmacology, I was uncertain quite what was wanted.

Psychiatric investigation of 342 patients attending a urological clinic during one year showed a wide spectrum of problems. Patients with lower urinary tract complaints scored higher on the Hamilton Scale than those with upper tract complaints.