In recent studies in alcoholism where systematic desensitization of social anxiety has been used, it would appear that there are many changes in the total behaviour of the patient, as well as the removal of the need for excessive alcohol (Kraft, 1968). This paper aims at evaluating the changes which occurred in nine patients treated in this way, as shown in a variety of psychometric tests. Although the small size of the sample limits the scope of the study, it is hoped that the information might be of use to further investigators in this field.

Pimozide is a new neuroleptic drug and is chemically described as bis-para-fluoro-phenyl-butylpiperidine. It is active after oral administration, with a 24 hour duration of action and a peak effect lasting four to six hours (1). Superiority over placebo has been demonstrated by Brugmans (2).

Many text-books of psychiatry include an inquiry about a history of nail-biting in their scheme of history taking, and if nail-biting is noted when a patient is examined it is often recorded.

The classification of depressive illnesses continues to be a problematic and controversial issue (Kendell, 1968; Hope, 1969). The many statistical approaches applied to this complex question since Hamilton's original study (1960) have been reviewed by Kendell (1968). More recently, Pilowsky, Levine and Boulton (1969) have offered evidence (based on the application of information theory taxonomy to patients' questionnaire responses) which supports the validity of regarding ‘endogenous' depression as a clinical entity. Following on this study, Pilowsky and Boulton (1970) have developed a decision rule for the identification of depressive class members and have shown that class membership is related to the response to electroconvulsive therapy; patients in the ‘endogenous' Class B group having a better clinical outcome.

The use of mono-amine oxidase inhibitors (MAOI) entails the risk of hypertensive crises with various foodstuffs and other drugs. On the other hand, the tricyclic antidepressants have a slow onset of action, and this may be a serious disadvantage in a condition like acute depression where there is always a danger of suicide. The use of an MAOI can therefore be justified if it is shown to be more effective than the tricyclic compounds.

Unilateral E.C.T. applied to the non-dominant hemisphere has been tried by several workers in cases of depressive illness. Although Levy (1968) has pointed out that the evidence is not sufficient to recommend unilateral E.C.T. as a routine procedure, its main advantages over bilateral E.C.T. have been demonstrated as reduction of post-E.C.T. memory disturbances (Zinkin and Birtchnell 1968 and Valentine et al., 1968), and diminution of post-E.C.T. confusion (Halliday et al., 1968). The present investigation studies the effect of unilateral E.C.T. on schizophrenic delusions and hallucinations with a view to testing the hypothesis that the apparent superiority represented by the diminished side-effects with the unilateral technique might be therapeutically disadvantageous where treatment of patients with delusions and hallucinations is concerned. According to this hypothesis memory impairment may be part of the therapeutic mechanism responsible for the disruption of delusions and hallucinations and their ultimate amelioration or disappearance. If this hypothesis is correct patients treated with bilateral E.C.T. should do better than those treated with the unilateral technique.

Recently increased interest has been shown in the physiological and behavioural consequences of DC polarization of the brain.

As part of the study of alcoholism, we have investigated the possibility that early age of onset of alcoholism indicates a possible diagnosis of personality disorder while later age of onset does not.

In 1964 Cutler et al. (1) reported on a family in which 11 members apparently had primary hyperparathyroidism. Seven cases were diagnosed at surgery; four other members had elevated serum calcium and other evidence of the disease. It was noted as an incidental finding that two of the affected members also suffered from severe psychiatric illness. The present study is a six-year follow-up investigation of the family from a psychiatric viewpoint, using non-hyperparathyroidism family members as controls to explore the possible relation of hyperparathyroidism to psychiatric illness.

The Green Paper was welcomed as an outline of the new proposed structure and as a considerable advance on the first Green Paper of 1968, discussed in the Association's Memorandum published in the British Journal of Psychiatry, 1969, 115, 601–3.