A survey of patients with drug-related problems seen in London casualty departments during the course of one month revealed 1,706 separate incidents. In 477 cases the patients were dependent on drugs, and more than 40 per cent were dealt with by only five hospitals, all in the West End of London. The remaining 1,229 incidents involved non-dependent patients who had taken a drug overdose, and these cases were distributed more evenly between hospitals all over the Greater London area. The implications of this study for service planning and for further monitoring of the patterns of drug misuse are discussed.

Using a classical click/flash paradigm, the CNV was recorded from the following three groups of subjects at Broadmoor Hospital: (1) 14 ‘psychopathic’ patients selected by use of the 4/9 MMPI profile and confirmed by independent clinical diagnosis; (2) 15 ‘non psychopathic’ patients, all psychotic and mainly schizophrenic; (3) 14 healthy staff control subjects. All three groups were matched for age and sex; the two patients groups were also matched for length of stay. Two series of 32 paired stimuli were used, separated by an interval of 30 minutes. The mean CNV voltage was significantly lower in the ‘non-psychopathic’ patients. The amplitude of the ‘psychopath's' CNV response did not differ significantly from that of the staff controls, but the response variability between the first and second series of trials was much greater in the ‘psychopathic’ patients than in the other two subject groups. The ‘psychopathic’ subjects tended to show more rapid initial development of the CNV.

The quarterly distribution of births of patients born in England and Wales 1921–60 and first admitted in 1970–75 was examined by decade of birth and by age at year of admission. For patients with schizophrenia and affective psychosis, the distribution varied: in the early decade (1921–30), and for older patients (45–54 years) the proportion of births in the fourth quarter of the year was high, compared with expectation from live births in the general population; but it became lower in succeeding decades and for younger age groups. No comparable change occurred for births of patients with neurosis or personality disorder.

Classifications given to self-inflicted deaths between 1959 and 1972 by a coroner and his deputy were compared for differences in the use of the suicide, accident, and open verdict definitions. The coroners varied in their use of the open verdict and the suicide verdict for poisoning cases but not for deaths from other causes.

Twenty general practice patients selected for treatment with tricyclic antidepressants were matched with an equal number of psychiatric in-patients who had been admitted to hospital for depressive illnesses. In order to assess their depressive status, the Levine-Pilowsky (LPD) questionnaire was administered to both groups. It was found that although patients from each setting reported the same degree of depressive severity, the pattern of their LPD responses differed significantly. Twice as many hospital patients were assigned to either Class A (‘non-endogenous depression’) or Class B (‘endogenous depression) compared to the general practice patients, most of whom were classified as Class C (‘non depressed’). These results indicate the importance of distinguishing between depressive severity and depressive classification when comparing patients encountered outside the hospital setting with those who are in-patients.

Various benefits claimed for methadone maintenance in the treatment of opioid drug takers are reviewed. It is said to stop illicit drug use, maintain treatment contact, reduce morbidity, mortality and crime, and improve social adjustment. Little firm evidence is found to support these claims. Results are reported comparing 26 drug takers on methadone prescriptions with 16 illicit opioid takers. The measures used are Stimson's (1972) ‘Patterns of Behaviour’ questionnaire, and direct behavioural measures of social functioning. The groups are found not to differ in terms of treatment contact, work status and involvement with other drug takers. There is some evidence that the methadone group is involved in less criminal activity. However, no association is found between amounts of drugs prescribed and numbers of local pharmacy thefts. It is concluded that the benefits of methadone maintenance have been exaggerated.

There is growing evidence that early parent death can affect the severity of adult depressive illness. It was anticipated, therefore, that early-bereaved depressed patients might score higher on certain MMPI clinical scales than non-bereaved, depressed controls matched for age and sex. This is shown to be the case, the most affected scales being Hypochondriasis and Paranoia. Hypochondriasis is shown to be more strongly associated with early father death, while Paranoia is associated equally with mother and father death. There is some suggestion that early mother death is also associated with elevation of the F score. Early parent death is shown to have no effect upon the MMPI scores of non-depressed patients.

The number of microvolt seconds of alpha rhythm emitted during a five-minute period were collected for 30 male and 30 female subjects. This measure of alpha abundance was then compared in subjects who scored high and in those who scored low on the E and N scales of the Eysenck Personality Inventory. Subjects who scored low on the E scale tended to have a significantly greater number of microvolt seconds of alpha than did subjects who scored high on the scale. No differentiation on the basis of emitted alpha was possible for subjects scoring high and low on the N scale.

Fifty persons who had all been heavy cannabis users for a long time were given psychological tests measuring psychomotor, perceptual and other variables. Half of these persons were ‘Charas' smokers, half ‘Bhang’ drinkers. The duration of cannabis use was 4–10 years, with an average daily dose of 150 mg tetrahydrocannabinol. A matched control group of twenty-five persons were given the same tests. Compared with this group, the cannabis users were found to react more slowly, to be poorer in concentration and time estimation, to have higher neuroticism and greater perceptuo-motor disturbance. The Charas smokers were the poorest performers and also showed poor memory, lowered psychomotor activity, and poor size estimation.

This paper is concerned with the evaluation of the Hilton Drinking Behaviour Questionnaire (HDBQ), which is based on the proposition that although there are wide variations in the types of problems caused by alcohol abuse there are certain symptoms which are generally considered to indicate ‘alcoholism’. Also that there is an identifiable pattern of symptom development in the acquisition of dependence.

The HDBQ proved to be a unidim.ensional scale which was valid and reliable as a m.easure of alcoholfsm, All items significantly discritninated between the alcoholic and control groups, and total scores correlated highly with those on the Alcadd test and with quantity-frequency measures of drinking. The theoretical and clinical implication of the results are discussed.

Three different patterns of morbid grief are noted. The effect of forced mourning procedures on morbidly grieving patients is discussed with some indication of beneficial and harmful effects of psychotherapeutic intervention.

A comparison has been made between persons aged 50 and over dying from suicide and a matched control group of persons dying from other violent causes with respect to the incidence of malignant neoplasms and benign intracranial tumours found at autopsy. Significantly more of the suicide cases were found to have cancer, meningiomas and benign pituitary tumours. The implications of this finding and the relationship between depression and neoplasia are discussed.

Forty patients took part in this study. Twenty patients treated by group desensitization were compared with twenty treated by individual desensitization. Group desensitization appeared the more effective treatment if outcome was measured on the patients' self-rating scale, but the less effective if outcome was measured by the sexual interest questionnaire. Of the two, the group method took longer to administer, but more patients treated in this way completed the course of treatment.

The Zung Self-Rating Depression Scale (ZSDS) correlated well (0·69) with the treating physician's global rating in 26 depressed out-patients during the six weeks of treatment with a tricyclic antidepressant. In a larger sample of 41 patients, a high correlation was found between the ZSDS and the Hamilton Rating Scale. The sensitivity of the ZSDS was found to be adequate. The scale was able to differentiate, at the 0·05 level, four severity groups classified on the basis of the global rating. The importance of the direct relationship between the range of severity studied and the value of the correlation coefficient was discussed. Previous investigations and the results of this study indicate that the ZSDS is a valid and sensitive measure of clinical severity in depressed patients and support its continued use as a research instrument.

It has been suggested that cerebral noradrenaline turnover in patients can be assessed from the excretion in urine of 3-methoxy-4-hydroxyphenylethylene glycol (MOPEG). Studies were therefore made on the effects of mild exercise on the excretion of the conjugates of MOPEG as this might complicate interpretation. Changes are produced, but there are individual differences between subjects.

Physical fitness was also studied and, although it could not be shown to be the factor explaining differences between different patients, nevertheless it is probably a factor influencing the levels of MOPEG excreted.

The study of the distribution of free MOPEG and its sulphate conjugate in a human brain also raised doubts about the proportions which could have a cerebral origin.

The observations suggest the need for caution in using MOPEG excretion to detect abnormal amine changes in brain. They do not, however, conclusively refute the hypothesis that MOPEG sulphate in urine significantly reflects cerebral noradrenaline activity.

To date there has been no suitable scale for the self-assessment of irritability in the clinical situation. Existing scales have either included aspects of personality trait together with present state or they have been constructed on non-clinical populations. A self-assessment scale has been constructed which seeks to overcome such faults. Measures of depression and of anxiety are included, together with measures of outwardly directed irritability and inwardly directed irritability. This scale should be known as the Irritability, Depression, Anxiety—or IDA—Scale.

Glucose utilization, serum insulin, human growth hormone, and free fatty acids were studied in 18 unipolar depressed patients and 14 normal controls, using the intravenous glucose tolerance test. Patients were kept drug-free for at least two weeks before testing, and physical activity and diet were carefully controlled. Previously described abnormalities in the balance between glucose and free fatty adds were not seen, but endogenous depression was associated with lowered glucose utilization rate with insulin resistance. Changes in kinetics of membrane transport in endogenous depression which could account for this finding are discussed.

The account of mental processes emerging from the work of cognitive psychologists is briefly reviewed, and aspects of the theoretical basis of the work of psychoanalytic and behaviourist psychotherapists are considered in the light of this. It is argued that in both traditions increasing attention is being paid to cognitive processes. A restatement of psychoanalytic theory in cognitive terms could free it from its present confusion of metaphors, and an extension of behaviourist theory in this direction could free it from reductionism. The advantages of the adoption of a common language, based on the models of cognitive psychology, to theory, practice and research are briefly considered.

The conviction rates for the first 61 admissions to a therapeutic community for drug dependence were obtained for a period two years prior to admission and two years after discharge, by searching in the Criminal Records Office at Scotland Yard.

A long-stay group (n = 20) which had remained in residence more than six months was compared with a medium-stay group (n = 20) which had remained from one to six months and a short stay group (n = 21) which had remained less than one month.

The long-stay group had a pre-admission conviction rate of 60 per cent, which was significantly reduced to 10 per cent during the follow-up period. The conviction rate of the medium-stay group was reduced from 70 per cent before treatment to 45 per cent after treatment; that of the short stay group remained constant at 57 per cent before and after treatment. It is suggested that periods of more than six months treatment in the community are effective in reducing subsequent criminality.

Undetermined deaths in England and Wales between 1968 and 1972 did not show the same pattern of seasonal variation as suicides.