Procyclidine was administered to 25 chronic psychotic inpatients, stabilised on chlorpromazine, haloperidol or fluphenazine decanoate injection. We observed a significant reduction in mean serum levels of all three neuroleptic drugs which was reversed on stopping procyclidine and was Inversely correlated with mean serum procyclidine levels. No significant alterations occurred on the BPRS scores or in serum prolactin levels throughout the study In any of the three groups. Possible mechanisms of this interaction and its clinical relevance are discussed.

The effects of children's exposure to parental alcoholism was assessed using records from an existing prospective 40-year longitudinal study of working-class families: 176 men who had grown up with an alcoholic parent or parents were compared with 230 men without such exposure. Degree of exposure to alcoholism in the childhood family environment was highly correlated in later life with alcohol use, alcoholism, time in jail, sociopathy, and death, but not with increased rates of unemployment, poor physical health, or measures of adult ego functioning. Most of the impairments observed occurred in those subjects who actually developed alcoholism. Exposure to alcoholism in the family environment and family history of alcoholism independently contributed to the later development of alcoholism.

The case notes of 23 schizophrenic patients who participated in a study of somato-sensory cortical evoked responses were examined for descriptions of the clinical features of their mental state at the time of first illness or most recent relapse. A comparison of syndrome scores derived from Present State Examination with those derived from case notes showed that the latter was a reliable method of mental state description for the purposes of this study. A group of syndromes similar to that described in electrodermal research was identified from the case note review and found to be highly correlated with the presence of an abnormal response in the somato-sensory evoked potentials study.

The natural history-including psychiatric symptoms, precipitating factors, onset and course of illness, and personality characteristics-of 47 social phobics, 80 agoraphobics, and 72 simple phobics was examined. The social phobia group differed from the agoraphobia group by having a lower mean age, fewer females and married members, and a higher educational and occupational status. They were less fearful generally, less obsessive, and less likely to follow a fluctuating or phasic course. There was overlap between the two groups with regard to main phobias, and they were similar with regard to adjacent symptomatology. Both the social and agoraphobia groups differed in similar and significant ways from simple phobics.

The Piedmont Health Survey interviewed 3798 adult community residents in a region of North Carolina. Current major depression was nearly three times more common in the urban than in the rural counties; rural residence decreased the risk of major depression for some, but not all, demographic subgroups. The risk of major depression was decreased for young rural residents, compared with their urban age peers; rural residence was more protective for young women than for young men. Rural residence appears to be a buffer against major depression.

Female agoraphobics and their partners were compared with three groups of control couples (non-phobic female psychiatric patients and their husbands, maritally distressed couples, and happily married couples) on measures relating to marital adjustment, intimacy, and needs. Neither agoraphobics nor their partners rated their marriages as more maladjusted or unpleasant than non-phobic psychiatric patients or their partner controls. Instead, agoraphobics and their spouses were found to be more comparable to happily-married couples than to maritally-distressed controls. Non-phobic psychiatric patients and their partners were generally found to rate their marriages as being as distressing and unpleasant as those of maritally distressed controls.

In a 6-month prospective study of the three main general hospitals in Ibadan, Nigeria, 39 cases of deliberate self-harm were reported out of a total 23, 859 subjects attending the sections of hospital studied. Thirty (76.9%) were under 30 years of age and 36 (86.3%) were under 34 years of age. The male to female ratio was 1.4.1: more than half of the population (51.3%) were students and 25.6%, manual workers. The methods used were mainly ingestion of chemicals (24 patients) and psychotropic drugs (11 patients). Disturbed Interpersonal relationships, especially with parents, were mainly found to have motivated the acts. The implications of these findings are discussed.

Intracavernosal injection of phenoxybenzamine or papaverine has been tried on 127 men suffering from erectile impotence. In 113 of them it caused an erection which should have sufficed for coitus. Seventy-three men have used such injections, given at home by themselves or their wives, fortnightly or less often, to make coitus possible after each injection; 54 of them still do so.

Two patients are described in whom an obsessive-compulsive disorder began just after the onset of epilepsy. Neurological factors in OCD are then reviewed, and clinical reports of patients with OCD and co-existing brain pathology, EEG abnormalities, CT scan changes and electrical stimulation of the brain discussed. It is concluded that neurological factors are present in only a minority of cases of OCD. Successful behavioural treatment is independent of such factors.

This paper argues that recent research on normal-belief formation is relevant to our understanding of the establishment and maintenance of delusions. Bayesian theory provides a normative model of the way in which evidence relevant to normal beliefs may be evaluated: this makes it possible to classify delusional beliefs in terms of deviations from optimal Bayesian inference. Some hypothetical forms of deviation appear to correspond closely to cognitive processes observed in some groups of deluded patients. Theories of the precise nature of the abnormal judgemental processes also have implications for psychological approaches to treatment of deluded patients. The role of hallucinations in the formation and/or maintenance of delusions and the extent to which the distortions of cognitive processes associated with delusions are content-specific or mood-specific are also considered.

Nutritional deficiencies have been implicated in the pathophysiology of various mental disorders. Life in institutions has been associated with development of nutritional deficiencies, the elderly being most at risk especially those with senile dementia. In this study nutritional status, particularly vitamin and essential mineral status was assessed in a group of 64 new admissions to a psychogeriatric unit and 49 long-term patients.

The results indicated that psychogeriatric patients were at risk of experiencing nutritional deficiencies and those with senile dementia were likely to have more abnormalities than those with functional illnesses. Those patients in long-term care would appear to have a better nutritional state than those on admission.

The presence of tardive dyskinesia in a sample of 43 patients with schizophrenia and 37 psychopaths who had been hospitalised for many years and exposed to large amounts of medication was assessed while testing their cognitive function. Subjects who showed no evidence of abnormal movements performed significantly better on the test of delayed recall, but there were no differences in performance on any of the other tests of cognitive function used. Multiple regression analysis revealed that age and the total lifetime dose of neuroleptic medication received (in chlorpromazine equivalents) were the only variables to predict the Abnormal Involuntary Movement Scale score, although a large amount of variance in this variable was unaccounted for. The duration of treatment with neuroleptics did not predict AIMS score.

The treated one-year prevalence and point-prevalence of schizophrenia, schizoaffective psychosis, and paranoid state in the city of Salford were derived from the Salford Psychiatric Case Register. The high rates found are attributed primarily to the effects of selective migration from the area. A breakdown of the use of health services in the area by patients with these diagnoses is given; hospital care was found to be the major form of treatment.

Zinc deficiency has been reported in association with dementia and linked with its pathogenesis. A group of 45 elderly patients admitted to a mental hospital were given diagnoses in accordance with ICD-9, and their fasting plasma zinc levels were recorded. No difference was found in zinc levels between patients with diagnoses of senile dementia and those with other diagnoses.

The dexamethasone suppression test was performed on 79 patients with a diagnosis of generalised anxiety disorder. A non-suppression rate of 27% was obtained, comparable to that found in out-patient major depression but notably higher than previous reports in panic disorder. No good clinical predictors of non-suppression were discovered, nor was the co-occurrence of depression sufficient to account for the finding.

HLA haplotypes A and B were studied in eight familes with two or more schizophrenic members. All index cases and all but two sick relatives satisfied Research Diagnostic Criteria for the diagnosis of schizophrenia; 45 subjects were studied. Data were analysed by sequential tests for the detection of linkage and by the affected sib-pair method. The results do not support a linkage between HLA and schizophrenia.

The views of practising psychiatrists on treatment of the depressions were investigated as part of a Quality Assurance Project. A one in six random sample of all Australian psychiatrists was mailed a questionnaire. This asked for treatment recommendations for each of five case descriptions of patients with depression. Respondents were asked to code their treatment plans from a glossary listing possible treatments for depression: 85% of the sample responded. Tricyclic antidepressants were the treatment of choice for two cases of endogenous depression, electroconvulsive therapy (ECT) being recommended when psychotic features were present or when drug therapy had failed. Psychotherapies were the treatment of choice for cases with neurotic features, drugs being recommended when Improvement with psychotherapy did not occur.

Fifty-five cases of suicide by doctors under the age of 40 were studied because of concern about deaths among anaesthetists in training. The excess mortality of doctors from suicide was confirmed, suggesting that risk factors associated with being a member of the medical profession continue to operate, although mortality for young male doctors from accidental poisoning is falling. Analysis of the branches of medicine in which the doctors were working showed no definite specialty predominance. There was a somewhat greater risk for women doctors born overseas.

Of 105 patients admitted to a surgical ward with acute abdominal pain, 18 were considered to be without evidence of any organic aetiology for this symptom. These ‘non-organic’ patients were almost all female and differed from the ‘organic’ patients in state anxiety and in the illness behaviour questionnaire scales of psychological versus somatic perception, denial and affective disturbance. The two groups of patients could be differentiated on the basis of scores derived from the Illness Behaviour Questionnaire, and the State-Trait Anxiety Inventory.