Twelve women with bulimia participated in a study in which they binged and vomited on the day after hospital admission. Caloric intake, time spent bingeing and vomiting, and selfreported mood ratings demonstrated much variation from subject to subject. Both subjective and objective ratings of mood indicated that anxiety decreased more frequently and to a greater extent than depression, both during and after bingeing and vomiting. The present data, obtained in a controlled setting, tend to confirm previous information on binge episodes obtained by self-report from bulimic patients. Bingeing and vomiting episodes may provide bulimic patients with a physiological mechanism for temporarily relieving a dysphoric mood state.

Prior studies on weight change and hypothalmic-pituitary-adrenal (HPA) axis functioning are reviewed. Data on 58 depressed and eight anorexic patients is presented. No significant difference in the frequency of cortisol non-suppression in the dexamethasone suppression test (DST) was found between depressed patients with a history of weight loss and those without, nor between depressed patients who lost weight during their first week in hospital and those who did not. Mean weight loss of suppressors did not significantly differ from that of non-suppressors. Of 12 patients whose DST normalised during their stay in hospital, only four gained weight. Five anorexics who were non-suppressors were <70% of their ideal body weight (IBW), while three suppressor anorexics were ≧70% IBW. These results indicate that mild to moderate weight change is not a significant influence on DST response in depression.

Intellectual impairment, negative symptoms, and medication history were assessed in chronic schizophrenic patients with and without abnormal involuntary movements (tardive dyskinesia). Patients with involuntary movements had received neither longer nor more intensive treatment with neuroleptics or anticholinergics. However, the presence or absence of involuntary movements was prominently associated with the presence or absence of intellectual impairment/negative symptoms; these features are characteristic of the defect state/type II syndrome of schizophrenia, in which structural abnormalities of the brain may be over-represented. The role of subtle organic changes in conferring vulnerability to the emergence of such involuntary movements should be re-evaluated.

Three groups of torture victims were studied with the aim of establishing a concept of psychotherapy for such victims. Analysis of the first group, consisting of 200 case-reports made by Amnesty International medical groups, resulted in a general outline of the psychological methods of torture and their main impact on the victims. A second group of 24 torture victims was examined by the authors, and a quantitative assessment of long-term neuropsychological complaints and a qualitative insight into these symptoms achieved. In-depth interviews with victims in the third group which, consisted of the victims from the second group and six others, together with the results from the other two groups, formed the basis of a concept of psychotherapy for torture victims.

SOMA, a questionnaire designed by J. T. Quinn to measure sexual anxiety in patients presenting at a psychosexual clinic, has been used extensively as a clinical and research tool. Its construction and scoring are described, and data are presented for internal consistency, test-retest reliability, principal components analysis, and validity. Practical applications for diagnosis, prognosis, and research are discussed.

In a prospective study of the 295 admissions in one year to an acute psychiatric ward, 14 subjects without delirium or dementia were found to have developed temporary urinary incontinence. When compared with matched controls (n = 56) the incontinent patients were found to be suffering from psychosis (P < 0.0002) and to have a history of childhood enuresis (P < 0.01). Compared with psychotic controls (n = 22), the incontinent patients were older (P < 0.05), they had been exposed to a greater variety of treatments (P < 0.01), and they had received more thioridazine (P < 0.04).

The present study describes the results of a 7-month and a 15-month follow-up of 32 agoraphobic patients treated with exposure in vivo or applied relaxation. During the followup period, all patients were given self-exposure instructions. Assessments were made in three response systems-subjective-cognitive, behavioural, and physiological-at the follow-up points. The study showed overall maintenance of treatment results in all three response systems for exposure-treated patients. For applied relaxation/self-exposure, there was a relapse on Δ heart-rate at 7 months for physiologically reactive patients, but the improvement was regained at the 15 month follow-up. Furthermore, a large proportion of the total improvement occurred during the follow-up period: 36% and 22% for exposure and applied relaxation/self-exposure respectively. The proportion of patients reaching a clinically significant improvement was 50% at the end of treatment and 66% at the 15 month follow-up.

The point-prevalence of tardive dyskinesia in schizophrenics from a discrete geographical area (Nithsdale, in Dumfries and Galloway Region) in 1981, 1982, and 1984 was 31%, 27%, and 30% respectively. This suggests that the prevalence of tardive dyskinesia in a community of schizophrenics has reached a plateau. In 12% of patients there was persistent dyskinesia, i.e. abnormal involuntary movements were present at all three assessments. Persistent dyskinesia was more common in older patients. The severity of tardive dyskinesia fluctuated between assessments in 41 % of patients, indicating that it is only a transient feature in some cases.

In an investigation of white, coloured, and black patients admitted to a psychiatric hospital, the prevalence and treatment of depression in schizophrenia was assessed and found to be 30% in group of acute, nuclear schizophrenics. While the prevalence was similar in the three groups, depression was clinically under-detected in black patients.

A total of 149 children aged 13–17 years were examined. 83 were mildly and 66 severely mentally retarded. These children, especially the severely retarded ones, are representative of all mentally retarded children born in 1966–1970 and living in Göteborg, Sweden. 64% of the severely mentally retarded and 57% of the mildly mentally retarded children were suffering from a handicapping psychiatric condition. Autism-like ‘psychotic behaviour’ was common in the severely retarded. 0.2% of the total child population aged 13–17 years suffering from the combination of mental retardation and ‘psychotic behaviour’. Epilepsy was associated with psychiatric abnormality, but Down's syndrome was generally not so associated.

Reports have appeared in the literature suggesting an association between physical illness and the later development of anorexia nervosa. The histories of 326 patients with anorexia nervosa were examined for physical illness. A higher rate of severe physical illness was found in this group when compared with controls suggesting that it should be regarded as a risk factor for anorexia nervosa. No statistically significant differences were found when illness was examined by time in relation to onset of anorexia, system involved, or when subjects were stratified by age. Possible explanations for the observed association are discussed.

The results of applied relaxation training in patients with generalised anxiety and panic attacks are reported. ART was taught during one session, by means of participant demonstration, written instructions, taped instructions, or a combination of all three, with instructions to practise at home. All four methods proved superior to a waiting list control, but there were no differences between the treatment groups. There was some evidence for the non-specific effect of expectancy, but this did not completely explain the treatment effect.

The distinction between hyperactivity and conduct disorder was explored in a mixed group of 64 children referred to psychiatric clinics because of antisocial or disruptive behaviour. A semi-structured interview measure (the Parental Account of Children's Symptoms, PACS) proved to have adequate inter-rater reliability, internal consistency and factorial validity. The PACS scales of defiance and hyperactivity, and similar subscales from Conners' Teacher Rating Scale, were tested against laboratory and clinical measures of activity, attention, cognitive performance, psychosocial background and family relationships. The hyperactivity (but not the defiance) scales were associated with greater activity, younger age, poorer cognitive performance and abnormalities on a developmental neurological examination. The defiance (but not the hyperactivity) scales were associated with Impairment of family relationships and adverse social factors. It was concluded that a dimension of Inattentive, restless activity should be separated from one of antisocial, defiant conduct In children with psychiatric disorder.

Out of 1279 first-year undergraduates, two matched groups of students potentially vulnerable to psychological disturbance were identified. One was left to its own resources; the other was offered psychotherapeutic intervention, the effects of which were measured by the number of consultations with general practitioners, type of treatment and rate of withdrawal from university. Although the students in the intervention group had fewer consultations, lower General Health Questionnaire scores at follow-up, and fewer withdrew from university, due to the small numbers involved none of these differences achieved statistical significance.

Patients attending a regional head and neck Oncology Unit were assessed for depression and anxiety (using the Leeds self-assessment scales) before diagnostic biopsy investigations. At the time of the assessments, neither patients nor investigators knew the biopsy results. Patients whose biopsies subsequently proved positive (showing the presence of a tumour) had significantly higher depression scores than those whose biopsies were negative. Differences in mean anxiety scores did not differ between groups. It is suggested that depression is part of the clinical picture of head and neck cancer.

Specific questioning and frequent observation of a 69 year-old woman with cyclic bipolar manic-depressive illness showed that she had disturbances of thirst, appetite, bowel and bladder function and dramatic changes in body weight, in association with different phases of her mental illness. Examination of one manic phase under constant diet and inpatient control showed cardiovascular changes, sodium retention, body weight gain, with raised aldosterone secretion but steady vasopressin. There appears to be a sub-group of manic-depressive patients with evidence of disturbed hypothalamic functions as part of their mental illness, as shown particularly by changes in water and electrolyte metabolism.

The opinions of patients who had caused deliberate self-harm about the attitudes of doctors, nurses, families and others towards their acts were studied. Their views of the attitudes of hospital staff were found to be markedly different from attitudes reported elsewhere by staff themselves. There were no differences between the patients' views of their handling by nurses, families, and others towards their acts were studied. Their views of the attitudes of families were unsympathetic. A significant association was found between repetition of an act of deliberate self-harm and the perception of an unsympathetic attitude within the family.

The correlations between eye movements on the EOG of a patient with a 48 hour cycle of manic-depressive type are described. They are used to confirm the fact that his switch from one state to another occurred at the same time of night whether he was awake or asleep.

A retrospective analysis of the violent incident forms returned over a one year period in a psychiatric hospital recorded 283 incidents involving 144 patients. Almost all were of a petty nature, none leading to lasting injuries. Compared with the average daily in-patient population, offending patients were more likely to be male, to be less than 45 years old, and to have a diagnosis of schizophrenia.

Post-ECT blood pressure rise and its relationship to cognitive and affective change were studied in 29 depressed patients, using the Benton Visual Retention Test, the Hamilton Rating Scale for Depression, and the Leeds Self-Assessment Scale for Depression and Anxiety. No real difference was established in the Benton Test error scores before and after ECT, no correlation between rise in blood pressure and change in Benton Test error score with ECT was found, and no correlation was found between blood pressure rise and affective improvement following ECT. Previous studies which reported such correlations are not supported.