Two hundred and ninety West Indian and 73 West African patients were identified and matched against 204 and 53 English patients respectively. Significantly more migrant patients were: not referred to hospital by their GPs, showed disturbed behaviour prior to psychiatric contact, and were admitted formally. Studying consecutive attendances or admissions to one hospital may lead to an unrepresentative sample.

Chronic schizophrenic patients were maintained for six months on a dosage of haloperidol adjusted to give optimum clinical effect. A correlation was found between extrapyramidal symptoms and prolactin levels and also between plasma haloperidol concentration and plasma prolactin levels. Estimation of plasma prolactin would be a reliable measurement of patients' compliance with medication.

Cognitive function was compared in carefully matched groups of ECT and non-ECT treated depressives and in matched normal volunteer controls on admission, at 4 months and at 7 months. ECT caused little impairment at 4 months and no impairment at 7 months on a comprehensive cognitive test battery. Severity of depression had a marked effect on cognitive function. Within the ECT group bilateral ECT caused more impairment than unilateral ECT one week after a course but 3 months later the differences had disappeared. They were equally antidepressant.

A method is described for identifying a genuine boundary between related syndromes, if one exists, by demonstrating a non-linear relationship between symptomatology and outcome. The technique was applied to the putative boundary between schizophrenic and affective psychoses, but a non-linear relationship could not be demonstrated.

The effects of three single oral doses (25 mg, 50 mg and 100 mg) of amitriptyline and desipramine, and of placebo, were compared on a range of cholinergic functions (resting pupil diameter, pilocarpine-evoked miosis, baseline-sweating, carbachol-evoked sweating, salivation, heart rate) in eight healthy volunteers. Three measures (pilocarpine-evoked miosis, carbachol-evoked sweating and salivation) reflected the antimuscarinic property of the antidepressants; in two tests (pilocarpine-evoked miosis and salivation) amitriptyline appeared to be more potent than desipramine. Resting pupil diameter was not affected by amitriptyline, whereas desipramine caused mydriasis, indicating that pupil size is not a reliable measure of anticholinergic activity in the case of drugs which also affect adrenergic mechanisms. Baseline-sweating and heart rate were not affected by the antidepressants.

In a double-blind comparative trial of sulpiride (600–1,800 mg/day) and trifluoperazine (15–45 mg/day) in 38 chronic schizophrenic patients, ratings of therapeutic results and unwanted effects were made at two-weekly interviews during the six weeks treatment period. The results show that sulpiride has neuroleptic properties and a spectrum of therapeutic activity similar to that of trifluoperazine. There was an association between plasma sulpiride levels and therapeutic response after four weeks' treatment.

The clinical features shown by 50 psychotic patients were documented by interviews held with the patient and next-of-kin, brief videotaped interviews and nurse rating in addition to the hospital case record. Three raters studied all the available material and made master ratings. Comparison of the ratings made at mental state interview with these master ratings showed that this interview missed a great deal of the pathology agreed to be present. The interview with the next-of-kin was helpful in identifying manic symptoms. Nurse rating based on an 8-hour period of observation was less effective overall, but highly significant associations with the master ratings were achieved in 29/57 areas studied. In four areas (uncooperative behaviour, concern for others, agitation and distractibility) it was superior to either interview.

Normal controls and schizophrenic patients on propranolol as sole drug or combined with neuroleptics showed superior active and passive avoidance learning to schizophrenic patients who were medicated with conventional neuroleptics only. Active avoidance involved responding quickly, passive avoidance withholding a response to avoid an unpleasant noise and reacting to the appropriate stimulus. This may reflect an improvement brought about by propranolol in the limbic regulation of stimulus and response processes.

This retrospective study, based on 18 case reports, describes an organic affective syndrome, manic type, occurring shortly after the initiation of thyroid replacement in hypothyroid patients. The symptomatology and homogeneity of the syndrome offers insight into the relationship between thyroid activity and affective disturbance. The patients experiencing mania showed concurrent psychopathology at the time of replacement therapy, frequently had a past history of personal or familial psychiatric disorder and were given dosages in the high range of normal. The potential morbidity of the manic state was considerable. These findings suggest that a group of hypothyroid patients at risk can be identified. In such a group, lower initial dosages and gradual increases in dosage may be indicated.

This paper describes a patient with an almost 48-hour manic-depressive cycle but with a daily shift of the switching time, the latter having itself a cycle of five days. The mood change always occurred gradually and during the day, never at night. Between manic and depressive phases there was a difference in the frequency of the EEG alpha rhythm. The patient showed a good response to lithium treatment.

Heredity has been shown to be an important factor in the aetiology of manic-depressive psychosis. Recent linkage studies with colour blindness have suggested the presence of an X-linked dominant gene in the transmission of manic-depressive psychosis. We report here positive evidence of a linkage between manic-depressive psychosis and glucose-6-phosphate dehydrogenase deficiency in an informative family assorting for both traits. These results strengthen previous linkage studies in affective illness and support the hypothesis of X-linkage in a subgroup of manic-depressive psychosis.

In a four-week, double-blind, clinical trial thirty-one patients with depressive neurosis were treated with viloxazine, doxepin, or placebo. There were no differences among the three groups in therapeutic effects. Many depressed out-patients improve on placebo. Viloxazine hydrochloride is one of a series of compounds developed to explore the central nervous system activity of the aryloxypropanolamine type of β-adreno-receptor antagonists. Initial clinical studies support the hypothesis that viloxazine has antidepressant properties in man (Bayliss et al, 1974; Bereen, 1973; Pichot et al, 1975; Tsegos and Ekdawi, 1974).

Amongst 100 chronic paranoid schizophrenics depression occurred in 30 per cent over a mean 6 years and was significantly associated with parental loss before 17 years.

Ten patients, 5 male and 5 female, with bipolar psychosis beginning before the age of 16 years, mean 14.1 years, are described. Difficulties in diagnosis in this age group are discussed and background factors of possible aetiological importance analysed. Lithium therapy was effective in 6 out of 7 patients.

Plasma growth hormone (GH) release after TRH injection was investigated in 27 unipolar and 23 bipolar depressive women, and in 39 normal female controls matched for age, sex and menopausal status. Peaks of GH secretion after TRH were observed in some depressive patients as well as in some normal controls, but there were no significant differences in GH response after TRH administration between patients and controls. The implications of these findings are discussed in reference to such factors as non-specific stress responses and abnormal neuroendocrine circadian rhythms in affectively ill patients.

Formerly anticipatory grief was viewed as a potential coping mechanism for a prospective loss. More recently it has been studied in preventive psychiatry as a determinant of the severity of post-mortem grief. The authors in a critical analysis of methodological and theoretical inconsistencies recommend a reconsideration of the concept within a psychosocial context.

A study was carried out to compare the sensitivity as well as cost of three different methods of psychiatric case detection. It was found that the simplest method, which involved interviewing about 3 per cent of the adult population, with a questionnaire taking only five minutes to complete, picked up as many adult epileptics and nearly as many psychotics as the inquiry with all the adults in the population using a sophisticated structured interview schedule. A method of medium complexity, in which the short five-minute questionnaire was given to one adult member of each family, detected in addition to all adult epileptics and psychotics, and many juvenile epileptics and mentally retarded.

The cost of the simplest method was one-ninth and that of the method of medium complexity, one-fifth of the cost of the most sophisticated method.

The method of medium complexity is recommended for use in the rural psychiatry programme of the developing countries.

Erythrocyte membrane adenosine triphosphatase activities were examined in twelve unipolar depressed patients receiving ECT. Eleven patients undergoing diagnostic cystoscopy served as controls for the acute effects of anaesthesia, and sixteen healthy subjects served as non-depressed controls. The unipolar depressed patients had a slight reduction in their (Na++K+)-ATPase activity but effective ECT treatment was not associated with any increase in this activity. This approach is unlikely to cast further light on the membrane phenomenology of depressive illness.

Homosexuality in the male is commonly held to be the product of a specific family constellation consisting of a dominant mother and an ineffectual or hostile father. Prospective studies however, on boys with early effeminate behaviour, the majority of whom subsequently become homosexual, show that their closeness to the mother and distance from the father spring from their own needs. The physician should feel free to relieve parents of guilt for this condition.

Under double blind conditions 55 young, bottle feeding, multiparous women received L-tryptophan 3 g daily or placebo for ten days after delivery, and were also assessed daily for psychiatric symptoms. This treatment did not reduce ‘maternity blues', but the mothers' blues scores correlated significantly with the scores for anxiety, depression and hysteria on the Middlesex Hospital Questionnaire given in the eighth month of pregnancy.