The concept of social abnormality can be given a fairly precise meaning and is relevant to the theory of legal responsibility. Much work, however, would need to be done before it could take its place alongside mental abnormality as an excusing condition in the courts. The implications of such a plea would, moreover, be far reaching, two of the more obvious being the individualization of excuses and the relinquishing of the general preventive possibilities of punishment.

Some problems of prognosis in patients with head injury are reviewed, and a case of late and unexpected recovery from post-traumatic dementia presented. The possible mechanism of recovery is discussed with particular reference to normal pressure hydrocephalus.

From a series of 255 patients who had undergone temporal lobectomy for the relief of intractable psychomotor epilepsy, all 47 patients with ‘alien tissue’ (small tumours, hamartomas, focal dysplasia) in the resected temporal lobe were contrasted with a group of 41 patients who showed mesial temporal sclerosis in their resected lobe. Five per cent of the mesial temporal sclerosis group and 23% of the alien tissue group were psychotic. A marked interaction occurred between psychosis and ‘left handedness’. In the alien tissue group, females, especially left-handed females, were the most likely to have developed a schizophrenia-like psychosis.

Two experiments concerned with the statistical characteristics of speech in presenile dementia are described. Apart from a lowered rate of production of words under certain conditions no speech abnormalities were detected on the variables examined.

Patients diagnosed on the basis of structured interviews as having affective psychoses were less sensitive in detecting the presence of a transient auditory signal than were schizophrenic patients or non-patients. Patients with affective psychoses also benefited more (their reaction time was more reduced) than the other two groups from the presence of a second auditory transient.

Following an earlier report, plasma cortisol-binding capacity (CBC) was estimated in a new series of 11 men with unipolar depression and 11 men with bipolar illness admitted to hospital. The two groups were comparable except that the bipolar group tended to have more frequent episodes of illness and to have more family histories of affective disorder. There was no significant difference between the CBC values in each group.

Depressed patients (unipolar) were given one of the following combinations in an attempt to test aspects of the ‘amine hypothesis’ and to find a preferential therapy: (1) clomipramine; (2) clomipramine and tryptophan; (3) desipramine and clomipramine, and (4) desipramine and tryptophan. Treatment (2) should have given optimal potentiation of 5-HT neurones and (3) and (4) should have acted similarly on both serotoninergic and adrenergic pathways. In no group was there any evidence of accelerated recovery, indicating that the process of conversion to normal mood may be more complex than suggested by most versions of the amine hypothesis.

The sulphate and glucuronide conjugates of 4-OH-3-methoxyphenylethyleneglycol (MOPEG) and 4-OH-3-methoxymandelic acid (VMA) have been serially studied in the urine of a manic-depressive patient before and after a therapeutic response to lithium carbonate. Excretion of both conjugates correlates with changes in mood. Some reasons to suggest that the sulphate might be a more useful measure of brain activity are stated.

This study is based on a sample of 35,486 consecutive confinements in Cardiff (1965–72) which gave rise to 67 cases of post partum mental illness. No difference was found between these cases and all resident Cardiff maternities for the same period in respect of social class, maternal parity, weight gain in pregnancy, length of gestation, birth weight, and sex of infant. A statistically significant cyclic variation in month of conception and date of birth was found with a peak frequency among conceptions in the first quarter of the year. The bearing this finding may have on the prevention of post partum mental illness and the implications of the observation that post partum mental illness and the functional psychoses have a remarkably similar temporal behaviour are discussed.

In a prospective study of rheumatoid disease (RD) clinical, serological, radiological, and biochemical factors were assessed on 102 patients and scores obtained on the Middlesex Hospital Questionnaire (MHQ). Patients with early RD had MHQ scores closely resembling those in the normal population. Using a new clinical prognostic index, patients who develop severe RD tended to have low scores at initial testing on the MHQ. Patients whose serum was positive for rheumatoid factor also tended to have low scores on the MHQ. Together these findings suggest a possible subclassification of RD into a less severe form in which psychosocial factors may be important, and a more severe form in which heredity or some other constitutional factor (or factors) may be important, rheumatoid factor acting as a ‘marker’.

The results of a survey carried out at Rampton and Moss Side Special Hospitals into physical and behavioural incapacity associated with mental handicap are described and compared with the findings of the 1970 National Survey. The Special Hospital patients were found to be less mentally handicapped than similar patients in subnormality hospitals in the National Health Service. The prevalence of physical incapacity associated with mental handicap was also lower in the Special Hospitals but the Special Hospital patients were assessed as more behaviourally disordered. In both surveys the incapacities present were concentrated in the severely mentally handicapped patients. In the Special Hospitals survey the women, when compared with the men, were found to be more behaviourally disordered and to suffer from a greater degree of multiple severe incapacity. All the differences found between the two surveys are consistent with the statutory criteria for admission to a Special Hospital.

A sample of male prisoners was examined by means of a questionnaire and subsequently by a structured interview. Control subjects who denied heavy drinking were used to study test-retest reliability of a group who admitted that drinking was a problem and a third group who admitted heavy drinking but denied problem drinking. Non-heavy drinkers and the heaviest drinkers are shown to be the most reliable and the intermediate group least reliable.

A case is reported in which platelet monoamine oxidase (MAO) activity fluctuated in the course of a schizophreniform psychosis in a way which suggests a direct relationship between low levels of MAO activity and the psychosis.