Within a few years of their introduction into psychiatry in 1893 the terms ‘endogenous’ and ‘exogenous’ were widely used. The development of the two words and the semantic uncertainty which surrounded them is traced in this article.

The concept of screening, and in particular multiphasic screening, is being introduced into medical practice. The subject is controversial and doubts have been expressed as to ils present applicability. This article is concerned with whether screening is appropriate for psychiatric disorder and is subdivided into a review of screening in general, the distribution of psychiatric disorder, psychiatric screening instruments, an outline of a psychiatric screening survey, and, finally, the evaluation of psychiatric screening.

Previous studies have suggested that, because of the chronic and disabling nature of mental illness, psychiatric patients do not fare as well in their careers as they should do. In the present study the parental social class, the current social class and the social mobility has been compared in 2,861 male referrals to the psychiatric services in North-Eastern Scotland and 1,487 men randomly selected from the local population. Within the psychiatric sample similar comparisons have been made between diagnostic groups. In all three aspects of social class considered decade of birth was shown to be an important variable.

It is argued that personality deviance and personal symptomatology fall within different universes of discourse and that any individual may belong to either, neither, or both classes. In order to develop suitable measurements, distinctions are drawn between symptoms, states, deviant and normal traits, which have implications for the distributions of scores and for their stability or change over time. Measures likely to meet the criteria are illustrated. A classification is developed which incorporates those with and without the ability to cope with personal symptomatology and/or personality deviance. Some uses of the classificatory scheme and the measurements are suggested.

On the Intensity measure of the Grid Test acute and chronic thought disordered schizophrenics were significantly different from controls, and acute non-thought disordered schizophrenics significantly different from acute thought disordered schizophrenics. The difference between chronic thought disordered and non-thought disordered schizophrenics just failed to reach the 10% level of significance. On the Consistency measure results were variable. Only the acute non-thought disordered schizophrenics were significantly different from the acute and chronic thought disordered schizophrenics. The findings are discussed.

Fifty consecutive patients suffering from primary depressiv illness, but excluding those who had a distinct episode of mania, were rated for the presence and degree of certain symptomatology, especially agitation and retardation. They were also divided into two groups (‘early’ and ‘late’ onset), according to whether their first-ever attack of depressive illness had occurred before the age of 45. After they had recovered from their illness, aspects of personality were assessed on a battery of self-rating personality tests. There was no evidence from this study that any of the personality traits measured was in any way significantly related to any of the clinical features of the illness.

As part of a study of various aspects of differential development between the sexes, the series of patients with epileptic psychoses published by Slater, Beard, and Glithero (1963) was reanalysed in the light of a hypothesis of differential cerebral maturation. As predicted by the hypothesis, females had an earlier onset of epilepsy and of psychosis than males. Whereas the sex ratio in epilepsy normally shows an excess of males, the sex ratio in epileptic psychoses is almost equal. Unlike most chronic temporal lobe epilepsies, the epilepsies which were later associated with psychosis arose largely within a specific developmental epoch around the pubertal growth spurt. Some of the clinical and biological implications of this finding are discussed.

An attempt has been made to explain the changes in uric acid levels observed in the phase of manic depressive illness by suggesting that they may be a reflection of changes in brain RNA metabolism. The effect of prolonged lithium administration on RNA synthesis in rat brain and liver has been studied. Differences in the rate of turnover of brain RNA between the lithium-treated and saline control animals have been observed.

A case of acute schizophrenic psychosis developing during the treatment of hyper-thyroidism with carbimazole is described. The patient was clinically and biochemically euthyroid at the time the psychosis developed. It is suggested that an acute alteration in thyroid status, without necessarily producing hyper- or hypothyroidism, may be sufficient to induce a psychotic reaction.