There have been few previous attempts to study factors which affect the duration of treatment with psychiatric drugs in general practice. In the present study ‘duration of treatment’ was regarded as analogous to ‘survival time’, and techniques of survival analysis were applied to data from a previously published study of psychotropic drug use in general practice (Williams et al. 1982). Methods of logistic modelling were used in an attempt to construct a comprehensive and parsimonious model to describe and predict the duration of psychotropic use. Such a model was found to include the effects of previous psychotropic treatment, social problems, duration of treatment and general practitioner behaviour. The implications of the findings, vis à vis the prevention of unnecessary long-term psychotropic drug use, are discussed.

This paper reports the factor structure of the symptoms comprising the GHQ when it is administered in the general practiāe service of a hospital. Two shorter versions are proposed: one with 6 scales and 30 items, and the other with 4 scales and 28 items. The latter is compared with the 28-item English version. Preliminary data concerning the validity of the scales are presented. In a comparison of the screening potentiality of the 60- and 28-item versions, no significant differences were found.

Recent data from a 2-year follow-up of functional non-affective psychosis, and particularly schizophrenia, favoured social selection rather than social causation theory. Data concerning the cohort were compared with inter- and intra-generational mobility in a random Dutch sample. The results indicate that the educational and occupational mobility of patients, relative to their fathers, was greater than expected. Although patients were better educated than the random sample, they fared less well occupationally. An analysis of patterns of occupational mobility before and after the onset of psychosis also showed that social selection played a major role in achieving social status. The outcome of patients' occupational career at follow-up was poor, and only a minority succeeded in obtaining or keeping a regular job.

Whereas in Western societies there is an inverse relationship between high social class and low body weight, the inverse is true of less developed, non-Western societies. It has also been shown that the longer immigrants have been in Western societies, the less obese they tend to be. This study examined how Kenyan Asian, British and Kenyan British females from similar backgrounds perceived female body shapes. As predicted, the Kenyans rated larger figures more favourably and smaller figures less favourably than the British. Also, as predicted, it was found that the Kenyan Asian British were more similar to the British group in their perceptions. The results support the view that social and cultural factors play dominant role in the perception of one's own and others' body shapes. In addition, the results reveal that in Britain preferences for small body shapes to the point of being anorexic are not uncommon.

A program on an inexpensive microcomputer was designed to elicit personal histories from patients in a general psychiatric ward. Their answers were compared with the information recorded by the responsible psychiatric team. Where answers disagreed with the clinicians' records, the patient was interviewed to investigate the discrepancy. In the computer-elicited case-histories 90% of items were correct; a further 3% of items were considered correct by the patient. Most patients' computer histories revealed several items unknown to the clinicians and of importance in the management of the patient. Most patients (88%) found that the computer interrogation was as easy as a clinical interview. Computer assessment is proposed as a useful technique for the routine assessment of patients to augment the clinician's findings and to allow him to concentrate on the most relevant areas.

The presence and severity of Minor Psychiatric Morbidity (MPM) as measured by the 60-item General Health Questionnaire (GHQ), and being female rather than male, increases the consulting rate of people in the community to their general practitioner. The rate of increase of consulting decreases as the severity of MPM increases. There is an interaction between age and MPM, giving progressively increased consulting rates in the older age groups in males but not females. The possibility of a biological difference between males and females in the interaction of MPM and physical, and of age and physical illness, is raised.

It is well established that a diagnosis of cancer and the subsequent treatment can cause a great deal of stress, and the need for psychosocial support is increasingly being advocated. The data for the efficacy of intervention programmes are reviewed. The evidence relating to the benefits gained by patients is equivocal. The indication is that a selective rather than a blanket service is needed, with the target for intervention being patients at high risk for psychological morbidity. The advantages of one type of support over another remain unproven.

The 30-item General Health Questionnaire (GHQ), the 24-item Self-Reporting Questionnaire (SRQ), and a Chinese version of the Minnesota Multiphasic Personality Inventory (MMPI) were administered to 225 English-speaking Chinese. The GHQ was found to have high internal consistency as a scale and to assess 5 dimensions of psychopathology: anxiety, inadequate coping, depression, insomnia, and social dysfunctioning. As a brief screening instrument, it correlated 0·49 with the SRQ. In the ‘case–non-case’ classification, it yielded a concordance rate of above 75% with the SRQ. Using the MMPI modal profiles derived from classification research as criterion measures, sensitivity, specificity and correct classification rates were above 70%. Implications for future research with the GHQ are discussed.

A consecutive series of 94 patients recently admitted to hospital from a defined catchment area and diagnosed as having a depressive illness were examined using standardized techniques for eliciting mental state, etc. The overlap between psychotic and neurotic diagnoses was 8·5% on discriminant function analysis of mental state items. A sub-sample of 71 patients was given a comprehensive postal and case record follow-up 5 years later. When patients developing organic and other complicating illnesses were excluded, those suffering from psychotic depression showed a significantly poorer outcome, as defined by relapse and required lengths of hospital care, than those diagnosed as suffering from neurotic depression.

Thirty-two adult females who consulted a general practitioner with psychiatric training were assessed by questionnaires on first attendance and at follow-up 6 months later. Major life events and the degree of social support were of importance. Failure to improve was associated with major negative life events; in the absence of such events, improvement seemed likely to occur given a high degree of social Support; major positive events appeared to be associated with improvement, regardless of the degree of social interaction. These factors, and the initial and final GHQ scores, are inter-related in a complex manner and it is suggested that these findings merit further investigation on a larger sample of patients.

In anglophonic countries erotomania has traditionally been regarded as a female disorder of little more than curiosity value. The French literature recognizes the disorder in males, but as a rarity. In a recently collected group of violent male offenders the syndrome proved to be fairly common. The offending behaviour was invariably triggered by the core symptom. A description is provided of four cases whose level of aggression was low but appeared to be directly related to the firmness with which the delusion of being loved was held. The disorder of these men can be regarded as a variant of one of the major functional psychoses, but for the purposes of predicting behaviour and management there may be advantages in treating it as a syndrome in a similar taxonomic category as that of morbid jealousy.

Eighty–one children previously treated for congenital dislocation of the hip (CDH) before the age of 5 were followed up several years after their treatment, and their psychological adjustment was compared with that of 3 other groups; (i) 44 children who had experienced a single hospital admission of less than a week before the age of 5; (ii) 26 children who had experienced 2 or more hospital admissions, the first being before the age of 5; and (iii) 51 children who had no experience of hospital admission. All 4 groups were similar in composition in terms of sex ratio, age at follow-up, family size, birth order, parental age and social situation. Psychological adjustment was measured by means of Rutter's questionnaires for parents and teachers. In addition, the children completed a Schonell reading test. Both the parental and the teacher's questionnaires selected more disordered children in the CDH group. The CDH group also had a higher total score and more health and behaviour problems than did the single admission group on the parental questionnaire. On the teacher's questionnaire they were more antisocial than the single and no admission groups combined. No significant differences were found on the reading test. While the overall impression is that the CDH group are poorly adjusted, there is some suggestion that it is the younger children who are contributing to this effect.

From a total of 410 post-mortem examinations on Gaiway residents deceased in 1978 the examining pathologist and 3 psychiatrists were in close agreement in 22 cases that death was by suicide. These figures were extrapolated, and a Republic of Ireland minimum true rate of suicide was computed which was 3 times greater than the official reported rate. Irish suicide data were found not to be dependent on coroners' reports as is commonly believed. It is concluded that under-reporting reduces Irish suicide rates to a far greater extent than has been supposed. The substitution of clinical for legalistic methods of recording suicide data is recommended.

Inventories designed to measure neuroticism are similar in form and content to inventories used to measure symptoms or subjective well-being. In addition, it is not clear to what extent traits as well as a person's present state explain the variance of such measures. Three inventories – the Neuroticism Scale from Wilde's Amsterdamse Biografische Vragenlijst, Bradburn's Affect Balance Scale and a Symptom Measure – were administered three times in order to study their reliability, stability and relation with psychosocial stress and life events. Major differences between inventories were not found. The results favoured the trait position.

A comparison of the homicide rate of mentally abnormal offenders and murderers who subsequently commit suicide, from a range of different populations, shows a uniform consistency when compared with the overall rates. ‘Laws’ are proposed which govern the rates within these subgroups in comparison with the population as a whole and which determine fluctuations. Qualitatively different psychiatric and sociological factors are thought to account for these findings and require further elucidation.

The phenomenon of a Doppelgänger (the double autoscopy; heautoscopy) and its resolution in a psychotic patient is presented. A comparison is made between this experience and the phenomenon as it is described and defined in the literature. The themes of death and disintegration so commonly associated with the Doppelgänger in folklore and literature are highlighted by this patient's experience.

In a matched controlled clinical study of 300 neurotic depressives collected over 6 years, 13% had experienced parental death before 17 years of age compared with 10·7% of the controls; this difference was not significant. There were no significant differences between the two groups when maternal or paternal death was examined separately either before 11 or 17 years of age. Thus the experience of parental death as a child is not in itself a risk factor for neurotic depression as seen in psychiatric patients.

Schizophrenic patients' self-reports of their experience of neuroleptic treatment were used as the basis for the construction of a scale predictive of drug compliance. Reliability analysis of the responses of 150 patients indicated high internal consistency in the 30-item scale, and preliminary validation in the form of discriminant classification accurately assigned 89% of the sample to compliant and non-compliant groupings. Both discriminant and factor analyses suggest that maximum variability in responding is accounted for by items reflecting how the patient feels on medication, rather than what he knows or believes about medication.

The Personality Assessment Schedule, an interview schedule specifically designed for assessing personality disorder, was administered twice to 28 psychiatric patients, with a mean interval of 2·9 years between each assessment. The first assessment was made by a psychiatrist and the second by a medical student who had no prior knowledge of the patients. The reliability of the 2 assessments was measured using 4 different techniques. Although the reliability of individual personality traits was inconsistent over time, the categorical diagnosis of personality disorder was good (Kωw = 0·64), giving some support to the validity of the schedule. Reasons for discordance in the assessments were examined and appeared to be due mainly to confusion between clinical symptoms and personality traits, retrospective errors in recording past personality in chronic patients, and special difficulties in determining the primary abnormality in severe personality disorder.

The significantly favourable changes in medical students' general attitude to psychiatry and intention to specialize in the subject, which we found after an 8-week psychiatric clerkship, were maintained one year later, at the time of the students' M.B., B.S. examinations. However, of 18 specific attitudes to psychiatry, only one changed significantly overall – fewer students agreed that ‘psychiatrists are held in poor regard by most other doctors’. Contrary to other reports, these preliminary findings suggest that a psychiatric clerkship may be followed by stable attitudes and intent towards the specialty.