The extent of psychiatric morbidity was investigated in a consecutive series of patients attending a south London general practitioner. The GP identified a psychiatric component in the reason for consultation in 40% of the sample, and he regarded 24% as ‘psychiatric cases’. The estimated true prevalence of psychiatric morbidity in the sample was 34%. These data are used as the basis for a theoretical discussion of prescriptive screening strategies for psychiatric disorder in general practice.

A prospective follow-up study was undertaken of two groups of women first studied in the mid 1960s when they were children: 94 girls reared in institutions to which they had been admitted because of a breakdown in parenting, and 51 girls in a general population comparison group. Both groups were interviewed in detail when aged 21–27 years and home observations were undertaken for those with young children. The institution-reared women showed a markedly increased rate of poor psychosocial functioning and of severe parenting difficulties in adult life. However, the support of a non-deviant spouse and of good living conditions in adult life provided a powerful protective effect.

The relationship was examined between symptoms rated in a sample of out-patient depressives, and measures of life stress derived from a separate interview. There was an association between symptoms reflecting the endogenous–neurotic distinction and life stress. However, the association was relatively weak, and was mainly with total social problems at the time of presentation, rather than with life events at onset. These findings are consistent with other studies which indicate that the absence of prior life events and the presence of the endogenous symptom pattern are only weakly related.

Eight idiot savant calendrical calculators were tested on dates in the years 1963, 1973, 1983, 1986 and 1993. The study was carried out in 1983. Speeds of correct response were minimal in 1983 and increased markedly into the past and the future. The response time increase was matched by an increase in errors. Speeds of response were uncorrelated with measured IQ, but the numbers were insufficient to justify any inference in terms of IQ-independence. Results are interpreted as showing that memory alone is inadequate to explain the calendrical calculating performance of the idiot savant subjects.

Healthy multiparous women having elective interval (N = 69) or postpartum (N = 69) sterilization were interviewed pre-operatively and 6 weeks and 6 months post-operatively, using standardized instruments. They did not differ significantly from control samples of comparable non-sterilized women with respect to mental state (Present State Examination) or subjectively-assessed mental or physical health or abdominal pain. More sterilization subjects than control subjects reported subjectively experienced improvement in sexual satisfaction at the later follow-up. Reports of poor physical health and abdominal pain increased over time within both the sterilization and the control groups. Reports of adverse effects at follow-up were often associated with higher PSE scores initially. Regrets and wish for reversal were rare and were also associated with higher initial PSE scores. Since the adverse effects were more common among postpartum subjects, it is suggested that subjectively experienced sequelae of sterilization may sometimes be attributable to ‘normal’ postnatal events.

A retrospective survey was undertaken of the clinical EEG in a series of consecutive admissions to Broadmoor Special Hospital (N = 265). Following reporting of the records by visual inspection, the EEGs were classified according to 4 descriptive categories: predominantly monorhythmic; low voltage fast, ‘choppy’ dysrhythmic with excess theta; and dysrhythmic with paroxysmal features. The last 3 categories constituted EEG patterns with atypical or anomalous features. The EEGs of patients with high scores on Welsh's MMPI Anxiety scale (‘withdrawers’) were compared with those of patients with low scores (‘approachers’). Lateralization of paroxysmal EEG features was studied with reference to MMPI personality measures (Blackburn's Impulsivity and Sociability and Welsh's Anxiety), legal diagnosis, type of offence, and relationship to victim. The EEGs were studied in a further sample of 29 admissions who had been assessed, using Hare's Research Scale for the Assessment of Psychopathy (Hare, 1980). While the overall incidence of atypical EEG features reported in the present study (around 60% of cases) was comparable with that reported previously for offender populations, they occurred significantly more frequently in ‘withdrawers’ than in ‘approachers’. This suggests that the high frequency of atypical EEG features in abnormal offenders may be due to the preponderance of ‘withdrawers’ in this population. Patients who had committed violent offences against strangers, as opposed to people known to them, tended to have bilateral paroxysmal features in their EEG. High scores on Hare's Psychopathy scale were significantly associated with prominent Posterior Temporal Slow Activity. The study offers some prospect that the combined use of EEG and personality assessments may be of potential value in the assessment of dangerousness.

A sample of 79 young women whose mothers had died in the subjects' childhood, and whose fathers had remarried, was studied to determine any effects on state and trait depression associated with modification of high and low risk parental style. Lack of care from fathers and lack of care from step-mothers were the parental variables most strongly associated with high trait depression, and almost all subjects scoring both these parents as uncaring affirmed a distinct life-time episode of depression. In a married sub-group of 63 subjects, low marital affection and low step-mother care accounted for 33% of the variance in trait depression scores, while low paternal care was no longer a significant predictor. Data for the married sub-group suggested that an affectionate husband largely corrected any diathesis to greater depression exerted by uncaring parenting, while the protective effects of caring parenting on adult depressive experience were largely undone by marriage to an unaffectionate husband.

This paper reviews recent research into cognitive functioning in depression, with particular reference to the theories of Lewinsohn, Beck, Seligman and Klein. The major cognitive changes in depression are a decrease in the ability to maintain concentration and effort, and an increase in the relative salience of aversive events and memories, with a corresponding decrease in the salience of pleasant events. There is as yet little evidence to support the view that depressions arise out of pre-existing depressive attitudes. Attention is drawn to the heterogeneity of depressive disorders, and the significance of the endogenous/non-endogenous distinction is discussed.

Evidence relating smoking and neuroticism is inconsistent; some studies report no significant relationship, while others report a positive association. The present study examined smoking in relation to neuroticism (N), extraversion (E) and psychoticism (P), in the light of predictions that interactions between N and E, and between N and P, could underly these inconsistent findings. The subjects were female student nurses (N = 270), of whom 34·1% were smokers. Discriminant analyses revealed that E differentiated most strongly between smokers and non-smokers. N and P did not add to the predictive power of the discriminant function, but the N × P and N × E interactions did make significant contributions. Among extraverts, and among subjects low in psychoticism, N was not related to smoking; but among introverts, and among subjects high in psychoticism, the relationship was significant and positive.

Two hundred and forty women with young children who were patients in a Harrogate general practice were studied. About a third of them were found to be suffering from ‘mental distress’. Younger mothers were more affected. The number and spacing of their children were not related to symptoms of depression and anxiety, but poor personal relationships and difficulties getting out and about were so related, despite relatively affluent circumstances. Children of distressed mothers were more inclined to be disturbed. A controlled trial using amitryptyline involving 25 of the women suggested that this drug can improve depressive symptoms under these circumstances and that the improvement is likely to be maintained over the course of a year.

Nearly 10% of a sample of men charged with a variety of offences claimed amnesia for their offence. The amnesia occurred only among those who had committed violence and was most frequent following homicide. All the amnesics had a psychiatric disorder, four having a primary depressive illness and the remainder being almost equally divided between schizophrenia and alcohol abuse. None of the amnesias had any legal implications. The circumstances of the offences suggested a variety of mechanisms to account for the amnesia, including repression, dissociation and alcoholic black-outs. Psychological defence mechanisms were probably of some importance, even when alcohol was an important factor.

Although numerous reports have strongly argued that there is a need for a closer collaboration between the health and social services, studies investigating the health of clients in contact with the personal social services have been few and limited. This study collected information regarding the physical and mental health of clients referred to social workers in a local authority intake team and to a general practice attachment scheme by means of questionnaires completed by the client and at interview. The results indicated that the proportions of patients with physical or mental illness were very high. However, while social workers in the attachment scheme had many contacts with members of the primary care team regarding these clients, contacts between intake social workers and medical personnel were very limited.

Following a television documentary on bulimia nervosa, people who thought that they had this type of eating problem were asked to complete a confidential questionnaire. 579 women who fulfilled self-report diagnostic criteria for bulimia nervosa were thereby identified. These women closely resembled patients with bulimia nervosa, although the age range was wider. They had grossly disturbed eating habits and almost half vomited at least daily. Laxative abuse was also common. Although almost two-thirds had been overweight in the past, the majority had a weight within the normal range. A minority had previously fulfilled diagnostic criteria for anorexia nervosa. On standardized measures, these women had abnormal attitudes to their weight and shape, as well as significant levels of psychiatric symptomatology. Nearly three-quarters thought that they definitely needed professional help, yet only a third had ever been referred for psychiatric treatment. Using data from this sample and an independent sample of 499 probable bulimia nervosa cases, the significance of three issues relating to the diagnosis of bulimia nervosa were examined: laxative abuse, the frequency of self-induced vomiting, and a history of anorexia nervosa.

Using an apparatus which provides a continuous horizontal slit of light of variable length, self-estimations of 4 body widths were carried out before and after a mirror confrontation procedure on 4 groups of young female subjects – anorexic, bulimic, emotionally disturbed and normal. The results confirm that anorexic subjects overestimate body size, although in this study the hip diameter was frequently underestimated. Bulimic and emotionally disturbed subjects overestimate to much the same degree as anorexics, whereas normal subjects are remarkably accurate with the exception of the head width. Mirror confrontation resulted in reduced estimations in the majority of subjects, but significant differences were found in the degree to which this occurred in the 4 groups; anorexic subjects showed the greatest change and normal subjects the least. This relative instability of the anorexic subject's body image cannot be explained simply on the basis of a self-correcting experience, as many estimations which were initially below actual width were even lower on re-testing. In the anorexic and bulimic groups a significant correlation was found between the degree of overestimation after mirror confrontation and progress in treatment, as measured on a specially devised rating scale. Possible explanations for these findings and their diagnostic and prognostic implications are discussed.

In a retrospective study, children referred to the Maudsley Hospital with conduct or emotional disorders who also suffered from hallucinations were found to be older than other children seen with similar diagnoses, more of them had below-average IQs and they were more frequently admitted as in-patients. In most cases hallucinations were auditory. When compared with a group of 20 controls matched on these differentiating features, the 20 children with hallucinations had more precipitants of illness, a shorter duration of the disorder, symptoms of depression, and a family history of mood changes. They also had more symptoms suggestive of cognitive–perceptual dysfunction.

The age of onset in bipolar affective disorder was determined in 200 hospitalized patients. The mean age of their first affective syndrome was 28·3 years, and the mean age of first hospitalization was 30·8 years. However, the median age for first affective syndrome was 23 years (26 years for first hospitalization), and the most common age of onset was 15–19 years. Those patients with an early onset, especially if they were first hospitalized for mania, were most likely to have received a diagnosis of schizophrenia.

In a controlled study, 20 children with hallucinations and emotional or conduct disorders were followed up into adulthood. The mean follow-up time was 17 years and the mean age at follow-up was 30 years. Hallucinations in childhood did not carry an increased risk for psychoses, depressive illness, organic brain damage or other psychiatric disorders. The continuation of hallucinations and episodes of altered awareness in some of the subjects may indicate a special predisposition to hallucinate.

Normal and anorexic subjects' estimates of their own body width were obtained. The estimates were reliable measures, but they did not correlate with the subjects' actual body widths. The implications of this finding especially when relating anorexic patients' self-perceptions to their clinical outcome, are discussed. It seems preferable to use such estimates untransformed by division with the subjects' actual body widths.

Prior research has indicated that the type-token ratio (TTR), a measure of repetition in language, correlates with clinical judgements of thought disorder when spoken language was examined, and differentiates statistically thought-disordered from non-thought-disordered schizophrenics and psychiatric and normal controls. We replicated this finding and examined the clinical sensitivity and specificity of the TTR measure in the diagnosis and in the assessment of thought disorder. The current clinical value of the TTR is limited, but further investigations of the nature of repetition in schizophrenic language are warranted.

Previously employed techniques for the measurement of body image are briefly described, with a short consideration of methodological or procedural limitations associated with each technique. A new procedure is described which employs a simple modification to a standard video camera to produce an image which appears from 20% thinner to 40% fatter than the actual person, without other distortion of the image. Reliability and preliminary validity data for the new procedure are presented.