Rapaport (1945) was the first worker to advance evidence that at least two types of formal thought disorder contributed to the disturbance of thinking found in schizophrenia; and furthermore that neither of these types of thinking was specific to schizophrenia. Rapaport administered the Bolles Goldstein Object Sorting Test to 217 psychiatric patients and to a control group of 54 patrolmen. He found that schizophrenics showed a tendency to function more at a concrete level and less at an abstract conceptual level, as described first by Vigotsky (1934). This tendency was also shown by depressives and by persons who were not mentally ill but had a poor cultural background.

Body size estimation was studied in 22 patients with bulimia and 20 normal controls. Two methods of body size estimation were used, a distorting television image method (DTIM) and the image marking method (IMM). The subjects estimated body size of a dummy as well as their own body on the DTIM. When estimating body size on the DTIM the bulimics overestimated and the controls underestimated, there being a significant difference between the two groups. There was no difference between the groups when estimating the size of the dummy. On the IMM a significant difference was found between the bulimic and control groups, the bulimics overestimating body size and the controls being more accurate. Marked directional effects were found with the DTIM. The two methods of body size estimation are compared.

The use of the flash and pattern reversal visual evoked potential (VEP) in the diagnosis of primary presenile dementia was investigated. The results from 20 patients with primary presenile dementia were compared with those from a control group of normals of equivalent age and from a control group of 20 patients with cortical atrophy but no dementia. Presenile dementia caused a slowing of the major positive (P2) component of the VEP to flash stimulation. However, the VEP to pattern reversal stimulation (P100) was of normal latency. The difference between these two latencies characterises this unusual combination of results and is found to be a more specific diagnostic indicator of primary presenile dementia than the EEG or CT scan.

There has been increasing public concern about the risks of high-dose antipsychotic (neuroleptic) treatment, arising in part from an, as yet unproven, association between high-dose treatment and death in a small minority of patients. The clinical issues related to the use of neuroleptics in doses exceeding the maximum recommended in the British National Formulary (BNF) were discussed at the Psychopharmacology Subcommittee. When, if ever, should the recommended doses be exceeded?

Prevalence studies of mental subnormality among regional populations are few. Detailed epidemiological enquiries have been carried out in the regions of Northern Ireland (Scally and MacKay, 1964), Wessex (Kushlick, 1965) and, for severe mental subnormality in children, in Middlesex and London (Goodman and Tizard, 1962). The North-East Region of Scotland is especially suitable for epidemiological studies in psychiatric morbidity by reason of its geography, demography and centralization of psychiatric services (Innes and Sharp, 1962; Baldwin and Millar, 1964). A Regional Psychiatric Case Register giving rapid access to social and clinical information on all patients is fully operational (Baldwin et al., 1965). Using this facility as a primary source of data, a prevalence study of mental subnormality among the half million population of the North-East of Scotland was carried out. The objects of the study were three-fold: first and primarily, to establish case rates for known subnormality, examine patterns of morbidity and the factors that influence this and to compare these with the findings of similar epidemiological studies; second, to gain operational data relevant to existing practice, needs and planning of services; third, to provide a data bank within the Regional Psychiatric Case Register for mounting detailed clinical, genetical, social or biochemical studies on an area population of subnormal patients.

The first three and a half years' operation of a psychiatric intensive care unit, based on the general hospital model, is described. This eight-bedded ward focusses on the treatment of the most acutely psychiatrically ill patients, and not on the forensic or custodial aspects of such units previously described. It has gained general acceptance within the setting of a state psychiatric hospital, and has received 1132 admissions since its inception. Demographic, clinical, and treatment data are presented and the advantages and disadvantages of the unit are discussed.

We examined white matter volumes in four prefrontal subregions using structural magnetic resonance imaging in 10 pathological liars, 14 antisocial controls, and 20 normal controls. Liars showed a relatively widespread increase in white matter (23-36%) in orbitofrontal, middle and inferior, but not superior, frontal gyri compared with antisocial and normal controls. This white matter increase may predispose some individuals to pathological lying.

The clinical, psychometric, and computed tomographic (CT) status of previously fit elderly volunteers is described at follow-up for up to four years. A number of relationships were found between psychometric and CT scores, but a dementing group could not be determined on the basis of a single scan. However, a subtle reduction in cognition over time was significantly related to CT changes, and occurred in 10%. Larger ventricles were also found in a small sub-group, who developed late-onset depressive disorders; recent bereavement was related to ventricular size. Thus a single CT scan may not be a useful discriminatory test in early dementia, but a repeat demonstrating ventricular enlargement, is likely to be significant. In the elderly, cognitive and CT scan deterioration should not be expected unless a disease process is occurring; this may be indicated by subtle cognitive impairment or by late-onset depressive disorder.

This paper, by a general practitioner and a psychiatric social worker, is based upon an investigation, at present in progress, into the influence of the family upon children's achievement and emotional adjustment, which is supported by the Mental Health Research Fund and supervised by Dr. D. A. Pond. In the present paper we are reporting on some of the data collected from part of the population being investigated. The main survey will include all families registered with the general practitioner (A.R.) where the head of the household is in Social Class III, IV or V, in which there are children born between 1949 and 1954, and from which at least one parent is also registered. From the first 70 families visited in this survey 50 couples, including those who cohabit but are not legally married, have been selected for the present study. The 20 excluded families consist of five where only one parent is registered with the G.P., four where the mother is separated or divorced, three unmarried mothers, and two families where one parent has died. Failure to co-operate fully, which seems more common in families known by the G.P. to be disturbed, led to the exclusion of six further families.

Reasons are given why the hospital diagnosis of schizophrenia may be accurate enough for the proper study of certain aspects of its epidemiology. Studies in the seasonality of admissions and of births in schizophrenic patients have produced consistent results in different countries and at different times. The results are summarized, and causal hypotheses based on them are discussed. The idea that schizophrenia is a relatively recent disease is compatible with these hypotheses.

One hundred and fifty four patients admitted to a general hospital psychiatric unit with a history of poor diet were examined. Serum pyruvate was estimated in all, red cell transketolase in 74 and red cell aspartate transaminase in 66. Significantly more of the 58 abnormally low thiamine patients than of the normal thiamine group showed clinical signs of malnutrition or were diagnosed as chronic alcoholics, drug addicts, schizophrenics or endogenous depressives. Significantly more endogenous depressives than other patients had a raised aspartate transaminase activity coefficient (pyridoxine lack.) While most low thiamine findings are probably manifestations of malnutrition pyridoxine lack may have some aetiological significance in endogenous depression.

Suicide is a rare phenomenon – in most countries, it explains between 0.5 and 1% of all deaths – no more than 15 per 100 000 population. Although rates increase with age, its impact on the total mortality of the young is greater than its impact on the elderly. Despite its rarity, the subject has attracted, and continues to attract, wide interest among academics and popular writers.

Four major categories of nonspecific or common factors are systematically analysed: relationship, expectancy, reorganising, and impact factors. The placebo control method should be discarded in psychotherapy research for two reasons: (a) sham treatment controls are unworkable because common factors in treatment are manifest only when real treatment is administered; and (b) the very events which were once thought of as ‘nonspecific’ noise are now recognised as active therapeutic factors common to many schools.