Previous research has shown that nominal dysphasia occurs commonly as a language disorder in senile dementia (Alzheimers' type). This study provides evidence that the degree of nominal dysphasia shown by a patient may be a reliable index of the severity of dementia, as measured by both behavioural and cognitive rating scales.

In 1959, J. M. Roberts claimed that in 50 depressed women aged 40–60 years the response to the intravenous injection of 15 mg. methylamphetamine differentiated significantly between those diagnosed as ‘psychotic’ and those diagnosed as ‘neurotic’. Following the injection each patient was observed closely for two to three hours, and in the great majority one of two responses occurred. Either the patient experienced a ‘sustained period of general uplift of mood and a feeling of greater well-being'—the ‘normalization’ response; or the patient showed ‘an immediate, or almost immediate, intensification of symptoms, particularly a worsening of any agitation present, often together with a deepening of the depressive affect'—the ‘intensification’ response. In only two patients, both with neurotic depression, was it not possible to classify the response.

It has repeatedly been demonstrated that hyperactive children improve in behaviour and school functioning when treated with amphetamine, methylphenidate and, according to recent studies, imipramine (Conners, 1972). While these drugs affect catecholamine and indoleamine metabolism, there have been few studies intercorrelating the clinical and biochemical effects of these agents. A small number of untreated hyperactive children have been found to have normal urinary catecholamine and indoleamine excretion (Rapoport et al., 1970; Wender, 1971) although whole blood hydroxyindole concentrations have been reported as reduced (Coleman, 1971). In the present study, platelet serotonin content was examined before and during treatment with methylphenidate and imipramine of a group of boys with the hyperactivity syndrome.

The extent to which religion and spirituality are integrated into routine psychiatric practice has been a source of increasing controversy over recent years. While taking a patient's spiritual needs into account when planning their care may be less contentious, disclosure to the patient by the psychiatrist of their own religious beliefs or consulting clergy in the context of treatment are seen by some as potentially harmful and in breach of General Medical Council guidance. Here, Professor Rob Poole and Professor Christopher Cook debate whether praying with a patient constitutes a breach of professional boundaries in psychiatric practice.

We studied 162 cases of hanging by suicide occurring in 24 coroners' jurisdictions in England within a 6-month period in 2001. Prison and psychiatric ward suicides accounted for only 6% of these. The most frequently used ligatures (ropes, belts and cable) and ligature points (beams, girders, lofts and trees) are commonly available in community settings, limiting opportunities for prevention. In only half the cases (52%) were victims fully suspended with both feet off the ground. Four per cent had also taken an overdose.

To be unemployed when you want to be working is indisputably bad for both mental and physical health. Job insecurity too is bad for health (Ferrie et al, 1995). Because work itself can be both hazardous and beneficial to mental health and because most adults spend a lot of their life working, and because the nature of work is potentially modifiable, it is worthwhile gaining a more thorough understanding of the impact of work on mental health.

The observations recorded in this paper form part of an investigation into the mineral constituents of the central nervous system both in normal and pathological conditions.

Investigation of the prevalence of eating disorders among a large sample of Japanese alcoholics admitted for hospital treatment revealed a strong association between eating disorders and alcohol abuse and alcohol dependence among young women. That association was not apparent in young men. The results of this study of the clinical courses of eating disorders and alcohol abuse and alcohol dependence suggest that women with eating disorders, especially bulimia nervosa, are at high risk of becoming alcoholic.

Forty-three neurologically and psychiatrically assessed patients with idiopathic Parkinson's disease (PD) underwent detailed cognitive assessment. Cognitive deficits typical of senile dementia of Alzheimer's type (SDAT) were found in 7% but the majority showed definite impairments not typical of SDAT. Cognitive impairment was significantly more likely in those with more severe PD symptoms. There was substantial agreement between psychiatric diagnosis and psychological picture of SDAT and some links were found between other diagnostic categories and nature of cognitive functioning. However, cognitive deficits were also found In two-thirds of patients with no psychiatric diagnosis.

Psychoanalytic literature has a number of references to suicidal acts taking place on the anniversary of the death of a loved person. Anniversaries of significant bereavements have been seen as likely to reactivate a depressive syndrome and as possible precipitants of suicide. Zilboorg (7) suggested that suicides might take their lives on the anniversary of a parent's death as though to expiate the death which they unconsciously perceived as the result of their own wishes. Others have seen the meaning of the suicide's act as a fantasied rebirth or new beginning with a lost love object, and the supposed occurrence of suicides on the anniversary of a death has again been instanced as support (Jackson (3)).

The contribution of genetic differences to variation in ageing and the relationship of ageing to certain types of dementia are discussed. Neuropathological changes commonly found in the ageing brain are present in more severe form in Alzheimer-type dementia, Down's syndrome, multi-infarct dementia, and a substantial number of patients with Parkinson's disease. An increased frequency of ageing-associated changes outside the brain have been reported in Alzheimer-type dementia, Down's syndrome, and multi-infarct dementia, although the evidence is generally meagre and in many cases requires further corroboration. Genetic studies of Alzheimer-type dementia support the existence of heterogeneity on the basis of family history and age of onset; early onset is associated with greater genetic risk and severity of abnormality. The increasing evidence of an association between DNA damage, premature ageing, and neuronal cell loss may provide insights into the aetiology of these and other forms of dementia.

Many years ago Eugen Bleuler postulated a correlation between alcoholic hallucinosis and schizophrenia. In his textbook, he stated his belief that ‘alcholic hallucinosis could … be a mere syndrome of schizophrenia induced by alcohol (1)’.

Recently several communications have been published implicating impaired 3′5′ cyclic adenosine monophosphate (cyclic AMP) metabolism as a causal factor in affective disorders (1, 3, 7, 8, 9, 11). In particular, the urinary excretion of cyclic AMP in manic patients is reported to be increased compared with that of normal subjects, whereas in depressed patients a decreased excretion has been observed (1, 7, 8, 9). These findings form the basis of a theory explaining the systemic and mental symptoms of affective disorders (1).

A conspicuous deficiency of practically all birth order studies is the absence of a general population control group. Instead, a number of statistical methods of estimating the expected number of subjects in each sibling position have been used. These are based upon the assumption that for any given size of sibship there should be equal numbers of subjects in each birth rank. As Price and Hare (1969) have pointed out, there are a number of reasons why such as assumption is incorrect, and therefore why the conclusions based upon it are unreliable. Because, in most studies, only relatively small numbers of patients are available various methods of combining sibships of different sizes are adopted and the sexes of the siblings are ignored. To consider a sibling position irrespective of the size and composition of the sibship in which it occurs is unjustifiable. As birth order effects are relatively slight, large numbers of subjects are required to detect them. Unless a patient sample of several thousand is used the numbers in any sibship size are too small to permit analysis by birth rank. As sibship size is itself a possible variable, and as within each sibship the sexes of the siblings can be distributed in a variety of ways, birth order studies should ideally consider one sibship size at a time and should investigate sibling position by sex of sibling. Unfortunately, in sibships of four or more the numbers of combinations become so great as to render this approach impracticable.