Stutter, tic and the Gilles de la Tourette syndrome have many features in common. Haloperidol has been found of value in the treatment of the last-named syndrome (1) and also of tic (2). Our study was intended to evaluate its use, combined with orphenadrine, in stutterers. We used it both with and without speech therapy, as shown in Table I. The trial was controlled, and double blind. Our 36 patients, aged 15 to 60, were of both sexes and neither psychotic nor subnormal. They were not on other therapy. They were randomly divided by an independent third party equally into the following groups, and treated as indicated.

Ten hospitalized chronic schizophrenic patients were given chlorpromazine alone and chlorpromazine plus high dose propranolol in two 7-week treatment periods according to a randomized crossover design. In the six patients who completed the whole study, plasma levels of chlorpromazine and chlorpromazine sulphoxide, total serum levels of neuroleptic and serum levels of prolactin were consistently and significantly elevated during treatment with chlorpromazine plus propranolol relative to levels during treatment with chlorpromazine alone. These effects are sufficient to explain previously reported clinical improvement in schizophrenic patients given propranolol in addition to neuroleptics.

Three cases of monosymptomatic delusion of alimentary stench are described. Each patient was referred for behaviour therapy as a last resort, after extensive medical investigation for halitosis or flatulence and failure of other psychiatric treatment. Two of the patients showed clinical improvement after treatment sustained at follow-up. Monosymptomatic delusion is now a treatable condition and is important to diagnose.

In a previous paper (Pilowsky, Levine and Boulton, 1969) the classification of a group of 200 patients on the basis of their responses to a depression questionnaire and certain other attributes was described. The classification was carried out by using a form of numerical taxonomy based on information theory (Wallace and Boulton, 1968). By this technique the 200 patients were grouped into three classes, labelled A, B and C. Class A was regarded as a mixed group of ‘reactive’ depressions, Class B corresponded to ‘endogenous' depression and Class C comprised a non-depressive group.

The use of illicit substances such as cocaine and heroin during pregnancy is common. Anonymous screening of consecutive urine samples testing positive for pregnancy from a UK inner-city clinic demonstrated that approximately 16% of the women had taken one or more illicit substances (Sherwood et al, 1999). The prevalence of drug misuse in the USA appears to be even higher: prospective screening of newborns in a high-risk urban population revealed that 44% of 3010 babies tested positive for opiates, cocaine or cannabis (Ostrea et al, 1992). The aim of this editorial is to emphasise the importance of this topic by describing the unfavourable effects illicit substances can have on both pregnancy and infant outcome. In addition, discussion of the evidence base for current management highlights the need for appropriately designed studies to optimise treatment and reduce morbidity.

This article presents an analysis of challenges and considerations when developing digital mental health innovations. Recommendations include collaborative working between clinicians, researchers, industry and service users in order to successfully navigate challenges and to ensure e-therapies are engaging, acceptable, evidence based, scalable and sustainable.

The pharmacological treatment of depression was quite limited in efficacy before the discovery of iproniazid and imipramine (Rees, 1960).

In 1964 Lippold and Redfearn described the mental changes induced by the passage of small positive and negative polarizing Currents through the human brain in volunteer patients. They further reported the clinical effects of polarizing the brain in 29 patients with long standing depression (Redfearn et al., 1964), and they also conducted a controlled trial of polarization in depressive illness (Costain et al., 1964). When the head was positive to the leg, an elevation of mood was said to follow, while the reverse was the case with a negative head electrode. In the uncontrolled trial of long standing depressives, 13 were said to show clinical improvement of the 24 who were considered to be adequately treated. In the controlled trial a significant therapeutic effect was rated by both doctors and nurses. Sheffield and Mowbray (1968), using normal human subjects, failed to validate the mood changes said to follow positive and negative polarization. Lifshitz and Harper (1968) found no appreciable effect of polarization in five chronic male schizophrenic patients studied over 14 weeks. The following study was designed to replicate the double blind trial on depressed patients.

The literature indicates that whether or not schizophrenic patients are reported to have significant lateral ventricular enlargement depends on control, and not schizophrenic-group values. This discrepancy does not result from differences in age, the ratio of males to females, the number of control subjects used in each study, or whether control groups are comprised of normal subjects or medical patients. However, medical-patient controls tend to have smaller ventricles than do normal individuals. Thus, we assessed lateral-and third-ventricle size and the degree of cortical atrophy in 30 normal volunteers, 30 medical patients, and 30 chronic schizophrenic patients. The use of a medical control group seemed to result in underestimates of ventricle and sulcal size in the normal population and, therefore, overestimates of these values in schizophrenic groups.

From 1972 to 1976 130 epileptics presented 171 times to the Western Infirmary, Glasgow, as medical emergencies with self-poisoning. They constituted 3.5 per cent of 3,733 patients poisoning themselves on 4,121 occasions. Repetition of self-poisoning was commoner in epileptics (18.5 per cent) than in non-epileptics (7.0 per cent). The 130 epileptics have been compared with a non-epileptic group of self-poisoners matched for age, sex, and number of repetitions and have been found to have less alcohol excess but significantly more psychopathy. Possible explanations and prophylactic measures are discussed. In view of the relative incidence of epilepsy and self-poisoning in the community, and of epilepsy among self-poisoners in this and other studies, it is concluded that self-poisoning is a common complication of epilepsy.

One hundred elderly patients with chronic organic brain syndromes were assessed by standard interviews, nursing ratings and from historical information. The data were subjected to cluster analysis and eight clusters were isolated. The significance of these clusters is discussed and other features of the patients reviewed.

It is generally accepted that psychological factors are of importance in determining the effects of drugs—beneficial or adverse (Green, 1964; Wilson, 1966; Boszormenyi, 1969). Placebo studies have suggested that one such psychological factor may be prior knowledge of side-effects (Wolf, 1950; M.R.C., 1950; Coleman, 1969). In a controlled trial of amitriptyline in general practice (Blashki et al., 1971) the patients were asked to record their experience of side-effects on a prepared list, and it was thought that this might have ‘involved the risk of suggesting side-effects to the patients'. In a controlled trial of Imipramine in general practice (Porter, 1970) the data suggested that side-effects were an important cause for patients abandoning treatment. Doctors may be chary of detailing side-effects, thinking that imparting such knowledge to patients may in a proportion of them induce the side-effects to appear and lead to discontinuance of therapy.

Although chlorpromazine was the first of the phenothiazine drugs to be used in psychiatry, and has since been the subject of an extensive literature, there is a surprising dearth of information about the nature of its effect in chronic schizophrenia. Some early reports indicated that it produced a beneficial change, but before this could be examined and documented the attention of most psychiatrists was diverted to newer and supposedly more potent analogues. The present trial was undertaken with three factors in mind, which had not been fully taken into account of in previous studies. These were:

Two classifications, DSM–III and catego4–derived ICD–8, included in the CIDI, are compared in 63 in-patients and out-patients with a broad range of psychiatric illness. Agreement for main diagnosis between these classifications was statistically significant for two time frames, the present state and lifetime. However, while diagnostic assignment by catego4 remained fairly constant between time frames, there was a marked shift in DSM–III-assigned diagnosis, with cases changing from anxiety state diagnosis (present state) to affective disorder (lifetime). Thirty-nine subjects were assigned a DSM–III diagnosis of affective disorder for lifetime illness compared with 21 assigned to this diagnostic group by catego4.

The Psychopathology Instrument for Mentally Retarded Adults, a recently developed, empirically derived measure of psychiatric disturbance for the mentally handicapped, gives a total of eight scales which correspond to DSM–III diagnostic categories. This paper reports its psychometric properties in a British population and the psychometric properties of three scales derived by factor analysis. The internal consistencies of the scales were only barely acceptable in this sample and less acceptable than in previous studies.