We examined nationally representative data from the 2002–2004 South Africa Stress and Health Study, a national household probability sample of 4351 persons aged 18 years and older: 9.1% of respondents reported lifetime suicide ideation, 3.8% a plan and 2.9% an attempt. Among four ethnic groups, the Coloureda group had the highest lifetime prevalence for attempts (7.1%). Those at higher risk of suicide attempts had one or more DSM-IV disorders.

During the clinical observation of a female patient suffering from recurrent schizophrenic attacks, it was noticed that each psychotic episode was associated with the appearance of acne, and also that during remissions the patient showed an unusual craving for salt. These observations, together with the automatic disturbances characteristic of the onset of attacks, suggested that the adrenal cortex might play a part in the metabolic changes in this type of case, particularly the changes in nitrogen balance which have been demonstrated by Gjessing (1932, 1938). The work here reported was therefore primarily concerned with investigating the possible relationship between adrenal cortex activity and nitrogen metabolism in two patients of this type.

Nyasaland is a narrow strip of land 40,000 square miles in extent. It lies approximately between latitude S. 9’ 45” and 17’ 15”, and longitude E. 33’ and 36’. It is bounded on the North by Tanganyika Territory, on the East by Lake Nyasa and Portuguese East Africa, and on the West by Northern Rhodesia and Portuguese East Africa.

Chronic obstructive pulmonary disease (COPD) is often complicated by depression and exemplifies the challenge in managing chronic illnesses that require active patient participation in care. In a clinical trial (NCT00151372), we compared a novel personalised intervention for depression and COPD (PID-C) targeting treatment adherence with treatment as usual (TAU). In 138 patients with major depression and severe COPD, PID-C led to a higher remission rate and a greater reduction in depressive symptoms and in dyspnoea-related disability than TAU over 28 weeks and 6 months after the last session. If replicated, PID-C may serve as a care model for patients with both depression and medical illnesses with a deteriorating course.

COVID-19 has changed our lives and it appears to be especially harmful for some groups more than others. Black and Asian ethnic minorities are at particular risk and have reported greater mortality and intensive care needs. Mental illnesses are more common among Black and ethnic minorities, as are crisis care pathways including compulsory admission. This editorial sets out what might underlie these two phenomena, explaining how societal structures and disadvantage generate and can escalate inequalities in crises.

The quarterly distribution of births of patients born in England and Wales 1921–60 and first admitted in 1970–75 was examined by decade of birth and by age at year of admission. For patients with schizophrenia and affective psychosis, the distribution varied: in the early decade (1921–30), and for older patients (45–54 years) the proportion of births in the fourth quarter of the year was high, compared with expectation from live births in the general population; but it became lower in succeeding decades and for younger age groups. No comparable change occurred for births of patients with neurosis or personality disorder.

Obsessional slowness is regarded as an uncommon but severely disabling variant of obsessive-compulsive disorder. This paper examines the psychopathology, classification, pathophysiology and treatment of obsessional slowness. It argues that primary obsessional slowness does not require classification as a separate syndrome because it can be found to be secondary to recognised phenomena of obsessive-compulsive disorder or anankastic personality disorder. The treatment described in the literature is not thought to be successful in the long term, and controlled trials are required to evaluate new strategies and antidepressant medication.

An assessment of 31 main care-giving relatives living with schizophrenics was carried out using the General Health Questionnaire and the Social Adjustment Scale by Self Report. More than 75% of relatives had a high probability of themselves being a psychiatric case. Relatives also showed social role dysfunction and impairment especially marked in social and leisure activities. Relatives' distress was related to the level of symptoms in patients, as assessed by the Present State Examination.

As part of an epidemiological survey of a rural community in the North of Spain we analysed the interaction between physical illness and neurotic morbidity using a two-phase cross-sectional analysis of a representative sample of the population over 15 years old. There was a very high prevalence of neurosis in the somatically ill (males—15.6 per cent, females—33.1 per cent) and much physical pathology in the group of neurotics (males—42.4 per cent, females—39 per cent). The personal characteristics of the sample, as well as some sociological factors like rural-urban way of life, educational level and social class, appear to influence the relationship between both types of illness. The neurotic morbidity of the somatic group comprised depressive, anxiety and hypochondriac types.

Sustained attempts were made to identify all families in which there was a pattern of two or more generations of child maltreatment and multi-agency involvement in North-East Wiltshire (population 200,000) and where there were also two or more children maltreated in the current generation (born between 1960 and 1980). One hundred and forty-seven families were discovered. Disorders of behaviour of the parents of the 1960–1980 children are described. Collating information laboriously from at least 34 different agencies revealed very high levels of disturbance. Such detail was generally inaccessible, and its full significance for each family could only be assessed by using family medical record linkage methods. In the parents and antecedents, mental and personality disorders, suicidal attempts, mental handicap, dependence on drugs (mothers) or on alcohol (fathers), epilepsy and criminality were conspicuous features.

It is argued that obsessional indecision reflects a formal cognitive characteristic, and should therefore be detectable in slower performance of insignificant, neutral tasks. The obsessional will not be handicapped in structured tasks requiring concentration and a deductive approach, but he will be slower in less structured tasks requiring a predominantly inductive approach. Results from two neutral (numerical) tasks support the predictions.

Schizophrenic patients given LSD-25 show an increase of psychopathological phenomena and a regression to the prime stage of their psychosis, the manifestations of which seem to be more directly related to the life history of the patients.∗ It has also been observed that some “normal” experimental subjects show various paranoid symptoms with the same drug, but whether these are in any way determined by heredity is not known.

Anorexia nervosa is a disorder characterized by loss of weight occurring as a result of a reduced intake of food; it may be aggravated by vomiting, excessive exercise or purgation. Females are affected much more commonly than males; the illness often begins during adolescence and one of its early manifestations is the cessation of menstruation.

The authors investigated the dexamethasone suppression test (DST) in 93 female patients with primary (endogenous) major depression; in 20 female paranoid schizophrenics, and in 17 healthy females. Depressed patients had a significantly higher rate of abnormal DST response and significantly higher post-dexamethasone serum cortisol levels than schizophrenics and normal controls. The unipolar and bipolar depressives showed a similar profile of DST abnormalities. Depressed patients with psychotic features had a significantly higher rate of positive DST results than non-psychotic patients.