One hundred and fifty anxiety neurotic and neurotic depressive twin probands were differentiated into three groups by means of discriminant analysis, 50 in each group. The groups were named: pure anxiety neurosis, mixed anxiety-depression, and pure neurotic depression. Analysis of concordance rates indicated that only pure anxiety neurosis seemed to be influenced by hereditary factors.

An investigation was conducted in the Aberdeen area on wives of oil men working either off-shore or on-shore. No differences were found in measures of general health; but ‘off-shore wives' were shown to experience mood and behavioural changes, linked to the pattern of swiftly recurring partings and reunions. While a majority of such wives appeared to tolerate or even thrive on their style of life, 10% had reactions sufficiently pronounced to deserve the label of Intermittent Husband Syndrome or ‘caseness'. Many others would have benefited from more effective preventive and support services.

A case of weight loss from food avoidance and vomiting in a young Ethiopian torture victim is described, and possible aetiological factors discussed.

We evaluated the efficacy and safety of vagus nerve stimulation therapy in the treatment of 11 patients with chronic treatment-resistant depression. Mood was evaluated at frequent intervals over the year following implantation. All measures of depression, including the Hamilton Rating Scale for Depression reduced significantly. The response and remission rates were 55% and 27% respectively at 1 year. Side-effects were common, and some were severe.

The Government emphasis on tackling health inequalities and the availability of recent data on mental health inequalities from the Office of Population Censuses and Survey's (OPCS) National Psychiatric Morbidity Survey (NPMS) (Meitzer et al, 1995) suggest that it is time to review the evidence on inequalities in mental health. We aim to summarise the relevant research on rates of psychiatric morbidity within the general population, and define specific populations at high risk of mental disorder. The theories put forward to account for these inequalities are considered, noting the limitations of the data they are based on and highlighting their implications for the data required to facilitate further research. Inequalities in access, provision and appropriateness of services are also discussed. We make policy recommendations for reducing these inequalities at national, regional and district levels.

Although beta-amyloid, anxiety and depression have been linked cross-sectionally to reduced memory function in healthy older adults without dementia, prospective data evaluating these associations are lacking. Using data from an observational cohort study of 178 healthy older adults without dementia followed for 3 years, we found that anxiety symptoms significantly moderated the relationship between beta-amyloid level and decline in verbal (Cohen's d = 0.65) and episodic (Cohen's d = 0.38) memory. Anxiety symptoms were additionally linked to greater decline in executive function, irrespective of beta-amyloid and other risk factors. These findings suggest that interventions to mitigate anxiety symptoms may help delay memory decline in otherwise healthy older adults with elevated beta-amyloid.

There is a strong prima facie case linking the abuse of psychiatry with difficulties about the concept of mental illness. However, a survey of recent Soviet literature showed that the concept of disease employed in the former USSR (where abuse was for a time widespread) was similar to its counterparts in the UK and USA in being strongly scientific in nature. A number of factors - legal, bureaucratic and professional - are important in abuse becoming widespread. These, however, fail to explain why psychiatry, rather than physical medicine, should be vulnerable to abuse. It is here that the concept of disease could be important. A scientific model of disease suggests that a significant vulnerability factor is the relatively underdeveloped status of psychiatry as a science. This leaves room for poor standards of scientific work in clinical research and practice, factors which are recognised as important in the Soviet case. In addition to the scientific element, there is an evaluative element of meaning in the concept of disease. Hence a second vulnerability factor could be the evaluatively problematic nature of judgements. of mental illness. It is concluded that a failure to recognise this factor greatly increases the vulnerability of psychiatry, not only to gross abuses, but also to inadvertent misuses of involuntary treatment in everyday practice. This conclusion, far from undermining the role of science in psychiatry, is a step towards clarifying its proper role.

ANK3 gene variants have consistently been associated with bipolar spectrum disorder and schizophrenia spectrum disorder. However, the relevance of its encoded protein, ankyrin-3, in these disorders remains elusive. Here, we show that ANK3 gene expression in blood is significantly increased in bipolar disorder and schizophrenia compared with healthy controls. Additionally, we identified potential cis-acting expression quantitative trait loci located close to the transcription start site of one of the isoforms of the gene. These findings suggest that ANK3 mRNA is an interesting marker for further investigation of the underlying mechanisms in psychotic disorders.

Ninety-two Danish manic–depressive patients with a first psychiatric admission between 1969 and 1983, who committed suicide before 1 July 1986, were considered. Information on any prophylactic or continuation treatment at the time of the suicide was obtained. In 64 of the patients, every precaution seems to have been taken: 28 patients committed suicide during ongoing treatment; 10 while not receiving prophylactic treatment (not indicated); 7 while not in prophylactic treatment because the patients refused or did not tolerate such; and 19 while in prophylactic treatment with antidepressants (10), or lithium (6), or both (3), in usually adequate dosage. In 28 of the patients, suicide might have been obviated. Guidelines for improvement of suicide prevention in manic–depressive illness are presented.

Thirty Kenyan patients of black African origin undergoing treatment for clinical depression in Nairobi, and 40 matched non-psychiatrically disturbed controls in the community were studied for life events using the Brown-Harris model. It was found that the depressed group had significantly more life events (P <0.001 with Yates correction for continuity) in the twelve months preceding the onset of their depression than the controls in the same period. These results are similar to those obtained by several workers in Western settings. Their implication for the practice of psychiatry in an African context is examined, and some myths about psychiatry in Africa re-examined.

Previous studies (McConaghy, 1969, 1970a; McConaghy et al., 1972) evaluated the efficacy of three widely different forms of aversion therapy in treating homosexuality. The methods investigated were aversion-relief, apomorphine therapy, and avoidance conditioning.

In this study memory changes during and after electroconvulsive therapy were investigated by means of three different tests. The investigation was double-blind and the subjects were 96 patients hospitalized with depressive illness. Amounts of post-ECT amnesia were evaluated in relation to number of treatments for symptom remission and stability of the therapeutic result over the period of one year.

Patients with a clinical diagnosis of Alzheimer's disease were studied using MRI, SPECT, and psychometric tests. Significant correlations between focal perfusion deficits and focal cognitive deficits were found. Significant correlations between regional relaxation time of white matter and psychometric tests of diffuse and focal categories were also found. Pathological examination confirmed Alzheimer's disease as the only diagnosis.

The possible failure of a notional sensory filter in schizophrenia was studied by means of habituation of the orienting response. Non-paranoid schizophrenics failed to habituate, but paranoids habituated normally. Paranoids, however, showed a different impairment: they responded to a dishabituating tone as if the novel stimulus were somewhat familiar.

The failure of habituation in non-paranoids could not be explained in terms of arousal when the index was the rate of skin conductance fluctuation. Neurotic controls showed considerably higher levels than either group of schizophrenics.

Non-paranoid schizophrenics had lost the normal inverse relationship between habituation and level of arousal as manifested in the rate of spontaneous skin conductance fluctuation.

It has been suggested that schizophrenia is a disappearing disease. The evidence for this assertion is reviewed, and also for a parallel theory advanced in recent years that the disorder may be undergoing a benign metamorphosis in its course and outcome. It is concluded that the evidence is presently unconvincing given the methodological problems inherent in most follow-up studies; changes have taken place in clinicians' assumptions, in treatments, and in the quality of follow-up studies, rather than in the disorder itself. Nevertheless, possible time trends in the incidence and outcome of schizophrenia call for further scientific investigation.