There is evidence that dependence can develop to tranquillizers and that they can cause states of physical dependence similar to those obtained with barbiturates. Withdrawal manifestations are usually less severe and of shorter duration. They include agitation, restlessness, tremor, muscle twitching, insomnia, anxiety, depression and confusional states with disorientation. After high doses hallucinations, delirium and convulsions can occur.

In determining the diagnostic value of psychological tests the usual external criterion is the psychiatric diagnosis. This criterion has suffered a steady decline in prestige among both psychiatrists and psychologists. The following remarks by Noyes (1953) would be endorsed by many psychiatrists: “The principal value of classification is not in the categorizing of a disease entity but in quickly eliminating those considerations which will be least useful in understanding the patient and in directing attention to those which are likely to be relevant. Except in organic disorders a classificatory diagnosis is less important than a psychodynamic study of the personality. The psychiatrist should be interested in processes, not in labels … we should endeavour not so much to fit the symptoms into a classificatory scheme as to understand the sick person in terms of his life experience.”

The context of voluntary befriending schemes to help mothers of young children is outlined. There is evidence that two main UK voluntary befriending schemes to help mothers of young children engage families where there is significant psychosocial morbidity. It is concluded that well conducted befriending schemes can make a significant contribution to the mental health of mothers and children. Whether they do so will depend on their experience and training and the elements they incorporate.

Three cases of Capgras' syndrome were identified in one psychiatric hospital within a 1-year period. These are presented and their psychopathology discussed. The traditional assumption that this is a rare syndrome is challenged.

There are few studies relating electroencephalographic characters with mental deterioration. Romano and Engel (1) (2) made an EEG and clinical study of “delirium” which they defined as the “toxic-infective state or psychosis associated with somatic disease” which was accompanied by “fluctuation in the level of awareness” and “intellectual, emotional and motor regressive behaviour”; the group included cases of chronic and acute cardiac decompensation, chronic alcoholism, hypertensive states, and severe Addison's disease. These authors considered that the EEG changes could be graded into three main groups, in order of severity: firstly,” decrease in frequency,” with increase of slow 4–7 frequencies and normal blocking responses to visual attention; next, “disorganization,” with irregular slow 2–7 frequencies and poor blocking responses; and finally,” reorganization at a lower energy level,” with moderately high voltage slow 3–7 c./sec. activity, few or no normal frequencies, and absent blocking response to visual attention. This latter stage was, in some cases, found to be irreversible. Previously, Engel and Margolin (3) had published the results of an investigation into the effect of both oxygen and glucose-deprivation on the human electro-encephalogram. Both these conditions produced bursts of diffuse generalized 3–6 c./sec. activity which, in those cases with an acute onset, reverted to normal rhythms as clinical improvement occurred. However, 4 patients with chronic cerebral anoxaemia were examined (end-stages of chronic bronchitis with right-sided heart-failure) in whom the EEG abnormalities persisted; at an early stage, activity with a frequency of 5–6 c./sec. appeared, and still later the records became completely disorganized. There was one patient who ultimately recovered whose EEG showed a regular dominant alpha rhythm with a frequency of 7.5 to 8 c./sec. It had already been noticed that, in a few cases where the EEG had apparently returned to normal in prolonged anoxic and hypoglycaemic cases, there yet remained some degree of intellectual deficit on psychological testing. Hill (4) had observed that a type of EEG with a slower dominant alpha-rhythm than the normal 8–13 c./sec. (i.e. a rhythm at 6–8c./sec.) was frequently associated with mental deterioration. An investigation was accordingly instituted to determine to what degree mental deterioration and slowing of the dominant rhythm in the post-central areas (alpha-rhythm) were associated.

In recent years electrophoretic methods for the analysis of the serum proteins have been extensively and fruitfully applied to studies of diseases of the nervous system (Volk, Saifer, Rabiner and Oreskes, 1955; Volk, Saifer, Rabiner and Hinterbuchner, 1956; Press, 1956).

A schizophrenic patient whose severe level of auditory hallucinations had proved refractory to neuroleptic medication was given two treatment techniques derived from Green's theory that hallucinations represent verbal activity in the non-dominant hemisphere. Voice activity was markedly reduced in frequency and severity over a six-month period, and led to general improvements in interpersonal functioning. There was evidence for independent and additive effects of the two techniques.

An investigation into the factors concerned in the etiology and pathogenesis of childhood schizophrenia is fraught with difficulties in numerous areas. Encountered are such problems as the diagnosis itself; doubt that psychoses exist in childhood; the existence of the duality organic or functional schools of thought, and of frequent contradictory findings reported by various groups of investigators in the field.

The usual leucotomy cut in this country, made through burr holes orientated by means of skull measurements, in the majority of cases enters the brain at about the middle of pars triangularis of the inferior frontal gyrus (Brodmann's Area 45), and if performed in a strictly coronal plane remains entirely within the prefrontal region. Intentionally or unintentionally cuts are not infrequently placed either anterior or posterior to this plane. That cuts made posterior to strictly prefrontal levels are often followed by an unfavourable post-operative course distinguished by particularly severe personality change, persisting incontinence, vasomotor, trophic and neurological disturbances has been demonstrated by Knight (1943), Meyer and Beck (1945), Ziegler and Osgood (1945), Reitman (1946) and others.

A retrospective study of psychiatric referrals from a general hospital inpatient population was carried out for three separate years, 1973, 1976 and 1979. Reorganisation of the liaison service to the responsibility of one consultant team was associated with changes in referral rate and disposal. In particular, there was a significant increase in the referral rate of patients from medical and surgical wards who were not involved in acts of deliberate self-harm.

This study investigated parental bonding patterns of hypochondriacal patients using the Parental Bonding Instrument. Hypochondriacal patients and a matched control group were drawn from in and out-patients of a psychiatric hospital. Maternal over-protection was found much more frequently (P <.005) in the hypochondriacal group than in the control group. This offers support for previous clinical observations on hypochondriacal patients. The implications of this and other findings of the study are discussed.

Total and free plasma tryptophan levels were measured in depressive and manic patients before and after recovery. No change was found in total or free plasma tryptophan concentration on recovery from depressive illness. Free plasma tryptophan levels were higher in recovered manics than in active manics, and a group of four manic patients tested before and after recovery showed a significant increase in free plasma tryptophan concentration on recovery.

Videotaped social interactions were shown to a population of schizophrenics and controls who were asked to comment on the emotional state of the principal protagonist. Their free responses were subjected to a content analysis to examine which of three possible explanations of known schizophrenic inaccuracies on this task were responsible: formal thought disorder, selective avoidance of psychological factors, or perceptual/attentional deficits. Neither selective avoidance nor marked thought disorder were found to explain these errors. The schizophrenics as a group rated much the same, irrespective of clinical profile. Their judgements of personality were less clear-cut than the controls.

The seasonality of births was examined for 4,855 schizophrenic patients born in Ireland between 1921 and 1955. All general births for the same years were used as controls. Schizophrenic births were found to be significantly elevated in the second quarter of the year (P <.001). The excess was 11 per cent higher than for any European country examined to date.

The premenstrual and menstrual periods are associated with increased psychiatric disturbances, both of a psychotic and neurotic nature. Pre-existing psychosis can worsen in the premenstrual period, or, as we describe in the following case report, a psychosis can occur in the premenstrual period with complete remission once the bleeding has ceased. The role of menstruation in the timing and pathogenesis of the major psychoses is largely ignored in present-day psychiatry. In the nineteenth century, however, psychosis coincident with menstruation was thought to merit its own special term (Menstruationpsychose), and Kraepelin himself described the importance of the association (Kraepelin, 1909). In contrast, premenstrual tension has been the subject of continuous interest since the term was first used by Frank (1931), and there have been cases described of premenstrual tension in association with psychosis. Williams & Weeks (1952), for example, reported on 16 cases where the psychosis was characteristic of mania or catatonic schizophrenia, and more recently, Price & DiMarzio (1986) found that 60% of a group of rapidly cycling manic-depressive psychotics suffered from severe premenstrual tension. Psychosis associated with the menstrual cycle without concomitant symptoms of premenstrual tension has also been described. Lingjaerde & Bredland (1954) presented a case of a 24-year-old woman who developed a manic–depressive (manic-type) psychosis synchronous with her menstrual cycle, after childbirth. A Japanese cohort of patients diagnosed as suffering from “periodic psychosis” (Wakoh et al, 1960) showed significant correlation between acute psychosis and the luteal phase of the menstrual cycle. The premenstrual period is also known to exacerbate pre-existing psychosis; Ota et al (1954) and Gregory (1957) have shown a significant increase in psychotic behaviour in the last 10 days of the menstrual cycle. We present a patient with a schizophreniform psychosis occurring irregularly but concomitant with her menstrual cycle, with total remission during the interval stage.

The HLA (Human Leucocyte Antigen) types A and B were studied in 80 patients diagnosed as schizophrenic. There was an increased incidence of HLA-BW5 and a decrease in HLA-AW29 and HLA-BW17 as compared with healthy controls. In the sub-group of patients exhibiting Schneider's first-rank symptoms there was an increased incidence of HLA-A1 with a decrease in HLA-A2 and HLA-BW17.

In order to evaluate how many patients presenting at accident and emergency (A&E) departments show signs of psychiatric disturbance, 140 consecutive medical presentations to an A&E department were evaluated using a range of simple self-report and rater measures, then followed up a month later. High levels of reported psychological problems were detected at screening, and these persisted at follow-up. Correlates of psychological disturbance and repeated attendance at A&E were investigated, indicating the relevance and feasibility of psychiatric intervention related to simple predictors.