This paper presents findings related to the measure of stress in 641 schizophrenics (125 acutes and 516 chronics) and 95 comparable normals. Stress was defined as an imbalance between environmental demands and the respondent's ability to meet that demand successfully, and was measured in terms of level of stress experienced in relation to specific problem situations. Twenty-one dimensions of stress were measured, subsumed under the following four general areas: social performance, family interaction, social interpersonal interaction, and social maladaptive activities.

Results indicated that, in general, normals experience significantly less stress in dealing with life events than do schizophrenics. Within the schizophrenic group, the pseudo ambulatory chronic patients evidenced more stress than did their acute counterparts, a finding not previously described in the literature.

Implications of these findings do not support the present community after-care concepts. Discharged chronic schizophrenics appear unable to remain in the community for any reasonable period of time because of the high level of stress under which they function.

The notion of transcultural psychiatry is an attractive one. It creates visions of palm-lined beaches and tropical abundance in the midst of which energetic epidemiology leads to aetiological revelations. Nissl commented to his friend Kraepelin (1904), about to embark on his journey to Java, that his research was only a scientific cloak to hide his enthusiasm for travel—a jest that all subsequent transcultural workers have had to suffer. It is unfortunate that not only are the palms and beaches overrated but the differences in culture and morbidity found are often scarcely greater than those existing between sections of one's own society, where even communication may be as great a problem. Even if the contribution made to the understanding of our own illnesses is meagre, transcultural studies can still be justified because they allow us to evaluate the needs of the peoples studied and, we may hope, permit us to indicate how they may be helped. The view sometimes expressed, particularly by anthropologists, that one should endeavour to observe without changing is unacceptable to doctors. Help is indeed required—there are no noble savages nowadays.

In recent years there has been an increasing interest in the observation that rates of psychiatric disorder and of educational problems in children may vary considerably according to area and to types of living conditions. However, very little is known concerning the extent to which rates actually differ, and even less about how particular area characteristics co-vary with the rates of different types of child disorder. Gath et al. (1972) found that child psychiatric referral rates were higher in areas of low social status, but data were not available to determine whether the difference lay in the preyalence of disorder or in the likelihood of detection or referral. Reading backwardness has also been associated with low social class areas (Miller et al., 1957; Eisenberg, 1966). In addition, it has been found that reading standards are lower in England than in Scotland (Davie et al., 1972). None of the studies of reading have taken IQ, into account, and it is not known whether the correlates are mainly with IQ or with a specific disability in reading. The present investigation was designed to examine these issues by determining if there were differences in the rates of child psychiatric disorder and of specific reading retardation between an inner London borough and the Isle of Wight. If differences were found, it also sought to examine the reasons for them, in order to elucidate possible causal or precipitating factors.

Disorders of the skin, either congenital or acquired, associated with nervous disorders and disturbance of normal mental functioning arc numerous. The classification is very wide-ranging and includes: phakomatoses, hamartoses, adenomatoses and neurocutaneous syndromes. In 1972, Liebaldt and Leiber collected 40 titles of the syndromes, and since then many more reports of the new syndromes and their variants have appeared in the world literature.

In his monumental work on the history of dynamic psychiatry (1970), Henri Ellenberger has traced the origin of the modern depth psychologies back into the mists of time. Both ills of the body and ills of the mind were originally handled by the priest-physician of primitive societies along much the same lines. But there came a parting of the ways. Glimmerings of an empirical approach to the external world led to some degree of objectivity and to the primordial elements of science. Some physical illnesses could be traced to physical causes, and an understanding of causation led in course of time to rational therapy along physical lines. But mental illnesses remained refractory. It was only in a small area of their vast extent that their causes could be attributed to bodily conditions and thereby to physical causes. Over a great reach of time up to the present day, or at least till yesterday, it was generally believed that, as bodily illnesses had physical causes, the illnesses of the mind must have psychological causes. It proved beyond the powers of priests or physicians to identify them; and there was no way of accounting for the variable course, outcome and responsiveness to treatment of mental disorders.

This study of suicide in Dublin during 1964–1968 from coroners' records was undertaken to estimate the discrepancy between coroners' verdicts, the national suicide statistics compiled from them and the clinical assessment of probability of suicide by psychiatrists examining the same records. The large difference in numbers of suicides deriving from the two approaches has considerable implications for national suicide statistics, and these have been briefly considered. From the findings presented we believe that we are justified in concluding that: (a) there are real differences in national suicide rates, at least between Ireland, England and Wales, and Scotland, and (b) the Irish suicide rate is low, though not as low as official statistics suggest, and (c) the discrepancy between official and ‘true’ suicide rates in Ireland is greater than in England and Wales and in Scotland.

Much attention has been devoted to the classification of the behaviour disorders of childhood, and various authors have identified what they consider to be clinically homogeneous groups. The alternative to a clinical approach to classification is a multivariate approach in an attempt to identify more scientifically the main dimensions underlying the wide range of behaviour disorders that occur in children. A model for a multivariate classification was pioneered by Hewitt and Jenkins (1946), who delineated three behaviour syndromes:

1. (a) socialized delinquency;

2. (b) unsocialized aggressive behaviour;

3. (c) over-inhibited behaviour.

It is generally thought that there is considerable regional variation in rates of educational retardation. American studies have shown that reading difficulties are considerably more prevalent in areas of low social status (Miller et al., 1957; Eisenberg, 1966), and Eisenberg (1966) found that inner city children had the lowest reading attainments. The National Child Development study (Davie et al., 1972) showed that reading standards were higher in Scotland than in England, and the Inner London Education Authority (1970) has shown that London primary school children have an average reading level below national norms. In south-east England, Morris (1959 and 1966) showed that levels of reading skills varied according to the characteristics of the schools the children attended. In Japan, a survey using teacher judgements has suggested that the prevalence of reading disability is greatly below that in Western countries (Makita, 1968).

The original aim of the U.S./U.K. Diagnostic Project, founded in 1965, was to examine differences in the national statistics for the diagnostic frequencies among patients admitted to state mental hospitals in the United States of America and to area mental hospitals in England and Wales.

In recent years there has been a resurgence of interest in pornography, particularly in Great Britain and the U.S.A. There have been many more publications on the subject, as well as various surveys and enquiries; some of these have been officially sponsored. Well-publicized prosecutions have helped to keep the topic in the public eye, but at the same time have drawn attention to uncertainties and ambiguities in present-day legislation (Tribe, 1973). Underlying all this is a continuing concern about the possible harmful effects of pornography, its implications for mental health and the need for more research and informed psychological guidance.

This is a report by a Working Party of general and specialist psychiatrists appointed in June 1972, by the Executive Committee of the Scottish Division of the Royal College of Psychiatrists. The remit of this Working Party was ‘to consider and make recommendations on the future provision of psychiatric services in Scotland’.