In a cross-national comparison of the frequency of occurrence of various diagnoses among elderly psychiatric patients admitted to public mental hospitals in London and New York, a short battery of psychological tests was administered to all patients independently of psychiatric examination. The psychological assessment was focused on the differentiation between dementing and affective disorders. The test performance showed a highly significant difference between the two groups as diagnosed, and when patients were allocated to groups on the basis of tests alone these allocations showed a high rate of agreement with initial psychiatric diagnosis. There was a similar high rate of agreement between test allocation and hospital diagnosis in the U.K., but this was not so in the U.S.

No significant differences were found between the test performance of U.K. and U.S. patients, except on the WAIS Vocabulary and the Angles Error measurement of the Bender-Gestalt test. When the effects of age and Vocabulary score were eliminated these differences disappeared.

The hypothesis that the diagnosis of affective disorder would be confirmed by a relatively greater improvement in test performance over time in this group of patients was not upheld by the non-parametric analysis of change scores. However, an analysis of covariance utilizing age and initial score did indicate the expected differential improvement.

The stability of sleep was examined in two kinds of induced insomnia, namely after caffeine administration and after hypnotic drug withdrawal. The duration of each episode of any one sleep stage or any episode of intervening wakefulness plus drowsiness was determined.

After caffeine mere was an increase in longer episodes of intervening wakefulness plus drowsiness, but no significant change in the episode duration of any of the sleep stages. In the case of drug withdrawal there was no change in the episode duration of intervening wakefulness plus drowsiness, but there was a significant shortening of episode duration in sleep stages 2 and 3 +4, with a similar trend for REM sleep episodes.

Caffeine ‘insomnia’ thus seems characterized by increased stability of wakefulness, and hypnotic withdrawal ‘insomnia’ by decreased stability of sleep. The type of analysis undertaken in this study could increase understanding of other types of insomnia.

It is common clinical knowledge that parents of schizophrenic patients show an apparent disability to comprehend their children's illness. They often minimize its severity or show complete lack of insight and deny gross psycho-pathological symptoms. The concept of illness by parents of schizophrenic patients is the subject of the present investigation. Investigations of such attitudes are not common in the literature. They are impeded by the lack of appropriate objective techniques of measurement. The Repertory Grid method (Kelly, 1955) provides a flexible and sensitive instrument for investigation of single subjects. According to Kelly's theory, each person has his own unique way of construing. He evaluates a set of elements within his range of comprehension, using Personal Constructs in a network of interrelationships. Difficulties occur, however, when groups of people are to be compared. One can compare groups by the way they use Constructs to evaluate a set of Elements; but one must ensure not only that the Elements are within the range of convenience of all subjects of the group but also that Constructs used by the group occupy some significant place in the construct system of each person of the group. The work reported in this paper was performed in two distinct phases.

Previous research suggests, though by no means consistently, that schizophrenic patients may be less able than normals to predict the speech of other people, and that schizophrenic speech is less predictable than normal speech. The present experiment tests these two suggestions and also a third possibility, that the difference between schizophrenic and normal speech is less marked for schizophrenics asked to make the predictions than for normals. Twelve schizophrenic patients recently admitted to hospital, and twelve comparable, psychiatrically normal, orthopaedic patients, were asked to predict both schizophrenic and normal speech, using Cloze Procedure, under both fourth-word and fifth-word deletion. The first hypothesis was upheld, but the second and third received only very limited support. The findings are discussed in the light of previous work, and suggestions are made for future research.

The subject of impotence has hardly been approached in the Arab countries though sexual dysfunction of a functional nature is of no less importance there than elsewhere.

Work in England (Kaldegg, 1956) and America (Wechsler, 1958; and Jones and Parsons, 1972) has suggested that heavy drinking, while in the later stages leading to all-round intellectual deterioration, in the early stages frequently causes deficits in visual/spatial and visual/motor co-ordination and visual memory. Kleinknecht and Goldstein (1972) suggest two general areas of deficit, inability in abstract reasoning and problem solving, and inability in tasks involving speed and perceptual/motor co-ordination. These functions are known to deteriorate with age and so deficits due to alcohol look like premature senescence of intellectual and psychological processes.

The patient undergoing rehabilitation is expected to do more than passively accept care and treatment. He is also expected to learn. The doctor or nurse purveying rehabilitation finds that the job increasingly includes teaching as well as treating patients. Most but not all of the transactions between teachers and taught are conducted by means of the spoken word. The extent to which messages are conveyed intact by this means (and without this no learning will occur) will depend among other things upon the speaker's clarity of expression and the listener's ability to understand.

In this study we have compared certain personality variables in alcoholic individuals, depressed subjects and in controls.

A group of 46 bipolar probands and their first degree relatives were studied. A high rate of affective disorder (19.6 per cent) was found, including both unipolar (13.2 per cent) and bipolar (6.4 per cent) types, with females predominating (3: 1). The presence of four father-son pairs suffering from affective disorder made the hypothesis of X-linked dominance untenable. Results compatible with polygenic inheritance were found, using both Slater's and Falconer's methods. There was no evidence for assortative mating or for increased total number of females (both well and ill) among first degree relatives. The probands and affectively ill first degree relatives who have died show an alarmingly high rate of suicide (46 per cent). Other forms of mental disorder, including alcoholism, were no more common than in the rest of the community.

In a previous study, macrocytosis was found in non-anaemic mentally retarded epileptic patients treated with anticonvulsants, and a direct relationship was found between drug dose and the degree of macrocytosis, when the sole anticonvulsant given was phenobarbitone (Eastham and Jancar, 1970a and b). An attempt to use the measurement of red cell size to detect folate deficiency during anticonvulsant therapy before the development of overt anaemia was unsuccessful. Following these findings, yeast tablets were given as a natural source of folate to both epileptic and non-epileptic mentally retarded patients, and preliminary results showed that folate deficiency associated with long-term anticonvulsant therapy could be corrected within three months, without increasing either the frequency or the severity of convulsions in epileptic patients (Eastham and Jancar, 1971). Supplementary yeast tablets were therefore given routinely to all epileptic patients on anticonvulsant therapy in the hospital; there were no side effects from this medication.

IQ, appears to play a major role in the development and course of schizophrenia. Patients with low IQ tend to have an earlier onset (Pollack, 1960; Belmont, Birch, Klein and Pollack, 1964; Offord and Cross, 1971), to stay in hospital longer (Offord and Cross, 1971) and improve less while there (Pollack, 1960), to remit less often (Stotsky, 1952) and to make a poorer post-hospital adjustment (Pollack, Levenstein and Klein, 1968) than patients with normal or high IQ. In addition, schizophrenics, particularly the men, tend to have lower childhood IQs than their siblings (Lane and Albee, 1965; Offord, 1974).

In 1972 three old hospitals were closed and patients transferred to a new hospital for the mentally handicapped. Four to six weeks before transfer, disturbed and a sample of non-disturbed patients were rated on a selected scale; they were again rated four to six weeks after transfer. The disturbed patients numbered 39 per cent of the total and both men and women shared a significant improvement, though the men did not improve to the same extent as the women. There was also a significant improvement among the non-disturbed patients, though this did not apply to the epileptic patients.

The application of techniques of behaviour modification to chronic adult psychiatric in-patients has for the most part been directed towards individual patients, and to specific problems such as hoarding, eating, soiling or speech (Ayllon, 1963; Ayllon and Haughton, 1962, 1964; Ayllon and Michael, 1959; Bachrach et al., 1965; Isaacs et al., 1960; Mertens and Fuller, 1963; Kennedy, 1964; Sherman, 1965). In this country, Baker (1970, 1971) and Kassorla (1968) have reported on the use of operant conditioning in reinstating speech in mute schizophrenics. There have, however, been few British reports relating to groups of patients, for example in wards where nurses have been trained to function as ‘behavioural engineers' (Ayllon and Michael, 1959); whereas Krasner and Attowe (1968) specified no fewer than 200 institutions and individuals in the U.S.A. currently involved in token reinforcement programmes, concerned with disturbed or autistic children, delinquent adolescents and the mentally handicapped; 22 projects involved chronic adult psychiatric in-patients.

Most people are aware of their own age, and are able to give it, at least to within a year or two, without reflection. Correct recall presumably depends upon the information being revised and up-dated with the passage of time, i.e. upon a new learning process. Some demented and mentally subnormal patients may be expected to be deficient in reporting their ages, but little is recorded that would lead one to expect such a defect in patients suffering from a functional psychosis.

Manic-depressive psychosis is considered to comprise two different clinical entities, bipolar and monopolar. This dichotomy is based mainly on Western clinical material. The present study aimed at eliciting any differences that might exist between monopolar and bipolar manic patients in respect of three factors: (i) occurrence of psychiatric illness in first degree relatives; (ii) parental death before the patient's 15th birthday; and (iii) socio-economic status of the patient. Venkoba Rao (1973) studied the differences between monopolar and bipolar endogenous depressives on three factors: occurrence of affective disorder (including suicide) in first degree relatives; parental loss before the patient's 12th birthday, and the extent of ‘jointness' of the patient's family.

Psychotherapy can borrow an empirical base from behaviour technology, a discipline which involves the control and prediction of behaviour through environmental manipulation. Fundamental to the achievement of control and prediction is measurement.

An analysis of the drug regimes prescribed to two separate groups of unselected schizophrenic patients indicates certain trends of clinical importance. The results demonstrate a need for the adoption of a personalized dose regime. The scatter of dose regimes found effective is too great to recommend a standardized approach to the prescription of L.A.P. injections.

Two other results of particular significance are that the dose of drug required to control symptoms can be gradually reduced in nearly half of patients, and that helpful trends in prescribing were identified that will help the clinician to abolish side-effects.

Pierce-James (1967), has shown that British heroin addicts have a very much higher mortality rate than the general population. The same applies to American narcotic addicts; a 20-year follow-up study of a group of narcotic dependents showed the very high death rate of 23 per cent over this period (Vaillant, 1973). Pierce-James (1967), distinguished between suicidal, accidental, and other causes of death, and also demonstrated a higher rate of successful suicide attempts among heroin addicts than in the general population. Connell (1965) suggested that the incidence of suicidal threats and attempts in childhood and adolescence is higher than is generally recognized, and in both adolescents (Gould, 1965) and intravenous narcotic addicts (Frederick et al., 1973) suicidal and self-destructive behaviour is more common than successful suicide. The distinction between suicidal attempts and self-destructive behaviour is unclear. Stengel (1964) defined as suicidal attempts, ‘all cases of potentially dangerous self-poisoning or self-inflicted injury.’ The present study, however, does not assume that self-poisoning or self-inflicted injury necessarily implies suicidal intent.

In 1965, the Department of Social and Preventive Medicine of King George's Medical College, Lucknow, established an Urban Health Centre in the Alambagh suburb of Lucknow city and registered 500 families representing a cross-section of the resident population with the purpose of training undergraduate and postgraduate medical students in the practice of community health (Gupta, 1966).