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 following enquiries into the careers of trainee psychiatrists were undertaken as part of a personal attempt to contact all doctors working in psychiatry in sub-consultant grades in the South-Western Region. The original intention was to establish a register of trainees in the Region, which is geographically large, extending from Gloucester down to the furthermost parts of Cornwall. The academic centre has traditionally been in Bristol, with its University Medical School and Professorial Department of Mental Health. The Regional Clinical Tutor in Psychiatry organizes regular post-graduate meetings and courses, and some of these take place throughout the Region. The Avon Membership Course, now in its fourth term, takes place on Friday afternoons in Bristol during University term time, providing a two-year theoretical framework for trainees preparing for the M.R.C.Psych. The meetings are traditionally open to all interested persons from any discipline, but trainees working at a distance from Bristol find it difficult to attend this course.

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.

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.

Remember that the interview with the examiners is short. It is therefore very important that you do not waste time talking about irrelevancies and giving a long list of normal findings.

If a diagnosis etc. is possible, give it in the form of a Case Formulation. If it has not been possible to make a diagnosis, say so. You can then offer either to discuss the case or to propose what collateral information you think is required, e.g. an interview with a relative, a P.S.W.’s report, psychological or other kinds of tests, and so on.

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.

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.

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.