Lindemann (6) first used the term ‘anticipatory grief’. It referred to the separation of two people with one anticipating the death of the other and preparing for it to such an extent that on the return of the other there is rejection rather than happy acceptance. In his example a soldier returning from combat complained that his wife no longer loved him and was seeking a divorce. After seeing the man, Lindemann attributed the problem to the wife's ‘anticipatory grief. It seems there could be other explanations to his example.

It is a common clinical observation that schizophrenic subjects often exhibit abnormalities of verbal behaviour in both the spoken and the written modes. Such abnormalities may range from minor idiosyncrasy to gross linguistic deviance. Where the linguistic deviance is very obvious, this of itself may carry considerable diagnostic weight in the overall schizophrenic symptomatology. In general, two main questions have been asked concerning this phenomenon: (a) why do schizophrenics produce abnormal language?; (b) what precisely is the linguistic characteristic of the abnormality? For mainly historical reasons it has been the first question which until relatively recently has received the most attention. The past twenty years or so have seen a remarkable advance in linguistics and its vigorous hybrid, psycholinguistics, without which present attempts to analyse and quantify language deviance would have been impossible. All of this is relevant to question (b). Since the beginning of this century, however, psychodynamic models and theories have afforded sufficient frameworks for speculation over question (a).

Psychotherapists tend to view homosexuality as a neurosis or as a neurotic symptom (Sadger, 1909, 1921; Klein, 1932; Rado, 1940; Ellis, 1952, 1955; Bieber et al., 1962; Ovesey et al., 1963). In support of this viewpoint, several authors have observed that the frequency of typical neurotic phenomena in homosexual males is much higher than that in a heterosexual male population, and have concluded that homosexuality is one of the neurotic symptoms of their patients (Stekel, 1929; Henry, 1937; Ellis, 1959; Musaph, 1960; Doidge and Holtzman, 1960). However, an alternative interpretation is that such maladaptive patterns develop from the difficult situation of a homosexual male in a heterosexual society and from the general disapproval he encounters. Moreover, the finding of increased prevalence of neurotic symptoms in homosexual males has itself been challenged by Kronfeld (1923) and Hooker (1957), who pointed out that the investigated homosexual males represented a selection of people who sought psychiatric help. Hooker studied non-patient samples from homosexuals' clubs and did not find an abnormally high frequency of neurotic symptoms.

Psychiatrists differentiate types of abnormal personality in practice by assigning a descriptive label to indicate the chief way in which the patient's behaviour deviates from what is usual in society. The use by psychiatrists of such a category system for diagnosing abnormal personality has been discussed in two previous papers (Walton et al., 1970; Walton and Presly, 1973). The diagnostic system evaluated was one which included categories contained in the American Psychiatric Association classification (1968) and in the relevant section of the International Classification of Diseases (1965).

Among the various methods of assessing morbid anxiety the psychiatric interview remains pre-eminent. By this means, we attempt to elicit what patients actually feel—the criterion against which all other measurements are validated. Dissatisfaction with the subjective nature of psychiatric interviews and with their low reliability (Cattell and Scheier, 1958; Kreitman, Sainsbury, Morrissey, Towers, and Scrivener, 1961) has led, on the one hand, to the use of rating scales which quantify subjective clinical judgements (Kellner, Kelly and Sheffield, 1968), and, on the other, to the development of techniques which purport to measure anxiety objectively. The latter fall into two broad categories: (i) questionnaires such as the Manifest Anxiety Scale (Taylor, 1953) and the IPAT Anxiety Scale (Cattell and Scheier, 1963), and (ii) measurements of somatic correlates of anxiety, in particular the various endocrine and physiological responses reviewed by Mason (1968) and Lader (1969), respectively.

Gilles de la Tourette's disease is a relatively rare condition characterized by multiple motor tics and an irresistible compulsion to swear. It was first described by Itard in 1825. Many years later, at the Salpêtrière under the tutelage of Charcot and Brissaud, Georges Gilles de la Tourette made a study of nine cases, including Itard's original one, and published his account of the disorder in 1885. He defined it as a nervous affliction characterized by motor incoordination accompanied by echolalia and coprolalia. He distinguished it from the large number of conditions which previously had been grouped under the heading of chorea. He pointed out similarities between this syndrome and the ‘jumping Frenchmen of Maine’ described by Beard in 1880 and the ‘myriachit’ of Siberia described by Hammond in 1884. Other authors however, question whether these conditions are really part of the same disorder.

In 1957, Lewis, writing about obsessional neurotic illness, stated: ‘There has been no marked increase in our state of knowledge of it in recent years, and indeed much of what can be found on the subject in current textbooks had already been fully stated and closely discussed in the first two decades of this century ….’ A recurrent theme in the literature is the supposed relationship between obsessional neurotic illness and ‘obsessional’ character traits. The psychoanalytic view that there is a strong association between obsessional symptoms and the ‘anal’ character traits was disputed by Lewis (1935). He found little evidence to support the existence of a well-marked constellation of character traits, or of a relationship between ‘obsessional’ traits and obsessional neurotic illness. Sandler and Hazari (1960) gave supportive evidence for the psychoanalytic view, but Reed (1970) doubted whether their conclusions were justified by the findings. Makhlouf-Norris (1968) summarized the literature in fourteen points, two of which are outlined below.

In a previous paper (Kniveton and Stephenson, 1970) we suggested that children with few interests of their own are likely to be more susceptible to the influence of filmed or television models than children with more extensive interests. However, neither we nor any other workers in this field have demonstrated that the tendency to imitate is a consistent behavioural characteristic. In fact, examination of the within-group scores for the subjects in the above-mentioned experiment reveals exceptionally large standard deviations for the amount of time spent imitating. These characterize both middle-class and working-class groups (Kniveton and Stephenson, 1972), although such groups differ consistently in their susceptibility to the filmed model used by the authors.

Respiratory relief (R.R.) appeared to be a simple and rapid treatment for specific phobias and for the phobic components of more complex neurotic conditions (Orwin, 1971). The basic hypothesis was that the R.R., satisfying an intense need to breathe, if simultaneous with the presentation of a phobic stimulus, would inhibit the degree of anxiety previously provoked and that this inhibition would persist. The need to breathe was induced by voluntary restriction up to maximum voluntary respiratory arrest (M.V.R.A.). As in conventional desensitization (Wolpe, 1958), a hierarchy was drawn up and the patients were desensitized using R.R. instead of relaxation. Carbon dioxide-oxygen mixtures were introduced because CO2 is known to stimulate respiration, and it was expected that by intensifying the need to breathe the speed and effectiveness of treatment would be increased by the augmented respiratory relief (A.R.R.).

It has been demonstrated that experience with alcohol leads to a decrease in its behavioural effects (Jellinek, 1960). There is also evidence that personality factors affect tolerance for alcohol; for example, psychological adjustment (Vogel, 1958), extraversion (Drew, Colquhoun and Long, 1958) and field dependence (Smith and Carpenter, 1966) have been reported to be associated with alcohol effects.

Intravenous diazepam is widely used both in general medicine and in psychiatry. It is used to produce sedation in psychiatric emergencies and to enhance systematic desensitization; it is also employed in the treatment of drug-induced dystonic reactions, status epilepticus and tetanus, and as an anaesthetic agent. Its property of relieving severe muscle spasm has been utilized to treat patients suffering from ‘stiff-man syndrome‘.

When a frequency distribution of motor vehicle accidents in any particular group is analysed, there is found to be a number of individuals who have a greater proportion of accidents than can be explained by chance alone. Research on the psychology of accident causation has been aimed largely at isolating particular personality characteristics which seem to be associated with high accident liability. However, the results from past research have been far from encouraging. Very little has been conclusively proved regarding the bearing of any one attribute on the accident rate, and there is still no single specific factor that is psychometrically capable of being identified as a predictor of accident liability.

D-L-propranolol has been reported as having a beneficial effect in anxiety (Granville-Grossman and Turner, 1966; Wheatley, 1969; Suzman, 1971). The effect is believed to be due to the drug's (β-adrenergic blocking action which suppresses many of the somatic manifestations of anxiety, such as tachycardia (Turner, Granville-Grossman and Smart, 1965) and tremor (Marsden, Gimlette, McAllister, Owen and Miller, 1968). Although the peripheral manifestations of anxiety may be ameliorated by propranolol it is not clear whether the drug has any effect on the subjective, central feelings of anxiety experienced by the patient (Marsden, 1971).

Gilles de la Tourette's syndrome had been considered an organic, often hereditary illness for many years after it was first described in 1885 (1, 2), but when medicine became psychologically oriented, the syndrome was more frequently classified as a psychological illness (3), and patients have been said to be schizophrenic, psychotic, obsessive-compulsive, hysteric, to have inhibited aggression, and eventually to deteriorate intellectually and psychologically. However, no support for common psychopathological and dynamic factors was found in our previous study of 34 patients or in a review of the literature (4). Recently, as medicine has shifted back from a psychological orientation, and as case histories have accumulated, an organic aetiology has been more frequently postulated.

On 13 May 1969, intercommunal rioting broke out between the Malay and Chinese sections of the population of Kuala Lumpur and continued for a full week. Subsequently a state of emergency was proclaimed, parliamentary government was suspended and the country was placed under the rule of the National Operations Council (a council of top ministers, civil servants and the chiefs of the armed forces and police) which ruled by edict.

Agoraphobia was the name given by Westphal (1871) to the fear of walking through streets and public places. The agoraphobic syndrome, which covers much else and includes fear of confined spaces, crowds, travelling and shopping, was carefully defined by Marks (1969). His full description and review revealed, perhaps surprisingly, that although the desire to escape rapidly from a feared situation has been clearly recognized in the literature, no detailed observation seems to have been made of the rate of locomotion in this condition.

Mild alterations in serum magnesium are said to be symptomless (D. N. S. Kerr in Cecil and Loeb, 1971). Cade (1964) reported high levels in depression but Frizel et al. (1969) found low values restored to normal with clinical recovery. Raised serum magnesium concentrations have been reported in manic patients (Nielson, 1964; Goodwin, Murphy and Bunney, 1968) and schizophrenics (Cade, 1964). These results suggested that serum magnesium had predictive value in the treatment of psychiatric patients, so we estimated pre- and post-treatment serum magnesium concentrations in a number of patients and investigated their relationships with diagnosis and clinical course.

The dangers of transcribed drug lists were emphasized in the Aitken Report (1) and by Trillwood (2). Subsequent work by Crooks (3) and by Wallace (4) has demonstrated the disturbingly high level of transcription errors in other centres.

The Gilles de la Tourette syndrome is a puzzling disorder, usually beginning in childhood. It is characterized by (1) facial and bodily tics progressive in involvement and frequency, (2) grunting and barking noises and, (3) coprolalia (i.e. compulsive obscenities). Although this pattern of behaviour has been described with striking uniformity over the past century (Gilles de la Tourette, 1885; Fernando, 1967; Kelman, 1965; Lucas, 1967; Prabhakaran, 1970), no specific neurological or psychological aetiology has been found.

The term psychogenic headache is not regarded as defining a meaningful diagnostic entity and can be used to refer to any type of headache in which psychological factors appear to play a significant aetiological role.