Boulton (1971), in an authoritative review, has pointed out that biochemical research into schizophrenia has depended upon the assumption that hallucinogens, such as mescaline and LSD produce a state similar to schizophrenia, and that such research has therefore principally been concerned with attempts to find hallucinogens, or substances closely related to them, in the bodily fluids of schizophrenics. Since this model has been criticized on phenomenological grounds, we decided to make a comparison between states of visual hallucinosis and of schizophrenia with thought disorder, using a measure which tests a common hypothesis concerning the origin of schizophrenic symptoms. This hypothesis suggests that the symptoms of schizophrenia are manifestations of failure of a hypothetical sensory ‘filter’ (Broadbent, 1958). This mechanism determines the individual's ‘selective inattention’ to the irrelevancies of his environment. Its function can be assessed by a study of habituation, which is the process whereby a randomly repeated stimulus fails in time to elicit an orienting response.

Various inevitably indirect attempts to quantify mood states have recently been reviewed by Aitken and Zealley (1970). In the present study, the results of administering two depression rating scales to the same group of patients were compared and their usefulness appraised.

Goldstein (1962) and Frank (1963) have emphasized the importance in the treatment process of the patient's and therapist's assumptive world. A number of authors have related certain personality variables, such as thinking introversion, to choice of medical specialty and orientation to treatment on the part of the doctor. The immediate fore-runners of the present investigation are the reports of Caine (1970), Smail (1970) and Caine and Leigh (1972), in which a test of ‘direction of interest‘, in terms of an interest in the external world rather than in the internal world of thoughts and feelings, and a test of ‘conservatism’ were found to relate to nurses' attitudes to patient care and patients' symptomatology and treatment expectancies. This report is an extension of the search for the personality variables underlying patient and therapist expectancies. A third variable, namely convergent-divergent thinking, as defined by Hudson (1966), has been added. Convergent-divergent thinking has to do with whether one prefers to converge on a single solution to a problem or whether one prefers to investigate several possible solutions. Personality variables similar to the ones with which we have been working have been described in association with these thinking types.

Much of the recent work on electroconvulsive shock has been concerned with retrograde amnesia. These studies have generally produced results consistent with Ribot's Law (1885), which states that the susceptibility of a memory to impairment in retrograde amnesia bears an inverse relationship to the age of the trace (Chorover and Schiller, 1965; Kesner and D'Andrae, 1971).

Ergotamine preparations are extensively used in the treatment of migraine. Although not widely appreciated, there have been reports in the literature of ergotamine abuse, related to the development of tolerance and withdrawal headaches, which result in a steadily increasing consumption of the drug (Wolfson and Graham, 1949; Peters and Horton, 1951; Friedman et al., 1955). It is important clinically to recognize this condition, as ergotamine can have dangerous vascular side-effects (Byrne-Quinn, 1964; Cranley et al., 1963; Young and Humphries, 1961).

In recent years provision of care for psychiatrically disturbed adolescents has received increasing attention. The present situation was summarized in a leading article in the British Medical Journal (1971) which emphasized one aspect of this provision—the need for adolescent in-patient facilities based within the community. This paper describes the ideas and practices of an adolescent unit which was opened at Hill End Hospital, St. Albans, in September 1969 to take younger adolescents (up to 16) of both sexes, from the area of the North-West Metropolitan Regional Hospital Board. This area covers 13,000 square miles and has a population of 4½ million, which the Unit aims to serve with 11 available beds. Who should be admitted to these places is clearly a critical question.

The use of a token-economy system to condition ward-wide behaviours in psychiatric in-patients, is gaining acceptance as a definite therapeutic modality (Franks, 1969).

In most mental hospitals some attempt is made to effect change among long-stay patients. This problem in rehabilitation has been approached in several ways, but irrespective of individual approach it is desirable to have some assessment of the degree of change accomplished. Social aspects of behaviour, rather than symptoms, are the target of such rehabilitative efforts, and nurses play an important part both in pursuing the goals of treatment and in assessing change in individual patients. The NOSIE (Honigfeld and Klett, 1965; Honigfeld, Gillis and Klett, 1966) is a particularly well-developed rating scale whose content has been tailored to the task of assessing change in long-stay patients and has been successfully used for this purpose in the United States. In its present form it comprises 30 items which form 6 scales: namely, Social Competence, Social Interest, Personal Neatness, Irritability, Manifest Psychosis and Retardation. This note is concerned with three questions which the British user should ask before using the scale; does it do what it claims to do, does it do it accurately, and what range of scores could be expected in a British hospital population.

There is much neuropathological evidence that Alzheimer's Disease and senile dementia are essentially identical disorders (Stam, 1962; McMenemey, 1963; Jamada and Mehraein, 1968; Lauter, 1970; Torvik, 1970). Family and genetic studies also give support to this opinion, for there appears to be a tendency for both senile dementia and Alzheimer's Disease towards familial aggregation (Zerbin-Rüdin, 1967; Pratt, 1970). An extensive Swedish study has given evidence that senile dementia is determined by a single autosomal dominent gene (Sjögren et al., 1952). The difference in concordance rates between identical and non-identical twins with senile dementia is in agreement with this hypothesis (Kallmann, 1956). Furthermore, a number of families in which Alzheimer's Disease is transmitted as a regularly dominant trait have been described (Pratt, 1970). For the sporadic cases of Alzheimer's disease a cumulative polygenic action has been assumed (Larsson et al., 1963). Chromosome analysis of patients with Alzheimer's Disease and senile dementia has revealed certain abnormalities (Nielsen, 1968; Bergener and Jungklaass, 1970). Wheelan (1959) found that the MNSs blood groups appear to segregate with Alzheimer's Disease: however, another investigation failed to confirm a significant linkage between blood group genes and Alzheimer's Disease (Feldman, 1969).

It has frequently been argued that requests for cosmetic rhinoplasty, particularly in patients with minimal disfigurements, may be indicative of psychological disturbance. Authors such as Meerloo (1956) and Roubichek (1960) have further argued that corrective operations in these minimally disfigured patients are contra-indicated, as the patients are always dissatisfied by surgery, sometimes demanding restoration to the original state.

In recent years workers in the area have reached and secured several points of critical importance in the aetiology of schizophrenia. Studies carried out on children bora to schizophrenic mothers but separated from them at birth or in early infancy have established that genetic factors play a major role in the disease (Heston, 1966; Karlsson, 1966; Rosenthal et al., 1968). The index children in these studies become schizophrenic at roughly the same rates (10–15 per cent) as children reared by their schizophrenic mothers and much more commonly than control children separated from non-schizophrenic mothers early in life and placed through the same agencies to comparable foster or adoptive homes.

Because of the empirical nature of the treatment procedure, many investigators have sought predictors of clinical response to ECT (Abrams, 1972). Three studies (Hobson, 1953; Carney et al., 1965; and Mendels, 1967) provide well-defined methods for calculating an index for prediction of response to ECT. Each assigns individual weights to specific features of the clinical state and the history of the illness, as determined during a pre-treatment interview. The predictive accuracy reported for these indices ranges from 79–87 per cent. Three attempts have been made to replicate Hobson's (1953) results—two were successful (Roberts, 1959; and Mendels, 1965), and one was not (Hamilton and White, 1960). We have found no reports attempting to test the prognostic accuracy of the indices of Carney et al. (1965) or Mendels (1967).

Sociopathy, alcoholism, and drug dependence have been shown to be the only psychiatric disorders more frequent among convicted male felons than in the general population (4, 5). In these studies, sociopathy, regardless of other disorders, was found in nearly 80 per cent. An increased prevalence of sociopathy, alcoholism, drug dependence, and hysteria, or Briquet's Syndrome (3), was found among the first-degree relatives of these felons; hysteria (Briquet's Syndrome) among the female relatives and the other disorders predominantly among the male relatives. Overall, 44 per cent of the male felons' first-degree relatives received a psychiatric diagnosis (6).

Several previous studies have demonstrated involvement of the central nervous system in diabetes mellitus. Reske-Nielsen and Lundbaek (1963) gave a description of cerebral changes seen in an autopsy study of three cases of long term diabetes and considered these to contribute a diabetic encephalopathy. Lawrence et al. (1942) demonstrated lesions in the brain following fatal hypoglycaemia, and Fineberg and Altschul (1952) described cases in which permanent brain damage followed non-fatal hypoglycaemia. Grunnet (1963) found cerebral atherosclerosis to develop at an earlier age and more severely in the diabetic than the non-diabetic, and a higher incidence of cerebrovascular accident was found in diabetic than non-diabetic subjects by Alex et al. (1962).

In the course of a study on endogenous depressive illness, whole blood 5-hydroxytryptamine (5HT) has been recorded in sixteen in-patients at Roffey Park Hospital. Thirteen patients received L-tryptophan 1 G t.d.s. and 3 G nocte, of whom two received in addition phenelzine 15 mg. b.d. for 48 hours followed by 30 mg. b.d. thereafter. Three patients received amitriptyline 25 mg. b.d. and 50 mg. nocte for 48 hours followed by 50 mg. b.d. and 75 mg. nocte thereafter. One patient receiving Ltryptophan had essential hypertension and received α-methylDOPA throughout. Observation continued for six weeks.

Renal dialysis has been a life-saving miracle for the ‘chosen few‘, but has created major moral, social, financial, psychological and interpersonal problems.

Acute alcohol intoxication is commonly followed by partial or total amnesia† for events occurring during the drinking period (Goodwin et al., 1969a). Individuals observed during the ‘blackout’ period have been noted to have a specific short term memory deficit, with remote and immediate memory largely intact (Ryback, 1970; Goodwin et al., 1970; Tamerin et al., 1971). The amnesia appears to be anterograde rather than retrograde, resembling the characteristic memory deficit in Korsakov's syndrome. Speculation has ensued that blackouts and Korsakov's syndrome may share common pathophysiological elements, though there is no direct evidence for this (Goodwin et al., 1969b).