The history of the words paranoia and paranoid is traced from the Greeks to the present day and their fluctuations of usage and concept are explored.

Early work on the reticular formation has been largely overlooked, and this article traces back to the beginning of the 19th century the roots of modern developments in this field.

A case of Klinefelter's syndrome with XXY karyotype and a dementing neuropsychiatric illness associated with a diffuse degeneration of the deep cerebral white matter and adrenal cortical atrophy is presented. The possible relationships between genetic abnormalities and disordered function and structure of the brain are discussed in the light of the clinical and pathological observations.

The regulation of body temperature was investigated in 11 patients with anorexia nervosa, initially while they were in a malnourished state and again after refeeding when they had reached a near normal weight. The results suggest that there may be a primary defect of temperature regulation in anorexia nervosa which is linked in some way with the feeding disorder characteristic of this illness.

This paper describes an investigation into the relationship between senile dementia and slowing of peripheral nerve conduction velocity. Twenty-eight demented patients and 19 controls were studied. Each patient was rated clinically and given a battery of simple psychological tests in addition to the physiological recordings. The results were as follows: (1) Motor nerve conduction was slower in the demented group than in the control group but this difference was not significant. (2) When subjects were divided according to their dementia score, those with scores above 7 were found to have motor nerve conductions which were significantly slower than those with scores of 7 or less. (3) There was a significant correlation between the severity of the dementia as measured by the rating scale and the psychological tests and the degree of slowing of motor nerve conduction. (4) In those patients who were retested after one year, increase in dementia was significantly correlated with a further slowing of conduction in motor nerves. (5) The possible role of vitamin deficiency was investigated in a small sub-group of demented patients. Deficiencies of thiamine, nicotinic acid, and vitamin B12 were not thought to be important but some patients had low folate levels. The significance of these results is discussed.

The construction and development of an inventory of 69 questions dealing with the subjective assessment of obsessional traits and symptoms is described. A card-sorting procedure requiring supervision is used, which gives rise to information about feelings of resistance and interference with other activities, in addition to the straightforward answers to the questions. The resulting scores are shown to differentiate well between a group of selected obsessional patients and normals. The problem of to what extent replies to apparently specific questions in inventories and questionnaires can be interpreted as having only general significance is discussed.

An inventory of obsessional symptoms and traits was administered to patients with depressive illnesses while they were ill and again after recovery. They obtained higher scores than normals even when well and their scores increased considerably during episodes of depression in proportion to the depth of the depression. In mania, on the other hand, obsessional symptoms are rare.

A stratified sample of 404 prisoners and ex-prisoners from three contrasted London prisons were interviewed: 40% were found to be excessive drinkers, although drunken offenders with very short sentences were excluded. The significant differences between heavy drinkers and the rest are considered in relation to history and social status.

Problems arising from the categories used in the Eighth Revision of the International Classification of Diseases, and from some of the definitions included in the British Glossary, are discussed. Suggestions are made for changes which would facilitate the use of the I.C.D., firstly for furnishing quantitative data to answer questions about groups of cases, and secondly for retrieval of information about patients with particular syndromes for purposes of research studies. Finally, a multi-axial system for diagnostic coding is described.

This paper, an abbreviation of the first Aubrey Lewis Lecture, concerns itself initially with the evolution of the institute concept as a part of western institutional development. The growth of the concept of the institutes of psychiatry as organizations in medicine, initially bringing together the biological, psychosocial, and clinical sciences as they relate to the field, is documented briefly in the history of the beginnings of the New York State Psychiatric Institute, the earliest established institute in the specialty. Later sections of the paper concern themselves with the conflicts between the goals of these institutes, those of related universities, the supporting governmental agencies, and private supportres. The author discusses the problems inherent in bridging the gap between the formation of a multidisciplinary institution and one which may come to function effectively in an interdisciplinary fashion. Consideration is given to the theoretical and administrative measures potentially valuable in bridging this gap. This abbreviated version of the lecture deletes the evaluation of those factors which have led to the widespread development of the institutes of psychiatry.