The literature of the nineteenth century often referred to chiorosis. Some examples, taken from French sources, are mentioned. The illness was only given its name at the beginning of the seventeenth century, but the clinical picture of febris alba virginum had been known for a long time previously. The history of chiorosis is interesting because of the variety of explanations, including the psychological, it attracted before it came to be recognized as due to hypochromic anaemia or iron deficiency.

Serum and CSF choline levels were measured in 12 patients with pre-senile Alzheimer's disease before and 1 hour after administration of 1·5 g choline chloride or 25 g lecithin granules. Serum choline levels were increased threefold and CSF choline levels by 72%. CSF choline levels in the untreated Alzheimer patients did not differ significantly from age-matched controls. In 35 neurological controls, CSF choline levels increased with age (γ = 0·64, P<0·001).

Choline influx into erythrocytes from 10 male and female Alzheimer patients did not differ significantly from 40 male and 43 female controls. Choline influx into erythrocytes was not related to age or sex, although the range was greater (P <0·05) in females than in males.

Our results indicate that there is no impairment of choline transport into CSF or erythrocytes in patients with pre-senile Alzheimer's disease.

LHRH was administered by continuous 4-hour intravenous infusion to 14 anorexia nervosa patients on a refeeding programme. Infusions were repeated in 7 patients following weight gain and in 4 after a course of bromocriptine. Five healthy female volunteers in the early or midfollicular phase of the menstrual cycle served as controls.

The LH response was diminished in patients at 65% standard weight, but was of progressively increasing magnitude in patients at 80% and 95% standard weight. The pattern of LH response to the 4-hour infusion was suggestive of a deficient stimulation by endogenous LHRH in patients at extremely low weights, and of an impaired oestrogen feedback mechanism in patients at intermediate weights. Bromocriptine enhanced the LH response on one occasion in a patient with moderately elevated plasma HPR values, but failed to produce a similar effect when given to 3 patients with normal HPR levels. The mean FSH response did not differ significantly between patients in different weight categories, although those at 65% standard weight had a markedly greater variance of response. Plasma oestradiol values were lower in patients at 65% standard weight than in those at higher weights.

The relationship between left-handedness and birth complications was studied. No evidence of any association was found in either 2 retrospective studies, or 1 large prospective study.

Electrodermal activity was measured bilaterally at rest and during stimulation in 22 schizophrenic, 11 depressed and 12 anxiety state patients, and in 32 normal volunteers. No group showed a distinctive pattern of lateral asymmetry. The frequency of spontaneous fluctuations in electrodermal activity was greater in the anxiety state and schizophrenic groups and in those patients who reported auditory hallucinations during recording. Few schizophrenic subjects failed to respond to visual stimulation but a substantial minority failed to habituate. The implications of these findings are discussed.

The Eating Attitudes Test (Garner & Garfinkel, 1979) was administered to 578 students (446 females and 132 males) at a College of Technology and to 14 ‘control’ subjects fulfilling diagnostic criteria for anorexia nervosa. Although no male students scored highly, a total of 28 female students (6·3% of the female student sample) scored in the ‘anorexic’ range. These ‘high scorers’, together with a random control group of 28 ‘non-high scorers’, were subsequently Interviewed. Interview revealed that the symptoms of anorexia nervosa were common in the high scoring group but virtually absent in the student control group. It is concluded that a substantial proportion of post-pubertal females (approximately 5%) develop a subclinical form of anorexia nervosa. The implications of these findings are discussed in relation to the aetiology, prevention and treatment of disturbances in eating behaviour.

In a cohort of patients with an operationally confirmed diagnosis of mania, half of the patients had received a previous diagnosis of schizophrenia, and over one third of the patients had received a diagnosis of personality disorder. Retrospective analysis of case-notes, using operational criteria based on DSM-III, found that manic-depressive illness was more likely to have been the correct previous diagnosis.

Suicide pacts, though occurring infrequently, are neglected occurrences. They have features distinguishing them single suicides which can be seen as residing in the characteristics of the pact relationship. Dyadic, family and collective suicides are reviewed and found to have several common features, including exclusivity and isolation, the threat of dissolution of the relationship, and the presence of a powerful initiator.

One hundred patients, selected to be representative of those attending general practitioners with non-psychotic psychiatric disorders were followed up for one year. standard assessments of mental state, personality, social stresses and supports were carried out for each patient at the outset and after a year.

The outcome for this cohort determined both by the level of psychiatric morbidity at interview after one year and by the pattern of the psychiatric morbidity during the year has been analysed with reference to the assessment measures. Discriminant function analysis indicates that the initial estimate of the severity of the psychiatric morbidity and a rating of the quality of the social life at the time of follow-up are the only factors that significantly predict the psychiatric state after one year. Social measures also predict a pattern of illness charactorized by a rapid recovery after the initial assessemtn. Patients who reported continuous psychiatric morbidity during the year were, older, physically ill and very likely to have recevied psychotropic drugs. Receipt of this medication during the year was associated with initial assessments of abnormality of personality, older age, and a diagnosis of depression.

The findings of this study are seen to support a triaxial assessment and classification of non-psychotic psychiatirc disorders, with symptoms, personality and social state being rated independently.

This paper presents some results from a survey conducted in West London in 1977. The 2-week prevalence of psychotropic drug consumption was found to be 10·9 %, an almost identical figure to that obtained in an earlier survey conducted 8 years previously. The reasons for the absence of the expected rise in prevalence of consumption are discussed.

Consumption was found to be strongly associated with various measures of health, and there was a marked sex difference in drug consumption (females > males) which was independent of health.

A two-stage psychiatric survey of a random sample of adults aged 18–64 from Camberwell is described. Agency interviewers carried out the first stage (N = 800), using the shorter form of the Present State Examination (PSE). MRC interviewers, using the full PSE, saw a stratified sample of these (N = 310) in the second stage. A second interview was sought with all those of Index of Definition (ID) level 5 and above at the first interview (‘cases’) and with a random sample of those below that level. 20·9% refused or were never available for the first interview. Of the 800 subjects successfully interviewed, 10% refused a further interview and 12·4% of those finally selected for this interview were either unavailable or changed their minds. The MRC data, weighted to represent the whole sample, are used in our analyses. The prevalence of psychiatric disorder as defined in our study was calculated at 6·1% for men and 14·9% for women. Women shared a higher prevalence of disorder in the age-groups 25–34 and 45–54, but in men there was no significant association with age.

In contrast to the findings of Brown & Harris (1978), social class did not have a strong association with disorder. Single men had much higher rates than married men, while the reverse was true in women. In both sexes employment was associated with lower rates of disorder. An attempt to explain the high prevalence in women in terms of their role in marriage and child-care was only partly successful.

An earlier survey of a random sample of women in Camberwell in South London has shown that the majority of new occurrences of depressive disorders were brought about by certain kinds of life event and ongoing difficulty (provoking agent) and that the risk was increased under these circumstances by the presence of certain other social factors (vulnerability factors). Working-class women were much more likely to develop depression because they experienced more of these factors. A new survey in a rural population in the Outer Hebrides has confirmed the importance of these factors in the genesis of depression, although provoking agents occurred much less frequently in this rural setting. However, integration into the traditional way of life, rather than a middle-class status, was related to a lower chance of developing depression, and this appears to be explained by the relationship of provoking agents and vulnerability factors to such integration in the Outer Hebrides, and to social class status in Camberwell.

In an earlier paper we found that a model of depression developed on a sample of women in a London population was confirmed in a female population in the Outer Hebrides. Differences in the rates of onset and chronic cases between the two populations, however, suggested that the Scottish women might be more likely to become depressed after the death or intimation of death of close relatives; furthermore, it seemed that such depressions were more likely to remain chronic in the Scottish islands than in London, and to contain a strong anxiety component. This difference is discussed in the light of socio-cultural differences between the two populations, particularly in terms which relate family structure, marital position and contact with relatives to affective disorder in terms of theories of attachment.

This study examines the role that clinical and social factors play in compulsory admissions to hospital in a London borough. 150 patients compulsorily admitted under a Section of the Mental Health Act 1959 were compared with 100 informally admitted patients. Significant differences in social-demographic and clinical characteristics are described as well as differences in outcome on follow-up. A long-term unwillingness on the part of the compulsory patients to engage in follow-up services was evident. These differences still held when the compulsory patients were compared with a group of informal patients matched for age, sex and diagnosis. Patients referred by the police and admitted under Section 136 of the Mental Health Act showed those features associated with compulsory admission in general to the most severe degree.

Family genetic data, based on standardized and independent diagnostic procedures of index and secondary cases, confirmed the dichotomy between schizophrenias and affective disorders. The classical schizophrenic subtypes exhibited a significant tendency towards homotypia among their secondary cases. The genetic evidence did not support the monopolar–bipolar subdivision of affective disorder. Schizo-affective disorders impinged on the clear-cut schizophrenic and affective psychotic disorders and there was no homotypical tendency among the relatives of index cases with this diagnosis.

In general, linguistic analyses have not proved useful to psychiatrists because of their complexity and their inability to differentiate between diagnostic groups. However, cohesion analyses of disordered speech seem to offer both a simple and potentially useful tool for clinical diagnosis. This study was designed to test whether psychiatrists can use the rudiments of this analysis in order to differentiate between two diagnostic groups, manics and schizophrenics.

Urinary free cortisol was measured in 24 patients with primary depressive illness. The patients were classified according to their family history (Winokur's classification) and the Newcastle scale. There was a significant increase in urinary free cortisol (UFC) excretion in patients classified as endogenous on the Newcastle scale, but UFC excretion was normal in patients with neurotic depression. No significant relationship between urinary free cortisol and the Winokur classification was observed.