This paper analyses the influence of medical professional organization on the formation of attitudes and policies towards narcotics in England. Restrictions on sale were one corollary, and the extension of medical control helped delineate a hypodermic morphine problem and disease theories of ‘inebriety’. In the period 1916–26 the Home Office attempted to impose a penal and nonprofessional policy. The 1926 Rolleston Report marked a compromise between medical professionalism and public policy.

Interpersonal relationships pose problems additional to those arising from social behaviour. If there is to be a science of interpersonal relationships, it must rest on a firm descriptive base. It is suggested that the following categories of dimensions are likely to prove useful: the content of the interactions within the relationship; their diversity; their qualities; their relative frequency and patterning; the nature of their reciprocity v. complementarity; and the intimacy, interpersonal congruency and commitment between the participants. A science of relationships will also require principles concerned with their dynamics. Three likely categories are those concerned with social constraints, with learning, and with positive and negative feedback. Principles concerned with learning will require an adequate categorization of the resources used in interpersonal interactions. The specification of these principles depends on the adequacy of the descriptive base.

The study reports a comparison of 10 definitions of schizophrenia (Feighner's, Taylor's, Schneider's, Langfeldt's, Spitzer's, Carpenter's, Astrachan's, 2 from Forrest & Hay and Catego) in respect of their reliability, concordance and prediction of outcome. Some (including Feighner's) proved too strict, and others (including Schneider's) were weak predictors of clinical and social state. Four definitions (Spitzer's, Langfeldt's, Carpenter's and Catego) emerged as relatively effective and these also had a somewhat more satisfactory mutual concordance.

Very little is known about psychiatric disorders in severely and profoundly retarded adults. We have investigated these disorders by systematically recording and collecting data about the behaviour of 100 severely and profoundly retarded hospitalized adults and subjecting the data thus derived to cluster analysis. Eight clusters were isolated. The clinical psychiatric significance of these clusters is discussed and their relationship to cause of retardation, duration of stay in hospital and visiting is considered. A diagnostic framework for psychiatric disorder in severely and profoundly retarded adults is put forward and some possible treatment approaches are suggested.

Suicide rates in towns with a Samaritan branch were compared with rates in matched control towns without a branch. Four methods of choosing controls are described, all of which have advantages over those used by Bagley (1968). No statistically significant differences between Samaritan and control towns were found. The scientific case for the effectiveness of the Samaritans in reducing the suicide rate is therefore seriously weakened.

The records of all suicides and of all open verdicts in Lusaka (Zambia) over a 5-year period (1967–1971) were studied. The following suicide rates (per 100000 of the population per annum) were found: 7·4 for all races; 11·3 for men of all races; 3·0 for women of all races; 6·9 for all African residents; 11·2 for African males; 2·2 for African females; 12·8 for all Africans above the age of 14 years; 20·9 for all European residents; 20·7 for all European males; 21·0 for all European females. The male: female ratio among the Africans was 5:1. There was a tendency for the suicide rate among the Africans to rise with age. Differences in suicide rates between African and European residents were found not to be statistically significant. Though hanging was by far the most commonly used method of suicide by Africans, Europeans and ‘doubtful suicides’ among Africans preferred other methods to a statistically significant degree. It is suggested that the role of other methods in African suicides may well have been underestimated in the past. No definite seasonal variation in suicide rates was found. Domestic quarrels, mental illness and physical diseases would appear to be some of the important precipitating factors of suicide in Lusaka. It is also suggested that the question of whether or not suicide is rare in Africans cannot be answered until such time as when reliable figures are available in Africa.

Monthly hospital admission rates (HA) for mania were classified by sex, type of admission (first, or re-admission) and by country (England and Wales or Scotland). Of the 8 classes thus created, all but one showed a statistically significant annual cycle with a peak in Summer and trough in Winter. There was no significant difference in phase or amplitude between male and female cycles. A linear increase in yearly re-admission rates was found during the 8 years of the English and the 11 years of the Scottish data.

Current month's mean daily temperature (lag0) and last month's (lag1) mean day-length and mean daily hours of sunshine correlated better with admission rate than did the values for other months. In a multiple regression analysis temperature made the other 2 climatic variables redundant in accounting for variation in HA.

By means of the Self-Administered Dependency Questionnaire (SADQ), 4 types of dependency on mother were measured in 65 children with epilepsy attending ordinary school, subgrouped according to sex, level of schooling, electrographic type of epilepsy, and drug treatment. The various dependency scores of each subgroup were compared with the appropriate norms available for the SADQ. Compared with normal boys, epileptic boys of primary school age (N = 16) were generally found to be more in need of close physical emotional contact with their mother and her physical proximity when away from home, although they were less ready to talk to her about their practical problems and ask for her help. The needs of epileptic boys of secondary-school age (N = 18) were expressed more in terms of their mother's help with practical matters at home. In contrast, no significant differences were apparent between epileptic and normal girls at either level of schooling. In comparisons between epileptic children who consistently produced only generalized seizure activity in their EEG (N = 31), a right temporal spike discharge (N = 16) or a similar discharge on the left (N = 18), both boys and girls with a left temporal spike discharge tended to show significantly higher need for close physical emotional contact with their mother than children in the other electrographic groups. No clear relationship was seen between dependency scores and type of anti-epileptic drug treatment.

The social reports on 84 children taken to court for failure to attend school were studied. Independent raters were able to assess reliably the presence and absence of a variety of variables concerned with the individual's behaviour, school, family, and involvement with social work agencies. In 68 instances teachers' questionnaires measuring psychiatric disturbance had been completed. There was no evidence that truancy in these circumstances is a homogeneous condition. At least 3 independent sets of features appear to be involved in most cases. One involves antisocial and educational problems (‘clinical truancy’), a second is concerned with adverse social factors and parental complicity (‘school withdrawal’), and a third set includes a tendency to social isolation (‘school refusal’). There was no evidence that individuals tend to exhibit one of these features to the exclusion of the others.

The 60-item General Health Questionnaire was completed by 90% of 4798 patients aged 15–69 years who consulted, on one day, the general practitioners of 97% of practices in the Perth Statistical Division. A point prevalence rate of minor psychiatric morbidity in various demographic groups was calculated in terms of the population at risk. The demographic pattern of morbidity was compared with that found in a probability sample of 2324 community residents drawn from the same population at risk, and surveyed at the same time using the same screening instrument.

Widowed persons, British-born men who had recently migrated to Australia, and lower-social-class men with minor psychiatric morbidity were under-represented in general practice. Elderly men and women in upper-class occupations with minor psychiatric morbidity were over-represented in general practice. These differences, unlike others that were found, could not be explained by differing consulting habits or by differing completion rates of the screening instrument.

Test and retest scores on the Symptom Rating Test (SRT), Manifest Anxiety Scale (MAS) and Maudsley Personality Inventory (MPI) were obtained from 45 non-psychotic psychiatric in-patients. The change in scores and the score distributions were examined to assess the extent to which these tests meet Foulds' criteria for measures belonging respectively to the universes of personality and personal illness. MPI Extraversion emerged as a stable, normally distributed, personality trait in contrast to the SRT which showed the characteristics of a symptom-state measure. MPI Neuroticism and MAS scores could not be allocated definitively to either universe and seemed to be hybrids. It is suggested that more attention must be paid to the ‘ purity’ of scales if meaningful interpretation is to be made in treatment assessment.

It proved possible to make lesions which interrupted the striatonigral GABA-containing pathway in the rat brain without causing concomitant damage to the nigrostriatal dopamine containing system. Estimations of striatal concentrations of dopamine (DA), dihydroxyphenyl-acetic acid (DOPAC) and homovanillic acid (HVA) indicated that these lesions had no influence either on normal striatal DA turnover or on the enhancement of DA turnover induced by neuroleptics. Behavioural experiments suggested a motor output function for the striatonigral pathway.

The effect of fluphenazine on basal human prolactin (hPRL) concentrations was studied in 10 male schizophrenics who had received fluphenazine treatment for at least 6 months, in 10 male alcoholics before and during the first week of fluphenazine treatment and in 8 alcoholics at daily intervals before and after treatment. The results were compared with basal hPRL concentrations in 17 healthy male controls. Investigations involved giving fluphenazine (Modecate) by intramuscular injection and taking blood samples at appropriate intervals by venepuncture. Basal hPRL concentrations were significantly increased in the schizophrenics. The alcoholics showed a significant rise in hPRL concentrations after fluphenazine but there was considerable variation in hPRL levels between individual patients. Most patients showed marked elevation of daily hPRL levels with peak concentrations occurring 5–6 days after the injection. The results demonstrate that fluphenazine elevates basal hPRL levels and the variation between levels of individual patients merits further investigation.

Two of the tryptophan pools in the body and their associated fluxes, as defined by multicompartmental analysis, were studied in patients with unipolar affective disorder, bipolar patients (manic) and control subjects. The 2 pools were tentatively associated with extra- and intracellular compartments. The investigations were performed fasting and may have been mildly stressful. Under these conditions the concentration of tryptophan in plasma and perhaps amounts in the extracellular space were reduced in unipolar depression, with intermediate values after recovery. Some model parameters were lower in females than males. The results in unipolar affective disorder were interpreted in terms of a previously presented hypothesis that this illness may result in an idiosyncratic response to stress in which patients are unable to maintain normal amounts of tryptophan in the body. In manic patients extracellular levels of tryptophan were unchanged but intracellular and total quantities of ‘freely available’ tryptophan may have been reduced.

The hypothesis that schizophrenia is caused by the release of prostaglandin E into the hypothalamus and may sometimes be accompanied by an elevation of temperature was examined by a clinical trial of the prostaglandin E suppressant N-acetyl-p-amino-phenol (paracetamol, acetaminophen). Ten acute schizophrenic patients were included in a double-blind, crossover trial of paracetamol and a placebo, in which each treatment was given for a week. Regular 4-hourly temperatures were recorded in all these cases and in 5 non-schizophrenic patients for comparison. The findings provided no evidence that paracetamol mitigated the symptoms of schizophrenia. The temperatures of the schizophrenics were not elevated more than those of the controls, but the number of cases used was probably too small for this finding to be conclusive.

Thyrotropin response to thyrotropin-releasing hormone is impaired during endogenous depression and normalized between the depressive periods. Changes in the thyrotropin response to thyrotropin-releasing hormone were shown to be of predictive value and might be useful in the control of continuation therapy with antidepressants in patients with endogenous depression.

Previous reports suggest that high serum dopamine-β-hydroxylase (DBH) activity may be associated with vulnerability to alcoholism. However, there are also contradictory studies in the literature. Therefore we measured serum DBH in chronic alcoholics followed for 12 months in a treatment programme after psychiatric hospitalization for acute alcoholism. Mean serum DBH activity in the alcoholics was unchanged from controls at 3 months, 6 months and 12 months following hospital discharge. These data imply that serum DBH activity does not provide a useful metabolic screen for vulnerability to chronic alcoholism. However, prospective studies of patients at high risk to develop alcoholism will be helpful in further clarification of this issue.