Psychiatrists react to the complexity of human nature in two principal ways; they either take it as justification for their ascientific humanism, or, with unwavering optimism, they accept the challenge and seek scientific explanations. ‘Hormones and behaviour’ has been a favourite hunting ground for such hopefuls, and it is perhaps the sexual part of our natures that we are most ready to attribute to chemistry.

This is an uncertain, neglected and misunderstood corner of organic psychiatry. Calcium disturbances are clinically the concern of physicians interested in bone diseases, in malabsorption or nutritional deficiencies, and opinions vary on whether such illnesses are accompanied by emotional and behavioural disorder: at least psychiatrists are not usually called in. Parathyroid disease is generally granted to have frequent psychiatric accompaniments (e.g. see Granville-Grossman, 1971) but is very rare in the psychiatric clinic, and possibly under-diagnosed there. Laboratory aids tend to be underused or inadequately applied. Total plasma calcium as a screening test cannot be understood without at least a plasma protein measurement as well; but serum phosphate, parathormone and plasma 1, 25-dihydroxycholecalciferol levels, urinary calcium and magnesium, and Ca45, may all have roles in fuller investigation (Nordin, 1976).

It has been argued by many biographers of King Ludwig II that he was not mentally ill but simply labelled mad as part of a conspiracy to remove him from the throne. The evidence for his mental disorder is reviewed and the conclusion drawn that he was probably suffering from a schizophrenic illness of some twenty years duration prior to his suicide in 1886.

The sociological study of institutions has developed considerably in the past two decades. It has moved from the case studies of mental hospitals (e.g. Stanton & Schwartz, 1954; Belknap, 1956) and the graphic, speculative typology of Goffman (1961) to empirically based comparative studies of facilities for both the mentally ill and the mentally handicapped (Hewett et al. 1975; Wing & Brown, 1970; Ullman, 1967; Wing & Hailey, 1972; Morris, 1969; King et al. 1971; Raynes et al. 1977). All these studies have included among their goals the development of our understanding of the structure and functioning of these institutions so as to facilitate the planning, administration and evaluation of better residential services. Further, since the publication of Better Services for the Mentally Handicapped (DHSS, 1971), it is clear that in the United Kingdom the government supports the provision of a continuum of services for mentally handicapped persons. As part of that continuum there is a commitment to provide residential facilities in the community for those who need such services.

William Mayer-Gross was born in the ancient Rhineland town of Bingen. He attended the Gymnasium in Worms and studied medicine in Heidelberg, Kiel and Munich. He took his final medical examinations in Heidelberg in 1912. He then became an assistant in the Heidelberg Psychiatric Clinic and in 1913 presented his doctoral thesis, which dealt with the phenomenology of abnormal feelings of felicity. On the outbreak of the First World War he was called up and served for a year on the Western front; he was then in 1915 assigned to duties in a base hospital where neurotic soldiers were being cared for.

Some experiments, reported in detail elsewhere, on the effects of mother–infant separation in rhesus monkeys are here reviewed and compared. They involved 4 groups – one in which mothers were removed for 13 days leaving the infant in the social group; one in which infants were removed; one in which mothers and infants were removed and separated; and one in which mothers and infants were removed but not separated. The nature of the separation experience had a profound effect on the infant's response: infants left in a familiar environment while their mothers were removed showed marked but brief ‘protest’ and then profound ‘despair’, whilst infants removed to a strange cage showed more prolonged ‘protest’. A major factor determining the effects of the separation experience in the weeks following reunion is the degree to which the mother–infant relationship has been disturbed by it. The multiplicity of factors affecting the outcome of a separation experience are discussed.

One hundred and seven unrelated Danish patients considered to be manic-depressive according to strict diagnostic, symptomatic and course criteria were typed for antigens of the HLA system, the major histocompatibility system in man. Preliminary results from the first 47 patients had previously been reported to suggest a positive association between manic-depressive disorders and HLA-A3, HLA-B7, and HLA-Bw16 and a negative association between such disorders and HLA-B8. Results from the extended series provide confirmatory evidence that there is a positive association between manic-depressive disorders and HLA-Bw16 and also strongly suggest a positive association between HLA-B7 and such disorders. HLA typing may prove to be a useful way of identifying sub-groups of manic-depressive patients for other biological studies. The associations described provide a potential lead for formulating hypotheses about the nature of the biological mechanisms which predispose to manic-depressive disorders.

This essay traces the shifting perception of the nature and prevalence of suicide in early modern England. Suicide is presented as one form of deviance contemporaries recognized and is used to illuminate the history of mental disorder in its social and intellectual context.

Daft Meg [an idiot and suicide] was a sort of household familiar among us, and there was much like the inner side of wisdom in the pattern of her sayings, many of which are still preserved as proverbs.

John Galt, Annals of the Parish, p. 126.

The published work relating to the effects of noise on man and animals is reviewed from the standpoint of mental health. Evidence from a number of different disciplines shows that the presence of meaning in the noise is of critical importance in determining the persistence of physical reactions to the noise. The existing evidence linking noise with mental illness is found to be unsatisfactory. The concept of annoyance and the relevance of noise annoyance to mental illness are discussed. Some specific suggestions for further work are put forward.

Inhibition of central dopamine functions appears to be a common basic property of antipsychotic drugs. The mesolimbic and nigrostriatal portions of the dopaminergic system are probably the main targets of these drugs for the mental and the extrapyramidal actions respectively.

Dopaminergic hyperfunction, induced by amphetamines or dopa, may lead to a disturbance mimicking paranoid schizophrenia, lending further support for a key role of dopamine in mental functions.

While a primary disturbance in dopamine function in schizophrenia cannot be ruled out, the intimate relationship between dopaminergic and other neuronal systems must be emphasized. The possible involvement of other amine, aminoacid or peptide transmitters in schizophrenia cannot be disregarded.

The capacity of the hypothalamic–pituitary axis to respond with changes in LH release to the negative and positive feedback effects of oestrogen was assessed in 19 patients with anorexia nervosa at different stages of the illness. Ethinyl oestradiol, 200 μg daily for 3 days, was administered and serial estimations of serum LH were carried out during and after the course of oestrogen.

In patients with anorexia nervosa tested when markedly underweight, negative feedback effects of oestrogen were demonstrated in those patients with detectable levels of LH. None of the patients demonstrated positive feedback release of LH to the oestrogen stimulus.

After the resumption of a more normal weight, basal LH levels were higher and negative feedback effects of oestrogen were observed in 11 out of 12 patients. The complete response to oestrogen with a subsequent positive release of LH to the oestrogen stimulus was shown by only 3 patients. Two of these 3 patients maintained a normal weight during the subsequent 6 months and both resumed regular menstruation shortly after the test. Three additional patients who had shown only negative feedback effects of oestrogen on LH release similarly maintained a normal weight and only 1 of them resumed menstruation, starting 3 months after the oestrogen test.

It was concluded that in recovery from anorexia nervosa there is a return of normal hypothalamicpituitary–gonadal activity in a definite sequence with recovery of the hypothalamus to respond normally to the negative feedback effects of oestrogen followed by return of the positive feedback capacity between oestrogen and LH which allows menstruation to resume. The resumption of normal hypothalamic–pituitary function is clearly dependent in part upon correction of the malnutrition. However, after correction of the malnutrition some patients fail to menstruate, and this appears to be determined by a continuing impairment of the hypothalamus to respond normally to the feedback effects of oestrogen upon gonadotrophin release.

An ultrasonic system for measuring psychomotor behaviour is described, and then applied to compare the extent to which English and French students gesticulate.

The findings supported the hypotheses that: (1) French students gesticulate more than the English both when using descriptive speech and when discussing their feelings; (2) descriptive speech elicits more gesture then affectively-toned speech; (3) when verbal expression is more difficult the use of gesture increases; (4) individuals tend to maintain a characteristic level of gesturing.

We concluded the ultrasonic system provides a reliable and sensitive method for measuring gesture activity and can be applied clinically to the study of psychomotor behaviour.

The hypothesis that neuroleptic drugs exert their therapeutic effects by blocking dopaminergic transmission has been investigated by examining the effects of 3 neuroleptic drugs on dopamine turnover in 2 dopaminergically innervated regions of brain – the neostriatum and nucleus accumbens. The drugs chlorpromazine, thioridazine and fluphenazine, known to be therapeutically active in the treatment of schizophrenia, but to have differing incidences of extrapyramidal side effects, were administered to rats in dose ratios approximating to those effective in man. All 3 drugs induced a similar rise in the content of the dopamine metabolite homovanillic acid (HVA) in the nucleus accumbens, whilst the changes in HVA observed in the neostriatum were in the rank order in which these drugs produce extrapyramidal side effects. While the concentrations of dopamine metabolites in the frontal cortex were too low to assess the possibility that neuroleptic drugs have actions at this level, our results are consistent with the hypothesis that these drugs exert their therapeutic effects by dopamine receptor blockade in the nucleus accumbens.