A number of studies have demonstrated that married pairs in which both partners have, or have had, a psychological illness are substantially commoner than would be expected by chance. These have been reviewed elsewhere (Kreitman, 1964; Nielsen, 1964). In most of these investigations the findings have been analysed in terms of “neuroticism” or of nonspecific “mental illness” without reference to diagnosis, and detailed attention has rarely been given to any other clinical features.

In recent years, a number of surveys of attempted suicides have been reported (Middleton et al., 1961; Sclare and Hamilton, 1963; Parkin and Stengel, 1965; Whitlock and Schapira, 1967). Other studies (Kessel, 1965; Oswald, 1966) have shown that the number of cases of attempted suicide has greatly increased in the last decade. Apart from one survey from Tasmania (Gold, 1965), all these have come from large urban or industrial communities.

In December, 1965, a patient was admitted to the wards at Parkside Hospital, Macclesfield, with a Korsakoff syndrome which had appeared following a suicidal hanging attempt. Strangulation as a cause of the Korsakoff syndrome appears in all surveys of the numerous causes of the disorder, from Bonhoeffer (1904) to Lewis (1961), but only one case (Whiteley, 1958) has been described in the English literature and this only briefly. Indeed, the whole subject of the neuropsychiatric sequelae of attempted hanging has received scant attention in the English literature, yet according to statistics of the Registrar-General (Stengel, 1964), hanging is the second commonest method of suicide in males in this country. Moreover, Bokonjic (1963) has collected 19 cases admitted to hospitals in Aarhus and Copenhagen between 1948–1958 suffering from the anoxic effects of attempted hanging, whilst Berczeller and Nowotny (1935) claimed to have dealt with 100 hanging survivors in the Vienna University Clinic over a ten-year period. Possibly of greater importance in justifying a review of this subject is the fact that the neuropsychiatric sequelae of attempted hanging are really those of cerebral anoxia. In this age, when surgical techniques involving interruption of the cerebral circulation are growing more frequent and when methods of anaesthesia and particularly dental anaesthesia are evoking a good deal of attention and contention, it is important that the psychiatrist should have some acquaintance with the psychological and neurological symptoms and signs that are caused by cerebral anoxia.

It is common knowledge that women often get depressed after childbirth. Yet there has been little evaluation of what this depression amounts to. Transitory tearfulness in the early puerperium, as observed in maternity wards, is commonplace; has been designated “the Blues”—3rd, 4th or 10th day, Maternity or Mother's—and is generally regarded as a normal phenomenon. It has been variously attributed to psychological difficulties and physical discomfort at the onset of lactation, “narcissistic loss before rediscovery of the child” (Sclare, 1955), perineal soreness and hormonal changes.

In the present paper the author will try to elucidate the stability of nosological categories as revealed by a personal follow-up investigation of 301 previously hospitalized patients with paranoid psychoses. Since the terminology used will be the Scandinavian one, a short review of the diagnostic concepts will be given. The Scandinavian concept of schizophrenia is rather narrower than that employed in the rest of Europe, and especially narrower than that prevailing in the Anglo-American literature. Many American authors include in their concept of schizophrenia what may be called “the schizophrenic reaction types”. In the present paper, the concept of schizophrenia used by Langfeldt (1937, 1939), sometimes, referred to as “process schizophrenia” or “nuclear schizophrenia” is used. “Primary symptoms” occur in clear consciousness; these include disturbances of thinking, disintegration of emotions, autism, marked feeling of influence and passivity, massive depersonalization and derealization. As a rule the illness has an insidious development and a chronic course ending up with a greater or lesser degree of mental deterioration.

There seems little doubt from available statistics that the Republic of Ireland has the highest rate of hospitalized psychiatric morbidity in the world. There are no complete international figures available for this statistic but the World Health Organization published for the first time in 1961 returns for numbers of patients treated in hospital in 119 different countries (W.H.O. 1961). In many cases the returns were incomplete or unsatisfactory in one or more particulars. The ideal was to establish for each country the total number of patients treated during each one of the five years 1955–1959. The number treated was defined as “the patients present at the beginning of the year in the various public and private institutions specializing in psychiatry and in other institutions (general hospitals, etc.) plus admissions and readmissions during the year”. Unfortunately this ideal was achieved for only a minority of the 119 countries. The difficulties encountered in compiling the figures are set out in the publication itself.

It is twenty years since the appearance of Stoll's paper: “Lysergic acid diethylamide, a hallucinatory agent of the ergot group” (23). In this he sought to reproduce in a group of subjects Hofmann's personal experiences of the drug, and so set the LSD snowball on its way. Some 1,500 papers must by now have been gathered to it; they deal with a greater range of uses than has been thought of for any drug, a greater variety of benefits and disasters, and a confusing number of claims. Yet we have little hard information about this curious substance.

From time to time, normal human beings not suffering from any mental illness have reported experiences either akin to or identical with hallucinations (Byrd, 1938; Slocum, 1948; Ritter, 1954; Bombard, 1955). The common features in these reports have been the social isolation of the people involved and the physical hardships of their living conditions. They have usually been solitary mariners or polar explorers. Scientific interest was not aroused in these phenomena until directed to them by the experiences of prisoners of war in Korea who had undergone “brain-washing” techniques. At this time, Hebb and his colleagues began a series of experiments which opened up an era of widespread research into the field of Sensory Deprivation.

There is no uniformity in the use of the terms habituation, addiction, intense desire, and craving. V. Petran (19) talks of craving as the irresistible desire to acquire a drug and the impossibility of abstaining from it. Craving may be manifested immediately after first consumption, but addiction represents a regular use, from which craving may develop in time.

The immense literature on schizophrenia abounds in discoveries of single associations between the symptoms of the disease and certain other factors. Braithwaite (1960) says in speaking about “science like psychology and the social sciences which make great use of tendency statements… that to assert an isolated tendency statement is to say very little”. Such isolated statements in themselves are not explanations. A theory, on the other hand, interprets information; it explains.

It is part of the magical aura of the physician that he must have some omnipotent tool with which he dramatically makes patients better. In individual psychotherapy the individual interview and the interpretation, like the surgeon's scalpel, provides such an omnipotent instrument. In therapeutic community practice it is often group therapy in the form of the daily ward meeting and the review that plays the role of the omnipotent therapeutic tool. But in our opinion it is the daily living situation and not the formally organized therapeutic meeting which provides the greatest potential for learning and growth on the part of patients and staff. We have found the crisis situation and its resolution to be potentially the most useful of these daily living situations.

Current views on aggressive behaviour (Buss, 1961; Berkowitz, 1962) propose a direct relationship between the frequency and intensity of aggression, both of which are in turn considered to be related to extraverted personality patterns (Buss, 1961; Bendig, 1961). The frequency and intensity of aggressive responses, it is maintained, are both indications of the habit strength of the aggressive response. Such conclusions are derived from laboratory studies in which, for obvious reasons, intensity of response will not reach extreme proportions. However, studies of those who have indulged in extremely aggressive behaviour are not in accord with this view. Megargee and Mendelsohn (1962), for example, found that extremely assaultive criminals scored lower than nonviolent criminals and normals on personality scales related to hostility and lack of control, and more recently Megargee (1966) has reviewed the literature on this subject, which suggests that a large proportion of those who have committed crimes of extreme violence have no previous history of assaultive behaviour and are well controlled in their behaviour generally.

The literature on “psychogenic” potency disorders in the male is vast, and opinions abound on every aspect of these disorders. However, despite this abundance there is a dearth of factual data. The present author has been able to find only two major studies which have set out to study systematically and objectively facets of these conditions. El-Senoussi et al. (1959) undertook a statistical study to delineate psychological factors related causally to impotence; whilst Johnson (1965b) retrospectively studied male potency disorders to define their natural history.

Surprisingly little has been written on the interview with the child as a diagnostic tool, in contrast to the voluminous literature on the therapeutic interview. Whereas standard texts on child psychiatry usually include a discussion of the physician-child relationship and of the use of play situation, it is rare for there to be any systematic account of the interview with the child as a diagnostic procedure.

An earlier commentary on the level and regional variation of Irish hospitalized psychiatric illness was limited by the absence of age-specific and standardized data (Walsh and Walsh, 1968). The present paper presents age- and sex-standardized rates by county for 1959, and then suggests some socioeconomic influences in [partial explanation of the variation in these rates. Psychiatric services in Ireland are provided on a county basis: in eleven instances one hospital serves a single county, in six cases there is one hospital to two counties and the remaining hospital serves three counties.