Haloperidol treatment for stuttering was examined in a double-blind cross-over study of 26 adult volunteers with long-standing stuttering. Most had had unsuccessful speech and drug therapy. During the three-month study, their speech and stuttering patterns were repeatedly evaluated from videotaped readings of a standard passage and during spontaneous speaking. Of the 18 patients completing the trial 11 were significantly more improved on haloperidol than on placebo, three benefited equally from both, and four were unchanged. Improvement over placebo was indicated by fewer dysfluencies, increased speed of speaking, and reduced secondary 'struggle’ phenomena. Side effects were common on a dosage of 3 mg haloperidol daily. Poor concentration, akathisia and dystonic movements caused 8 patients to discontinue the trial despite significant improvement in 5 of them. Although 'statistically significant’ improvement occurred in most patients on haloperidol, the ‘clinical significance’ of this form of therapy will be limited by the partial response, the need for continuous medication, the side effects of haloperidol and the attitude of stutterers to this type of therapy.

Seventy-eight psychiatric in-patients were allocated to personal illness classes by means of the Delusions-Symptoms-States Inventory (DSSI). Paper and pencil measures of psychomotor speed and scatter of tapping were administered with an immediate retest. It is suggested that from a social desirability position one would have to predict that the more personally ill (i.e. those endorsing the more socially undesirable items) would be slower and more diffuse on these measures. We found, however, such patients to be more constricted and slower. It is concluded that such a combination adds to the utility and validity of the hierarchy of classes of personal illness.

Fifty-two patients thought to be suffering from dementia when first seen as neurological out-patients were fully investigated.

Four of them were found to have tumours, whilst in five the dementia was due to a treatable cause.

Neither a long history nor an age above sixty-five precludes a dementia being due to a treatable cause.

Home Office records were used to trace the current status of a sample of 128 persons for whom heroin was prescribed in 1969 at Drug Dependence Clinics in London. In October 1975, after a mean time since self-reported first use of heroin of 11 · 25 years, 51 per cent were attending clinics, 40 per cent alive and not attending, and 9 per cent dead. One third of the sample were still receiving heroin on prescription, and 23 per cent appeared to have received heroin without interruption since 1969. The report points to the need for career studies of addicts' lives and the need for follow-up interviews, especially for the 40 per cent no longer attending clinics.

Abnormal EEGs have been reported in XYY and XXY men located in psychiatric hospitals and prisons. In general, persons resident in institutions are more likely to exhibit EEG abnormalities than ‘normal’ population, and this bias of ascertainment has complicated the interpretation of these results.

The present study was conducted in Denmark. Chromosome determinations were made on 4,140 men selected from a birth cohort of 31,438 men. Twelve XYY and 16 XXY men were detected. Appropriate XY control groups were selected from the same population. The XYY men were found to have a significantly lower average frequency of the occipital alpha activity than their controls. The XYY and XXY men showed significantly more theta activity than the controls.

It seems reasonably well established that most pregnancies in schoolgirls occur in the context of relationships of some duration, and are not the outcome of casual or promiscuous contact. Further, especially in some ethnic groups and in some indigenous families, the occurrence of pregnancy in a fourteen- or fifteen-year-old girl is regarded by no means as a disaster, least of all by some of the girls involved who may be delighted and wish to continue with the pregnancy and bear the child.

How patients are seen by themselves and others close to them may influence the process of re-integration in the community after discharge. In a study in a psychiatric admission unit employing a therapeutic community approach, patients who sought little or no contact with the unit after discharge saw themselves, and were seen by others, as less ‘pleasant’ but less ‘ill’ than those who continued more regular contact. Perceptions were measured with the semantic differential technique. Patients' social class and household position were found to have a marked effect on the level of contact and on its association with how patients were seen. Diagnosis did not appear to influence hospital contact.

A case of folie à quatre is described affecting a proband and his wife, sister and brother. The three family members retained their symptoms of paranoid schizophrenia. The wife was not mentally ill and her delusions disappeared in time (folie imposée). Coincidentally, there were several cases of Huntington's chorea amongst her relatives. Different categories of folie à deux are demonstrated in the various family members and relationships.

We report for the first time the case of a male patient with the Noonan syndrome (Turner phenotype with a normal karyotype) who also had a psychiatric disorder which satisfied research criteria for schizophrenia.

Questionnaire replies from 43 experienced psychiatrists showed wide variation in the ways they would manage a common type of neurotic problem. There were considerable differences in the nature and duration of treatment and in the use of other members of the psychiatric team. The conclusions have implications for training and for the use of health care resources.

As a District Community Physician I am interested in two particular areas. Firstly, the management of resources to improve services to patients, and secondly, the prevention of ill-health. In broad terms within the field of psychiatry these correspond to community psychiatry and social psychiatry. Community psychiatry is sometimes used interchangeably with social psychiatry, but the term is best used to signify the applied practice at the community level and especially the programmes for maximizing the resources of the community towards providing direct services for those in need (Bernard, 1964; Sutherland, 1971).

On 23 March Mr M. Spicer initiated an adjournment debate on the future of St Wulstan’s Hospital, Malvern, which had been recommended for closure by the West Midlands RHA. He emphasized the unique nature of the rehabilitation facilities at the hospital and its outstanding success in that field. In his reply the Minister repeated a previously given pledge that the hospital would not be closed unless it was clearly shown that equivalent facilities could be provided elsewhere, and a special survey would be conducted for this purpose.