A distinctive pattern of clinical change during eight affective episodes is reported in a rapidly cycling manic-depressive patient. After a rapid switch to near maximal intensity of affective symptoms, slow changes in symptomatology were documented by significant slopes and correlation coefficients over the course of each episode. Decreases in depression, anxiety, drowsiness, helplessness/hopelessness, anger, and sadness preceded the switches into mania; decreases in mania, euphoria, seeking others, and talking preceded the switches into depression. Psychologically important events appeared to regularly precede rapid mood switches. It is suggested that the consistent, slow clinical changes which occur during affective episodes may reflect part of an underlying rhythmic biological process and that environmental events may be capable of triggering a final common pathway for the mood switch during a vulnerable period.

Elderly psychiatric patients who were in contact with the hospital one year after in-patient admission were retested on a number of clinical and psychometric measures first done soon after admission. In general, changes were small; and for several measures very high correlations existed between the scores gained on the two occasions. When those patients with uncomplicated chronic brain syndromes were considered separately, increasing impairment was demonstrable.

Although ward behaviour rating scales for use with long-stay psychiatric patients by nurses have been in existence for many years, their content tends to reflect the opinions of psychiatrists and psychologists rather than those of nurses. An analysis of five commonly used rating scales illustrates the lack of agreement on what should be included. The opinions of 76 nurses from four separate hospitals were sought, using a 34-item questionnaire, to establish what areas of content were considered important in nursing practice. Apart from agreement on general content, consideration should also be given to the presentation of individual items of ward rating scales.

This paper considers possible relationships between cognitive deficits and symptomatology in schizophrenia. It is argued that a combination of defective filtering and slowness in response selection results in a state of information overload in acute schizophrenia. The methods by which normal subjects adapt to experimenter-induced overload may therefore be relevant to aspects of schizophrenic behaviour. The considerable intra- and inter-subject variability in symptomatology of schizophrenic patients may represent differing adaptations to similar cognitive disturbance, such secondary abnormalities being prominent in chronic patients. Sections of the literature on acute-chronic differences are consistent with such a formulation, although one cannot infer intra-individual change from cross-sectional studies; there is a clear need for longitudinal investigations in this area. The preferred method of adaptation will be dependent on the severity of overload, the environment, and personality factors independent of the psychosis. The implications for the modification of schizophrenics' behavioural abnormalities by operant procedures are discussed.

The fitting of the multifactorial model of disease transmission to the familial clustering of hysteria and sociopathy by Cloninger et al (1) involved an approximation. This note reports the results of fitting the bivariate Normal model exactly and also two other distributions.

The measurement of agreement between ratings of patient symptomatology by two or more psychiatrists is discussed. It is noted that coefficients which allow for possible chance agreement are to be preferred, but they involve assumptions about the way in which chance factors may operate. Assumptions which involve prior probabilities of the incidence of a symptom appear to be too stringent, and a new coefficient, called the RE coefficient, is recommended in which chance is assumed to operate in a purely random way. Binary scales are discussed in detail, but methods of dealing with scales of wider range are also referred to.

The reasons which led to the search in the brain for substances with morphine-like actions are discussed. Two pentapeptides, methionine-enkephalin and leucine-enkephalin, were isolated. The amino acid sequence of methionine-enkephalin occurs also in the pituitary prohormone β-lipotropin, of which longer fragments (endorphins) of up to 31 amino acids exhibit strong morphine-like action.

The physiological significance of these short and long opioid peptides is discussed, particularly with regard to their possible roles as neurotransmitter or neuromodulator.

With regard to the mechanisms involved in the development of tolerance to and dependence on opiates, the importance of interaction between the endogenous opioid peptides and the exogenous opiate alkaloids is stressed.

The possible therapeutic implications are discussed briefly.

This study is concerned with the roles of doctors, nurses, occupational therapists and social workers in psychiatric hospitals, as perceived by members of these occupations. Fifty-one respondents from three psychiatric hospitals were interviewed. Information was sought concerning the ways respondents evaluate (a) occupational importance, (b) occupational competence and (c) inter-group contacts. Most respondents regarded the occupational importance of psychiatrists as being higher than that of the non-medical occupations. There was, however, disagreement among the various groups regarding their specific roles and areas of occupational competence. Existing inter-group contacts were evaluated as much less satisfactory by non-medical staff than by psychiatrists.

Two groups, 10 subjects in each, one consisting of depressed patients and the others normal controls, ranked photographs of faces for two sets of six constructs. One set consisted of the critical constructs of the Bannister and Fransella grid test, while the other set of constructs were all related to affect. The depressed patients showed a higher intensity score for affective constructs than did the normal subjects. There was no difference for critical constructs. The affective intensity score decreased on two further retestings for the depressed group; for the normal group they remained reasonably constant. These results may shed light on the reorganization in construing aspects of affect which occurs with depression and its remission.