Obsessional neurosis, inasfar as it comes to the attention of the psychiatrist, is a comparatively rare disorder, comprising not more than about 3 per cent of all cases of neurosis. Its rarity is reflected in the fact that the largest series so far described, that of Pollitt (1957), consisted of only 150 cases, though a limited amount of information has been available from the somewhat larger series of the Bethlem-Maudsley Hospital (Blacker and Gore, 1955) and of the Registrar General (1964).

Since the long-term results of the treatment of elderly depressives admitted to the writer's care between 1949 and 1951 were communicated (1962), further experiences (e.g. Colwell and Post, 1959; Post, 1968) have confirmed that affective illnesses in late life are associated with much subsequent mental invalidism and needs for further treatment. It was hoped that these needs might be met by increased use of out-patient and community care as well as by the introduction of thymoleptic drugs. A follow-up investigation of a further consecutive series of depressives over the age of 60 receiving inpatient treatment from the same psychiatrist in the same hospital during the years 1966–67 was undertaken with the following aims in view:

Firstly, it was intended to test the proposition that the less reluctant use of electro-convulsive therapy in old persons, as well as the introduction of antidepressant drugs and of more active after-care measures, had improved the long term outlook in the affective illnesses of late life. It was realized that a comparison of two series of patients separated from one another by some 15 years might be vitiated by differences between the samples other than those due to changed methods of treatment. It would, however, have been unethical to withhold the new forms of management from a control group.

It is accepted as professionally unethical for doctors and nurses to be influenced by their (negative or positive) feelings in their behaviour towards patients. ‘Emotional involvement’ with patients, though seldom defined, is usually sternly discouraged during medical and nursing training. As a result many graduates deny not only that they are influenced by their feelings towards their patients but even that they have any feelings at all.

Scientific studies of the families of depressed patients have shown that the risk of development of similar illnesses for close relatives is greater when the illness of the index case began relatively early in life than when it began later. These studies have included both manic-depressive and single episode endogeneous depressions, and no account has been taken of the mode of precipitation of the illnesses. It has been postulated that (a) the penetrance of the gene may be lower in those families with late onset of depression, and (b) that depressive illness may be of diverse aetiology, so that genetically determined forms appear earlier in life and those which are not genetically determined occur later (Hopkinson and Ley 1969).

The main activities of the Association in recent months have been concerned with the referendum on the representation of trainee psychiatrists, and with organizing this month's meetings.

The aim of this study was to determine the relationship between loose or ‘allusive’ thinking and conditioning performance. The theoretical proposition examined was that looseness of thinking is associated with weak internal inhibition of autonomic responses in classical conditioning.

To demonstrate how 'senile dementia emerged as an important psychiatric concept is not an easy task. Although the history of general psychiatry can be satisfactorily traced to the spirited endeavours of Hippocrates (460–375 B.C.), Celsus (circa 30 a.d.), Soranus the elder (circa 100 a.d.), and Aretaeus (circa 150 a.d.), the psychiatry of old age unfortunately lacks such a clear and well-defined genealogy. The term 'senile dementia’ itself seems to have been first used by Aretaeus, the physician of Cappadocia, but exactly how it had evolved and how it was differentiated, if at all, from normal senescence is not at all clear. Certainly modern psychiatry has inherited a wealth of graphic description of old age in general, and for a detailed account of the relevant ethnographic literature the reader is referred to the excellent article by Rosen (1961). From a scientific point of view, however, it is unfortunate that the spirit of enquiry and the descriptive contributions of the early writers seem to have been tempered more by the degree of optimism or pessimism with which they anticipated the intellectual and behavioural foibles of old age, than by a desire to explore and evaluate systematically its possible deviations.

The Scottish Home and Health Department have informed the Regional Board that they are prepared to make capital monies available to the extent of £3½ million for new hospital development on the Cornhill Hospital Site, Aberdeen; building is to commence about 1978. Agreement has been reached with the Department that up to 600 bed places may be included in the development of this new hospital complex. Planning is now under way, the Board having set up a Professional Planning Committee to advise them on the form, content and detail of the project.

Over a hundred years ago Griesinger (1861) identified hypochondriasis with melancholia; and quite recently, Kenyon (1964) in a study of 512 patients with a diagnosis of hypochondriasis concluded that it was always part of another syndrome, most commonly a depressive or anxiety state. Many patients with a depressive illness experience localized somatic symptoms. The question arises why, during an episode of depression, some patients have localized somatic symptoms, sometimes consistently in the same site in recurrent episodes, whilst others have none. The head, chest and abdomen have been reported as the most common sites (Schneider, 1959; Gittleson, 1962). Jaspers (1913–46) pointed out that ‘we should distinguish between phenomenological description of actual bodily experiences and any discussion of the significance for the individual of his own body in terms of the effective meaningful connections where there are hypochondriacal narcissistic or symbol-forming tendencies influencing the self-awareness'. The present study is concerned with the possible meaningful connections related to the localization of symptoms to the chest in depression, and follows a descriptive account of respiratory symptoms in depression (Burns, 1971). These symptoms include sighing respiration, hyperventilation, ‘vital feelings' on the chest and depressive delusions directed towards the chest.

In a study by Hinchcliffe, Lancashire and Roberts (1971), results of verbal behaviour analysis are described which purport to show objective, quantified evidence of ‘psychological defence mechanisms' in the speech of depressed patients. The method employed was based on earlier work by Weintraub and Aronson (1962, 1964), involving the tape-recording of speech during interviews of both patients and controls. Analysis is made of both temporo-physical events (e.g. speech rate; pausing) and lexical and semantic content. Regarding the latter, particular emphasis was placed on frequency of ‘negators', defined as ‘not, never, nor, nothing’ (Hinchcliffe et al., 1971) and ‘All negatives, e.g. “not“, “no”, “nothing“, “never”.’ (Weintraub and Aronson, 1964). Such ‘negators' are taken to indicate ‘denial’ in the psycho-analytic sense. Hinchcliffe et al. used a group of ten depressed in-patients and a control group of ten surgical in-patients ‘matched for age, sex and socio-economic position’, but sharply demarcated in terms of their scores on the Zung Self-Rating Scale for depression (Zung, 1965). They found a preponderance of ‘negators' in the speech of the depressed group which was statistically highly significant (P < 0·005), comparing well with the findings of Weintraub and Aronson (P < 0 · 01). In a subsequent communication (Silverman, 1971), the present author expressed doubt as to the validity of the inference that ‘negators' do indicate ‘denial’ in depressed patients, and suggested an alternative experiment of which this is a report.

The Child Psychiatric Clinic of the Paediatric Department at St. Thomas' Hospital has had a relatively large number of referrals of disturbed children under 5 years of age, because of the existence of a day hospital where they and their families can be offered treatment together (Frommer, 1967). As there are few reports on psychiatric disturbance in this age-group, we thought it worthwhile to report on some aspects of their problems as we have seen them. Clinical experience led us to the supposition that we would find recurring patterns of family disturbance and symptoms accompanying the main behavioural disturbances for which they were brought. For this reason, we undertook an analysis of the presenting features, symptoms, behaviour, and family circumstances of all pre-school children who were referred to this Clinic during six years from August, 1962, when the day hospital first opened as a part-time pilot venture, to August 1968. The following is an account of some of our findings.

Tests involving the arrangement of pictures to tell a story have long been included among tests of intellectual ability. First devised by De Croly (1914), one or more items of this type have appeared in a number of experiments and standardized tests; and the Wechsler intelligence scales (1944, 1955) include a Picture Arrangement subtest consisting of six or eight items ranging in length from three to six pictures. However, apart from its possible use for psychiatric interpretation (e.g. Wechsler, 1958; Ch. 10) its specific value as a component of the scale has not been established. Some critics, suggesting that the test has a low reliability, are inclined to omit it from short forms of the Wechsler scales; yet test-retest reliabilities of about 0.65 (Wechsler, 1958) are similar to those of Arithmetic and Object Assembly, which are rarely omitted. Perhaps a more cogent reason for its omission is uncertainty as to what ability the test measures. Wechsler (1958) suggests that it shows the subject's ability to ‘comprehend and size up a total situation’; and that, as all the stories concern human activities, it may be a measure of social intelligence and awareness. Identification of the ability or abilities involved by factor analysis is also inconclusive: the test does not show significant association with Picture Completion, the other pictorial subtest in the Wechsler scale; and in different analyses it has shown associations with a Memory factor or with a factor described as ‘freedom from distractibility’.

The psychiatric services in the field of community psychiatry in Israel have developed in a number of directions over the past decade. Following the establishment by the Workers' Sick Fund (Kupat Holim) of a Rehabilitation Unit for chronic psychiatric patients (Wijsenbeek and Lindner (53)) and the opening of a Day Hospital for acute cases in conjunction with a psychiatric hospital (Ramot and Jaffe (45)), a Day Hospital was established in October 1968, at the Out-Patient Mental Health Clinic (Ramat Chen), to serve acute psychiatric patients. This represented the first attempt of its kind in Israel. The professional literature on Day Hospitals, which in the main describes a ‘half-way out’ type of hospital (Farndale (16); Epps and Hanes (14); Kramer (32)), also reports the existence of a ‘half-way in’ type of institution, operating as an autonomous service catering to a particular geographical region, without being attached directly to a mental hospital. This kind of Day Hospital, specifically designed for acute cases, has not yet been tried in Israel.