It was with much regret earlier this year that St. Thomas’ said farewell to Dr. William Sargant, for 24 years Physician in charge of the Department of Psychological Medicine. In his honour a dinner was held at the hospital, at which a large gathering of colleagues and past members of his staff were present, and an inscribed silver amada dish was presented to him from the hospital and staff.

The present study describes certain characteristics of an in-patient population of newly-admitted patients at the only psychiatric hospital (approximately 3,000 beds) serving the two million inhabitants of Jamaica.

The diagnosis of hysteria has seemed a hazardous one since Slater (1965) pronounced it ‘not only a delusion but also a snare’. His conclusion was based on the demonstrable fragility of the diagnosis when usually accepted criteria are used. Against this, Guze (1967) has put forward evidence which suggests that when his criteria are applied the diagnosis is a stable one. Lader and Sartorius (1968), in a study of 10 patients, also seemed to show that those with conversion hysteria were a single group on the criterion of their failure to habituate to 20 repetitions of a standard stimulus, a disability which distinguished them from other neurotic groups. Slater, however, in criticizing the Perley and Guze (1962) concept, remarked that two residual groups, rather than one, remained as diagnostically unchanged in his 10-year follow-up.

The difficulties in providing adequate psychotherapy facilities in the N.H.S. are well known, and various psychotherapeutic techniques have been used to try to cope with them. Of these the most important have been variants of group and brief psychotherapy, and it is with the latter that this paper is concerned. The technique I have used in this series is to offer patients once-weekly psychotherapy for a maximum period of 6 months and then to terminate no matter what progress has been made, the patient having been informed of these conditions from the start. In this paper I shall consider the criteria used in the selection of patients, the technique and probable mode of action, a brief account of the cases with the therapeutic results obtained, and the follow-up on these cases.

The history of in-patient units for the psychiatric treatment of children in the United Kingdom is largely confined to recent years. Their number is now slowly expanding, and there are approximately 60 in-patient psychiatric units for children and adolescents (R.M.P.A. 1970; Department of Health and Social Security, 1970).

The psychiatric unit opened at Wexham Park Hospital, near Slough, earlier this year is the fourth of five to open at District General Hospitals in the region this year. The unit, which has 101 beds for in-patients and 50 places for day-patients, is part of a £5 million programme which will give the region eleven such units by 1975. The following are the other units now in operation : Luton and Dunstable Hospital; Queen Elizabeth II Hospital, Welwyn Garden City; Shrodells Hospital, Watford.

Over 70 years ago, Sibbald (1900) commented that the official statistics on suicide showed Scotland to have lower rates than England and Wales. It seems that Scotland has always been regarded as one of the countries with relatively few suicides. A recent World Health Organization publication (1968) commented on the official suicide rates in a sample of 20 different nations; among these Scotland ranked nineteenth in 1952–4. However, this picture appears to have been gradually changing over the last two decades, and the same W.H.O. publication, citing official statistics for the period 1961–3, quotes a value for Scotland which raises it to fifteenth in the list of 20 countries. Moreover, the Scottish rates and those for England and Wales have gradually come closer together over the last 20 years.

The aim of this paper is to examine the trends in Scottish statistics for the last two decades and to compare the current suicide rates with those of the rest of the United Kingdom. All the data quoted are based on the publications of the Registrars General for Scotland and for England and Wales.

Notwithstanding Hamilton's remark that childbirth is responsible for a great deal of neurotic illness, the literature is heavily weighted in favour of studies of puerperal psychosis, even though this condition occurs in only one in a thousand births. Since the milder forms of illness tend to pass unrecognized they are often responsible for stress in the individual and family; thus it is right and proper that more attention has recently been paid to these. Pitt (1968), for example, found an incidence of 10–17 per cent of atypical depression and psychosomatic illness that persisted for several weeks and in some cases for as long as one year following childbirth. Between normality and psychotic or neurotic illness lies the mild affective disorder that so often characterizes pregnancy and the early Puerperium, but does not amount to an ‘illness'. Perhaps because women regard it as an expected hazard from which they will recover it has not generally been considered to merit serious study. Jarrahi-Zadeh et al. (1969) looked at this and found that as many as 55 per cent had one or more depressive symptoms during pregnancy. If anything it was less common post-partum, and they furnished evidence for a brain syndrome of mild degree occurring at this time. Yalom et al. (1968) have described the post-partum blues syndrome as occurring in 66 per cent of their subjects and hold it to be a self-limiting condition of only a few days duration. It is likely that patients with the blues have a greater risk of developing a neurotic depression, which might reflect upon personality factors, but the same cannot be said to hold for post-partum psychosis.