As part of the study of alcoholism, we have investigated the possibility that early age of onset of alcoholism indicates a possible diagnosis of personality disorder while later age of onset does not.

In 1964 Cutler et al. (1) reported on a family in which 11 members apparently had primary hyperparathyroidism. Seven cases were diagnosed at surgery; four other members had elevated serum calcium and other evidence of the disease. It was noted as an incidental finding that two of the affected members also suffered from severe psychiatric illness. The present study is a six-year follow-up investigation of the family from a psychiatric viewpoint, using non-hyperparathyroidism family members as controls to explore the possible relation of hyperparathyroidism to psychiatric illness.

The Green Paper was welcomed as an outline of the new proposed structure and as a considerable advance on the first Green Paper of 1968, discussed in the Association's Memorandum published in the British Journal of Psychiatry, 1969, 115, 601–3.

It is known that pernicious anaemia is sometimes associated with mental symptoms which improve following vitamin B12 therapy (Eilenberg, 1960; Holmes, 1956; Smith, 1960). Further, it has been pointed out that such mental symptoms can occur years before the development of anaemia and no definite relationship exists between them and the severity of anaemia (Smith, 1960). Cases have been described with a variety of psychiatric symptoms and low serum vitamin B12 levels without any neurological manifestation or abnormality of peripheral blood and bone marrow. Since pernicious anaemia is due to vitamin B12 deficiency it is suspected that B12 deficiency is responsible for the mental symptoms, and serum B12 assays have been advocated routinely in psychiatric patients (Strachan and Henderson, 1965; Hunter and Matthews, 1965).

1. The Royal Medico-Psychological Association feel obliged to express concern at the Department of Health's apparent lack of consultation with practising clinicians in the mental subnormality field before formulating policy. The Association welcomes experimental schemes with regard to patient care, and considers that these schemes should be properly evaluated in various parts of the country before their acceptance or rejection as national policy.

Narcolepsy is a syndrome characterized by recurrent sleep attacks and one or more of the following symptoms: cataplexy (transient loss of muscle tone), sleep paralysis (inability to move in the transition between sleep and arousal), and hypnagogic hallucinations (Sours, 1963). Polygraphic sleep studies indicate that narcoleptics have an abnormal sleep record. Normally, rapid eye movement (REM) sleep is preceded by 90 to 100 minutes of non-REM sleep, whereas narcoleptics often have an REM-period at the onset of sleep (Hishikawa and Kaneki, 1965; Rechtschaffen et al., 1963).