Tradition retains the practice of attaching mental nurses to wards rather than to groups of patients, even though the wards are increasingly empty as patients come to lead more active lives in hospital. A system is described which enables nurses to relate more fully to the people in their care instead of having to confine their activities to the place in which only a part of the care is provided. This system involves all ward nurses in leaving their wards empty in ‘working hours', being relieved of the care of their intercurrently ill patients and undertaking in exchange the complete day care of their fitter patients in both wards and workplaces. The consequences of these changes are attractive to many nurses and helpful to many patients.

The paper reports an extension of work into the relevance of personality and pre-treatment expectancies for allocation and response of patients to group psychotherapy. The results show that subjects who are internally directed in interest and who have a liberal attitude to a variety of social issues and a ‘psychological’ set to treatment are more responsive to group psychotherapy as seen by their therapists as well as by themselves. Those who are externally directed in interest and who have a conservative attitude to life and a more ‘medical-physical’ set to treatment are more likely to be referred for behaviour therapy; if referred for group psychotherapy they are likely either to drop out or to show very limited response to treatment.

This study examined the hypothesis that there are seasonal variations for suicide, hospital admissions for depressive illnesses and electroconvulsive therapy and that these are inter-related. It was found that the seasonal variations did coincide, with peaks occurring in the Ontario spring and autumn. The importance of depression as a cause of suicide and the effect of electroconvulsive therapy upon the suicide rate are discussed.

In an effort to examine the placebo, psychological deterrent, and pharmacological deterrent effects associated with implanted disulfiram, subjects were given either disulfiram implants or sham operations. Ethanol challenges elicited no disulfiram-ethanol reactions (DERs), indicating that at the time of the challenge neither a pharmacological deterrent nor a placebo effect was operating. Of the patients who resumed drinking, only those with disulfiram implants experienced DERs. Sham operation subjects continued to drink after their first post-challenge drink; four of five disulfiram implant recidivists remained abstinent following their experience of a DER. It is concluded that the pharmacological deterrent effect of the disulfiram implant may have been underestimated in previous reports.

122 Schizophrenic patients treated with injections of fluphenazine ethanate, 97 with fluphenazine decanoate and 199 with flupenthixol decanoate were followed up for mean times of 41, 33 and 21 months respectively. Their progress was compared by examining reasons for discontinuing injections and outcome in three separate groups defined according to first preparation given; relating the events causing patients to discontinue injections or be readmitted to patient-months spent on each drug; and analysing reasons for inter-drug transfers 43 per cent, 24 per cent and 23 per cent respectively of these three groups of patients discontinued the injections. Severe extrapyramidal effects were most frequent with fluphenazine ethanate, intermediate with fluphenazine decanote, and least frequent with flupenthixol. Lack of cooperation was rather more frequent with flupenthixol than with the other drugs. Severe depression occurred with all three. More patients on fluphenazine injections were transferred for any reason to flupenthixol than vice-versa. A case of ‘irreversible’ movement disorder was seen with each preparation. It is suggested that current maintenance doses of flupenthixol decanoate are too low.

Factors from the social history of male psychopaths were examined in relation to their success or failure as measured by re-convictions or psychiatric hospital re-admissions 2–3 years after treatment at Henderson Hospital. From these data a weighted prediction formula was calculated and was tested out on a further cohort of patients. As a prediction instrument it was found to be reliable to a degree of significance just above the 1 per cent level. Other aspects of the subsequent career of treated patients are noted, in particular a tendency to early but often short-lived relapse and then longer standing success.

We compared conventional bilateral ECT treatment electrode placement with simultaneous unilateral electrode placement to both sides of the head (dominant/nondominant unilateral ECT) in 20 patients with endogenous depression. Under double-blind random assignment conditions we found that six bilateral ECT were significantly more effective than six dominant/nondominant unilateral ECT in reducing depression rating scale scores. In the light of data from intracerebral ECT current distribution studies we interpret our findings to support our previously advanced hypothesis that diencephalic stimulation is requisite for the therapeutic benefit of bilateral ECT in endogenous depression.