A group of 33 schizophrenic patients were typed for HLA-SD antigens and their qualitative clinical responses to chlorpromazine therapy determined. A highly significant positive correlation was found between response to chlorpromazine and HLA-A1 positive, while HLA-A2 positive subjects showed a significant negative correlation to chlorpromazine treatment.

In a second group of 17 patients the clinical responses to chlorpromazine were evaluated quantitatively, by WPRS, in HLA-A1 positive and HLA-A1 negative patients. There were no pre-treatment differences in the scores. After treatment the scores of positive patients were significantly lower, indicating that they responded to a greater degree.

Since the frequency of HLA-A1 in hebephrenic patients is higher than that in other schizophrenics this may explain our earlier finding that hebephrenics, as a group, respond better to chlorpromazine than do other schizophrenics.

Generalization of improvement in the behavioural treatment of psychotic patients must be planned in after-care settings, and for durability over time. The transfer of clinical gains is not an automatic by-product of treatment with severely and chronically impaired mental patients. Treatment strategies that facilitate generalization from hospital to community are illustrated in a case study using empirical data. Systematic and specific treatment programmes were co-ordinated between a state hospital ward and a community-based day hospital. Setting step-wise and limited goals is a feature of successful outcomes. Maintaining consistency in reinforcement contingencies from hospital to community settings, using natural reinforcers, pinpointing functional behaviours as therapeutic goals, over-learning, and training natural caregivers are methods that promote generalization.

Twenty-two anorgasmic women received 20 sessions of a multiple-technique behavioural therapy. The design included blind ratings by two independent assessors, multiple assessment instruments, and a waiting list control group.

Treatment was significantly better than no treatment in terms of: (1) the percentage of patients experiencing orgasm during at least 50 per cent of sexual relations; (2) the percentage of women reporting satisfactory sexual relations at least 50 per cent of the time; (3) patients' ratings of positive reactions to various sexual behaviours; and (4) assessors' global clinical ratings.

Significant improvement was also noted on the MMPI, IPAT, and Symptom Check List. Improvement was maintained at a follow-up average 9 months later. These results support the impression that a behavioural approach offers much promise in treating female orgasmic dysfunction.