Various studies of the numbers of patients in mental hospitals have been made, e.g. Brooke (1963); General Register Office (1960); Gore and Jones (1961); Hassall, Spencer, and Cross (1965); Malzberg (1955); Norris (1959); Norton (1961); Registrar General (1958, 1960, 1961, 1962, 1964); Tooth and Brooke (1961), but little attempt has been made to find whether these numbers are subject to natural law. In this paper I have tried to establish this. These researches have been made on the patients of the Central Hospital, Warwick, which has been in continuous use since 30 June 1852. The case sheets of the older patients are accessible; the recent ones are also personally known.

The idea of a relationship between respiration and mental functioning can be traced back to ancient superstition that the diaphragm is the centre of the soul as well as of emotion.

In their article published in this Journal in 1965, May and Tuma (1) suggested that only the use of medication made a difference in the outcome with schizophrenics, and that psychotherapy, whether or not combined with medication, made essentially no difference. Their data, however, as in so many psychotherapy projects, referred only to patients treated by inexperienced therapists, namely psychiatric hospital residents under supervision.

The present study is one of a series of investigations concerned with the relationship between parent death and mental illness. In previous studies (Birtchnell 1970 a and b) it has been shown that significantly more psychiatric patients, compared with a general population control group, experienced parent death during the first five years of life and during a period of one to five years before admission to hospital. It was further shown (Birtchnell 1970c) that within the patient group, though the incidence of early and recent parent death was similar among depressed and non-depressed patients, the severely depressed compared with the moderately depressed patients experienced sig- nificandy more parental bereavements during the first twenty years of life and during a period of one to twenty years before admission. In a large sample of depressed in-patients, Hill (1969) demonstrated a significant excess of early parent deaths in those who attempted suicide, and he suggested that this might be secondary to the association between early parent death and severe depression.

Pollin et al. (12) found that in a series of 11 monozygotic twins (MZ) discordant for schizophrenia all of the index twins weighed less at birth, 8 of the index twins were second- born and 7 out of the 11 mothers had varying thyroid pathology ‘of clinical significance’. The following report is probably the first giving details of investigations into a pair of MZ twins who were given thyroid extract during the neonatal period because of failure to make normal progress.

The syndrome of cleidocranial dysostosis was first reported by Marie and Sainton in 1898. It is a congenital condition giving rise to a defect in ossification. The principal clinical features are dwarfism, a large head with a small fades, and a depressed or saddle-shaped nose. The clavicles are incomplete or absent, scapulae are small and poorly formed, and frequently the symphysis pubis fails to fuse.

From time to time patients come to one who have had years of unsuccessful psychotherapy and are in desperate need of help. To undertake the treatment of such patients is to face many difficulties. Understandably they are suspicious of the new therapist; it will not do if he reminds them of the one who disillusioned them, but if they come to like or trust him they may feel that they are being disloyal to their first therapist, to whom they still have some attachment. If they notice improvement in their condition it gives them no pleasure, for they know that they have relapsed after appearing to improve in the past. On the other hand, any setback upsets them greatly; they are convinced that they will never get well, and blame either the therapist or themselves or both. They have been made to feel that analysis is the only worthwhile therapy, and that there must be something quite specially wrong with them if it cannot help them as it has helped others; so their depression and sense of failure are reinforced. Often it is not only their psychological condition but also their realistic situation that has deteriorated, sometimes beyond repair.

Amphetamine psychosis and severe amphetamine dependence are now well recognized clinical pictures leading to psychiatric in-patient treatment (Connell, 1964). These pictures, however, are probably seen in only a small proportion of those who take amphetamines. The true assessment of the total incidence of unprescribed amphetamine taking in any group is made difficult by the absence of specific clinical signs (Connell, 1966), denial of drug-taking by the patient (Scott and Willcox, 1965) and the large number of false positives found with the methyl orange screening test (Johnson and Milner, 1966). Gas chromatography for amphetamine substances in the urine (Rowland and Beckett, 1965), though both expensive and time-consuming, provides for the specific detection of amphetamine and many other drugs in the microgram and submicrogram quantities. This paper describes the use of the method to obtain a picture of amphetamine abuse amongst patients in a 20-bedded acute psychiatric ward in a Teaching Hospital.

An epidemiological approach to the problem of suicide may help to identify high risk groups and aid in the design of preventive programs. The aim of the present study was to determine the incidence of suicide among various population groups in Israel and to assess the methods employed. All records of suicide in Israel during the years 1962-63 were extracted from the files of the Central Bureau of Statistics, where data had been obtained from police records. Presentation will be limited to the Jewish population due to a lower reliability of data in the Arab segment.

In two previous papers (Kay et al., 1969a and b) the results obtained from a material of 104 depressed in-patients were discussed. One hundred of these patients were given the Mauds- ley Personality Inventory (M.P.I.) (Eysenck, 1959) at follow-up (5–7 years after the index admission) with the aim of relating M.P.I. scores at follow-up with the symptomatology of the original illness.

The word ‘yoga’ is very old and occurs in early Upanishads like the Katha and the Svetasvatara as well as in Mahabharata but it was Patañjali who attempted for the first time to offer a complete system in his Yoga-Sutra. Authorities differ as regards the exact time of the composition of the Yoga-Sutra. According to some it was written in the second century b.c., whereas others believe that it was composed as late as the fourth century a.d.

Patients are usually referred to outpatient departments by their family doctors, and it is generally assumed that after the initial assessment in the surgery they are directed to the appropriate clinic. However, it is clear that this does not always occur. In some cases there is difficulty in deciding to which clinic a patient may most profitably be sent, and this is especially so when a patient complains of both physical and psychiatric symptoms.

A number of studies have appeared (4, 5, 10, 11, 14, 15, 17, 18, 20, 28, 31, 32) providing evidence suggesting that unilateral ECT admin istered to the non-dominant hemisphere produces less memory impairment than bilateral ECT. It was also concluded in those studies investigating the problem (i.e. all except 10, 14 and 31) that these two methods of treatment do not differ significantly in their therapeutic effects. Some of the studies included a group of patients receiving unilateral ECT to the dominant hemisphere, but the main emphasis in all has concerned differences between unilateral non-dominant and bilateral ECT.

Blood-borne infection is a common complication of the self-administration of drugs of dependence by the intravenous routes. British drug addicts are notorious for their disregard of even the most elementary hygienic precautions. They will use dirty needles and syringes, which are often being used by other addicts as well. They may use unboiled tap water or even lavatory pan water to dissolve the drug for self-injection. They may not clean the skin before injection and in desperate moments may inject themselves through a number of layers of clothing.

In 1964 Lippold and Redfearn described the mental changes induced by the passage of small positive and negative polarizing Currents through the human brain in volunteer patients. They further reported the clinical effects of polarizing the brain in 29 patients with long standing depression (Redfearn et al., 1964), and they also conducted a controlled trial of polarization in depressive illness (Costain et al., 1964). When the head was positive to the leg, an elevation of mood was said to follow, while the reverse was the case with a negative head electrode. In the uncontrolled trial of long standing depressives, 13 were said to show clinical improvement of the 24 who were considered to be adequately treated. In the controlled trial a significant therapeutic effect was rated by both doctors and nurses. Sheffield and Mowbray (1968), using normal human subjects, failed to validate the mood changes said to follow positive and negative polarization. Lifshitz and Harper (1968) found no appreciable effect of polarization in five chronic male schizophrenic patients studied over 14 weeks. The following study was designed to replicate the double blind trial on depressed patients.

Progress in the behavioural sciences is bedevilled by the difficulty in finding adequate controls. This is a report of a patient who in two important respects provided her own control.

The anaesthetic agent propanidid (Epontol) has been extensively reported on in recent journal literature in terms of its general anaesthetic use. Published studies have included accounts of its effect on ventilation (Harnik 1964; Clarke, Dundee and Daw 1964) and on somatic pain (Dundee and Clarke 1965). There has, however, been no reference to a systematic trial of the drug in conjunction with electroconvulsive treatment (ECT), notwithstanding that the manufacturers (Bayer, Handbook 1965) have claimed that it is suitable for such use.

In a previous paper (Pilowsky, Levine and Boulton, 1969) the classification of a group of 200 patients on the basis of their responses to a depression questionnaire and certain other attributes was described. The classification was carried out by using a form of numerical taxonomy based on information theory (Wallace and Boulton, 1968). By this technique the 200 patients were grouped into three classes, labelled A, B and C. Class A was regarded as a mixed group of ‘reactive’ depressions, Class B corresponded to ‘endogenous' depression and Class C comprised a non-depressive group.