This paper reports the initial analysis of a series of observations of a number of depressed patients communicating with their spouses and with a third party. This is part of a larger study which arose out of our dissatisfaction with the traditional ways of thinking about depressed patients. By and large there is general agreement about the people who are called ‘depressed’; there are constellations of symptoms and signs which can be evaluated by using one of the many rating scales for depression which have a degree of reliability and consistency. However, we feel that most of the thinking which underlies these efforts is based on presuppositions which would place ‘the depression’ within the patient, that is to say that there is something wrong within the patient which causes the symptoms and gives rise to the signs. These views are reductionist in character and we have by contrast attempted to reexamine certain aspects of depression using non-reductionist ideas.

Over the past year the Society has submitted evidence to the Trethowan Committee, the Lane Committee and the D.H.S.S. Committee considering the ethical aspects of behavioural modification programmes. In each instance the evidence has been based on questionnaires or on draft statements amended in the light of members’ invited comments.

Likewise, early draft reports of Study Groups are submitted to all members for comment and rewritten to accommodate views expressed. The Study Group finally passes the Report to the Executive Committee for further amendment or approval prior to distribution as a Study Group Report to all psychiatrists in the British Isles and to members overseas.

The educational attainment of 100 school-phobic youngsters was compared to that of 100 other psychiatric patients, using the reading quotient as the main measure. Age and IQ were allowed for. RQs were, on average, higher in the school phobic group than in the other subjects, except in a small number of younger children of high IQ. Additional comparisons with another group of psychiatric patients and with the general population, using regression equations, failed to provide any evidence of poor educational attainment in school phobia.

The main questions of diagnosis and classification of depressive illness put forward by Sir Aubrey Lewis in the 30's are still under discussion. Despite the many published clinical studies of affective illness, there remain—as recently stressed by Klerman (1971)—problems requiring further description and investigation.

Those interested in the family backgrounds of delinquents have paid a good deal of attention to family size and position in family (see Mannheim, 1965, for a review), but little to the ratio of brothers to sisters. This is surprising, since it can be argued that boys who come from families with a preponderance of brothers may be particularly at risk of delinquency; for example, their parents might find it difficult to control them; they might be more likely to play out on the streets and thus have greater opportunities for delinquency; and, since delinquency is a predominantly male activity, they might have a greater chance of being set a bad example through the behaviour of their brothers.

The Marke-Nyman Temperament Scale (MNTS) is a questionnaire based on Sjöbring's theory of personality structure.

The function of religion in human society is complex. The part played by religion in psychiatric disorders is even more obscure. Previous literature and theories are divided into two groups: one school believes that intense religiosity is a symptom-complex indicative of psychiatric disorder, while the opposing view is that religious belief in some way acts as a defence mechanism protecting the individual and his psyche.

The present study of 50 Jehovah's Witnesses admitted to the Mental Health Service facilities of Western Australia suggests that members of this section of the community are more likely to be admitted to a psychiatric hospital than the general population. Furthermore, followers of the sect are three times more likely to be diagnosed as suffering from schizophrenia and nearly four times more likely from paranoid schizophrenia than the rest of the population at risk.

These findings suggest that being a member of the Jehovah's Witnesses faith may be a risk factor predisposing to a schizophrenic illness. Further studies would be interesting in investigating whether pre-psychotic people are more likely to join the sect than normal people and what part (if any) membership has in bringing about such a breakdown.

During 1973 there were 169,362 abortions notified to the Chief Medical Officer at the Department of Health. In a leading article the British Medical Journal (1973) acknowledged that ‘bald statistics cannot help to answer the important question of the nature of the physical and emotional sequelae of termination of pregnancy’. The article called for careful prospective studies to assess such sequelae. This paper is a report of a short-term prospective study of the psychiatric sequelae.

Since the discovery of adenosine 3'5'-cyclic monophosphate (cyclic AMP) by Sutherland and Rall (1958), the concept has evolved that this nucleotide acts as the second messenger substance for many neurotransmitter and hormone-induced responses (Sutherland, Robison and Butcher, 1968). Cyclic AMP occurs in high concentration in the brain. Cyclic AMP is functionally closely related, and possibly fundamental, to the action of catecholamines and serotonin, both of which have been implicated in the amine hypothesis of depression (Granville-Grossman, 1971). Cyclic AMP is formed from ATP by the action of an enzyme adenyl cyclase, and it is degraded by the enzyme cyclic-AMP-phosphodiesterase (Lancet, Editorial, 1970) both of which occur in brain.

The technique of measuring penile erection is the most valid assessment of sexual arousal in males (Zuckerman, 1971). The stimuli used during assessments of sexual preference with this technique have for the most part, been still or moving pictures of nude single females and males (Freund, 1963; McConaghy, 1967; Barlow, Becker, Leitenberg and Agras, 1970). Recently Abel, Barlow, Blanchard and Mavissakalian (in press) have shown that erotic films produce significantly greater penile circumference changes than either slides or audiotaped descriptions in homosexual males. Similarly, Sandford (1974) showed the superiority of films over slides in heterosexual males and suggested that sexual activity rather than nakedness per se may be the more important in producing sexual arousal. The main purpose of this study was to determine what sexual activities produce significantly different sexual responses in homosexual and heterosexual males.

Last November the new Charing Cross Hospital at Fulham was the scene of a ‘Medical Careers Fair’— the purpose being to provide undergraduate medical students with facts and informed opinion about the specialties open to them. Our College was represented, and we went along on the second day to provide some opinion.

Although there have been many accounts of depression in medical in-patients, there have been relatively few systematic studies of its prevalence and features. With respect to prevalence, most studies have concerned single medical diagnoses (4) or have been based on ward referrals to psychiatrists, in which referral practices may be of more importance than actual occurrences (10). Schwab et al. (12, 13) studied prevalence in 153 medical patients. They used multiple rating scales and compared depressed and non-depressed patients to investigate aetiological factors. Stewart et al. (14), who carried out a smaller study, also compared symptoms of five medical depressives with those of manic depressives.

In a cross-national comparison of the frequency of occurrence of various diagnoses among elderly psychiatric patients admitted to public mental hospitals in London and New York, a short battery of psychological tests was administered to all patients independently of psychiatric examination. The psychological assessment was focused on the differentiation between dementing and affective disorders. The test performance showed a highly significant difference between the two groups as diagnosed, and when patients were allocated to groups on the basis of tests alone these allocations showed a high rate of agreement with initial psychiatric diagnosis. There was a similar high rate of agreement between test allocation and hospital diagnosis in the U.K., but this was not so in the U.S.

No significant differences were found between the test performance of U.K. and U.S. patients, except on the WAIS Vocabulary and the Angles Error measurement of the Bender-Gestalt test. When the effects of age and Vocabulary score were eliminated these differences disappeared.

The hypothesis that the diagnosis of affective disorder would be confirmed by a relatively greater improvement in test performance over time in this group of patients was not upheld by the non-parametric analysis of change scores. However, an analysis of covariance utilizing age and initial score did indicate the expected differential improvement.