In 1963 Ödegård published a catamnestic study of the 5,010 boys and girls who graduated (i.e. left after obtaining the “graduation certificate” by examination) from the high-schools (Gymnasiums) of Norway 1916–20. When this population group was followed until 1950, 117 were found to have been admitted to psychiatric hospitals for a psychosis. This material proved too small for a detailed statistical analysis, and the conclusions, although interesting and suggestive, remained inconclusive.

In this investigation, the subjects were 180 female patients with pure endogenous depressions. These were divided into six different groups of 30 each. Of these groups, four were treated with nortriptyline, amitriptyline, imipramine and MAO-inhibitors respectively, and the results were compared with those obtained in the fifth group of patients who had been given electroplexy only, and finally with those obtained in the sixth group of patients who had received treatment before 1937.

The place of genetic factors in the aetiology of schizophrenia remains disputed. Several surveys have demonstrated a significantly higher incidence of the disorder in relatives of schizophrenic persons as compared to the general population. Furthermore, the closer the relationship, the higher the incidence of schizophrenia. The studies of Kallmann (1938) and Slater (1953) are especially significant and the research in this area has been thoroughly reviewed by Alanen (1958).

The demonstration by previous investigators (Table I), that more schizophrenics have experienced death of a parent in childhood than have control populations, suggests that the bereavement may be of aetiological importance. Gregory (1958) has criticized the methods of such studies, particularly in regard to their difficulty in obtaining well-matched control groups or data relating to the normal population, and the validity of these findings is therefore uncertain. The investigation described in this paper tries to overcome this methodological difficulty by comparing data on ages at bereavement of schizophrenics with those relating to their non-schizoohrenic sibs.

The validity of judgments based upon clinical methods such as interviews or projective tests has been persistently questioned over the past 15 years. The disappointing results of clinicians' efforts to predict the professional performance of Veterans' Administration clinical psychology trainees or Menninger psychiatric residents are well-known examples (Holt and Luborsky, 1958; Kelly and Fiske, 1950). Other investigators (Glass, et al., 1956; Holtzman and Sells, 1954; Plag, 1964; Thorne, 1960) also have reached highly critical conclusions with regard to the validity of clinical procedures, based upon their studies in military settings. Eysenck (1952), in particular, has strongly rejected claims of validity for the clinical approach. Hunt (1959), after many years devoted to the problem, reports progress in achieving stable validities by application of quasi-experimental approaches to the analysis of clinical judgments. Meehl (1954), in summarizing research on the accuracy of clinical judgments more than a decade ago, suggested that such predictions often err because the clinician typically does not know what weights to give the available information nor how to combine the various cues efficiently.

Endogenous depression appears to be frequently associated with autonomic disturbances, and it has been suggested that in this condition there may be some abnormality of the hypothalamus (Elithorn, 1962; Pollitt, 1965), investigation into which might throw light on its aetiology.

In the last decade, much physiological and biochemical information has been collected about the organic role played by the enzyme “true” cholinesterase in the transmission of nervous impulses (Crossland, 1957; Feldberg, 1957; Nachmansohn, 1959); but attempts to explain the function of pseudocholinesterase have been less consistent, and confined mainly to the effects of physical disease (Berry et al., 1954; Koster et al., 1943; Kunkel et al., 1947; McArdle, 1940) with one exception: Richter, (1942) discovered a significant relationship between raised pseudocholinesterase activity and neurotic anxiety or depression. Eysenck commented on this behavioural link (1947), but no further investigations appear to have been carried out in spite of the provocative theme. The possibility of other behavioural abnormalities being associated with an elevated pseudocholinesterase level therefore seemed to merit some attention.

Severe agoraphobia is difficult to treat. Encouraging immediate results have been reported with diverse treatments, including intensive psychotherapy (Friedman, 1959), acetyl choline injections (Sim, 1964), antidepressant drugs (King, 1962) and more recently with behaviour therapy (Wolpe, 1958). It is this latter claim which this paper examines. Early reports (e.g. Meyer, 1957; Wolpe, 1958) suggested that behaviour therapy might prove to be a rapid and effective treatment, but a small series studied by Meyer and Gelder (1963) demonstrated that results were not always as effective as single case reports suggested, and showed clearly that the treatment was often lengthy, taking 80 hours on the average. A retrospective investigation of a larger series (Marks and Gelder, 1965; Cooper, Gelder and Marks, 1965) again failed to support the early claims, although it was shown that behaviour therapy is an effective treatment for circumscribed phobias such as fears of animals and insects.

In this paper “response inhibition” refers to the individual's capacity to refrain from responding in ways that are inappropriate. Inappropriate responding, usually in the form of over-responding, is more natural when we are young; but as we grow older our capacity to inhibit response, and hence our effectiveness, is normally expected to improve.

Light may be thrown on the aetiology of human abnormalities by studying the position in birth order occupied by affected individuals and the age of the mother at the time of their birth. There should be no shift from average population values in either of these respects in the case of conditions directly and solely due to an abnormal gene, though there may be such a shift in conditions due to chromosomal abnormalities, such as mongolism (Down's syndrome). If, however, the question of a chromosomal anomaly does not arise, then departure from normality in birth order and maternal age suggest that environmental factors are involved in the causation of the condition.

The relationship between child and adult psychiatric illness, though of fundamental importance, has received scant attention, perhaps because of the split which exists between the study and treatment of children and of adults.

This report is based on a study of 21 cases of anorexia nervosa treated and followed-up for a mean period of 1½ years.

The lithium ion has been found increasingly valuable in the treatment of manic illness (1, 2). In the therapeutic use of lithium there are two phases, stabilization and maintenance. These data have been reviewed by Gershon and Yuwiler (1), but a clear explanation of the pharmacodynamics involved is not evident. Animal experimentation has been used to study the behaviour of the lithium ion as compared with other cations. The lithium ion's behaviour resembles sodium in some tissues and enzyme systems but is more like potassium in others. These authors have reported a three- to fourfold increase in the tolerance for toxic symptoms due to lithium ion in manic patients as compared to normals. They found that this increased tolerance decreased to normal as the patient's manic state subsided.

Psychiatric disorders occur among all groups of the general population, but it would be difficult to suggest a group of young people in whom the consequences are more serious than that of university students. So much is at stake during the short time spent at university that students cannot afford to be ill for any reason, least of all from psychiatric disorders where the ability to study, the first requirement of all students, is especially impaired. Much of the concern with which university authorities view the mental health of their students is due not only to the widely-assumed relationship between psychological illness and poor academic performance, but also to an increasing awareness of the central role played by emotional factors in the adjustment of the young adult to the new, competitive and often demanding world of higher education. Certainly the suicide rate is one criterion of mental illness which suggests that students are exposed to special risk: it is many times greater for undergraduates than for the equivalent age groups of the general population (Carpenter, 1959; Parnell, 1951; Parnell and Skottowe, 1957). While the suicide rates are high, particularly among students at the older English universities, the actual numbers are very small, and suicide is fortunately only a rare expression of psychological illness among students. Carpenter's (1959) analysis, showing that suicide rates differ in different universities (annual rates of 0.2 per 1,000 living students at Oxford and Cambridge, 0.06 per 1,000 at other British universities), has prompted speculation by university physicians as to whether the case load of psychiatric morbidity among students varies from university to university, and whether this is influenced, adversely or beneficially, by differing cultural and environmental factors in the universities and differing social and demographic characteristics of the student populations.

Introductory View

Bereavement is only the most measurable of many possible traumata in childhood; it is fortunately not the commonest and its frequency is still diminishing.

Conventional Child Guidance treatment includes a diagnostic “work-up” of five to ten hours and then weekly psychotherapeutic and casework interviews for the child and mother which last for months or years and are very expensive of professional time. There have been few reports of evaluation of such treatment, though Levitt (1963) combined the results of a number of studies to include nearly 10,000 child patients. Of those who received treatment, between two-thirds and three-quarters were improved, but a similar improvement rate occurred in those who were not treated. Eisenberg and Gruenberg (1961) found short-term treatment as effective as intensive psychotherapy, and Phillips and Johnston (1954) and Phillips (1960) claimed better results with short than with conventional treatment. Among the few reports from Britain is that of Barbour and Beedell (1955). They found no difference in outcome between treated and untreated cases or between short and long methods of treatment.

The blood pressure response to the injection of the parasympathomimetic drug methacholine (Mecholyl) has been used extensively in psychiatry to delineate various aspects of mental disease. Although originally used in diagnostic classification (Altman et al., 1943), its use, following the investigations of Funkenstein and his co-workers (1948, 1952), has more often been as an aid in prognosis or as a guide to the most useful type of somatic therapy. Investigations into this aspect of the test have resulted in many contradictory reports, and even after so many years there is still no agreement on the test's validity or usefulness.

Huntington's chorea is transmitted by a rare autosomal Mendelian dominant gene. Its hereditary transmission is facilitated by a late onset of the condition in many cases. Often the first signs are not seen until late in the reproductive period, so that it is not uncommon for a patient already to have produced a number of children before the diagnosis is made. On a theoretical basis, 50 per cent. of these offspring are at risk for carrying the gene and consequently for developing the condition themselves.

The aim of this study is to describe by means of certain psychological tests various personality characteristics of those who have made suicidal attempts and to see how they differ from other psychiatric patients and from normals who have not made such attempts at suicide.

In 1963 the Child Psychiatry Section of the R.M.P.A. set up a small committee to study problems concerned with the schools for maladjusted children. The role of the psychiatrist in the ascertainment and subsequent placement of such children varies between one part of the country and another so that there was general uncertainty about the respective roles of the educational and psychiatric services in dealing with maladjusted children.