This paper presents a replication of a study by Kiloh and Garside (1963). These workers carried out a factor analysis of 35 clinical features of 143 depressed patients. They demonstrated the presence of a factor which showed strong positive loadings with the clinical features classically accepted as characterizing neurotic depression and strong negative loadings with the clinical features characterizing endogenous depression. Of the 143 patients, 92 were diagnosed as more definitely suffering from endogenous or neurotic depression. Correlation coefficients were calculated between the diagnosis in these 92 cases and each clinical feature.

Many instances of regular cyclic or periodic psychiatric and clinical syndromes have been reported (Richter, 1957). The duration of each cycle varies from 2 days to 18 months but is usually constant in a given subject and bears no relationship to external factors. Presumably they have their origin within the body, and a disturbance of endocrine function has been suggested in many cases. Some women show cycles corresponding to the menstrual rhythm, the abnormal phase preceding or accompanying the menstrual flow.

Multitudinous factors play upon each patient; among them are the patient's relationship with the doctor, with other patients, with nurses, relatives, employers and a host of others. Many of these factors are unknown. This investigation is an attempt to put a numerical value on one facet of one factor and assess its relationship to a patient's recovery. The factor measured is the amount of attention given to each patient by the doctor.

On 30 March, 1966, at the Symposium “Enzymes in Mental Health” sponsored by the Carl Neuberg Society for International Scientific Relations, A. Hoffer (1) described the apparently successful treatment in 13 of 17 (acute and chronic) schizophrenic patients in 3 to 5 days by the daily oral use of 1 to 2 grams of nicotinamide adenine dinucleotide (NAD), better known as diphosphopyridinenucleotide (DPN). Widespread publicity given to this announcement attests to the need of more effective treatment for this illness. It also occasioned frequent and persistent inquiry from schizophrenic patients and their relatives as to the suitability of this treatment in their own instance. Rapid confirmation of the findings would justify widespread efforts to evaluate this preparation, whereas failure of confirmation would provide reasonable grounds for a more cautious approach to its use. The members of the Council of the American College of Neuropsycho-pharmacology decided that, as a group of impartial scientists, it would be appropriate for them to carry out such an investigation as rapidly as was compatible with adequate determination of the usefulness of the preparation.

In the previous paper a comparison was made between short-term outcome of two groups of 50 schizophrenic patients each, admitted to the Professorial Unit of the Maudsley Hospital before and after the introduction of reserpine and phenothiazines into treatment. It was shown that patients admitted in 1956/57 (Group B) had a better prognosis in terms of condition on discharge and length of stay in hospital than those admitted in 1952/53 (Group A).

This is the first of a series of papers reporting studies of various cognitive disorders in schizophrenia. The present paper deals with the validity of certain tests as measures of thought-process disorder: subsequent papers will relate type of disorder to various sub-categories of schizophrenia, as diagnosed clinically and by the Symptom-Sign Inventory (Foulds, 1965).

This paper reports and discusses the occurrence of transvestism in three members of the same family, over two generations. No similar series of cases has been found in the literature. Lukianowicz, in his survey of the subject, mentions two cases in which there was a suspicion of transvestite tendencies in another member of the family. Taylor and McLachlan mention that two brothers of one transvestite in their series were said to have symptoms similar to those of the patient. They located one of the two, but decided not to include him in their series because “his cross-dressing was not without strong and persistent criminal motives. He posed as a prostitute and carried a weapon with him to assault his ‘customers' before robbing them.”

The recent proliferation in mental hospitals of industrial units has created a need for some system of reporting on the work done by patients undergoing treatment in them. This paper is based upon four years experience of using a particular report form, provides some data about the validity and reliability of the form, discusses its shortcomings and concludes with a recently amended version of the form which it is hoped will be superior.

In previous communications (6, 9) we have presented data indicating that affective disorder (manic depressive disease, involutional depressive reaction, neurotic depressive reaction, psychotic depressive reaction) is more frequent in females than in males. More specifically, in a total sample of 366 affective disorder probands there was a ratio of 1·9 females to every male; and in the parents of the probands a statistically significant excess of mothers as compared to fathers was found to have suffered from the same illness. Calculations done on the same proband group revealed that alcoholism was significantly more prevalent in the fathers and siblings of the affective disorder group than in a matched control series. It appeared that if one added the alcoholic fathers to the affectively disordered fathers one found a prevalence of psychiatric illness in fathers which was similar to the prevalence of affective disorder itself in the mothers. Thus, it seemed that the deficiency in affective disorder diagnoses in fathers was made up by alcoholism.

A revival of interest in psychiatric classification has led to the use of statistical techniques such as factor analysis to help describe the depressive population. Several recent factor analytic studies rating symptoms in depressed patients have had results which portray a common clinical pattern (Hamilton and White, 1959; Kiloh and Garside, 1963; Rosenthal and Klerman, 1966b; Rosenthal and Gudeman, 1967). In each of these studies the first or primary factor has suggested the endogenous depressive pattern. In the most recent of these papers we presented the first factor in our study of 100 depressed women (Rosenthal and Gudeman, 1967). This factor was shown to be similar to the principal factors of the other studies, and to suggest the “endogenous” or “autonomous” pattern. This replication has been an encouraging indication that studies carried out in different patient populations may indeed give reproducible symptom patterns.

Therapeutic community principles have in recent years become increasingly and often enthusiastically applied. They have also attracted an extensive literature, including, among many, studies by Maxwell Jones (1952 and 1962), Cumming and Cumming (1962), and the contributions to two symposia: in Boston, edited by Greenblatt, Levinson, and Williams (1957) and in this country by Freeman (1965).

It is now widely accepted that abreaction as a technique can most usefully be applied in the field of psychoneurotic reactions arising from exceptionally traumatic experiences. During the last world war, ether and intravenous barbiturates were extensively used in the treatment of battle neuroses, often with dramatic results (Sargant and Slater, 1940; Shorvon and Sargant, 1947). For the less spectacular syndromes of peace-time, such methods are probably best applied to investigation and elimination of resistances encountered in the therapeutic situation (Horsley, 1943).

The effect that childhood experience may have upon the individual's adult life has always been a subject of great interest.

Since the publication of Freud's essay on “Mourning and Melancholia” (1917), much thought has been devoted to the influence of bereavement in childhood, more especially as an antecedent to depressive illness in the adult. Bereavement is peculiarsluyitable for such an investigation since the death of a parent is one of the few reasonably frequent events which are largely independent of the behavioural pattern of the family.