Various reports have suggested that the urinary excretion of adenosine cyclic 3'5’ monophosphate (cyclic AMP) is increased in mania and decreased in depression. However, our own serial studies from short-cycle bipolar manic-depressive patients showed no correlation between mood and cyclic AMP excretion (2). Jenner et al. (4) confirmed our findings, except in the case of a patient with a regular 48-hour mood cycle who did show a correlation between his mood changes and changes in cyclic AMP excretion. Paul et al. (5) also reported a general lack of correlation between these variables, but found a transient increase of urinary cyclic AMP during the rapid switch from depression to mania. We have investigated the situation in a bipolar patient who shows such a rapid switch in mood but have been unable to demonstrate any increase in cyclic AMP excretion during the switch period.

The poor prognosis of narcotic dependence is generally recognized, but this is a field in which it is specially difficult to make predictions about the outcome of treatment in the individual patient. Vaillant (1966a) noted that abstinence appears to depend more on the addict's ability to discover satisfying alternatives to his addiction than on methods of treatment. In an attempt to identify prognostic indicators in narcotic dependence a number of follow-up studies have examined the relationship between outcome and various social and psychological characteristics of the patients studied. While most follow-up studies are of male addicts or of samples containing only a small proportion of women, the present study is concerned with the outcome in a sample of 66 female narcotic addicts.

Historically, doctors have not always acknowledged that they have an obligation to prevent suicide, partly because they shared the prevalent idea that most suicides were caused by moral crises, no concern of theirs—and indeed suicide was a criminal matter until quite recently; but more, perhaps, because a fatalism has characterized their attitudes to its prevention, even where the suicide was clearly suffering from mental illness. Yet two recent American studies have shown more than 90 per cent of suicides to be mentally ill before their death (17, 8); this finding and the familiar clinical observation that suicidal thoughts disappear when the illness is successfully treated provide a strong case for a medical policy of prevention.

Psychiatrists, psychologists, and nursing staff are increasingly making direct observations and ratings of ward behaviour. Characteristically, a nurse may be asked to complete a multi-item rating scale on a group of patients during the course of a drug trial. Several factors are involved in the choice of an appropriate scale for a particular purpose. Among these factors are the number of points per item, which defines the sensitivity to change of the item, and the total number of items in the scale, which affects the time taken to complete the scale and hence the frequency of rating that can be permitted in an assessment schedule.

Disturbance of attention has been frequently suggested as one of the mechanisms underlying schizophrenic thought disorder (Weckowicz and Blewett, 1959; Chapman, 1961; Payne, 1966). Much effort has, therefore, been directed toward studying this variable in schizophrenia (McGhie, 1971; Neale and Cromwell, 1972). The approach undertaken has been determined by the psychophysiological and theoretical constructs presumed to be involved. To enumerate a few, disordered attention has been studied with indices of arousal (Venables, 1960; Venables and Wing, 1962), vigilance tasks (Mackworth, 1970), reaction time (Shakow, 1962), size constancy (Weckowicz and Blewett, 1959; Silverman, 1964a), tachistoscopic detection (Kornetsky, 1972), the WAIS Digit Span subtest (Blum et al., 1969), and immediate recall (McGhie et al., 1965). The lack of correspondence between these various procedures has become increasingly apparent (Neale and Cromwell, 1972). In one recent study, for example, the intercorrelations of five purported measures of attention ranged from –.23 to +.31 (Kopfstein and Neale, 1972).

Human conditioning is a remarkable phenomenon. I well remember the feeling of outrage I experienced at Kennedy Airport in New York when I was first frisked a mere two years ago. Nowadays, when I travel by air, at the moment I am to negotiate the last of a series of grids before reaping the reward of an actual seat on the plane, I automatically assume a cruciate position. I am no longer embarrassed, only hopeful that the frisker is sufficiently expert not to tickle and so provoke an ill-suppressed discourteous giggle. All this I rediscovered when leaving Heathrow at the start of the Study Tour of Italy on 10 May 1974.

Recent disputes in the N.H.S. are highlighting a number of problems which have been swept under various carpets of indifference, denial or muddle for a long time. One of these is the number and quality of recruits coming into psychiatry and completing their training. Like almost everything else in Britain, it gets worse as you go further from the London and the South-East area—at least until Hadrian’s Wall is reached. And in this, as in many other respects, psychiatry seems to illustrate the inherent difficulties of the N.H.S. in a particularly striking way.

The analysis of family data in the hope of detecting a recognizable pattern in the distribution of disease may be of value in respect of cause and of prevention. The recognition of classical Mendelian ratios, for instance, is both a partial explanation and an opportunity for genetic counselling which may lead relatives to take eugenic measures. In mentally subnormal populations, however, the occurrence of disease in families often shows more complicated distributions. From knowledge of the relationship between cause and distribution models may be constructed with which empirical data may be compared, for instance, in maternal-foetal incompatibility in respect of some antigen, or in polygenically determined diseases showing threshold effects in liability to disease.

Lionel Penrose's work was essentially concerned with medical genetics and, as this audience is well aware, especially with mental defect. He very seldom published in an anthropological journal, and on the few occasions when he mentioned anthropologists in his writings his remarks were not very complimentary. However, those of us who are in the business can take comfort from the fact that these remarks were generally aimed at an earlier generation of anthropologists who had failed to benefit from what human genetics already had to offer in the years before World War II.

In Orthomolecular Psychiatry; Treatment of Schizophrenia, edited by David Hawkins and Linus Pauling (1973), Beebe and Wendel (pp. 278–302) report a high correlation coefficient of r = 0.99 (which we calculate gives N = 42, p very much lower than 0.001) between whole blood glucose and adenosine triphosphate (ATP). This relationship they claim is no longer maintained in schizophrenics with anxiety, r = 0.16 (N = 62, p > 0.1). Erban and Hanzlicek (1966), Hansen (1972) and Hansen and Dimitrakoudi (1974) have suggested a possible significance of whole blood ATP in psychoses, and Naylor, Dick, Dick, Le Poidevin and Whyte (1973) have implicated red cell Na/K ATPases. The mechanisms involved in controlling blood ATP seemed therefore worthy of study especially if they are so dependent on glucose.

Some controversy exists regarding the notion that personality disturbance is specifically related to temporal-lobe epilepsy. A number of investigators have found no psychometric or psychiatric differences between psychomotor epileptics with a temporal-lobe focus and non-temporal epileptics with ‘centrencephalic’ or diffuse epilepsy or jacksonian sensorimotor epilepsy. But it is possible that the ‘negative’ findings in these studies may be explained by the reported acute psychoses caused by changes in anti-epileptic medication, or by the use of groups that were too heterogeneous or institutionalized and the use of less well-defined psychiatric and psychological variables. However, Janz (1969) has described a more primary, homogeneous, common and not serious form of grand-mal epilepsy, ‘Aufwach’ epilepsy, with psychiatric and Rorschach-test characteristics of a kind different from the corresponding characteristics of ‘Schlaf’ grand-mal epilepsy and psychomotor epilepsy. Furthermore, Meier and French (1965) obtained certain results with the MMPI test for a group of psychomotor epileptics with bilateral EEG temporal-lobe abnormalities. A separate analysis of this group showed that the presence of independent bitemporal EEG abnormalities was associated with the most and highest scale elevations.

The aim of the present study is to investigate probable socio-cultural determinants in the epidemiology of attempted suicide in Trinidad and Tobago. In an earlier paper the author described the clinical features which were noted among those patients who attempted suicide and were admitted to the only psychiatric unit in these islands (Burke, 1974). During the period before this unit was in full operation other workers had noted a tendency for suicide attempts to be made more frequently by women of East Indian origin, who most often reside in rural areas, than among the more urban African ones (Haynes, 1966; Roberts and Russell, 1969). Since those studies a suicide prevention service has been established which admits all patients who attempt suicide. The present study was intended to re-investigate the ethnic sub-cultural findings which occur in the new service. It was hypothesized that there was no difference in the distribution of attempted suicide, between the two sub-cultural groups.

This study concerns the scores on a questionnaire measure of ‘Psychoticism’ of patients with a diagnosed psychotic illness.

Eysenck (1952) postulated the existence of three main dimensions of personality—Extra-version, Neuroticism and Psychoticism. The label ‘Psychoticism’ as used to suggest the hypothesis: ‘that there exists a set of correlated behaviour variables indicative of predisposition to psychoticbreakdown, demonstrableas a continuous variable in the normal population and independent of E and N (Eysenck and Eysenck, 1968a). Psychotically ill patients are held to mark the extreme end of this dimension.