To overcome common limitations in assessing the outcome of psychotherapy, the following method was used: independent assessment by teams of experienced psychotherapists; individualized measures of outcome; and videotaped clinical interviews to allow the judges to rate, at one sitting, a patient's clinical state before and after eight months of therapy. Agreement between the judges' ratings was low both for the severity of the clinical state and for its outcome. Possible reasons for this low agreement are discussed.

Red blood cells (RBCs) from normal volunteers were incubated in vitro at four different extracellular lithium concentrations. Extracellular lithium concentration affected RBC lithium accumulation in several ways. As extracellular lithium concentration increased, the inter-individual variability of RBC lithium accumulation increased. Furthermore, the ratio of RBC lithium concentration to extracellular lithium concentration (lithium ratio) increased in relation to increasing extracellular lithium concentration. A lack of agreement among the authors of recent reports dealing with the significance of the lithium ratio as a psychobiological measure has been noted. It is suggested that this lack of agreement may be due, in part, to the study of patients with differing levels of extracellular lithium.

Parasuicide is not a single syndrome. Subtypes at present recognized are based largely on clinically derived stereotypes. When considering a series of patients, the clinician is unable to handle more than a few attributes at a time. This paper describes the application of three very different clustering algorithms to a material of 350 treated parasuicide patients. Mathematically, three types emerge. Clinically, two of these are interpretable and make sense. The types established are: I (n = 107) a group not characterized by any of the variables we examined; this group is a puzzle, mainly because the reasons for the parasuicidal act are not clear. II (n = 132) a depressed, alienated group with high life-endangerment. III (n = 111) a group whose act was highly operant: they felt alienated and were angry with others. These groups did not differ significantly on demographic variables. The usefulness of this typology, particularly for management, after-care and prevention, has now to be assessed.

Findings are presented on 42 children of school age, the offspring of 26 adult psychiatric patients. Psychiatric disorder was found in 19 (45 per cent) of the children, compared with 12 (26 per cent) of 47 children from a control group of families.

Families with disturbed children differed from the remaining families in the following ways: presence of frank marital discord, the diagnosis of personality disorder in the parents, the inability of the father to tolerate angry situations, and the presence of siblings of under 9 years of age. Six months later, 9 of the 19 children had improved considerably. In almost every family this was associated with improvement in the condition of the parents.

It is suggested that the psychiatric disorder of these children is reactive to the presence of emotional turmoil in the families.

This paper develops a structural equation model to assess the effects of mental state on EPI scores. This model is applied to results obtained from a clinical population. The findings show that: (a) the E scale is not influenced by mental state as measured by the Hamilton Anxiety Scale (HAS); (b) the N scale is influenced by HAS. An attempt to revise the N scale to produce an un-contaminated score is discussed.

Ninety-six out of 137 consultant psychiatrists working for the majority of their time in the London area outside academic units returned questionnaires concerning attitudes to their work. Analysis of the 88 fully completed questionnaires suggested the existence of four relatively discrete but overlapping patterns of psychiatric practice in the Regions concerned, of which two largely excluded individual psychotherapy. These findings are discussed in relation to the education in psychotherapy of trainee psychiatrists working in mental hospitals.

One hundred and thirty-three Chinese schizophrenic patients first seen in 1965 were traced for a follow-up assessment in 1975. Eighty-two patients attended and were fully evaluated, 47 failed to attend and 4 were known to have died. The course and outcome were graded into four categories, and it was found that 65 per cent of the fully evaluated group had full and lasting remission or showed no or mild deterioration only, despite some relapses. Intra-group comparison showed that being female, a shorter duration of illness, an acute onset, symptom-groups other than disturbances of emotion and volition, and the presence of a supportive relative are factors which affect the prognosis favourably.

In a group of 99 three-year-old children with behaviour problems identified in an epidemiological survey, family and social factors were compared with those in a group of controls. Behaviour problems were significantly associated with a strained marital relationship between parents, with social stresses and with type of housing. There was a high rate of maternal depression in both problem and control groups. The interaction between a behaviour problem in a young child, maternal mental health and social factors is discussed.

In a double blind chlorpromazine-controlled trial, high dosage haloperidol (100 mg daily) given for three months, appreciably improved the mental state of male chronic ‘drug resistant’ schizophrenic in-patients in the rehabilitation/long-stay unit of one psychiatric hospital. The results of a three-month follow-up suggested that the improvement could be maintained in some patients on lower doses of the drug.

Serious extrapyramidal side effects were not seen at high doses. However, the majority of patients on haloperidol showed a deterioration in ward behaviour, possibly related to drowsiness, and developed raised serum alkaline phosphatase levels. These side effects disappeared in the follow-up period when either the drug was discontinued or the dose of haloperidol reduced.

A statistical association has been found between reports of suicide inquests in a local paper and the subsequent suicide of men under 45 years.