This study of suicide in Dublin during 1964–1968 from coroners' records was undertaken to estimate the discrepancy between coroners' verdicts, the national suicide statistics compiled from them and the clinical assessment of probability of suicide by psychiatrists examining the same records. The large difference in numbers of suicides deriving from the two approaches has considerable implications for national suicide statistics, and these have been briefly considered. From the findings presented we believe that we are justified in concluding that: (a) there are real differences in national suicide rates, at least between Ireland, England and Wales, and Scotland, and (b) the Irish suicide rate is low, though not as low as official statistics suggest, and (c) the discrepancy between official and ‘true’ suicide rates in Ireland is greater than in England and Wales and in Scotland.

This paper presents an analysis of the factors which influence coroners in their decision to classify some deaths as suicides and others as accidental or ‘open‘. The most important influence on coroners' behaviour was seen to be the manner by which the person died. Those who died by cutting, hanging, drugs or gas were significantly more likely to receive a suicide verdict than those whose deaths were due to drowning, jumping, shooting or poisoning. If the deceased left any intimation of a suicidal intent, this increased the likelihood that a suicide verdict would be returned. Finally, persons aged under 40 were significantly more likely to be returned as suicides than older victims, especially those aged over 70. All of these results show that coroners operate by observing the law as it defines suicide, that is, by looking for evidence of intent of self-inflicted death. Our findings concerning the factors associated with the suicide verdict help to clarify the meaning of the official data on suicides in Ireland, and illuminate the reasons why, using clinical rather than legal criteria, a much higher rate is obtained.

For about fifteen years now a tradition has been evolving in the psychiatric literature towards a taxonomic separation of suicides and attempted suicides, on the assumption that they involve distinct psychogenic factors (Stengel and Cook, 1958; Farberow and Schneidman, 1961). However, even the originator of the distinction agreed that a better understanding of attempted suicide could be gained if it is regarded as conveying a degree of uncertainty that the attempt will succeed or fail (Stengel, 1958), and that the separation of ‘… suicide and attempted suicide … is artificial (as) … it is possible to view suicidal acts as a whole and irrespective of outcome’ (Stengel, 1969, p. 121). The latter view has been reflected in the recent introduction and usage of the term ‘suicidal behaviour’ which includes both suicides and attempted suicides (Hetzel, 1971).

1. The incidence of non-fatal deliberate self-harm throughout the City of Bristol during 1972 and 1973 was assessed by means of a survey of patients presenting to Accident and Emergency Departments of hospitals in the area. Fatal or repeated acts of self-harm were not included in the survey. 2. The rates for females exceeded those for males at all ages, with peak incidence of 645 per 100,000 females (age group 15–29 years) and 334 per 100,000 males (age group 25–29 years). Ninety-three per cent had taken a drug overdose of some kind. 3. The problem was found in all electoral wards of the city, though its distribution was markedly centripetal, with a central area having morbidity rates up to 2.8 times that for the city as a whole. 4. The socio-economic correlates of deliberate self-harm were examined by reference both to a series of 368 patients interviewed soon after the event and to the pattern of its distribution throughout the city. A significant positive association was found with areas of overcrowding, lack of exclusive domestic amenities and high proportion of foreign born residents, but there was no correlation with the proportion of persons living alone nor with the type of accommodation. 5. The central high rate area was found to be heterogeneous in socio-economic terms, ranging from a student and young professionals' bed-sitter area to one with a high proportion of unskilled manual labourers and New Commonwealth immigrants. 6. The aetiological implications of the ecological findings for deliberate self-harm throughout the city are discussed.

Mental and psychomotor speed scores were obtained for three affectively ill groups of bipolar depression, unipolar depression and bipolar mania, and three corresponding recovered groups.

Comparisons were made among ill groups, among recovered groups, and between ill and recovered groups for each illness type. The following conclusions were drawn:

1. 1. Though manic patients solve problems quicker than those of either depressed group, they do not differ much from normals.

2. 2. With stress to work faster, the patients in the two depressed groups can quicken their speed of work and bring it up to the level of the manic patients, even though the latter also increase their speed.

3. 3. On a psychomotor speed task, the bipolar depressives are significantly slower than the manics and the unipolar depressives, who do not differ. ‘Internal distraction’ causes a slight increase in speed in all three groups, with no significant difference, but ‘external distraction’ speeds up the bipolar groups and slows down the unipolar depressives, resulting in significant differences between the bipolars on the one hand and the unipolars on the other.

4. 4. All recovered groups perform at the same level on all measures.

5. 5. Comparison between ill and recovered groups seems to indicate that a manic illness does not affect mental or psychomotor speed significantly when tested objectively. Unipolar depression also does not seem to affect speed functions very significantly, but bipolar depression does decrease both mental and psychomotor speed significantly. Thus only bipolar depressive patients seem to show true retardation, and manic patients do not show the opposite of retardation.

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.

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.

It is common clinical knowledge that parents of schizophrenic patients show an apparent disability to comprehend their children's illness. They often minimize its severity or show complete lack of insight and deny gross psycho-pathological symptoms. The concept of illness by parents of schizophrenic patients is the subject of the present investigation. Investigations of such attitudes are not common in the literature. They are impeded by the lack of appropriate objective techniques of measurement. The Repertory Grid method (Kelly, 1955) provides a flexible and sensitive instrument for investigation of single subjects. According to Kelly's theory, each person has his own unique way of construing. He evaluates a set of elements within his range of comprehension, using Personal Constructs in a network of interrelationships. Difficulties occur, however, when groups of people are to be compared. One can compare groups by the way they use Constructs to evaluate a set of Elements; but one must ensure not only that the Elements are within the range of convenience of all subjects of the group but also that Constructs used by the group occupy some significant place in the construct system of each person of the group. The work reported in this paper was performed in two distinct phases.

Most people are aware of their own age, and are able to give it, at least to within a year or two, without reflection. Correct recall presumably depends upon the information being revised and up-dated with the passage of time, i.e. upon a new learning process. Some demented and mentally subnormal patients may be expected to be deficient in reporting their ages, but little is recorded that would lead one to expect such a defect in patients suffering from a functional psychosis.

In 1965, the Department of Social and Preventive Medicine of King George's Medical College, Lucknow, established an Urban Health Centre in the Alambagh suburb of Lucknow city and registered 500 families representing a cross-section of the resident population with the purpose of training undergraduate and postgraduate medical students in the practice of community health (Gupta, 1966).

This report describes a patient who developed a peculiar movement disorder and delirium after receiving hypnotics and phenothiazines during pentazocine withdrawal.

One of the problems with the administration of unilateral ECT is to select the correct side for giving the treatment. If it is given routinely to the right side of the head, a proportion of patients will receive ECT to the dominant hemisphere, which is more unpleasant for the patient and more disruptive of memory than even bilateral ECT (Halliday et al., 1968; Fleminger, Horne and Nott, 1970).

1. 1. The clinical functioning of the Young People's Unit, Edinburgh is described. This involves a relatively permissive, democratic ‘milieu‘. Psychotherapeutic efforts are devoted to the resolution of family psychopathology and the achievement of maturational progress for the adolescent.

2. 2. Data on the first seventy admittions to the Unit were examined. Two-thirds of the patients were diagnosed ‘developmental crisis’; the majority of these also had a personality disorder.

3. 3. Assessments of family functioning showed high levels of disturbance and psychiatric morbidity among the parents. The adolescents had mutually good, positive relationships with their opposite-sexed parents, but markedly negative ones with the same-sexed parents. This was not in accordance with the usual findings in ‘normal’ families. Delinquent and impulsive patients showed uniformly negative family attitudes.

4. 4. A simple estimation of treatment outcome at discharge gave results comparable to those of other units, with 70 per cent of patients rated as improved. Neurotic and psychotic patients had a relatively better outcome. Tension-discharge personality disorder and a history of very disruptive or antisocial behaviour were associated with poor outcome.

5. 5. The poor response of very disturbed, impulsive adolescents to this type of therapeutic regime is discussed. These individuals do not appear to have sufficient personality resources and organization to benefit from this type of treatment. Emerging from this is a suggestion for an increased provision of specialized units offering containment and intensive care to the very disturbed adolescent.