Twenty-four manic-depressive artists, in whom prophylactic lithium treatment had attenuated or prevented recurrences to a significant degree, were questioned about their creative power during the treatment. Twelve artists reported increased artistic productivity, six unaltered productivity, and six lowered productivity. The effect of lithium treatment on artistic productivity may depend on the severity and type of the illness, on individual sensitivity, and on habits of utilizing manic episodes productively.

The working of the Mental Health (Scotland) Act 1960 is examined by analysis of compulsory admissions both nationally and to one Glasgow hospital. Comparisons are drawn with England and Wales. Despite a six-fold increase in admissions since 1945 the use of compulsory powers has remained almost constant. It is suggested that an annual number of 45 compulsory admissions per 100,000 population may represent an inevitable basic level as foreseen by the Royal Commission in 1957. Section 31 (‘Emergency Recommendation’) secures 80 per cent of Part IV admissions, and Section 24 (‘Full Recommendation’) is employed in only 25 per cent. Part V accounts for only 300 admissions per annum, mostly remands for psychiatric report. Two suggestions are made for possible future amendments to the Act.

Patients' view of psychiatric care and its implications is a neglected area of inquiry, partly due to ideological factors as well as structural aspects of the National Health Service. It is acknowledged that patient satisfaction per se cannot be the major goal of the Health Services, but the path to improved welfare and treatment may be facilitated by patient satisfaction or at least by an awareness of patient opinion. Further exploration of this area is recommended.

The labelling theory of mental illness and particularly that version formulated by Thomas Scheff has been applied to psychiatry. Studies completed by Scheff have produced considerable evidence to support labelling theory. An attempt is made here to determine to what extent labelling theory applies to a group of British psychiatrists. The results give little support to Scheff's position.

Ninety-two children who had been examined in a psychiatric study of five to twelve year-olds in long-term residential care were followed up four years later. Three-quarters were still in children's homes, but over half had been moved to different establishments. At both the original study and follow-up, the majority showed evidence of psychiatric disorder. Considerable continuity of behavioural pattern was found, particularly amongst those who originally had antisocial disorders, who were also most likely to have had changes of care-taker during the four years. It is suggested that the persistence of their disorder may be due to a vicious circle of unacceptable behaviour and adult rejection.

In view of the previous finding that female deluded depressed patients do not respond to tricyclic antidepressants, a retrospective review of charts of thirteen male patients with primary depression accompanied by delusions was undertaken. None improved on tricyclics alone, whereas all those treated initially with neuroleptics improved. Twelve out of thirteen patients showed no improvement until neuroleptics were added to the treatment regimen. Implications for classification and treatment are discussed.

The authors attempt to integrate several psychoanalytical and more recent neurobiological concepts regarding the development of the organism and emergence of psychopathology. They highlight the rough temporal correspondence of neurodevelopmental myelination cycles with stages of psychosocial development. They discuss concepts of critical periods and unique times of vulnerability to psychosocial insult and recurrence of critical stresses, gleaned from a multidisciplinary point of view, in relation to the occurrence of psychic aberrations. They suggest that it may be fruitful to explore further psychological constructs such as fixation and regression, as well as unconscious mental processes, in relation to their biochemical, physiological, and anatomical representations in the brain.

A model for differentiating cerebral dysfunction in senile, arteriosclerotic dementia, and depressive states is proposed on the basis of electrocortical topographic measures of EEG coherence. Bipolar EEGs were recorded from central, parietal, occipital and temporal areas in 24 elderly patients with a firm clinical diagnosis of senile dementia, senile arteriosclerosis or depression. Power and coherence spectra were computed on 20 second epochs recorded during eyes open, eyes closed and photic stimulation. Significant group differences were reported in both power and coherence measures. Power results were uniform for all channels but coherence values differed significantly with derivation. The best discriminator between groups was EEG coherence estimates between right parietal and temporal derivation. Correlations between clinical symptomatology and EEG coherence supported the direction of the discrimination between groups. The EEG coherence function is discussed as a potential measure of neuro-functional pathology in psychiatry.

An interview schedule was used to record the personality traits of 130 psychiatric patients, 65 with a primary clinical diagnosis of personality disorder and 65 with other diagnoses. The results were analysed by factor analysis and three types of cluster analysis. Factor analysis showed a similar structure of personality variables in both groups of patients, supporting the notion that personality disorders differ only in degree from the personalities of other psychiatric patients. Cluster analysis revealed five discrete categories; sociopathic, passive-dependent, anankastic, schizoid and a non-personality-disordered group. Of all the personality-disordered patients 63 per cent fell into the passive-dependent or sociopathic category. The results suggest that the current classification of personality disorder could be simplified.

The inter-situational, inter-rater and temporal reliability of a schedule for rating personality disorders is described. In an initial study with a simplified form of the schedule in patients from different wards of a psychiatric hospital inter-situational reliability between raters was higher for patients with personality disorders than with no personality disorder. Using the full schedule, inter-rater reliability, using audiotaped and separate interviews, and temporal reliability at interviews conducted a mean of 12.5 months apart all reached a satisfactory level, suggesting that the schedule may be a useful instrument for measuring deviant personality traits. The interview may be used with a subject or an informant but agreement between ratings made with informants and psychiatric patients during illness was low, and the schedule is not recommended for use with patients alone during acute episodes of illness.

In a double-blind trial, female ‘drug-resistant’ chronic schizophrenic in-patients were given high dose or standard dose flupenthixol decanoate for 13 weeks. Plasma flupenthixol levels showed a five-fold interindividual variation, but were consistently higher with the high dose. Analysis of final scores showed no statistically significant differences between groups with regards to mental state, ward behaviour and extrapyramidal side-effects. When compared with pre-trial scores, the extrapyramidal side-effects worsened significantly in the high dose patients and social withdrawal decreased in the standard dose patients. The mental state of a sub-group of patients, possibly drug resistant for pharmacokinetic reasons, improved significantly on the high dose over the 13 weeks.