The Maudsley Personality Inventory (Eysenck, 1959a) measures the two factors of neuroticism and extraversion, which are considered to be independent and relatively stable aspects of personality in normal subjects. Bartholomew and Marley (1959) tentatively concluded that changes in the mental state did not greatly affect the N and E scores, and Mezey et al. (1963) found that the scores re mained relatively constant during depressive illness, although there was a slight increase in neuroticism. McGuire et al. (1963) noted that the relationship between N and E scores ceased to be orthogonal during illness when the scores became negatively correlated. Knowles (1960) found relatively high test-retest correlations in both a normal group and a neurotic group after a year, although the correlations in the neurotic group were lower than in the normal group; he also found some evidence that fluctuations in clinical state influenced the stability of the N scores. Moreover, on measuring neuroticism and extraversion with the Eysenck Personality Inventory (Eysenck and Eysenck, 1964), Knowles and Kreitman (1965) concluded that N (but not E) scores were influenced to a small but significant degree by changes in the patients' clinical state. Coppen and Metcalfe (1965) found that the mean N score of a group of depressed patients decreased significantly on recovery and that there was an associated significant increase in the mean E score. These changes were most marked in patients with endogenous depression. The scores of the recovered patients were within normal limits. Ingham (1966) demonstrated essentially similar changes over a three year period in a group of neurotic patients.

In an article published in 1961 entitled “MPI results in cases of endogenous depression before and after treatment” (7, in Swedish), the authors (Wretmark, Åström and Ölander) showed inter alia that the Lie scale in the Maudsley Personality Inventory (3, 8) has a certain value when it comes to predicting the ability of patients with endogenous depression to regain social function. In view of the restricted material, the authors are careful in their conclusions, but it appears from the article that “high values on the Lie scale can be seen as an unfavourable prognostic factor with reference to the patient's ability to re-adapt to working life after treatment for endogenous depression”.

The Eysenck Personality Inventory (EPI) was designed by Eysenck and Eysenck (1964) to measure two dimensions of personality—extraversion (E) and neuroticism (N). A high N score on the EPI has been found to dis criminate neurotic patients from normals (Knowles and Krietman, 1965; Eysenck and Eysenck, 1964).

Preliminary validation of the Middlesex Hospital Questionnaire (M.H.Q.) was described by Crown and Crisp (ig66). The M.H.Q. is a self-rating scale of psychoneurotic symptoms and traits comprising six sub-tests which are designed to measure free-floating anxiety (FFA), phobic anxiety (PHO), obsessional traits and symptoms (OBS), somatic concomitants of anxiety (SOM), depression (DEP), and hysteri cal personality traits (HYS). McKerracher, Loughnane and Watson (1968) used the Eysenck Personality Inventory (E.P.I.) and the M.H.Q. to delineate the personality of self-mutilating female psychopaths at Rampton Hospital compared with a matched group who had not behaved in this way during the previous year. There were no significant differences between the groups on the E.P.I. neuroticism, extraversion or lie scales. On the M.H.Q., totalscoresand three sub-test scores showed significant differences, which led to clinically relevant hypotheses to account for variations in the patients' behaviour. Mair and Crisp (1968) and Ryle and Lunghi (1969) used the M.H.Q., and the E.P.I. as well as the Kelly Repertory Grid to assess personality changes in individuals during psychotherapy.

Affective flattening is a disorder of emotional expression, of which a good definition is ‘a gross lack of emotional response to the given situation’ (Fish, 1962). It is a clinical sign whose assessment depends upon the clinician's intepretation of the patient's facial expression, tone of voice and content of talk (Harris ' Metcalfe, 1956). Although these are subtle cues, it has been shown that experienced clinicians can assess the severity of affective flattening with a high level of inter-rater agreement (Miller et al., 1953; Harris ' Metcaife, 1956; Wing, 1961; Dixon, 1968). The disorder is usually associated with a diagnosis of schizophrenia, although it may occur in other conditions, such as the organic psychoses (Bullock et al., 1951).

This study was conducted at an out-patient clinic employing group therapy techniques, where some workers felt that a balance between frequent participators and more silent members was advantageous to the group as a whole. As Taylor (1961) has observed, frequent speakers tend to withdraw from groups if not given enough scope for participation. Very silent members sometimes have difficulty in establishing themselves at all, yet the lack of even one active member may lead to a decline in group morale, hence in motivation to continue treatment.

The importance of psychotherapy, as one of the commonest and most distinctive methods of treatment used by psychiatrists, is hardly disputed, although the definition, theoretical basis and effectiveness of its various forms are subject to much debate. In the present article we are concerned with psychotherapy only as a form of service available to N.H.S. patients. Our aims are: (1) to calculate the numbers of patients, living in an area with relatively good services, who are receiving two operationally-defined types of psychotherapy, (2) to estimate the numbers of local patients already attending out-patient clinics who might be referred to a specialized psychotherapy department if certain rules of selection were applied, and (3)to discuss the relevance, if any, of these data for planning local psychotherapy services. The limitations of the material will be obvious and the calculations crude, but they should be adequate to open the subject to realistic discussion.

Various studies of the numbers of patients in mental hospitals have been made, e.g. Brooke (1963); General Register Office (1960); Gore and Jones (1961); Hassall, Spencer, and Cross (1965); Malzberg (1955); Norris (1959); Norton (1961); Registrar General (1958, 1960, 1961, 1962, 1964); Tooth and Brooke (1961), but little attempt has been made to find whether these numbers are subject to natural law. In this paper I have tried to establish this. These researches have been made on the patients of the Central Hospital, Warwick, which has been in continuous use since 30 June 1852. The case sheets of the older patients are accessible; the recent ones are also personally known.

An epidemiological approach to the problem of suicide may help to identify high risk groups and aid in the design of preventive programs. The aim of the present study was to determine the incidence of suicide among various population groups in Israel and to assess the methods employed. All records of suicide in Israel during the years 1962-63 were extracted from the files of the Central Bureau of Statistics, where data had been obtained from police records. Presentation will be limited to the Jewish population due to a lower reliability of data in the Arab segment.

A number of studies have appeared (4, 5, 10, 11, 14, 15, 17, 18, 20, 28, 31, 32) providing evidence suggesting that unilateral ECT admin istered to the non-dominant hemisphere produces less memory impairment than bilateral ECT. It was also concluded in those studies investigating the problem (i.e. all except 10, 14 and 31) that these two methods of treatment do not differ significantly in their therapeutic effects. Some of the studies included a group of patients receiving unilateral ECT to the dominant hemisphere, but the main emphasis in all has concerned differences between unilateral non-dominant and bilateral ECT.

The anaesthetic agent propanidid (Epontol) has been extensively reported on in recent journal literature in terms of its general anaesthetic use. Published studies have included accounts of its effect on ventilation (Harnik 1964; Clarke, Dundee and Daw 1964) and on somatic pain (Dundee and Clarke 1965). There has, however, been no reference to a systematic trial of the drug in conjunction with electroconvulsive treatment (ECT), notwithstanding that the manufacturers (Bayer, Handbook 1965) have claimed that it is suitable for such use.

Patients not uncommonly attend psychiatric clinics with the primary complaint of a cos metic defect in their appearance, e.g. that their nose is big or somehow conspicuous, or that their chin is protuberant or receding. Of the various features concerned, complaints about the nose are by far the most frequent. Such patients also consult plastic surgeons requesting the operation of cosmetic rhinoplasty and it is not unusual for the surgeon to seek a psychiatric opinion about some of the cases he sees, as it has been thought that the motivation of such requests is sometimes complex and the desire for operation may be indicative of psychological disturbance. The surgeons would appear to refer those cases where the defect is minimal or, of course, where severe psychological disturbance is obvious even quite superficially.