The symptoms of schizophrenia can be interpreted as the result of a defect in the mechanism that controls and limits the contents of consciousness. This defect can be understood as excessive self-awareness. Normally most of the complex information processing which is continuously required by even simple acts of perception, language and thought goes on below the level of awareness; whereas in schizophrenic patients some of this processing, or the results of this processing, not in themselves abnormal, become conscious. This excessive awareness can account for the typical symptoms of schizophrenia and explains many of the specific cognitive abnormalities found in schizophrenic patients.

The phenomenological criteria of prominent Anglo-American researchers on certain so-called passivity experiences, sense deceptions and delusional phenomena, reflecting their interpretations of Kurt Schneider's first rank symptoms of schizophrenia, are examined. In this way the frequent discrepancies and difficulties in delimiting the clinical boundaries of these phenomena more clearly come to light.

Dopamine and its metabolites homovanillic acid and dihydroxyphenylacetic acid, noradrenaline, serotonin and its metabolite 5-hydroxyindoleacetic acid, and tryptophan and its metabolite kynurenine have been assayed in 9 schizophrenic and 10 control brains, together with the monoamine-related enzymes tyrosine hydroxylase monoamine oxidase, dopamine-β-hydroxylase, and catechol-o-methyltransferase. In schizophrenic brains dopamine, noradrenaline and serotonin were significantly increased in some areas of corpus striatum, but there were no significant changes in enzyme activity or monoamine metabolite concentrations in any of the brain areas examined. The findings are not consistent with theories that serotonin or noradrenaline stores are grossly depleted or noradrenaline neurones have degenerated, or that monoamine oxidase activity is abnormal, in schizophrenia, and provide no direct support for the hypothesis that dopamine neurones are overactive.

A method is described for the study of therapeutic factors in group therapy in which patients and their therapists prepare brief reports at regular intervals about those events in treatment which they regard as important; these reports are then assigned by independent judges to a classification of therapeutic factors which has been specifically devised for this purpose. The feasibility, validity and reliability of the method are discussed and its potential application to group therapy research and training briefly mentioned.

Two representative samples of males first notified as addicts during 1969, one by hospitals and the other by penal establishments, were followed up for five years. It was found that 95 per cent of the hospital sample, but only 30 per cent of the penal sample, were addicted to opiates at some time during this follow-up, as judged by Home Office records. Notification may depend as much upon the setting and circumstances in which doctors see their patients as on their clinical judgement of a ‘notifiable’ case of addiction.

A system for monitoring drug use was based on the data from annual surveys of two contrasting population groups, a general cross-section of young people and a cross-section of antisocial deviants. Correlation of deviancy and drug use established that drug use, both licit and illicit, was more extensive among those who suffered parental deprivation, whose parents were divorced or separated, who had psychiatric illness and particularly those who had committed antisocial acts. The degree of antisocial deviancy correlated with the extent of drug use.

From 1972 to 1976 130 epileptics presented 171 times to the Western Infirmary, Glasgow, as medical emergencies with self-poisoning. They constituted 3.5 per cent of 3,733 patients poisoning themselves on 4,121 occasions. Repetition of self-poisoning was commoner in epileptics (18.5 per cent) than in non-epileptics (7.0 per cent). The 130 epileptics have been compared with a non-epileptic group of self-poisoners matched for age, sex, and number of repetitions and have been found to have less alcohol excess but significantly more psychopathy. Possible explanations and prophylactic measures are discussed. In view of the relative incidence of epilepsy and self-poisoning in the community, and of epilepsy among self-poisoners in this and other studies, it is concluded that self-poisoning is a common complication of epilepsy.

In spite of a decrease in the number of electroconvulsive treatments (ECT) administered during the decade 1966–1975, ECT is still commonly used in Sweden. About 4 per cent of all patients admitted for psychiatric treatment during 1975 received ECT. Affective disorders and confusional states appear to be the main indications. Treatment is usually unilateral, with general anaesthesia and muscle relaxants, generally using the same type of ECT machine.

Seventy cases each of temporal lobe epilepsy and grand mal epilepsy were studied for their sexual functioning. The two groups were similar as regards age, sex, duration of illness, frequency of seizures and menstrual and marital history.

A significantly greater number of temporal lobe epileptics were found to be hyposexual. They had a global loss of performance and interest in the sexual sphere and showed no concern over it.

One case in the group of temporal lobe epilepsy, as against none in the other group, was hypersexual. There were no cases of sexual deviations in either of the groups.

The findings of the study are discussed in the light of the relevant literature.

A consecutive series of 46 transsexuals, 35 men and 11 women, showed EEG abnormalities in 48 per cent and borderline abnormalities in another 24 per cent. Women showed the abnormalities in a significantly higher proportion than men. Those with the EEG abnormalities were slightly younger at inception, suggesting that they sought help at an earlier age, and their transsexualism became obvious to their families earlier. Those with personality disorders had EEG abnormalities more frequently, but not significantly so. This group of transsexual patients seemed to have a low sex drive, and those with abnormal EEGs even more so, but again the differences were not significant.

The possible significance of these findings for the understanding of transsexualism is discussed.

Morbid jealousy can occasionally be indistinguishable from obsessive-compulsive neurosis and then be partially amenable to broad-spectrum behavioural treatment. This can involve the partner and includes (a) methods to reduce jealousy and (b) other methods where appropriate, such as social skills training, and sex and marital therapy. This pilot study describes such treatment of four jealous out-patients. Rituals improved in three patients but ruminations in only one. Of three patients who were depressed at the start of treatment, two improved in rituals and in mood. The patient who failed was poorly motivated and did not comply with treatment.

Three cases with torticollis caused by an infratentorial tumour are presented. A father and his son both had a Lindau tumour, and another patient had an ependymoma.

It is stressed that torticollis may be the predominant or only sign of an infratentorial tumour, and that torticollis should always be suspected to have an organic origin.