It has been shown that in depressive states (Sedman and Reed, 1963) and in schizophrenia (Sedman and Kenna, 1963) there is an association between the occurrence of depersonalization, a premorbid insecure personality and depression of mood.

Seventy-six male patients referred to the Maudsley Hospital with a primary complaint of impaired sexual potency were studied in order to define the natural history of these conditions (to be reported). Two of the patients who complained of impotence were found to have intracerebral tumours. In the first case the tumour was limited to the temporal lobe: in the second case it was situated in the posterior part of the frontal lobe.

It is well recognized that the depressed person occasionally commits murder as a consequence of the mood disorder (Mayer-Gross, Slater and Roth, 1960). Despite the popular view to the contrary, there is much evidence that murders are rarely committed in or after epileptic seizures. Alström (1950), in a study of the frequency of criminality in 345 adult male epileptics, did not find any cases of homicide. In a 10-year period, crimes of violence were recorded for 17 per cent of the patient series and 11 per cent. of a control group. All these crimes, however, were minor, usually a complication of the abuse of alcohol. Neither severe bodily injury to others, nor a crime committed during a psychomotor seizure were encountered. He also made the important observation that, while mentally normal patients with idiopathic epilepsy had an incidence of criminality similar to that of the general population, those epileptics displaying mental disorder in addition to fits had twice this frequency of criminal records. Hill and Pond (1952) state that, from their experience in an epilepsy ward and clinic, violent or dangerous behaviour during epileptic or post-epileptic automatisms is rarely seen in any patient. Levin (1952), who studied 52 cases of epileptic clouded state admitted to the Boston Psychopathic Hospital, concurs with this view. He comments that these patients are often potentially aggressive, but their intellectual faculties are so disorganized that they are unable to carry out well-planned integrated behaviour of any kind, including aggressive acts. However, in a clinical and EEG study of 100 prisoners awaiting trial for murder, Hill and Pond, in 1952, found 18 cases of epilepsy, an incidence of epilepsy thirty-two times that of the general population. In all these cases, careful examination of the circumstances of each crime excluded the occurrence of a seizure beforehand with a high degree of probability. They concluded that a relationship exists between epilepsy and murder, although it is not directly a result of the seizure or of its immediate sequelae. In some cases, at least, the common factor may be a mental illness in the epileptic, in which the epilepsy plays an important causative role. Pathogenic factors in such cases include the disturbance of cerebral function by the seizure discharges and also the difficulties in psychosocial adjustment caused by the fits themselves or the underlying organic brain disease causing them.

In their review of the schizophrenia-like psychoses of epilepsy, Slater et al. (1963) document the belief that although epilepsy (especially that of the temporal lobe) often precedes schizophrenia-like reactions, schizophrenia rarely precedes epilepsy. In their review of literature on the co-existence of schizophrenia and epilepsy, Slater et al. found but one reported case where temporal lobe epilepsy developed in a patient already psychotic. Their own series of 69 cases contained no instance of psychosis occurring prior to definite onset of epilepsy.

Despite the apparent relevance of studies of the effects of “perceptual isolation” of the kind reported by Bexton et al. (1954) to some of the problems of abnormal psychology and psychiatry, there seems to be a dearth of plausible hypotheses Unking the consequences of this form of deprivation with clinical, disorders. A good deal of experimental evidence from deprivation experiments has been brought together by Solomon et al. (1961) in the report of a symposium held at Harvard Medical School in 1958. In 1959, however, yet another symposium was held at the American Psychological Association's annual meeting in Cincinnati which it was still found possible to entitle “Sensory deprivation: facts in search of a theory” (see Freedman, 1961; Riesen, 1961; Held, 1961; Teuber, 1961; Hebb, 1961).

The purpose of this investigation was to obtain data on the influence of the subject's conscious knowledge of the content of a posthypnotic suggestion on obedience to that suggestion. Little information is available on this problem, which is one having obvious bearing on hypnotherapy. So that results could throw some light on the hypothesis that hypnosis can be explained as role-playing (Sarbin, 1950), a role-playing control group was employed.

The term post-hypnotic suggestion (P.H.S.) will be used in this paper as meaning the form of words which constitute the suggestion, while by the term post-hypnotic effect (P.H.E.), will be meant the behaviour of the subject consequent on the P.H.S. Quantitative studies of post-hypnotic behaviour using slowing of reaction time (RT) as the P.H.E. have already been described in relation to the duration of P.H.E. (Edwards, 1963), and the influence of amnesia on P.H.E. (Edwards, 1965). The aim of the present study was to investigate the influence on P.H.E. of giving a signal similar to but not identical with the signal defined in the P.H.S. as that which would evoke the P.H.E.

Attempts to correlate diagnosis or prognosis in depression with metabolic or autonomic parameters have been largely unsuccessful. Although electrolyte fluctuations coincide with some cyclical psychoses (Rey, 1957) these may be causal or incidental and their endocrine origin is undefined. Similar difficulties are inherent in studies of autonomic function (Martin, 1960) which have included observations on skin temperature and resistance (G.S.R.), heart rate, pupil reactions and muscle potentials. Much interest has focused on the blood pressure, and the Funkenstein test has emphasized the difficulties of this research. After widespread study and application, its prognostic value, the reliability of its measurements and the basic theoretical assumptions are now largely discredited (Rose, 1962). In the search for reliable objective criteria to evaluate or explain the phenomena of mental illness salivary secretion may prove of considerable value.

German (1961, 1963) reported that serum from schizophrenic patients, in contrast to that from normal individuals and non-schizophrenic patients, when applied topically to the rat cerebral cortex, increased the amplitude of potentials evoked in the somato-sensory area by stimulation of the contralateral forepaw. Furthermore, similar changes were found when urine extracts were tested in the same manner (German and Kemali, 1963; Kemali, 1964).

In 1963, one of us reported that serum from schizophrenic patients, applied topically to the cerebral cortex of the rat, produced a large increase in the amplitude of the electrical response evoked in the cortex by cutaneous stimulation (German, 1963). This effect was not observed when serum from non-schizophrenic control subjects was used.

The number of alcoholics admitted to mental hospitals in the United Kingdom has recently shown a sharp rise. In Scotland the admissions have risen from 732 in 1956 to 1,347 in 1961 (General Board of Control for Scotland) and in England and Wales from 1,285 in 1956 to 2,479 in 1960 (Registrar General). Figures for admission to general hospital units are not as yet available but they may well show a similar rise. Admission rates for alcoholism to Scottish mental hospitals are about four times higher than in England and Wales, and one-third of first admissions of middle-aged men to Scottish mental hospitals are suffering from alcoholism or alcoholic psychosis (Morrison, 1964). The rise in admission rates cannot be taken as indicative of a rise in prevalence; it may be that they reflect other changes, such as the attitude of the patients towards the acceptance of treatment, the attitude of the family doctor towards referral, and the availability of hospital beds.

A number of drugs capable of mono-amine oxidase inhibition have been marketed with the claim that they alleviate depressive illness. One of these is tranylcypromine (‘Parnate’), which has won notoriety on account of the severe headache experienced by those receiving the drug when they also eat ripe cheese (Lancet, 1964). In chemical structure, it is related to amphetamine. Amphetamine is a drug of addiction, and addiction to tranylcypromine was therefore to be expected. A preliminay notice of the present patient has already been published (Le Gassicke, 1962).