Showing papers in "British Journal of Psychiatry in 1971"

Studies in the childhood psychoses. I. Diagnostic criteria and classification.

Abstract: 1. Three major groups of psychoses in child hood can be distinguished by their age of onset: under 3 years, 3-5 years and over 5 years. 2. Diagnostic criteria are proposed for the first and third groups, based on the work of Kanner and Creak for the first, and Fish (in adult schizophrenia) for the third. 3. The study reported in the following papers tests the value of distinction by age of onset and establishes the frequency of occurrence of the different signs in the different clinical groups, leading to discriminants for differential diagnosis.

Classification of Depressed Patients: A Cluster Analysis Derived Grouping

Abstract: One hundred and sixty-five depressed patients from a variety of treatment settings were rated as to clinical symptoms, previous history, life stress, and premorbid neuroticism, and the ratings were subjected to a special cluster analysis for classifying individuals. The results indicated a hierarchical structure of groups. At the first level there were two groups, one older and more severely ill, one younger and more mildly ill. Subsequent division of each of these produced four approximate groups. One group was characterized by a severe illness, sometimes with delusions, on a background of good premorbid adjustment, and corresponded to psychotic depressives as described in the literature. A second group consisted of moderately depressed patients with a strong admixture of anxiety, a high incidence of previous illnesses and high neuroticism scores. A third group comprised depressives with a considerable element of hostility; and the last group contained young patients whose relatively mild illnesses developed on a background of personality disorder. These groups resemble other groups of depressed patients previously described in the literature. They are also consistent with the psychotic-neurotic dichotomy, but suggest that non-psychotic depressives are diverse and comprise several groups. The emergence of these multiple and easily interpretable groups of depressed patients also suggests the utility of suck cluster analysis grouping techniques for studying the classification of psychiatric patients.

Studies in the childhood psychoses. II. The phenomenology of childhood psychoses.

Abstract: 1. Eighty psychotic children studied at Oxford or Newcastle have been classified as suffering from infantile psychosis (I.P.) if the illness began before the age of 3, or from late onset psychosis (L.O.P.) if it began later than 5. 2. This division was found to correspond to a distinction in clinical phenomena. The L.O.P. group displayed disorder of form and stream of thought and disordered thought content, were commonly hallucinated (especially auditorily), auditory and showed perplexity or an attitude of suffering. The I.P. group showed none of these but was characterized by severe speech delay and many speech anomalies, especially echolalia, by unusual responses to noises, by indifference to pain, by overactivity, by stereotyped movements, by self-directed aggression and a spread of compulsive acts, and by poor relationships with others especially as shown by gaze avoidance. 3. The problems of accurately assessing the presence of these and other clinical phenomena are discussed. 4. By ranking the symptoms in each group according to their frequency of occurrence it is made clear which particular symptoms are diagnostically discriminant. 5. L.O.P. cases with a simple schizophrenic picture may be confused with I.P. cases of the same age if a clear history is not available, but cases with pronounced symptoms are easily distinguishable.

Prospective study into puerperal depression.

Abstract: A prospective study of mood changes through pregnancy and puerperium was undertaken by a research group centred on the North Middlesex Hospital, Edmonton, London. Data collected from 189 women revealed an evolution of mood changes in those who later developed puerperal depression, which was characterized by anxiety at the first ante-natal visit, elation during later pregnancy and depression in the puerperium. The findings were in agreement with other workers in this field. The arguments in favour of a hormonal aetiology of puerperal depression are presented.

Depression Across Cultures

Abstract: The relevant literature on the differences in symptomatology of depressive illnesses in different cultures has been reviewed. A note has been made about the impressionistic nature of most of the reported studies. The symptoms exhibited by one hundred depressives from two North Indian clinics were studied in detail and rated on the Hamilton scale for depression. A statistical comparison was made of the symptoms seen in our patients with the symptoms of a study on 30 South Indian depressives and 116 and 143 British depressives reported in two studies from Newcastle upon Tyne. It was seen that somatic symptoms, hypochondriasis, anxiety and agitation were present in a significantly larger percentage of Indian depressives. The study did not support the frequent reports of less incidence of guilt feelings among the depressives from the East. A difference in the content of guilt feelings is, however, likely. Obsessional and paranoid symptoms were significantly less frequent among the Indian depressives. Possible explanations for the various observed differences have been offered.

Alcoholism IV. Is there more than one type of alcoholism

Abstract: Two hundred and fifty-nine alcoholics have been studied clinically. In addition, family histories of psychiatric illness were obtained and 507 first degree relatives were personally. interviewed. Clinically, there are three major groups of alcoholics, (1) primary alcoholics, (2) depression alcoholics and (3) sociopathy-alcoholics. Males predominate in the first and third groups; females in the second group. In first degree family members, alcoholism is more frequently seen for the primary alcoholism group, depression for the depression alcoholism group and sociopathy for the sociopathy-alcoholism group. Nevertheless, for various classes of relatives this kind of segregation does not stay consistent. In all three groups similar percentages of first degree relatives have alcoholism or depression. However, most ill male relatives have alcoholism, and most ill females have depression. The data may indicate three types of alcoholism, or alternatively the possibility that males and females differ in the way they express the illness. Because of the inconsistency in the various classes of relatives, the latter interpretation is probably correct, i.e., that in families of alcoholic probands, ill female relatives express their illness mostly by depression and sometimes by alcoholism, and ill male relatives express their illness mostly by alcoholism and sometimes by depression.

The chronicity of schizophrenia in indigenous tropical peoples. Results of a twelve-year follow-up survey in Mauritius.

Abstract: A twelve-year follow-up of mental hospital patients on the island of Mauritius was carried out to test the impression that the functional psychoses in indigenous African and Asian populations run a less chronic course than among Europeans or North Americans. The present paper concerns those cases labelled schizophrenic, and it is shown that (a) their incidence rate is very close to British rates; (b) the percentage found functioning normally and symptom-free on follow-up is higher than in comparable British samples; and (c) they show fewer relapses in the period between discharge and follow-up than a comparable British sample did. Judging by the symptoms at time of admission there is no reason for thinking that the label of schizophrenia had been misapplied, and the better outcomes cannot be accounted for in terms of better treatment, shorter hospitalization, easier environmental conditions or more liberal standards of outcome. It is therefore suggested that the question of chronicity in schizophrenia needs re-examination, with more attention being paid to the course of the disease in non-European peoples.

Anxiety and the effects of sodium lactate assessed clinically and physiologically.

Abstract: 1. Pitts and McClure reported that anxiety attacks could be produced in anxious patients by the infusion of sodium lactate, and they formulated a new theory to explain how this was achieved. To test their findings, 20 patients suffering from anxiety neurosis and 10 normal controls were given an intravenous infusion of saline followed by one of sodium lactate, and 12 minutes after the infusion ended they were stressed by mental arithmetic. Throughout the procedure, psychological and physiological arousal were monitored by observer and self-ratings of anxiety, forearm blood flow and heart rate. All these measures increased significantly when the intravenous cannula was inserted. 2. Eighty-five per cent of the patients experienced an anxiety attack during or after the sodium lactate infusion, as compared with only 5 per cent during normal saline. The number of anxiety symptoms and mean observer and self-ratings of anxiety, forearm blood flow and heart rate were higher during the lactate than during the saline infusion. 3. The maximum anxiety produced in the patients by sodium lactate, as measured by these variables, was significantly greater than that produced by the insertion of the intravenous cannula. 4. None of the controls experienced an anxiety attack during the saline infusion, as compared with 10 per cent during lactate. 5. Lactate produced more symptoms, and these started sooner in patients than in controls, and the number of symptoms per subject and number of anxiety attacks produced in our study were similar to those reported by Pitts and McClure. 6. Sodium lactate provides a biochemical means of producing anxiety in the laboratory which may prove to be useful for testing the anti-anxiety effect of various types of treatment. Eight patients who had experienced lactate-induced anxiety attacks were subsequently treated with M.A.O.I. antidepressants; those who responded well clinically experienced fewer symptoms during a repeat lactate infusion. 7. The Pitts and McClure hypothesis for explaining the relationship between anxiety and sodium lactate may not be correct, but more information about the biochemical changes involved may further our understanding of the aetiology and treatment of anxiety.

A study of facial dyskinesia in a mental hospital population.

Abstract: All those resident for more than three months in a regional mental hospital (426 men and 484 women) were examined for the presence of facial dyskinesia (bucco-linguo-masticatory triad). This was found in 15.3 per cent of men and 30.5 per cent of women. Phenothiazines, brain damage and length of stay in hospital all have some association with dyskinesia, but it is probable that these and other factors are contributory and that age and constitutional factors are more important in the genesis of these movement disorders. In rare individual cases dyskinesia appears to be caused by phenothiazine exposure, but in general the association between the two is of theoretical rather than clinical significance.

Comparative Effects of Lithium and Chlorpromazine in the Treatment of Acute Manic States

Abstract: A controlled double-blind evaluation of lithium and chlorpromazine in acute manic states is reported. Analysis of the results shows that lithium produced a highly significant improvement in the manic-depressive (manic phase) patients but no significant change in the schizoaffective (excited) patients. Chlorpromazine produced significant improvement in both diagnostic groups. An analysis of the differences of the two treatments showed that lithium produced the greater change in the manic-depressives, whereas chlorpromazine produced more change than lithium in the schizoaffective group. These differences, however, did not reach statistical significance. The importance of diagnosis for treatment outcome is discussed. Lithium is an effective and specific agent for the control of the manic phase of manic-depressive illness.

Flooding versus Desensitization in the Treatment of Phobic Patients: A Crossover Study

Abstract: Over the past five years several studies have suggested that flooding and its analogues reduce fear in animals and in man. The literature on analogues of flooding in animals was surveyed by Baum (1970), who himself demonstrated that prevention of a conditioned avoidance response in rats extinguishes the response (Baum, 1966). The longer the duration of response prevention, the quicker the extinction of the avoidance response (Baum, 1969a). The greater the shock trauma involved in the original learning of the response, the longer the response prevention had to be before the avoidance response was extinguished (Baum, 1969b, 1970). In phobic human volunteers controlled studies showed that flooding in imagination reduced avoidance responses to rats (Hogan and Kirchner, 1967, 1968; Kirchner and Hogan, 1966), and that the technique worked more quickly than desensitization (Barrett, 1969) in improving snake phobias. An analogue of flooding—exposure in real life with response prevention—was also shown to be more effective than desensitization for the reduction of snake phobias (Strahley, 1965). Two studies found, however, that desensitization was superior to flooding for the reduction of snake phobias (Mealiea, 1967) and mouse phobias (Willis and Edwards, 1969), while in a further two reports flooding was not significantly different in effectiveness from desensitization for the reduction of snake phobias (de Moor, 1970) or stage fright (Calef and Maclean, 1970).

An Attempt at Validation of Traditional Psychiatric Syndromes by Cluster Analysis

Abstract: Clinical data from two unselected series of patients were subjected to cluster analysis in order to find out whether clusters of patients corresponding to existing diagnostic categories could be obtained. Each series consisted of 250 consecutive admissions, one to an English area mental hospital and the other to an American state hospital. From the extensive clinical data available for each patient 70 items were chosen, and these were transformed into ten factors by principal component analysis. Both the American and the English data were then subjected to two different methods of cluster analysis—Wolfe's Normap and Everitt's Class 1—using scores on these ten components as input. All four analyses produced separate clusters identifiable with the manic and depressive phases of manic-depressive illness, with acute paranoid schizophrenia and with chronic or residual schizophrenia. Of these the manic and paranoid schizophrenic were the most and the chronic schizophrenic the least well defined. Patients with depressive and other neuroses, with personality disorders, and with alcoholism showed no tendency to form distinct clusters in any of the four analyses. The significance of these findings for psychiatric nosology is discussed. The finding of relatively well defined clusters of patients in this and other similar studies suggests that within the field of psychotic illness a typology may be the most appropriate form of classification, in spite of the lack of evidence for the existence of genuine boundaries between syndromes. Perhaps the most useful form of classification will eventually prove to be a combination of a dimensional system with a typology.

The Relation of Pain to the Eysenck Personality Inventory, Cornell Medical Index and Whiteley Index of Hypochondriasis

Abstract: The relationships between pain, its communication, personality, physical symptoms and attitudes to disease have been explored in 52 women with carcinoma of the cervix. Three groups emerged: those who were pain-free, and those who experienced pain but did, or did not, communicate this to nursing staff. Mean EPI neuroticism and extraversion scores of all patients were comparable with those of normal housewives. Lie scale scores did not differ between the three groups, but trends indicate that the presence of a raised neuroticism score is a prerequisite for the development of a `social desirability set' indicated by a raised L score. Current concepts concerning the significance of N and E personality factors are discussed and related to the score patterns obtained for each group. Pain-free patients had low N and high E scores, indicating a low degree of emotionality coupled with the potential to communicate freely. The second group, who experienced pain but did not complain, had high N and low E scores, indicating increased emotionality and a tendency not to communicate their distress. The third group, who experienced pain, complained to nursing staff and received analgesic drugs had high N and E scores. The first two groups are regarded as non-complainers, and the third as complainers. CMI results support the contention that awareness of symptoms of disease follows a life pattern dependent upon personality structure. Those from the Whiteley Index of Hypochondriasis indicate that denial is strong in all patients and that the spectrum of hypochondriacal attitudes increases in the presence of pain and other symptoms.

Phobic Disorders Four Years after Treatment: A Prospective Follow-up

Abstract: Sixty-five out-patients with phobic disorders of more than a year's duration were followed-up prospectively for four years after completion of treatment. This was a follow-up rate of 92 per cent of all patients who were treated. Phobias improved during treatment, but then remained static for the group as a whole over the follow-up period. The following ratings did not change for the group as a whole: general anxiety, depression, obsessions, depersonalization, work, social and sexual adjustment, and family and other relationships. Forty-two per cent of patients were unimproved in their phobias at the end of follow-up. Fifteen per cent required further treatment for depressive episodes, during which phobias were aggravated temporarily. One patient developed new paranoid features with depression. The group remained one of phobic disorders and did not develop any other kind of neurotic syndrome.

Incidence and sex ratio of transsexualism in Sweden.

Abstract: The difficulty in calculating the incidence and prevalence of transsexualism is obvious. Those figures which can be arrived at are always minimal values, and a group of persons with transsexual symptomatology, which are most difficult to assess, will always elude the calculations.

Psychoses in the Offspring of Schizophrenic Monozygotic Twins and their Normal Co-Twins

Abstract: A group of children, of whom one parent is a monozygotic (MZ) schizophrenic twin, has been compared with a group of children of whom one parent is a normal MZ twin to a schizophrenic twin. A third group, of whom One parent is a normal dizygotic (DZ) twin to a schizophrenic twin, was examined in order to function as a sort of control group. This third group, however, was after age correction too small to supply reliable information. In no case was the other parent psychotic. In group 1, consisting of 47 children, 3 schizophrenic cases and one suicide were found, giving a morbidity risk of 9.4 per cent after age correction. In group 2, consisting of 25 children, there were also 3 schizophrenic cases. The morbidity risk after age correction was 12.3 per cent (not a significant difference from group 1). The present investigation gives no support to the hypothesis that environmental factors, associated with being reared by a schizophrenic parent, should cause more schizophrenia in the offspring, since controls reared by a non-schizophrenic had the same morbidity risk. The result could be explained as due to factor(s) equally present in the schizophrenic MZ twins and their normal co-twin. As a pair of MZ twins are genetically identical, a hereditary factor is the most likely explanation. However, the present material is of such limited size that no conclusion can be drawn. Of the 6 psychiatric cases 5 were females. The twin-parents in the 6 cases were 4 female and 2 male, and 4 of these twin pairs were discordant for schizophrenia. From the precipitating factors, symptomatology and course of illness described in these cases, the question arises whether some cases of schizophrenia are (almost) only genetically determined, while in other cases both genetic and environmental factors are necessary for the outbreak of a schizophrenic psychosis.

Personality and Sexual Adjustment

Abstract: Some 800 unmarried male and female students were administered a personality inventory measuring psychoticism, extraversion and neuroticism, as well as a 98 item questionnaire of sexual attitudes. Factor analysis showed that some 15 factors were sufficient to account for the attitudes sampled; most of these were similar for the two sexes. High- and low-scorers on the three personality variables were compared for their responses to the attitude items, and numerous highly significant differences were found; similarly, male and female students' responses were compared. Personality scores were found to be correlated with some of the sex attitude factors. In general, high N scorers showed the greatest degree of pathology, followed by high P scorers; extraverts showed an absence of pathology. P scorers showed strong libidinal desires. These and many other findings are considered in the context of the writer's personality theory which had provided certain tentative predictions about the sexual attitudes and behaviour of different personality types.

Classification of depressed patients: a cluster-analysis-derived grouping

Abstract: used in endocrine, cardiovascular and many other disorders, where drug treatment aims to restore and preserve the patient's functional adequacy. Lithium does not abolish the clinical and psycho social evidences of recurrent affective disorders. It diminishes the severity ofsymptoms to varying degrees and reduces the amplitude of mood swings to a point where hospitalization can be avoided. Actually, most ofthe reported statistics concerned with prophylactic effects concern reduction of frequency or length of hospitalization. While hospitalization may be taken as a global measurement of the severity of affective episodes, clinical evaluation must also take into account the less severe mood fluctuations which continue during lithium therapy. It is well known that lithium is frequently combined with antidepressant drugs during depressive cycles to maintain patients' ambulatory status. Similarly, neuroleptic drugs may have to be added to control rapidly emerging manic disturbances to maintain the patients' functional balance. Neither clinical nor psychosocial patterns indicate that lithium prevents affective disorders to the point where evidence of illness disappears. Whatever the pharmacological action of lithium may turn out to be, it appears to interact effectively with an ongoing biochemical disorder, counteracting its socially and clinically disruptive manifestations. I believe that this is best conceived of as compen satory therapy rather than as prophylaxis. F. A. Fitzyss@. St. Vincent's Hospital and Medical Center ofXew rork, †̃¿ 53 West iith Street, New rork, X.r. iooii, U.S.A.

Bi-frontal stereotactic tractotomy. A follow-up study of its effects on 210 patients.

Abstract: 1. 210 patients with long-standing apparently intractable psychiatric illnesses who had undergone the operation of bi-frontal stereotactic tractotomy of the orbital cortex by the use of radioactive yttrium 90 seeds were studied. 150 patients (Group A) together with their relatives and friends were interviewed personally by the psychiatrist and social worker. Information about a further 29 was obtained from other psychiatrists, general practitioners, relatives and a perusal of the relevant clinical records. 2. Of the 150 A cases 49 (33 per cent) recovered completely from their illness and a further 24 (16 per cent) only had minor residual symptoms and required no further treatment. making a total of 49 per cent. A further 35 (23 per cent) improved but still needed treatment, with persistent symptoms. 41 (27 per cent) were unchanged, and one patient was worse. 3. The best results were obtained in the depressions, both recurrent and other forms (56 per cent recovered and much improved). Good results were also obtained in obsessional neurosis (50 per cent recovered and improved). In anxiety states the corresponding figure was 41 per cent. None of the schizophrenic patients did well. 4. No patient showed a gross frontal lobe syndrome post-operatively. In 4 out of the 150 (2.6 per cent) there were some moderate and lasting sequelae. 17 (11.4 per cent) displayed minor and trivial symptoms which were of no practical importance, whereas in 129 (86 per cent) there were no demonstrable personality changes whatsoever. Working capacity and normal enjoyment of pleasure were not affected in any patient. 5. Mortality due to operation was nil. 6. The incidence of permanent epilepsy due to the operation was less than 1 per cent. 7. Of all forms of leucotomy operation stereotactic tractotomy is the one which avoids unnecessary destruction of brain tissue between the cortex and the target area, and it is suggested that further research in this field, with the substantia innominata as a target area, is well worthwhile.

Extrapyramidal disorders after prolonged phenothiazine therapy.

Abstract: A systematic clinical study of certain defined types of `extra-pyramidal' motor phenomena was carried out in a population of 63 chronic hospitalized schizophrenics who had been treated with trifluoperazine for periods ranging from 3 to 13 years. Tremor was found in 88 per cent, muscular rigidity in 68 per cent, choreiform dyskinesia in 56 per cent, and motor restlessness in 38 per cent. The clinical data were submitted to factor analysis in order to identify the principal patterns of motor disorder affecting these patients. Sex, age, state of dentition, as well as phenothiazine and anti-parkinsonism drug treatment variables were then studied in relation to the distributions of the motor disorders suggested by factor analysis. Factor 1, which accounted for 32.5 per cent of the variance, represented restlessness of the trunk and limbs. The distribution of this disorder in the population was not affected by any of the personal and treatment variables studied. Factor 2 accounted for 19.1 per cent of the variance and represented tremor and rigidity of the upper limbs and facial musculature. This disorder was significantly more common in older patients. Factor 3 was bipolar and contributed 13.0 per cent to the variance. It suggested a disorder of the tongue, lips and jaw characterized by choreiform movements at one pole negatively correlated with tremor at the other pole. Chorea was more common and tremor less common in women than in men. For men, though not women, chorea was associated with a low total dose of phenothiazine and tremor with a high total dose. The usefulness of this method and the implications of our results are discussed, particularly with respect to choreiform disorders which may be irreversible.

The Family and Social Background in Childhood Psychoses

Abstract: 1. More parents of children with infantile psychosis belonged to social classes I and II and more parents of children with late onset psychosis to social classes IV and V. 2. A trend was demonstrated in the mothers of L.O.P. children towards a degree of social isolation. This was attributed to their personalities, whereas any social isolation in the mothers of I.P. children was thought to be a withdrawal secondary to the illness of their children. 3. Parents of the I.P. group had a low rate of schizophrenia, parents of the L.O.P. group a significantly high rate, suggesting a genetic connection between L.O.P. of childhood and adult schizophrenia. 4. Boys were more often psychotic than girls; there was some suggestion of a greater risk to the first born in the I.P. group only.

Depression and attempted suicide: a study of 91 cases seen in a casualty department

Abstract: 1. The severity of depression and some attitudes towards the suicide attempt were recorded in 91 cases seen in the casualty department of a Scottish university city. The sample contained 23 teenagers (25.3 per cent). 2. The self-administered depression rating scale had been used in a previous study of patients receiving E.C.T. There was found to be no significant difference in the depressive symptomatology of the E.C.T. treated patients and attempted suicides of comparable age distribution though the mean depression scores were lower in the attempted suicide group. 3. A significant relationship was demonstrated between the wish to die at the time of the attempt and the depression rating score. 4. There appeared to be no relationship between the level of consciousness and the severity of depression, but a significantly higher proportion of those who lost consciousness were recommended for admission. 5. A significant relationship was demonstrated between the period of contemplation of the attempt and the wish to die: of those who had wanted to die proportionally more had thought about it longer. The mean depression scores were higher the longer the period of contemplation. 6. Though the assessing psychiatrists had not seen the depression rating score those patients recommended for admission were shown to be significantly more depressed. 7. The use of the questionary as a possible screening procedure of attempted suicides seen in casualty departments was considered.

Cerebral Dysfunction and Childhood Psychoses

Abstract: A series of recent papers (Creak, 1961, 1963; Rutter, 1966; Brown, 1963; Lotter, 1967; Schain and Yannet, 1960) have provided evidence of degrees of cerebral dysfunction in infantile autism (Kanner, 1943) and other infantile psychoses. They have demonstrated that groups of cases of infantile psychoses satisfying broadly similar diagnostic criteria have in their backgrounds a variable frequency of cerebral insult and abnormal discharge in the EEC The diagnostic criteria in such series are of crucial importance. Imprecision and vagueness hamper comparisons between series. In childhood psychoses some investigators have excluded those cases in which there was any history or clinical evidence of organic features in an attempt to obtain a ‘pure’ group. This technique, while valid in delineating a syndrome, is handicapping to subsequent etiological study. For these reasons the present authors have used only age of onset and behavioural features as their ascertainment criteria it was a behavioural rather than an aetiological diagnosis.

Seasonal Variation in Suicidal Deaths

Abstract: Suicidal deaths were found to be most common in the spring and the early winter. The seasonal distribution of suicidal deaths was found both in comparison to deaths from all causes and in comparison to chance expectations. No differences were found in the seasonal variation of suicidal deaths for different subgroups of the population, but this technique is recommended as a tool for investigating the causes of the seasonal variation in suicidal deaths.

A Controlled Study of Lithium vs. Chlorpromazine in Acute Schizophrenics

Abstract: Twenty-one newly hospitalized schizophrenic patients were given chlorpromazine (10 patients) or lithium carbonate (11 patients) in a double-blind controlled fashion. The results unequivocally indicate superior treatment efficacy under chlorpromazine in either reducing symptom severity or bringing about illness remission; lithium often contributed to further decompensation in schizophrenic symptomatology. Indeed, lithium may be detrimental to schizophrenics in that these patients run a greater liability of developing neurotoxicity at modest lithium doses and blood levels.

Mental health in an Indian rural community.

Abstract: A study to assess the nature and extent of mental disorders in a rural community was undertaken in three paras of Nasibpur village in West Bengal The high prevalence rate of 27 per 1,000 population was found, with significant variations in the rates and diagnostic patterns of mental disorders in the three population groups The planning of an adequate mental health programme is regarded as a national priority

Acute adverse reactions to LSD in clinical and experimental use in the United Kingdom

Abstract: This survey of United Kingdom experience with LSD in clinical work covers some 4,300 subjects with a total of some 49,500 LSD sessions. There was an attendant suicide rate of 0.7 per 1,000 patients, a rate of 9 per 1,000 patients for psychosis lasting for more than 48 hours (from which some two-thirds recovered fully), and an accident rate of 2.3 per 1,000 patients. The survey is not one that permits clear comparison with other forms of psychiatric treatment, but the following conclusion is probably justified: treatment with LSD does give rise to acute adverse reactions, but if there is adequate psychiatric supervision and proper conditions for its administration the incidence of such reactions is not great.

Parental Personality and Attitude and Childhood Psychoses

Abstract: On clinical examination 42 per cent of the mothers of 32 children with L.O.P. were regarded as introverted, but only 13 per cent of the mothers of 46 children with I.P. Twenty L.O.P. mothers and 26 I.P. mothers were tested with the M.P.I. which confirmed the introversion of mothers of the L.O.P. group. There was a higher percentage of sensitive, suspicious parents in this group. More parents of I.P. children were over-protective. These findings are believed to support the differentiation of childhood psychotics into distinct diagnostic categories.