The case-history of a woman with psychiatric symptoms since childhood is reported, the best label for which was that of ‘chronic mania’. Cerebellar atrophy was suspected on radiological grounds. The literature on chronic mania in childhood and on cerebellar damage and mental changes is reviewed and the view is put forward that cerebellar dysfunction may play a part in the production of some psychiatric symptoms.

Clinical and psychometric characteristics of a sample of elderly psychiatric patients were established soon after admission and they were then followed for 1 year. Anoutcome was most successful for an unfavourable type which was predictable by measures related to intellectual impairment.

Prisoners' attitudes to their drinking behaviour, although largely accurate, minimize problems in terms of other assessments made at interview. Semantic differences are apparent in the use of the terms ‘heavy’ and ‘problem’ as descriptions of drinking behaviour; thus men who admit heavy but deny problem drinking are often reported to be problem drinkers by their family and myself. There is close agreement between the family's reported attitude to a man's drinking and the assessment made in a structured psychiatric interview.

An unsuccessful attempt to discover the variation in the time of day chosen for the suicide of 100 consecutive cases is described. The reasons for the failure are discussed.

Independent studies which showed a difference between the EEG frequency spectra of test and control groups have been compared. Some of the test groups included schizophrenic patients, others comprised groups with dyslexia, reading disability and left preference. The EEG differences between the test and control groups are shown to be similar across the studies. It is suggested that the common attribute of the test groups relates to the functional organisation of the brain and that investigation of EEG correlates of this phenomenon may be of value to research into the biological basis of psychiatric illness.

Occurrence of life events was recorded in 30 recovered depressed women undergoing clinical relapse in a controlled trial of maintenance treatment with amitriptyline and psychotherapy, and in 30 matched patients who did not relapse. Overall, patients who relapsed experienced significantly more life events in the three months before relapse, and especially in the month immediately preceding it. Undesirable events were particularly implicated. Event rates prior to relapse were closely comparable in treatment subgroups, giving no evidence that differential stress was required to produce relapse. The findings reinforce previous studies indicating an overall relationship between life events of certain types and depression, but do not suggest that the beneficial effects of maintenance treatment are specifically protective against life stress.

In psychiatry the relationship between treatment and punishment is variable and ambiguous. It has always been possible to employ physical methods of treatment for punitive ends, against which the introduction of liberal policies is no complete safeguard. Indulging one's personal animosities towards a difficult or violent patient has always been condemned, but the motives of a psychiatrist may be particularly easily misconstrued. These inherent risks in a psychiatrist's situation are illustrated by a case from the 19th century.

From a factor analysis of data from a learning experiment evidence is presented which appears to support the Blomfield–Marr thesis that in the learning of motor actions the cerebellum operates by the turning off of incorrect movements rather than by the turning on of correct ones. The factor model employed is that due to Godfrey Thomson which gives a neurostatistical explanation of the origin of mental factors.

The Isle of Wight Studies began in 1964–65 with a series of epidemiological studies of educational, psychiatric and physical disorders in9- to 11-year-old children. These early studies were financed by the Department of Education and Science and the Foundation for Child Development (then the Association for the Aid of Crippled Children). The findings were fully reported in two books (Rutter, Tizard & Whitmore, 1970; Rutter, Graham & Yule, 1970) and only brief details are included here.

Suicidal intent was assessed in a sample of 151 admissions to a general hospital for selfpoisoning or self-inflicted injury. Severity of intent was associated with the act's medical seriousness and with the risk of suicide derived from a validated risk scale. Although high and low intent cases were comparable in respect of precipitating factors, patients rated high on suicidal intent were more likely to have experienced depressive symptoms in the previous month.

The excretion of dimethyltryptamine (DMT) was studied amongst 122 recently admitted psychiatric patients and 20 normal subjects. DMT was detected in the urine of 47% of those diagnosed by their psychiatrists as schizophrenic, 38% of those with other non-affective psychoses, 13% of those with affective psychoses, 19% of those with neurotic and personality disorders and 5% of normal subjects. Ninety-nine patients were interviewed in a semi-standardized fashion, and also categorized according to a variety of operational definitions of the psychoses. The operational definitions failed to reveal any group significantly more correlated with urinary DMT than a hospital diagnosis of schizophrenia, but a discriminant function analysis of symptomatology could be used to define a group of 21 patients of whom 15 (71%) excreted detectable DMT. There was a general relationship between psychotic symptoms and urinary DMT, but specifically schizophrenic symptoms did not appear to be major determinants of DMT excretion.

The 1955–56 Annual Report of the Department of Research Psychology at the New York State Psychiatric Institute begins by noting that –Dr. Joseph Zubin, who had been Associate Research Scientist in this department since September, 1938, resigned January 15th, 1956 to become Principal Research Biometrician, heading a new Department [now Unit] of Biometrics Research…” While this move soon proved to be a stimulus for the development of significant new avenues of research, it by no means marked a sharp break with previous work. As Zubin has often noted, the late Carney Landis, when he was head of the Department of Research Psychology, actively fostered a variety of biometric studies, and indeed the annual reports of that department had eventually come to contain a separate section devoted to biometrics, in which the work of Zubin and his colleagues figured prominently. Much of this work would serve as the foundation of the new unit's research programme. In particular, an extensive study of prognosis in early and chronic schizophrenia had already been in progress for several years. In addition to interviews, a battery of tests was employed to sample a range of levels in the patients' functioning: psychophysical, psychophysiological, psychomotor, perceptual, behavioural, and conceptual.

Erythrocyte sodium and potassium concentrations, erythrocyte membrane ATPase (Na–K specific and non-specific) and the rate of potassium influx into erythrocytes (ouabainsensitive and insensitive) were estimated in a group of female patients suffering from mania and repeated on about two thirds of them when they had recovered. With recovery there was a statistically significant increase in the erythrocyte ouabain-sensitive potassium influx. The other parameters showed no significant overall change with recovery but the initial severity correlated significantly and negatively with the change in erythrocyte Na–K ATPase with recovery. The changes that occurred in the erythrocyte sodium concentration and Na–K ATPase activity were not random since they correlated significantly with changes in the active potassium influx.

Fewer than one half (238) of a cohort of 489 psychiatric patients who had stayed in hospital more than one year (longstay) were still in hospital three years later. One third of these ‘old’ longstay patients (170) were discharged and resettled – and 81 elderly patients died. During the same three years 1971–3 a further 108 patients became (new) longstay; 57 remained at the end of the study. The discharged patients were neither readmitted unduly often, nor did they become destitute.

There has been a child psychiatry research group within the Institute of Psychiatry since 1952. At first it constituted a section of the Departmentof Psychiatry and for a while it formed part of the MRC Social Psychiatry Research Unit. However, in 1973 London University established a Chair of Child Psychiatry and since that time there has been a separate Department of Child and Adolescent Psychiatry. The research in this field undertaken up to 1967 has been described previously (Rutter, 1968a) and the present report brings the account up to date with a summary of work carried out during the last eight years.

Many surveys of general populations have suggested a high untreated psychiatric morbidity, variously referred to as mental illness, pre-clinical neurosis, minor neurosis, untreated depression, etc.

An Index of Definition of psychiatric disorders is described which incorporates cut-off points on the basis of symptoms rated in the Present State Examination. Eight degrees of definition are specified. At the ‘borderline disorder’ level and above, disorders are sufficiently well defined to apply the CATEGO program of clinical classification. This procedure enables in-patients, out-patients and samples of the general population to be compared.

Data from surveys in south-east London are presented in order to illustrate the technique. The main conclusion at this stage is that it is possible to identify, by strictly defined and repeatable procedures, a substantial proportion of people in the general population who have ‘borderline disorders’ that can be tentatively classified in terms of the ICD. Whether it is clinically useful to do so requires further investigation.

It is also suggested that techniques of this kind can be scientifically useful in comparing the level of morbidity in various populations, both referred and non-referred, and in testing theories concerned with the causes and treatment of various types of psychiatric disorders.