Six cases are reported in which the bereaved kept the deceased's body for periods ranging from one week to ten years.

Some relevant anthropological and psychoanalytical observations are discussed. This phenomenon does not appear to have been reported in the literature of Western psychiatry.

Fifty-three psychiatric patients who had been receiving treatment with lithium continuously for more than two years were examined to estimate the prevalence of lithium-induced hypothyroidism. It was found to be 20 per cent among women. No men were affected among these patients. In order to study the characteristics of the disorder further cases were drawn from another population. One third of the patients developed hypothyroidism during their first year of treatment, others not until after 9 years. About two thirds of the female patients with hypothyroidism had thyroid antibodies. All cases with lithium-induced hypothyroidism showed elevated levels of serum thyrotropin, which in our experience is the laboratory examination of choice in these as well as other cases of ‘primary’ hypothyroidism. Since the probability of detecting these cases at a given control visit was found to be low, we feel that such visits need not include extensive laboratory investigations. Hypothyroid patients responding well to lithium treatment should continue their medication combined with appropriate thyroxine substitution.

The pattern of decline of a mental hospital population over fifteen years is described. Continuing problems are commented on, particularly the presence of ‘old’ long-stay patients and the accumulation of ‘new chronic patients'. The number of beds required for each of these categories is estimated.

The dissolution of the mental hospital service by degradation is deplored, and a suggestion is made that some of the good points of the old service might be salvaged before it is too late.

The Gods did not reveal, from the beginning, all things to us; but in the course of time, through seeking we may learn, and know things better.

Xenophanes

The Royal College of Psychiatrists is not primarily concerned with gambling as such but only in so far as in certain circumstances it may result in financial, social and psychological disturbance to the gambler and/or the family. For practical purposes, these effects are usually associated with heavy gambling.

Esrath Nashim was the name of the women's forecourt of the Second Temple in Jerusalem. The words can also be interpreted as ‘women's aid’ and were adopted as its title by a ladies' benevolent organization. This body, in 1895, established in the Old City of Jerusalem a one-room asylum where two patients were cared for. In 1905 the Esrath Nashim Hospital was opened in the Jaffa Road in the New City, and after the founding of the State of Israel in 1948 it remained as the only psychiatric hospital in the new State, though others were soon established. The old hospital was a Turkish-style stone building which was impressive of its kind, but the difficulties under which it operated may be illustrated by recalling that when the present chairman of the Hospital Board took office in 1948 and obtained the first grant from the newly-established Ministry of Health it was decided that the most pressing need was to install a hot-water system. In the late 1950s the chairman persuaded the Board that they should build a new hospital, and in August 1968 this was finally opened, the first purpose-built psychiatric hospital in the country. At that time three pavilions, each with 50 beds, were complete.

Chromosome examination was made in 22 monozygotic and 27 dizygotic twin pairs of whom one or both of each pair suffered or had suffered from manic-depressive disorder. We found a significantly higher frequency of chromosome variations among dizygotic twin pairs than was expected from population studies, but not in monozygotic pairs. There was no association between the chromosome variations and manic-depressive disorders. We found no greater intra-pair correlation in monozygotic twins compared with dizygotic twins as regards hypodiploidy, hyperdiploidy and unstable chromosome aberrations, which indicates that the aetiology of such aberrations is mainly of exogenic nature.

During their first two years’ deliberation the Joint Ethical Working Party of the College received many queries about aspects of confidentiality. They submit herewith a report on the subject to Council.

This report consists of:

1. 1. A review of the present position and recent statements

2. 2. Recommendations for action by Council

3. 3. A Position Statement for publication.

This paper describes a psychogeriatric service in Gloucestershire. Agreement on policies was reached with general practitioners, Social Services, other psychiatrists and hospital nursing staff. The day hospital is regarded as the preferred area of treatment for a wide variety of patients, including the severely demented. In this service less than five per cent of admissions appear to become long-stay. With emphasis on day hospital and community support the number of beds for this type of patient recommended by DHSS may be excessive.

An attempt was made to extend and cross-validate Mayo's (1969) study of ‘normals with symptoms' using the new Personal Illness measures. Groups of psychiatric patients and symptom-free normals were matched with a ‘normals with symptoms' group for age and sex. The two symptom groups were similarly matched on the number of symptoms as assessed by the Delusions-Symptoms-States Inventory. On the Personality Deviance Scales the ‘normals with symptoms' were found to be the most Extrapunitive group, the symptom-free normals had the lowest Intropunitive scores, whilst the patient group were the lowest scorers on Dominance.