It is suggested that a clearer distinction should be made between the statistical validity and the clinical utility of the Grid Test of schizophrenic thought disorder. The results of three published studies are examined, and in each case the Grid Test is found to have appreciable statistical validity in terms of correlations between grid predictions and clinical judgements of thought disorder. Two criteria are proposed for assessing the usefulness of the Grid Test as a diagnostic instrument, and from an examination of the results of three published studies it is concluded that, despite its statistical validity, the test, at least in its present form, has no appreciable clinical utility.

Two-hundred-and-seventy-nine patients (103 men, 176 women) were followed-up 1–2 years after an act of non-fatal deliberate self-harm. Of 155 patients offered a psychiatric out-patient appointment at the time, only 68 completed the treatment. A further act of deliberate self-harm was committed by 26 men and 41 women within twelve months. The factors most highly associated with repetition were previous psychiatric treatment, a previous act of deliberate self-harm, and a criminal record. These factors held good for a separate series of patients. Significantly more repeaters received prolonged psychiatric care after the initial episode of deliberate self-harm. The implications of these findings for the clinical management of such patients are discussed.

In the latter part of 1974 a questionnaire was sent to all senior registrars working in general psychiatry within the United Kingdom inquiring about their career intentions. of the 221 who fell within the scope of the survey 203 replied, a response rate of 92 per cent. A preliminary analysis of the replies was published in News and Notes for August 1975 and a more detailed account is to be published. In brief, 155 indicated that they were aiming for a consultant post in general psychiatry (with or without a special interest) in the United Kingdom while 28 indicated that they intended going into a psychiatric specialty in this country. This latter group were not asked which specialty they were going into nor what grade they were aiming for.

Phenothiazine drugs were withdrawn from 17 chronic schizophrenic in-patients, with a control group of 14 patients remaining on active medication. The trial was conducted under double blind conditions over a period of 42 weeks with weekly assessment of the patients by ward nurses. Of the placebo group 35 per cent relapsed, relapse being related to the level of previous active medication.

During 1972–74 nine populations of schoolgirls were surveyed in respect of the occurrence of anorexia nervosa. As well as the current school year, previous years (going back variously 3–6 years) were also carefully studied within seven of the schools. Anorexia nervosa was only identified as present or having been present if the diagnosis was unequivocal: for instance, seemingly evident and severe cases which could not be traced were excluded. The condition in severe form was found to be relatively common in the independent sector of education, probably implying a social class factor. In all such schools, the prevalence was one severe case in approximately every 200 girls. In those aged 16 and over it amounted to one severe case in about every 100 girls. Overall, these schools encountered one ‘new’ severe case in every 250 pupils aged 16 years and over. The condition is likely to be even more common than this study allows because of the stringent limits set here on inclusion of cases and the age-band studied. It is concluded that severe anorexia nervosa is a common condition and is probably getting more common.

Self-rating scales are finding an increasing use in psychiatric work. Not only are they widely used in research, but they provide the clinician with a score indicating the patient's psychiatric state at any one time, and these scores if repeated throughout the duration of treatment may be considered to provide a continuing measure of the severity of the illness, as does a temperature chart in a febrile illness. Most scales could be improved by item analysis, and in this study the Wakefield Self-Assessment of Depression Inventory, with added items, was subjected to statistical analysis. It was found that valid scales could be constructed for the measurement of anxiety and of depression in general psychiatric disorder, as well as scales for the measurement of the severity of endogenous (primary) depression and of anxiety states. In addition, the derivation of a ‘diagnostic’ score was confirmed in a cross-validation study and may be found of use both in research and in clinical practice.

The 16 PF was administered to 30 female attempted suicides and their spouses, to 20 male attempted suicides and their spouses and to 50 control men and their spouses. Both the female and male attempted suicides show personality disturbance, but there are also sex differences. The female attempted suicides and their spouses appear to share similar personality characteristics, but the spouses of male attempted suicides appear quite dissimilar from their husbands. The effect of the personality of the spouses is briefly discussed in the context of marital relationships of attempted suicides.

A patient is described who developed the classical syndrome of anorexia nervosa at the age of 52. Her illness occurred in relation to the marriages of her daughters and showed an extreme preoccupation with her body shape and a determination to slim by diet, purging and vomiting, and the hiding of food to the extent of rendering herself too weak to cope with the demands of her life.

It is suggested that anorexia nervosa, though predominantly a disease of onset in adolescence, may present at any age and should be considered in the differential diagnosis of anorexia in patients over the age of 50.

In a recent article a hierarchy of classes of personal illness was proposed (Foulds and Bedford, 1975), consisting of four classes, each with its constituent groups, apart from the highest class. These were: Class 4—Delusions of Disintegration (with, as yet, no groups); Class 3—Integrated Delusions (the groups being ‘Delusions of Contrition’; ‘Delusions of Grandeur’ and ‘Delusions of Persecution’); Class 2—Neurotic Symptoms (Conversion; Dissociative; Phobic; Compulsive and Ruminative symptoms); Class 1—Dysthymic States (states of Anxiety; of Depression and of Elation).

Total and free plasma tryptophan levels were measured in depressive and manic patients before and after recovery. No change was found in total or free plasma tryptophan concentration on recovery from depressive illness. Free plasma tryptophan levels were higher in recovered manics than in active manics, and a group of four manic patients tested before and after recovery showed a significant increase in free plasma tryptophan concentration on recovery.

This study attempted to clarify the nature of dysfunction in the selective attention of schizophrenics. Within the framework of Broadbent's (1971) theory of information processing it was argued that ‘filtering’ inefficiency should be reflected in a reduction in the discrepancy in performance on a short-term memory task between the condition of pre-instruction as to the relevant material and that of post-instruction. Three groups of subjects, 10 schizophrenics, 10 depressives, and 10 normals, matched for age and intelligence were tested on such a task. While the overall performance of normal subjects was superior to that of both psychiatric groups, depressives and schizophrenics did not differ. The normal group also showed a significantly greater improvement with pre-instruction than the psychiatric groups; again, the schizophrenics and depressives did not differ significantly, though there was a tendency for schizophrenics to benefit less than depressives from pre-instruction. It appears that ‘filtering’ difficulties as here defined may not be specific to schizophrenia. Alternative conceptualizations of the cognitive abnormalities shown by schizophrenics, such as slowness of information processing and difficulties in response selection, may be more useful.