In spite of increasing interest, the problem of the battered child remains controversial. Some see the problem as a response to stressful social circumstances and society's permissive attitude to violence (23), others view it as primarily a manifestation of parental maladjustment (64).

Peripheral whole blood uridine diphosphate glucose (UDPG) has been found to be significantly elevated in psychotic depression (Hansen, 1969; 1972a, b), and this was related to an equally significant lowering of whole blood adenosine triphosphate (ATP). Addition to healthy human blood of UDPG accelerated the hydrolysis of ATP in vitro (Hansen, 1972a), and UDPG concentration dependently enhanced the activity of a vegetable ATP di-phosphohydrolase (EC 3.6.1.5), which was also inhibited by adenosine 3’, 5′-cyclic monophosphate (cyclic AMP) in a concentration-dependent manner (Hansen, 1972b). Other workers have recently published a similar inhibition of a rat heart ATPase by cyclic AMP (Dietze and Hepp, 1972), and another research group have found that sodium-potassium exchange pump changes and changes in erythrocyte membrane ATPase activity correlate significantly with mood alterations in psychotic depressive patients (Dick, Dick, Le Poidevin and Naylor, 1972; Naylor, Dick, Dick, Le Poidevin and Whyte, 1973). This paper reports a study of the relationship between blood ATP levels and mood in patients suffering from manic-depressive predictable (Jenner, 1971) short term cycle psychotic states, and in depressive patients receiving electroconvulsive treatment.

The aim of the investigation was to compare rating scales for syndromes as given by a psychological test, the Minnesota Multiphasic Personality Inventory (MMPI), with those derived from a standardized psychiatric history (CAPRICE System). The first is dependent on information supplied directly by the patient, who answers a check-list; the second is based on a psychiatric interview and the completing of a codified case-history. The computerized form of the MMPI was employed (Fowler and Miller, 1969), and the scales selected were those corresponding with manifest anxiety (At scale); depression (D scale); phobias, obsessions and compulsions (Pt scale); and schizophrenia (Sc scale). The nearly corresponding scales derived from the CAPRICE System (Valentine, 1973) are the scales for Anxiety, Depression, Obsessional-Compulsive Disorder, and Psychosis.

In the mid-1960.s, reports came from Scotland and England of a high frequency of gonosomal aberrations among male patients in maximum security hospitals (Jacobs et al., 1965; Casey et al., 1966). This led to a lively discussion. If these observations could be generalized so as to apply also to similar institutions in other countries, the question would be whether gonosomal aneuploidy had any bearing on the development of criminality and psychic diseases? In particular, the significance of a double Y condition as a predisposing factor was called in question. Unfortunately, from the outset the discussion became too categorical and oversimplified. When in subsequent studies socially well-adjusted individuals of normal intelligence were found, it was doubted whether aneuploidy had any importance at all. In a survey as recent as 1972, for example, Owen questions whether there is any connection at all between excess Y-chromosomes and behaviour disorders and mental diseases. Hook (1973), on the contrary, in a somewhat more detailed compilation, shows that there is a clear connection between the occurrence of double Y-chromosomes and individuals whom he defines as ‘mental-penal’. A common feature in all the literature, however, is that almost all writers insist on the importance of more research in this field.

Changes in the excretion of adenosine 3’:5′-cyclic monophosphate (cyclic AMP) have been reported in depressive illness. Abdulla and Hamadah (1970) reported that urinary cyclic AMP excretion was lower than normal during depression and increased with recovery. However, these results were based on single 24-hour urine collections during depression and on recovery, with no creatinine estimations to suggest that the collections were complete. There was no control of diet, drugs or activity. The controls do not appear to have been matched for age. Paul, Ditzion, Pauk and Janowsky (1970) reported that the cyclic AMP excretion in neurotic depression was higher and in psychotic depression was lower than in a control group, but neither difference was statistically significant. However, on enlarging the study by including more psychotic depressives they reported that the cyclic AMP excretion of this group was significantly less than that of the controls (Paul, Cramer and Goodwin, 1971). These workers had controlled the patients' drug and dietary (but not fluid) intake. There appeared to be only minimal control of activity. The results were based on approximately two samples of urine per subject, which were very carefully checked for completeness of collection. Unfortunately the age of the controls (19–22 years) was very different from that of the patients (25–64 years). On two small groups of patients treated with either Laevodopa or lithium carbonate, they reported that changes in affective state were accompanied by changes in the urinary excretion of cyclic AMP. However, in serial studies on manic-depressive patients Paul, Cramer and Bunney (1971) failed to show a correlation between mood rating and cyclic AMP excretion in five out of seven patients; but they reported that the cyclic AMP excretion was increased on the day of rapid switch from depression to mania. The above groups of workers had used an enzymatic-isotope displacement technique to estimate the cyclic AMP. Brown, Salway, Albano, Hullin and Ekins (1972), using a saturation method to assay cyclic AMP, found no correlation between mood and cyclic AMP excretion in two short-cycle manic-depressive patients. Jenner, Sampson, Thompson, Somerville, Beard and Smith (1972) wrote: ‘We have measured daily excretion by a number of depressed and manic depressive patients over periods covering several mood changes without being able to establish any consistent correlation between cyclic AMP excretion and mood, … However, in one unusual case we have found a very marked correlation‘. We (Naylor, Dick, Dick, Moody and Stansfield, 1974) were unable to demonstrate any relationship between urinary cyclic AMP excretion and mood in a patient with recurrent psychotic episodes, in which depressive features predominated.

For some years EEG recordings have been carried out at the Maudsley Hospital on male persons charged with murder and in custody while awaiting trial. These recordings have been undertaken at the request of the prison authorities with the consent of the defence and irrespective of whether or not there was a recognized clinical indication for such a procedure. During the period 1964 to 1969 150 such prisoners were examined, only 97 of whom were subsequently brought to trial on a charge of murder, with the outcome as given in Table I. Towards the end of this period EEGs were recorded from 20 volunteer male members of the hospital staff, all within the same age range as the prisoners (mean age 30 years, range 16–70) and none with any previous history of obvious medical or forensic relevance.

The steady stream of publications on the XYY syndrome, including recent papers by Christensen and Nielsen (1973) and a comprehensive review by Hook (1973), demonstrates clearly that confirmation or refutation of the relationship in this syndrome between dull intelligence, even mental deficiency, and impulsive or delinquent behaviour requires further evidence. In an attempt to supply such evidence this report presents psychological and anthropometric information about five XYY subjects detected from amongst attenders at the Special School in the city of Aberdeen.

School-phobic youngsters have sometimes been described as wilful and stubborn in the family situation (Hersov, 1960), and this tendency has been invoked to explain the particular occurrence of school phobia in early adolescence (Leventhal and Sills, 1964). The emotional upset shown by these young people when faced with the prospect of going to school (Berg, Nichols and Pritchard, 1969), may occasionally appear to be more in the nature of anger, defiance and temper than either fearfulness or misery (Smith, 1970). The fact that in the general population dislike of school is reflected in actual absence only during the secondary school years (Mitchell and Shepherd, 1967) supports the view that assertiveness, which presumably becomes more effective as the child reaches the teens, plays some part in school refusal.

This paper describes the distribution of female attempted suicide and other psychiatric admissions to the twenty-bedded Psychiatric Unit of Trinidad and Tobago (population about 1 million). Reports from this area have hitherto been concerned with the socio-cultural but not the clinical aspects (McCandless, 1968; Roberts and Russell, 1969) of psychiatric disorders.

Broadmoor Hospital is one of three Special Hospitals provided for the treatment of patients of ‘dangerous or violent propensities', under conditions of security. By definition, it caters for a unique and highly selected group of patients; patients who it is thought are too dangerous to be cared for in more conventional psychiatric facilities. Studies of such selected groups of patients may help us towards a better understanding of the relationship between dangerous behaviour and mental illness. Special groups of patients have been studied (Blackburn, 1970; Le Couteur, 1966; McGrath, 1958), but apart from a general paper by Gould (1957), and a recent research report by Black (1973) remarkably little is known either about the characteristics of those patients who go into hospitals, or about what happens to them after they leave the hospitals.

Many surveys have been made of the course of schizophrenia, with results which may vary with diagnostic criteria, source and possible selection of patients, hospital admission and discharge policy (and facilities), and many other factors. The time scale is of particular relevance in view of the sometimes life-long course of the condition. Short-term studies thus have limitations to their value, and long-term surveys present problems, such as changes in fashions of diagnosis and management, which may affect their relevance at the time of publication. At present, there is much discussion of the relative roles of general hospital psychiatric units, mental hospitals and community care in the management of schizophrenia, and these organizational aspects are closely bound up and indeed are sometimes confused with the clinical course of the illness.