A survey of 100 female senile admissions to a mental hospital

An investigation was undertaken to determine the fate of 100 consecutive female admissions over 65 to a mental hospital. The patients were admitted to Kingsway Hospital, Derby, between October 1958 and December 1959 and were each followed up for a year or until death. These 100 patients formed 24% of the total female admissions for the period. The catchment area from which they came includes the County Borough of Derby (a heavy-industrial town) with a total of over-65 female population of 8,724; Shardlow Urban District (a rather rambling and mainly country area) with 5,633; and Long Eaton Urban District (a light-engineering town) with 1,934. Thus the total over-65 female population was 16,311. Working from these figures the expected admissions from these areas would be (in %): 53: 35: 12, whereas the actual figures were (in %): 62: 30: 8. This shows, as one would expect, a proportionately higher admission rate from the industrial areas.

The nature and measurement of schizophrenic thought disorder

The work to be reported is a replication and refinement of a previous study (Bannister, 1960). As preface to the previous study, four traditional approaches to the problem of schizophrenic thought disorder were briefly reviewed, namely “dissociation” (Kretschmer 1936), “deterioration in mental efficiency” (Babcock, 1933), “concretism” (Kasanin 1946) and “overinclusion” (Payne, Matussek and George, 1959). These explanations and the experimental work arising from them were not utilized in the current research since it is argued that they suffer from three major defects.

Amitriptyline: A controlled trial in chronic depressive states

Amitriptyline hydrochloride is 5–(3 dimethylaminopropylidine)–dibenzo (a,d) (1,4) cycloheptadiene hydrochloride. Structurally it is not related to the hydrazines and is not a monoamine oxidase inhibitor. It bears some resemblance to the phenothiazines and its chemical structure is related to imipramine, in which the central seven numbered ring is azepine, nitrogen replacing the partially unsaturated carbon of the amitriptyline cycloheptadiene ring (Dorfman, 1960; Vernier, 1961).

A controlled trial of cavodil (Pheniprazine) in depression

In reviewing controlled trials using mono-amine oxidase inhibitors in the treatment of depression it is soon obvious that workers vary as to whether they consider “depression” as a symptomatic mood change in diverse conditions or as a disease entity. Where the latter occurs, a variety of classifications of depressive illnesses appear, and that most widely used is the broad separation between endogenous and reactive depressions. Other points to note are the authors' definition of improvement, and particularly whether this refers to one aspect of the mental state only and whether the patient left hospital before receiving any treatment other than the drug.

Psychosis in hypoparathyroidism

Recently there has been a resurgence of interest in the subject of hypoparathyroidism and it has become increasingly clear that psychiatric symptoms may frequently be found in patients with hypoparathyroidism, even where no evidence of tetany is present. It is significant that in a survey, in the Cardiff area, of 82 patients who had had a thyroidectomy, Davis et al. (1961) found that mental symptoms (defined as a feeling of uneasiness, tension and anxiety, sometimes with attacks of panic, often with depression) occurred in 66 per cent. of 26 patients whose plasma calcium was below 9·3 mgms/cent, in 51 per cent. of 31 patients whose plasma calcium lay between 9·3 and 9·8 mgms./cent. and in 35 per cent. of 23 patients whose plasma calcium was above 9 · 8 mgms./cent. They estimated that at least 24 per cent. of the patients showed partial parathyroid insufficiency, and that this apparently accounted for many minor but disabling symptoms, particularly depression and lassitude. They found that often these symptoms could be cured by the administration of calcium.

The effect of thioproperazine administered by a continuous method on long-term schizophrenic patients

Thioproperazine is a phenothiazine compound with a piperazine nucleus in the side chain. The pharmacological investigations of Courvoisier et al. (1958) indicate that it is much less sedative than other phenothiazines and that it has weak anti-adrenaline, anti-histamine and anti-serotonin activity. Clinical reports by Delay et al. (1958), Perrin et al. (1958), Denber et al. (1959), Levy and Maarek (1960) and Perret et al. (1961) indicate improvement in schizophrenic patients, but their papers described trials of this drug in which both recent and long-term cases or other diagnostic groups were included. Denham and Carrick (1961) reported the total remission of symptoms in 32 of 58 chronic schizophrenics treated by the discontinuous method with significant improvement in a further 25. Their acceptance of the view that improvement was correlated with the occurrence of hypertonic syndromes and that failure of treatment was likely if anti-parkinsonism drugs were used to suppress the hypertonicity, excludes the possibility of the type of continuous treatment employed with other phenothiazines. Denber et al., however, advocated the suppression of these drug effects and Perret et al. reported 47% improvement using the continuous method in another mixed group of chronic patients.

Schizophrenic sub-diagnosis and age at menarche

Not uncommonly, schizophrenia seems to arise in close connection with the puberal years. This is sometimes attributed to psychological or physiological stresses at puberty, but there is no really adequate understanding of the phenomenon. One cannot predict at all dependably which personality characteristics or which stresses will result in a schizophrenic breakdown near puberty.

Bial's reaction for neuraminic acid in cerebrospinal fluid from schizophrenics

The possibility that schizophrenia is associated with a relative deficiency of neuraminic acid in the cerebrospinal fluid has been suggested by Bogoch (1) and confirmed by Chistoni and Zappoli (5).

The social orbit of psychiatric patients

The trainee psychiatrist usually looks upon patients' relatives as a nuisance. Later, he realizes that an essential part of psychiatric treatment is to mitigate the effects of the patient's illness on his family, and to protect him from injudicious interventions on the part of his friends. Finally, it may occur to him that the patient's illness might be causally linked with recent or past psychological disturbances of close associates. A review of recent researches into the relationship between illnesses of individual patients and psychological disturbances in the people around them (Post and Wardle, 7) revealed that much of the work was inconclusive, largely because the investigators had been prematurely preoccupied with some theoretical issues of interpersonal psychiatry. It was, therefore, decided to approach the subject from a practical, clinical angle.