bluuebunny/crossref_metadata_2025 huggingface dataset:
A Psychotherapist's Note on Behaviour Therapy
Authors: Mayer Doris Y.
Published: August 2008

To an analytically oriented psychiatrist a neurotic symptom is a meaningful expression or result of an unconscious conflict. To a behavioural therapist it is maladaptive, learned behaviour. The psychotherapist sees his task as a joint venture in which patient and therapist explore the patient's life history in order to determine how the trauma of the past manifests itself in the distortions of the present. Behavioural therapists contend that analytical theory, of whatever sort, is invalidated by their successes and by the fact that successful treatment of a symptom or set of symptoms has not, in their experience, led to substitution of some other symptom or to more serious pathological consequences. The claimed success rate for behaviour therapy is very high. Journals of recent years abound in reports of spectacular cures, especially of individual patients with traditionally refractory conditions (Clark, 1963; Cooper, A. J., 1963, 1965; Raymond and O'Keefe, 1965). The psychotherapist's aim is to help his patient to understand his problems and find his own solutions for them. Would he be better advised to use his authority to reward “acceptable” and punish “unacceptable” behaviour; or his imagination and inventive skill to figure out ever more ingenious procedures of deconditioning? Is the time-consuming process of intensive psychotherapy not only wasteful but inferior in results to techniques based on conditioning? It seems to me, to judge by recent reports, that some of the results of behaviour therapy are less impressive than a cursory reading would suggest.
Adrenocortical Responsiveness during Courses of Electro-convulsive Therapy
Authors: Elithorn A. , Bridges P. K. , Hodges J. R. , Jones M. T.
Published: August 2008

In a previous paper (Hodges, Jones, Elithorn and Bridges, 1964) we reported on adrenocortical activity in depressed and schizophrenic patients as revealed by plasma cortisol levels before and after electro-convulsive therapy (E.C.T.). Close similarity was found between the two groups except for three depressed patients who appeared to show considerably higher cortisol levels after the treatment than did the remaining subjects. The patients were examined at random different treatments during the whole treatment course and it appeared possible, both that the observed cortisol response to E.C.T. might depend partly on which treatment of the series in a whole course was under examination, and also that the response of the illness to therapy might be a significant factor. It was therefore decided to observe in a number of subjects the response to successive treatments throughout courses of E.C.T.
The Problem of Birth Order and Schizophrenia: A Negative Conclusion
Authors: Erlenmeyer-Kimling L. , Van den Bosch Elyse , Denham Bruce
Published: August 2008

A possible association between birth order and schizophrenia has been sought by a number of investigators. The question considered as early as 1916 by Rüdin has not been resolved satisfactorily since; late birth order has been indicated in some samples of patients (e.g. Granville-Grossman, 1966; Schooler, 1964), early birth order in others (e.g. Solomon and Nuttall, 1966; Sundararaj and Rao, 1966) and an absence of any birth order effect has been reported for still other samples (e.g. Burton and Bird, 1963; Gregory, 1959; Smith and McIntyre, 1963).
The Effect of Maternal Psychological Stress on the Foetus
Authors: James William H.
Published: August 2008

Folklore has had more to say than science about the relation between the outcome of a pregnancy and the psychological history of the parturient: our culture interprets a legitimate stillbirth as the sign of a sick marriage. And sceptics may think that accretions of folklore are with us yet in the form of facile psychoanalytic explanations. Helene Deutsch (1945) ably expounds the case: spontaneous abortion differs from induced abortion, she tells us, in that “the inducing agent is the psyche, and the pregnant woman who resorts to the help of this agent does not act from conscious will or in accordance with conscious wishes”.
Studies in Speech Disorder in Schizophrenia
Authors: Forrest A. D. , Hay A. J. , Kushner A. W.
Published: August 2008

Most clinical psychiatrists would agree that many but not all schizophrenic subjects show abnormalities in the field of language. Many use neologisms, i.e. new words for old referents, and some chronic patients talk in a more or less private language which at times degenerates into a word salad. The following features have been noted in the schizophrenic's verbal productions—alliteration, condensation, over-inclusiveness and the personal distortion of the symbol-referent tie. Stuart Chase said: “The point of every discussion is to find the referent. When it is found emotional factors dissolve in mutual understanding.” Psychiatrists often assume that they have identified the referent which ties in with the symbol the patient is using, but sometimes the patient uses new symbols, as “Bill” did the other week when he astonished the other group members by announcing that he was “troubled by warpations and distressed by ignorances”.
The Physiological Maturity of Adolescent Psychiatric Patients, Juvenile Delinquents and Normal Teenagers
Authors: Henderson A. S.
Published: August 2008

Do psychiatrically disturbed teenagers tend to be physically immature? This paper describes an investigation designed to answer this question by formal methods and to test beliefs based on imperfect evidence. Through the development by Tanner, Whitehouse and Healy (1962) of a refined technique for the estimation of physiological maturity by measurement of skeletal age, it has been possible for an investigation to be carried out in this area with considerable confidence in the instrumentation. For the author, interest in physiological maturity was prompted by both clinical impressions and experimental findings, both of suspect validity, yet each pointing to the possibility that physiological maturation might be significantly different in normal and in disturbed adolescents.
Intelligence, EEG, Personality Deviation, and Criminality in Patients with the XYY Syndrome
Authors: Nielsen J. , Tsuboi T.
Published: August 2008

Comparatively high intelligence level has recently been reported as an exception in patients with the chromosome constitution XYY (Borgaonkar et al. (1968), Forssman et al. (1968), and Leff and Scott (1968)). We found, however, normal or high intelligence level in all nine patients with the XYY syndrome diagnosed in our laboratory and found in psychiatric institutions (full scale IQ, by WAIS 99, 90, 93, 100, 120, 93, 96, 98, and IQ low in the normal range).
Serum Cholesterol in Mental Retardation
Authors: Eastham R. D. , Jancar J.
Published: August 2008

During the course of routine investigations it was noticed that an abnormal number of low serum cholesterol results were occurring in our laboratory, and that these results appeared to come from mentally retarded patients. An investigation was therefore carried out on over 1,400 patients in the Stoke Park Group of Hospitals. Whenever blood was taken for routine haematological examination a serum sample was also collected for cholesterol determination. A preliminary report of these findings was made (Eastham and Jancar, 1967).
On Telling Parents of a Diagnosis of Mongolism
Authors: Berg J. M. , Gilderdale Susie , Way Jean
Published: August 2008

The most appropriate time and way to inform parents of a diagnosis of mongolism is often discussed among physicians and others who have early contact with mongol children. Despite this, however, few attempts have been made to ascertain systematically the views of the parents themselves. We have had an opportunity to do this in the course of a clinical and cytogenetic investigation of mongolism. Information on the subject was obtained from 95 mothers of mongols, all of whom were personally interviewed by at least one of us during the past three years. Nearly all the parents were from north-west London and adjoining counties, and represented all social classes.
Self-applied Constricting Bands
Authors: Dawson-Butterworth K. , Wallen G. D. P. , Gittleson N. L.
Published: August 2008

Interesting accounts of injuries resulting from self-applied constricting bands have been given by Thurston (1963, 1967), Little (1965), Cutler (1967), Turney (1967) and Glew (1967). Callum (1967), Noott (1967) and Webb (1968) have reported injuries in babies where the band was presumably not self-applied. Cohen (1967) noted lesions in mental defectives produced by self-applied elastic bands round the teeth.
The Measurement of Relevant Change after Psychotherapy: Use of Repertory Grid Testing
Authors: Ryle Anthony , Lunghi Martin E.
Published: August 2008

Psychotherapists, who by temperament are likely to be tender-minded, have up to now largely failed to devote “attention to the problems of quantitative assessment” (Sutherland et al., 1967), and have perhaps been too prone to regard the complaints of tough-minded critics as manifestations of unconscious resistance. If, as most therapists do, one retains the conviction that patients are altered by the experience of psychotherapy, it should be possible to demonstrate and measure such alteration. The fact that attempts to measure change are often unconvincing is probably a function of the crudity or irrelevance of many of the measuring instruments used.
The Diagnostic Distribution of Treated Psychiatric Illness in Lebanon
Authors: Katchadourian Herant , Racy John
Published: August 2008

The background, methodology, and general results of a comprehensive survey of treated psychiatric illness in Lebanon have been described in an earlier report (4). The investigation consisted of obtaining biographical and diagnostic data on all patients seen by psychiatrists in Lebanon over a six-month period (15 February 1964 to 15 August 1964) and was carried out with the collaboration of all three psychiatric hospitals in the country and twenty of the twenty-one psychiatrists practising within and outside these institutions.
A Method for Analysing Assessments of Symptom Change
Authors: Philip Alistair E.
Published: August 2008

In studies which attempt to assess the efficacy of some new treatment it is customary to make a formal assessment of the relevant behaviour or symptomatology using standardized inventories, checklists, symptom rating scales or ad hoc ratings of variables considered to be important by the clinician-researcher. Ratings made at the beginning and end of treatment are compared for groups of patients using improvement scores, arbitrary cut-off points and other devices aimed at circumventing the statistical problems arising from the non-normal distributions of most rating scales. Present practice favours the use of some nonparametric statistic in these comparisons. The aim of this paper is to present a method which facilitates the analysis of ratings made on more than two occasions, allowing a trend analysis to be carried out without making assumptions about the distribution of scores. The method also allows the clinician-researcher to make a statistically-based decision regarding the efficacy of the treatment in question for individual patients.
Sexual Activity and Urinary Steroids in Man with special reference to Male Homosexuality
Authors: Dewhurst Kenneth
Published: August 2008

In his Upjohn lecture Professor G. W. Harris (1964) reviewed experiments on the effects of gonadal hormones on the sexual behaviour of animals. He compared sexual behaviour patterns of male rats castrated on the first day of life with those of adult castrates. When fully grown, these day-old castrates were either primed with oestrogen and progesterone and tested for female mating behaviour, or they were given testosterone and tested for male behaviour with receptive females. Thus, Harris was able to demonstrate bisexual behaviour (mediated through hypothalamic-pituitary pathways) with female type activity cycles occurring in male rats. These experiments suggest that gonadal hormones exert a dual effect. During the early phase of development they act inductively, and later in the adult they exert an excitatory action on the central nervous system.
The Lesbian Personality
Authors: Hopkins June H.
Published: August 2008

This paper is an attempt to fill the void in objective investigation into the personality factors of lesbians. Although the subject of male homosexuality has been investigated exhaustively, it was not until relatively recently that studies concerned with lesbianism have been published, beginning with Armon (1960), then Bene (1965), Kaye et al. (1967) and Kenyon's series of articles in 1968. These papers have all attempted to take the subject out of the myth and psychoanalytic theory stages and bring it into the light, to determine whether the many theories, which at times have been based upon knowledge gleaned from male homosexual studies, have any objective, quantifiable basis. For example, one view stated by Caprio (1957) ‘that the vast majority of lesbians are emotionally unstable and neurotic …’ is a view commonly held as true almost by definition in psychiatric circles. It might be that this type of observation has been too subjectively made, on the basis of psychiatric interviews of otherwise neurotic women, who also may have been homosexually inclined.
Predicting Verbal Participation in Group Therapy
Authors: Aston P. Jean
Published: August 2008

This study was conducted at an out-patient clinic employing group therapy techniques, where some workers felt that a balance between frequent participators and more silent members was advantageous to the group as a whole. As Taylor (1961) has observed, frequent speakers tend to withdraw from groups if not given enough scope for participation. Very silent members sometimes have difficulty in establishing themselves at all, yet the lack of even one active member may lead to a decline in group morale, hence in motivation to continue treatment.
Electrolyte Content of the Brain in Alcoholism
Authors: Shaw David Murray , Camps Francis E. , Robinson Ann E. , Short Richard , White Stuart
Published: August 2008

The results from a small series of persons suffering from alcoholism suggested that the amounts of water and electrolytes in their brains (obtained post mortem) differed from those of control and depressed individuals (Shaw, Frizel, Camps and White, 1969). Since publishing this work we have analysed brain tissue from a further series of alcoholic subjects, and in this paper we compare these findings with the original data from control and depressed groups.
Psychotherapy with Failures of Psychoanalysis
Authors: Schmideberg Melitta
Published: August 2008

From time to time patients come to one who have had years of unsuccessful psychotherapy and are in desperate need of help. To undertake the treatment of such patients is to face many difficulties. Understandably they are suspicious of the new therapist; it will not do if he reminds them of the one who disillusioned them, but if they come to like or trust him they may feel that they are being disloyal to their first therapist, to whom they still have some attachment. If they notice improvement in their condition it gives them no pleasure, for they know that they have relapsed after appearing to improve in the past. On the other hand, any setback upsets them greatly; they are convinced that they will never get well, and blame either the therapist or themselves or both. They have been made to feel that analysis is the only worthwhile therapy, and that there must be something quite specially wrong with them if it cannot help them as it has helped others; so their depression and sense of failure are reinforced. Often it is not only their psychological condition but also their realistic situation that has deteriorated, sometimes beyond repair.
Attitudes of Mental Hospital Visitors towards Unrestricted Visiting
Authors: Kumar K. , Willcocks A. J. , Handyside A. J.
Published: August 2008

A programme was undertaken to study the attitudes of visitors to mental hospitals. Initially a series of individual non-directive tape-recorded interviews were conducted on a small sample of visitors, who freely discussed various topics, including staff attitude, visiting problems and difficulties in having a mentally ill relative. A provisional questionnaire was constructed from the significant points of the recorded interviews and was used on another sample of visitors in a pilot study, on the basis of which a final ‘multiple choice’ questionnaire was designed incorporating 28 items. Copies of the final questionnaire were then distributed from the wards of two mental hospitals to consecutive visitors, with a stamped envelope addressed to Nottingham University, informing them that the study was in connection with an independent survey. The distribution continued until few new visitors attended. Of the two hospitals, the first, The Pastures (Hospital A), serves a wide county catchment area and has an ‘unrestricted visiting hours' policy; the second, Kingsway (Hospital B), on the other hand, has a ‘limited visiting hours' policy and serves a compact urban catchment area. Altogether 510 questionnaires (75 per cent) were returned completed, 306 (8o per cent) for Hospital A and 204 (70 per cent) for Hospital B at the end of the study. The rest of the paper is confined to the analysis of these 510 questionnaires in relation to the question on the effect of unrestricted visiting, which has already been studied by Barton et al., from the nurses' point of view. The particular question asked by us was, 'some hospitals allow visitors to visit at any convenient time. What effect do you think this would have on (1) the patients, (2) the visitors, (3) the nursing staff, (4) the doctors?’ The replies were to be given on a five point scale for each question. The scale was ‘Very good-Good-No effect-Poor-Very poor.’ the graded adjectives being determined from the earlier tape-recordings.
Sleep in Depression and Mania
Authors: Platman S. R. , Fieve R. R.
Published: August 2008

It is generally assumed that depressions are accompanied by sleep disturbances. We have combined staff objective ratings and patients' subjective responses to study sleep in depressed and hypomanic or manic patients. We report on ten nights only, because during that period all patients were on placebo medication.
Huntington's Chorea in Northamptonshire
Authors: Oliver J. E.
Published: August 2008

Northamptonshire is a county in which details of pedigrees containing patients suffering from Huntington's Chorea have been kept for the past 14 years. In some families these details cover a span of eight generations. Pleydell (1954) found the prevalence of this illness to be five cases per 100,000 in 1954 (eight choreic families in the county), but in 1955 he found four new affected patients in one family, making 6-5 cases per 100,000 in nine choreic families for the county. Reid (i960) found two new subjects in the tenth choreic family of the county.
Huntington's Chorea in the West of Scotland
Authors: Bolt Jean M. W.
Published: August 2008

There have been relatively few studies of Huntington's Chorea in Britain. They include those of Curran (1930), Critchley (1934), Spillane and Phillips (1937), Minski and Gutt- mann (1938), Bickford and Ellison (1953), Pleydell (1954), Lyon (1962), Heathfield (1967), and Oliver (1970). Julia Bell's (1934) monograph was primarily a review of the literature, but included cases previously reported in this country and the results of her own observations.
Treatment of Persistent Phenothiazine-induced Oral Dyskinesia
Authors: Roxburgh Peter A.
Published: August 2008

Since the first description of persistent oral dyskinesia following phenothiazine treatment by Sigwald in 1956 a good deal of evidence has accumulated indicating the regular occurrence of this syndrome. However there is a disagreement over its incidence and the aetiological role played by phenothiazine drugs. Kline (1968) in a recent review found a total of 114 cases of ‘irreversible’ oral dyskinesia and concluded that the incidence had been misrepresented since less than two dozen of these recorded cases were previously non-brain damage.
On the Genesis of Affective Illness. A Pair of Discordant Twins
Authors: Thomson Ian G.
Published: August 2008

Progress in the behavioural sciences is bedevilled by the difficulty in finding adequate controls. This is a report of a patient who in two important respects provided her own control.
Perception of Hidden Figures by Neurotic and Schizophrenic Patients
Authors: Crookes T. G. , Hutt S. J.
Published: August 2008

Weckowicz (1960), using pictures of common objects with superimposed lines, found that schizophrenics were less able to see the hidden figures than normal subjects and other patients. Unfortimately the task turned out to be too easy; most of the normal subjects and more than a third of the acute schizophrenics obtained the maximum possible score. Such a distribution of scores makes it difficult to carry out further analysis of the results. The aim of the present study was, using a more difficult task to obtain a better distribution, to confirm the lowered capacity of schizophrenics and to relate it to other variables. The task used was the ‘Gottschaldt Figures Test’, published by the University of California Institute of Personality Assessment and Research. This consists of the identification of two simple geometrical figures embedded in complex designs. The score (maximum = 20) is the number of figures correctly identified on two sheets, 2 minutes being allowed for each sheet. To ascertain how this task is ‘normally’ related to certain major personality variables, a group of neurotic patients was used, since they would not be expected to have any special disability on a task of this type.
A Controlled Study of Polarization in Depression
Authors: Arfai E. , Theano G. , Montagu J. D. , Robin A. A.
Published: August 2008

In 1964 Lippold and Redfearn described the mental changes induced by the passage of small positive and negative polarizing Currents through the human brain in volunteer patients. They further reported the clinical effects of polarizing the brain in 29 patients with long standing depression (Redfearn et al., 1964), and they also conducted a controlled trial of polarization in depressive illness (Costain et al., 1964). When the head was positive to the leg, an elevation of mood was said to follow, while the reverse was the case with a negative head electrode. In the uncontrolled trial of long standing depressives, 13 were said to show clinical improvement of the 24 who were considered to be adequately treated. In the controlled trial a significant therapeutic effect was rated by both doctors and nurses. Sheffield and Mowbray (1968), using normal human subjects, failed to validate the mood changes said to follow positive and negative polarization. Lifshitz and Harper (1968) found no appreciable effect of polarization in five chronic male schizophrenic patients studied over 14 weeks. The following study was designed to replicate the double blind trial on depressed patients.
The Effects of Imipramine and Electric Convulsive Therapy on the Excretion of Various Minerals in Depressed Patients
Authors: Flach Frederic F. , Faragalla Farouk F.
Published: August 2008

Previous studies from our laboratory (2) indicated that treatment of depressed patients with electric convulsive therapy (ECT) or imipramine was associated with significant decrease of urinary calcium excretion. The studies described in this report were undertaken to find out whether the decreased urinary calcium observed during ECT or treatment with irnipramine was accompanied by changes in the excretion of other urinary metabolites such as phosphate, magnesium, sodium and potassium.
Cleidocranial Dysostosis: Psychological Observation of Two Cases
Authors: Nolan G. , Hackman Ann
Published: August 2008

The syndrome of cleidocranial dysostosis was first reported by Marie and Sainton in 1898. It is a congenital condition giving rise to a defect in ossification. The principal clinical features are dwarfism, a large head with a small fades, and a depressed or saddle-shaped nose. The clavicles are incomplete or absent, scapulae are small and poorly formed, and frequently the symphysis pubis fails to fuse.
The Physical Status of Psychiatric Emergencies
Authors: Eastwood M. R. , Mindham R. H. S. , Tennent T. G.
Published: August 2008

Patients are usually referred to outpatient departments by their family doctors, and it is generally assumed that after the initial assessment in the surgery they are directed to the appropriate clinic. However, it is clear that this does not always occur. In some cases there is difficulty in deciding to which clinic a patient may most profitably be sent, and this is especially so when a patient complains of both physical and psychiatric symptoms.
Students' Strains and Stresses
Authors: Wolfenden John
Published: August 2008

I should like, in the first place, to express my deep and humble appreciation of the honour of your invitation to me to deliver this year's Maudsley Lecture. I am very sensible indeed of the honour, and equally of the responsibility, which you have conferred upon me. In my attempt to carry out that responsibility I should be in total despair, were it not for one sentence in the letter of invitation which I received from your impeccable Secretary. He wrote ‘What we want is to listen to people in other fields talking on their own subject with sufficient of a bridge for some degree of mutual understanding.’ That modest hope seemed to me to be conceivably possible of fulfilment.
The Mental Implications of Sex Chromosome Aberrations
Authors: Forssman Hans
Published: August 2008

I have chosen as the subject for my Blake Marsh Lecture the influence of sex chromosome aberrations on intelligence, mental health and social adjustment. This subject provides a fascinating example of how a branch of research, beginning in the field of mental retardation, arrived at discoveries which proved to be of significance to quite other fields of psychiatry. Ten years ago we learned that sex-chromatin-positive males, that is, males with additional X chromosomes, at least in some cell lines, were more often encountered among the intellectually retarded than among the average population of males. Shortly after this we learned that the same was true of women with double Barr bodies, that is, women with more than the usual two X chromosomes, at least in some cell lines. Today we have facts showing that an abnormal sex chromosome complement may have an unfavourable effect on mental health, and this in several different ways; thus we know that it may contribute to the development of functional psychoses, and may even influence such a complex variable of behaviour as our ability to adapt ourselves to the laws of the community. Myself, I am convinced that study of aberrations in the sex chromosomes will prove to have a radical effect on large sections of psychiatric thinking.
Androgen Excretion and Physique in Schizophrenia
Authors: Brooksbank B. W. L. , MacSweeney David A. , Johnson Anthony L. , Cunningham Ann E. , Wilson David A. , Coppen Alec
Published: August 2008

A proportion of individuals suffering from schizophrenia show either physical or psychological signs of gonadal underfunction or incomplete sexual maturation (Hoskins, 1943; Hoskins and Pincus, 1949; Bleuler, 1954; Sands, 1957; Reiss, 1958; cf. Shader and Grinspoon, 1967). Rey and Coppen (1959) reported significantly lower, that is more feminine, androgyny scores (Tanner, 1962) in schizophrenic patients, although reduced scores were also found to a lesser extent in depressive and neurotic patients. Sex chromosome anomalies were not found in those patients with abnormally low androgyny scores (Cowie, Coppen and Norman, 1960), and it is possible that the abnormal physique is caused by some hormonal malfunction during development which also may be associated with a predisposition to psychiatric illness.
Basic Psychoanalytic Concepts: VII. the Negative Therapeutic Reaction
Authors: Sandler J. , Holder A. , Dare C.
Published: August 2008

The clinical concept of thenegative therapeutic reactionhas been included in this series for a number of reasons. It is a concept of particular importance in the history of psychoanalysis, for it represents the clinical phenomenon chosen by Freud (1923) to illustrate the workings of an ‘unconscious sense of guilt’ and to indicate the existence of what he conceived of as a special mental agency—thesuperego.Moreover, it is a concept widely used in clinical psychoanalysis, although little has been written on the subject since Freud's original formulation of it. Unlike such concepts astransference(Sandler, Dare and Holder, 1970) andacting out(Sandler, Holder and Dare, 1970a) it has not been extensively applied outside clinical psychoanalysis. This may be regarded as surprising in view of the fact that it would seem to be readily capable of application without alteration to a wide variety of clinical situations.
Lincoln and Non-Restraint
Authors: Walk Alexander
Published: August 2008

Non-restraint in the mid nineteenth century was a watchword, a battle-cry, a symbol of that movement for the reform of the treatment of the insane which has been called ‘one of the finest flowers of Victorian philanthropy’. The need for such watchwords and symbols to dispel stagnation and stimulate progress has been well exemplified in our specialty in these times; and, strange as it seems to one of my generation, ‘mechanical restraint’ has even in the last few months again become a subject for discussion.
Childhood Autism: An Investigation of Aetiological Factors in Twenty-five Cases
Authors: Lobascher M. E. , Kingerlee P. E. , Gubbay S. S.
Published: August 2008

In 1943 Kanner described a disease entity which he referred to as ‘Infantile Autism’. Creak and Ini (1960) found no evidence of psychogenic aetiology in a study of 200 parents of autistic children. Bender (1955) retrospectively studied children seen at Bellevue Hospital for behavioural or developmental disorders and who had been diagnosed as schizophrenic before seven years of age. No preponderance of the sophisticated, intelligent, well-to-do parents as described by Kanner was found; every racial and religious group was represented, Jews predominating slightly. A strong genetic predisposing factor was indicated—40 per cent of the parents were schizophrenic. Stroh (1962) insists that the child's condition cannot be attributed to maternal mishandling, and Wing (1966) has said ‘It is possible to interpret the data to support both environmental and biological theories of primary causation, but on the whole the former argument is very difficult to sustain.’
The Personal Questionnaire as a Method of Assessing Change during Psychotherapy
Authors: Hobson R. F. , Shapiro D. A.
Published: August 2008

A cogent interpretation of the apparent average ineffectiveness of psychotherapy (e.g. Eysenck, 1960) has been proposed by Bergin (1966) and taken up by Truax and Carkhuff (1967). This explanation is based upon the suggestion that some therapeutic encounters harm patients and hence beneficial effects are cancelled out when the average results of large groups are considered. Rather than beginning with large miscellaneous samples treated in an unspecified variety of ways, our research programme involves detailed experimental and correlational studies of the therapy of a small number of patients with similar diagnoses. This paper is limited to a preliminary study of assessment of change in psychotherapy by means of the Personal Questionnaire (PQ,), (Shapiro, 1961, 1969).
Subacute Combined Degeneration of Unknown Origin with Extensive Involvement of the Brain
Authors: Hemphill R. E. , Stengel E.
Published: August 2008

The aetiology and pathology, as well as the clinical characteristics of those diseases of the nervous system in which the myelin sheaths and the axis cylinders are unsystematically affected, but the other elements of the nervous tissue spared, are as yet incompletely understood. Of these diseases, the group in which the changes of the nervous system are associated with anaemia and other dyscrasias of the haemopoietic system, generally classified as subacute combined degeneration of the spinal cord, is the most clearly defined. However, even in this group cases occur in which the characteristic degeneration of the spinal cord is not accompanied by gross pathological changes in the blood. There is still, therefore, much research required before these atypical cases can be brought into line with the general pathological conceptions of the subacute combined degeneration. Furthermore, the existence and character of pathological changes in the brain and other parts of the nervous system of cases with subacute combined degeneration, apart from the spinal cord, remain to be investigated more fully. The case which we have to report has various special features, the study of which should contribute in some degree to the elucidation of these complex problems. In this case, which presented the typical picture of a subacute combined degeneration without blood changes, there was an extensive affection of the brain and the peripheral nervous system.
The Incidence of Conjugal Neurosyphilis
Authors: Huttox E. L.
Published: August 2008

As syphilis is a contagious disease it is a matter for surprise that so few investigations have been made into the conjugal histories of patients suffering film general paralysis of the insane.

Until quite recent years the figures of O. Fischer (1913) have largely been quoted when the incidence of conjugal neurosyphilis has been brought into question. Among the husbands of 86 female paralytics he found 8 cases of conjugal neurosyphilis. More recent inquiries have been made by Moore, the Solomons and Kemp, and their results have been summarized by Moore (1933).
A Survey of Skin Testing, with Observations on a Suggested Method in Epileptics
Authors: Dewar D. C.
Published: August 2008

Skin sensitivity had been mentioned and demonstrated in isolated instances over a long period of years before Schloss in 1912 extended and described its usage and established it as a definite means of detecting hypersensitiveness. Since then it has been universally recognized as a most useful adjunct to the study of the aetiological problems of allergy. At first it seemed that a miraculous means had been found of explaining both the cause of and the reason for the recurrence of certain common disorders of obscure aetiology in widely separated organs. It promised to show how totally different symptoms could be attributed to a common agent. The fact that the skin was sensitive but that the only clinical evidence of disease appeared, say, in the lungs gave the impression that all organs of the body must be in a like state of sensitivity. This has since been widely disputed and denied and on this subject Alexander (1936) states that such an assumption, at least from the clinical standpoint, is a fallacy. Man, he believes, may exhibit general hypersensitivity if a sufficiently large dose of protein be experimentally introduced.

If, then, hypersensitiveness is localized in certain tissues, it follows that the skin may or may not be sensitive in any given case and at any given time. In other words, because the ingestion of a specific food leads to colic or urticaria, it does not necessarily follow that the skin will give a positive reaction to an extract of that food in all cases or at all times. Indeed, a positive reaction may not occur at any time. This limitation of skin testing is now accepted; but nevertheless, allowing for the fact that only 50-60 per cent. of allergics (and that is not an over-generous estimate) give positive results, it still remains a very valuable diagnostic aid.
Arachnodactyly (Dolichosténomélie of Marfan)
Authors: Dax E. Cunningham
Published: August 2008

Arachnodactyly, or spider digits, was first recognized as a clinical entity by Marfan in 1896, and since then a considerable number of cases have been described; thus in 1938 Futcher and Southworth were able to find two hundred examples in the literature. Reviews of the condition have been made by Marfan (1938) and Clément (1939). Its relationship to oligophrenia has never been stressed, but since skeletal and ocular abnormalities are so frequent in defectives, it is not surprising that cases of arachnodactyly should also be found.
On the Curability of Mental Diseases by “Shock” Treatment
Authors: Freudenberg Rudolf
Published: August 2008

The treatment of mental disorders by drastic methods coming as a “shock” to the patient was applied early in history all over the world (1). The severity of the procedure usually varies with the degree of civilization achieved. The earliest method was occipital branding. Water cures followed later: “The frantic person was placed with his back to the water without being permitted to know what was going to be done. He was knocked backwards into the water by a violent blow on the chest, when he was tumbled about in a most unmerciful manner until fatigue had subdued the rage.” Anglo-Saxon priests used a form of treatment described in Bald's Leechbook: “In case a man be a lunatic take the skin of a mereswine (porpoise), work it into a whip, swing the man herewith, soon he will be well. Amen.” (1).
A Study of Erythroedema Polyneuritis (Pink Disease)
Authors: Ratcliffe T. A.
Published: August 2008

Although Selter (1) appears to have described examples of this disease in 1903, it was not given its present name, nor was it generally recognized, until 1914, when Swift (2) in Australia described fourteen cases of a clinical disease entity and gave it the name of “erythroedema.”

Since then a number of other cases and series of cases have been described and much work has been done in investigating its possible pathology and aetiology.

Byfield (1920) (3), Parkes Weber, Thursfield and Patterson (1922) (4), Findlay and Stern (1929) (5), and Wylie and Stern (1931) (6) have contributed papers in the English language.

In 1923 Patterson and Greenfield (10) published a review of the disease and discussed in particular the pathology and causation of its polyneuritic aspect.

A description of the disease is to be found in most works on paediatrics, in particular those of Findlay (7) and Hutchinson (8), whilst Still (9) gives a series of 17 cases observed by him. A further description is given by Brain (12), whilst Rocaz (11) has published a monograph summarizing our knowledge of the disease. Reference to this and further literature will be made later in this paper as various points are discussed.

In the present investigation 15 cases of pink disease are considered. Of these 7 were obtained from the records of cases admitted to the Sheffield Children's Hospital in the two years 1931 and 1932. One was personally seen by the writer at St. Thomas's Hospital, London, in 1933, and 7 more have been personally investigated in the Sheffield Children's Hospital between October, 1933, and March 1, 1935. In addition many of the old cases have been seen and followed up in the Out-Patient Department by the writer. Some other investigations which bear upon the subject are also described.
Hyperostosis Frontalis Interna: Its Relationship to Cerebral Atrophy
Authors: Stewart R. M.
Published: August 2008

In not a few of the recorded cases of hyperostosis frontalis interna there has been observed some degree of cortical atrophy, chiefly affecting the frontal poles, and its occurrence raises the question of its possible relationship to the osseous change.

Three alternatives may be entertained: (1) Brain atrophy is caused by the encroachment and pressure of the hyperostotic area on the surface of the brain; (2) brain atrophy is primary, the shrinkage of the frontal convolutions in some way exciting a compensatory bony overgrowth ; (3) the two processes, osseous and neural, are entirely independent of each other.
Hyperthyrotic Catatonia: A Schizophrenic Symptom-Complex
Authors: Hemphill R. E.
Published: August 2008

The thyroid, as one of the glands of internal secretion to be studied first and subsequently most intensively, was early regarded with interest in relation mental disorder. Its role in the production of cretinism and in myxoedema in which the activity of the gland is diminished, as well as the association of thyrotoxicosis with psychic changes, suggested that anomalies of this organ might be linked with some forms of mental disease.
The Treatment of Tuberculosis in Unco-Operative Patients
Authors: Kennedy Alexander
Published: August 2008

The reduction in the incidence of pulmonary tuberculosis among chronic psychotic cases has been one of the most striking indications of the improvement in conditions of institutional care during the present century. Provided that he is sufficiently co-operative, the patient who enters a mental hospital with an active lesion has generally at least as good a prospect of recovery as the patient who attends a general hospital or dispensary for a lesion of similar severity. For even if the nature of his mental disturbance may sometimes be such as to make his attitude to the illness unsatisfactory, he is often relieved of that fear of economic stress and feeling of obligation to his dependents to return to work as soon as possible, which so often prejudices recovery in the patient of sound mind.
The Investigation of Personality in Patients Treated by Prefrontal Leucotomy
Authors: Hutton E. L.
Published: August 2008

I have been fortunate in having the opportunity of studying several of the 15 patients treated by prefrontal leucotomy in connection with the Burden Neurological Institute. I do not propose to discuss the clinical results; it is much too early as yet for any authoritative opinion to be given, and a brief review of the literature and of the early results of the first 8 cases in this series was recently published in the Lancet. It may be mentioned, however, that the results are such as to justify the cautious adoption of this operation for therapeutic purposes. Although obviously any procedure of this kind is only justifiable on therapeutic grounds, its value for psychological medicine is far more than the mere addition of another effective therapeutic method, since for the first time in history an opportunity has been presented for the study of changes in personality produced by a relatively standardized local lesion of the brain, enabling us to investigate as never before the role of the frontal lobe in normal and abnormal mental states. This investigation involves the study and correlation of both neurological and psychological data, and encounters all the difficulties inherent in such correlation.

I am only too well aware of the extremely hypothetical nature of much that follows, and of the crying need for experimental evidence to confirm or refute the view here propounded, but I believe that our knowledge of mental disorders would be immeasurably advanced could we but discover the rationale underlying our present empirical methods of therapy.
Serum Choline Esterase and Depression
Authors: Richter Derek , Lee Margaret
Published: August 2008

While investigating the serum choline esterase activity in anxiety states, a series of successive new admissions to the Neurological Section of the Mill Hill Emergency Hospital were tested with a view to obtaining further information as to the types of cases giving abnormally high or low esterase activities.

Sera giving abnormally high esterase activity were generally found to come from patients who had been diagnosed on admission as anxiety states, but an exception was noted particularly in the case of one patient (P. M—) with the very high esterase activity of 169. This patient was described on admission as “always emotional; he feels like weeping when the National Anthem is sung; not afraid of dangers.” He complained of uncontrollable weeping in company and he had considered suicide. Both from our own observation and from that of others it appeared that he was not a particularly anxious person, but he was extremely depressed. This observation raised the question of whether anxiety is the only emotional condition in which the serum esterase activity is raised or whether it may not also be raised in severe depression.

It appeared that information on this point might be obtained by analysing the data which had accumulated in testing the new admissions, which consisted of a varied collection of patients suffering from anxiety states, depressive states, hysteria and other neurological and mixed conditions. The possibility of subsequent analytical treatment was not considered at the time when the data were collected and the diagnoses were made by more than 12 different physicians who were known to differ to some extent in their diagnostic criteria. For this reason it was hardly expected that the results would be extremely clear-cut, but in actual fact the analysis brought out surprisingly clearly the differences in serum choline esterase activity in different types of neurotics. The diagnoses were made without a previous knowledge of the esterase activities and were therefore unbiased in this respect; we are indebted to the physicians for their permission to make use of them.

Methods.—The method of estimating the serum choline esterase was the same as was described in the preceding paper (Richter and Lee, 1942), except that venous blood from the arm was used instead of capillary blood. In some of the estimations acetylcholine bromide was used instead of the chloride. The bromide ion caused a slight inhibition of the enzyme which was corrected by multiplying by the factor 1·06, which was determined empirically by carrying out estimations on the same sample of serum with the chloride and bromide at the same time. The control group consisted of the 12 normal and 12 surgical patients described in the preceding paper; the mean serum esterase activity for the 24 controls was 75 units. The various esterases occurring in blood have been described by Richter and Croft (1942).
Invalidism from the Army Due to Mental Disabilities. The Aetiological Significance of Military Conditions
Authors: Tredgold R. F.
Published: August 2008

The question of invalidism from the Army appears to be inextricably bound up with the rather larger problem of the needs of the Army, with which, therefore, at the risk of seeming obvious, I shall try to deal very shortly.

If one may judge from the opinions of General de Gaulle, adopted largely in the training of Panzer divisions, this war differs from the last in the importance, firstly, of smaller bodies of picked men, and secondly of the continuance of production behind the lines. Thus it would now seem better to train as warriors a smaller number of eminently suitable men, while leaving others to fill those jobs of any essential kind to which they are best fitted.
Hamlet's “Madness”
Authors: Davie T. M.
Published: August 2008

Drs. Stern and Whiles, in an interesting and provocative article in the January issue (1), claim to have solved the problem of Hamlet on the assumption that Hamlet suffered from the Ganser state occurring during the course of another psychosis. By this theory they hope to reconcile the seemingly contradictory views that Hamlet was insane, and that he was pretending to be so. He was both, they say, and the latter because of his being in the Ganser state.

The authors claim to have examined the problem from a strictly psychiatric viewpoint; but it must be remembered that such a viewpoint is necessarily subject to many limitations, inasmuch as there exists no parallel to Hamlet in actuality. One has constantly to bear in mind that Hamlet is not an historical personage, but a character in a play, and that our task is not to explain some Hamlet of our own, but Shakespeare's Hamlet; and in consequence our theories must not only be psychologically acceptable, but must conform with the text of the play which, after all, is the final arbiter. With this in mind, a psychiatric study of Hamlet may be of great value, but it need not and perhaps cannot be expected to “explain” Hamlet.