Blood-letting in bulimia nervosa.

Three cases of blood-letting in association with bulimia nervosa are reported. This association has not previously been described.

Smoking attitudes amongst nursing tutors and their students.

We have compared the smoking habits, and attitudes towards the habit, in 51 nurse tutors and 649 of their students. There were similar proportions of never-smokers, but rather more ex-smokers among the tutors. Only nine (17.

Are polioviruses a cause of schizophrenia?

Pre-natal infection with polioviruses could contribute to the subsequent development of schizophrenia. The hypothesis draws support from the declining incidence of schizophrenia, the excess of schizophrenic winter births, and the increased rates of schizophrenia among West Indian immigrants. There are parallels with other late sequelae of poliovirus infections.

Doctors' views on anxiety management in general practice.

Various guidelines have been issued to doctors concerning the treatment of anxiety in primary care and particularly on the use of benzodiazepines. Little has been reported about how this advice has influenced doctors' opinions and practice. This paper describes results of interviews with 15 general practitioners and 15 general practitioner trainees on their management of anxiety problems.

The relationship between schizophrenia and immigration. Are there alternatives to psychosocial hypotheses?

Several recent studies have found markedly increased rates of schizophrenia among West Indian immigrants to the UK. Almost exclusively, authors have sought psychosocial explanations for these findings. This paper hypothesises that environmental causes, notably obstetric complications and perinatal infections, provide more plausible aetiological models, especially for the raised rates of schizophrenia among second-generation West Indian immigrants.

Physical morbidity in patients admitted for detoxification from alcohol.

A considerable level of physical morbidity (71.1% of cases) was found in 76 consecutive admissions to an alcoholism treatment unit. Sixteen patients (21.

To which neurotic patients do psychiatrists prescribe medication?

Of 318 newly referred neurotic patients, 43% were prescribed medication by their psychiatrist. Medication was more likely to be prescribed to patients who are older, who are married, who have lengthy illnesses and who do not have a history of deliberate self-harm. These findings are discussed in the context of current debate about optimal treatment methods for patients with neurotic disorders.

Obstetric complications in DSM-III schizophrenics and their siblings.

Blind to the adult diagnosis, the birth records of 27 patients fulfilling DSM-III criteria for schizophrenia and those of their healthy siblings were examined. A significant excess of obstetric complications was seen in the schizophrenic subjects.

Resistant bipolar disorder.

A 66-year-old farmer's wife had been admitted 31 times over eight years, suffering from manic depression. A variety of treatments for depressive episodes led to hypomania, and a case conference was held to discuss treatment.

A comparison of anorexia nervosa and affective psychosis in young females.

In a retrospective case note study, 73 young females with anorexia nervosa were compared with 88 young females with affective psychosis. These groups of patients did not differ in terms of place of residence, birth order or social class. They differed very significantly, however, in terms of age at onset of symptoms, marital status, educational attainments and in the pattern of family histories of psychiatric illness.

Relation between cognitive impairment and early death in the elderly.

Study Objective: To study the association between cognitive impairment and early death in elderly patients living in the community.

Design: Case-control study of 410 patients assessed by the mental status questionnaire and followed up after three years.

Setting: A general practice in Inverurie, Aberdeenshire, with 14,000 patients.

Token economy in a hospital rehabilitation system.

A ward-based token economy programme which formed one part of a larger rehabilitative service for long-stay psychiatric patients is described. The clinical effectiveness of the programme is examined by the use of various nursing, psychological and psychiatric assessments before and after the patients' treatment on the ward, and the progress of former patients is followed-up as they move to different parts of the rehabilitation service. Significant clinical gains in patients' psychiatric symptomatology and problem behaviour on the ward are reported, although there were indications that improvement was not fully maintained as the patients moved on to other parts of the service.

Decline in the diagnosis of schizophrenia among first contacts with psychiatric services in north-east Scotland, 1969-1984.

Annual age-standardised rates for first contacts with psychiatric services in the Aberdeen area from 1969 to 1984 were calculated for schizophrenia, paranoid states, reactive psychoses, all affective psychoses, mania, and depressive neuroses. Highly significant declines occurred in the diagnosis of schizophrenia and of depressive neuroses. No concomitant increase occurred.

Which neurotic patients do psychiatrists treat?

Of 336 newly referred neurotic patients, 80 were not offered continuing psychiatric treatment. The factors associated with patients' not being offered continuing treatment were: short duration of illness; history of alcohol abuse and/or deliberate self-harm; age over 50 years; being widowed; and living more than 20 miles from the main hospital complex. The implications of these findings are discussed.

REHAB: a new assessment instrument for chronic psychiatric patients.

The renewed interest in the care and treatment of chronic psychiatric patients has led to an awareness of the need for improved assessment methods for this group. This article describes the development of REHAB, a behavior rating scale for use with people with chronic psychiatric disability, which has been carefully designed with respect to content, format, and ease of use. The article also draws together the various factor-analytic, reliability, validity, and sensitivity-to-change studies that provide the basic psychometric evidence for the scale's value.

The psychological well-being of supporters of the demented elderly.

Interviews were conducted with the co-resident supporters of 79 elderly subjects. Forty of these elderly subjects had been diagnosed as being demented (20 mildly, 12 moderately and eight severely) following psychiatric assessment. The supporters were screened for psychological well-being with the 60-item General Health Questionnaire (GHQ) and the Relatives' Stress Scale (RSS).