‘Citizen, soldier and psychologist’ was the description of Sir John used by his obituarist. He was an eminent psychiatrist of his time, but why is he mentioned as a psychologist and what did he do for the Army to be rewarded with a knighthood? He established his career in rural Devon and at the age of 27 he became the first medical superintendent of the Devon County Lunatic Asylum, now the Exminster wing of Exe Vale Hospital. Here he remained for 18 years, but at the age of 45 on becoming Lord Chancellor's Visitor, he retired with a pension of £650, the fruits of leading a vigorous campaign on behalf of medical superintendents who were previously unsuperannuated.

The families of 25 probands with sleepwalking and 27 probands with night terrors were studied. Eighty per cent of the sleepwalking pedigrees and 96 per cent of the night terror pedigrees included one or more individuals, other than the proband, who were affected by sleepwalking, night terrors, or both. Our data appear to fit a ‘two threshold’ multifactorial mode of inheritance. This finding supports the hypothesis that sleepwalking and night terrors share a common genetic predisposition, with sleepwalking being a more prevalent and less severe manifestation of the same substrate that underlies night terrors. Heritable factors predispose an individual to develop sleepwalking and/or night terrors, but expression of the trait may be influenced by environmental factors.

Two studies are reported, citing the effects of unilateral versus bilateral electroconvulsive shock therapy on the performance of short cognitive tests. In Study 1, seven tests were administered before and after three treatment sessions The most interesting finding was that performance improved significantly on the Knox Cube Imitation test following right unilateral shock. Study 2 replicated this unexpected finding. These results were interpreted as demonstrating that the left cerebral hemisphere is specialized for the processing of sequential time-dependent information.

The effect of propranolol at a dose level of 1,280–1,920 mg per day was studied with a double-blind crossover design in twelve chronic schizophrenics with persistent psychotic symptoms despite maintenance treatment with a depot neuroleptic. By use of a psychiatric rating scale (CPRS), an improvement was seen during the two week period of propranolol compared to placebo treatment in six patients, whereas three patients were unchanged and three deteriorated. The effect on total symptom scores for the whole group was significantly better after propranolol. The data indicate that propranolol in high doses has an antipsychotic effect in some schizophrenic patients when receiving neuroleptics.

Normal controls and schizophrenic patients on propranolol as sole drug or combined with neuroleptics showed superior active and passive avoidance learning to schizophrenic patients who were medicated with conventional neuroleptics only. Active avoidance involved responding quickly, passive avoidance withholding a response to avoid an unpleasant noise and reacting to the appropriate stimulus. This may reflect an improvement brought about by propranolol in the limbic regulation of stimulus and response processes.

Amongst 100 chronic paranoid schizophrenics depression occurred in 30 per cent over a mean 6 years and was significantly associated with parental loss before 17 years.

The concepts of ‘borderline’ and ‘borderline schizophrenia’ remain a confusing area in psychiatry. In its functional use, the word ‘borderline’ refers to a hypothesized level of functioning on a continuum which extends from normality to psychosis, e.g. borderline personality organization. In the phenomenological use ‘borderline’ qualifies a psychiatric diagnosis, referring to a milder form of the disease process, e.g. borderline schizophrenia. In this paper we attempted to define and validate the concept of borderline schizophrenia using case records from the Danish Adoption study with this diagnosis and rating the cases on a new instrument: the Symptom Schedule for the Diagnosis of Borderline Schizophrenia, found reliable, and discriminating cases of borderline schizophrenia from cases of neurosis and personality disorder.

The Survey Psychiatric Assessment Schedule (SPAS) was used in a survey of elderly people living at home and in institutions to examine its reliability in determining mental state. A psychiatrist assessed the same subjects using the Geriatric Mental State Schedule (GMSS) and classified psychiatric disorder into three broad groups: organic disorders, schizophrenia and paranoid disorders, and affective disorders and psychoneuroses. The agreement between the psychiatrist's classification of mental state and the classification derived from SPAS was found to be satisfactory for organic disorders and less satisfactory for functional disorders. The limitations of this method of identifying psychiatric illness are examined.

In 1977, the University of Adelaide extended the psychiatric training of medical undergraduates to their 6th year. The four weeks course in psychiatry, for groups of no more than sixteen students at one time, was spent at an acute receiving unit of a psychiatric hospital and combined with a series of visits to a wide range of psychiatric subspecialties in the community. A systematic evaluation of the course showed that it was well received by students and by the preceptors who supervised students in the various hospitals and psychiatric units.

A randomized controlled trial of brief hospital admission failed to show any difference on clinical measures when compared with standard admission for all psychiatric patients admitted from a catchment area over one year. Psychotic and neurotic symptoms were examined separately and together, using the Present State Examination (PSE) a week after admission and three months later. Clinical outcome was not related to length of stay in hospital or psychiatric diagnosis. This study shows how the PSE can be used to measure change in clinical state for a heterogenous group of psychiatric patients.

Relationship between the psychiatric diagnosis and the side of temporal EEG focus was analysed in 62 temporal lobe epileptics. Neurotics had right temporal foci significantly more frequently, while there was no such laterality effect in other psychiatric diagnostic groups.

Several cases of increases in frequency of mood cycling have recently been reported in women as a result of tricyclic antidepressant treatment (Siris et al, 1979; Wehr and Goodwin, 1979). We report here the occurrence of 48-hour rapid cycling in a man with recurrent unipolar depression after treatment with dibenzepin (Noveril), an atypical tricyclic antidepressant. Alterations in urinary cyclic adenosine monophosphate (AMP) have been reported with mood changes and were therefore evaluated at the same time.

Adult metachromatic leucodystrophy (MLD) is a rare demyelinating disease of the central nervous system caused by a genetic autosomal recessive defect and mediated through a deficiency in the enzyme arylsulphatase A (Peiffer, 1970). The initial manifestation may take the form of symptoms suggestive of schizophrenia or dementia (Sourander et al, 1962; Austin et al, 1968).