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Two hundred and fifty couples in the general population completed self-report questionnaires which measured life events, personality, marital intimacy, and symptoms of non-psychotic emotional illness. Path analysis was utilized to explain the development of symptoms of nonpsychotic emotional illness. Personality traits of neuroticism and extroversion explained most of the variance of symptoms of nonpsychotic emotional illness. Life events played a much smaller but significant role and marital intimacy was a nonsignificant factor. The data support a proneness model for the etiology of nonpsychotic emotional illness.

To determine the personality and attitudinal characteristics of emotionally disturbed psychiatric residents and their short-term adjustment the authors conducted a series of psychological tests with physicians entering two psychiatric residency programs. Seventy residents completed the test battery, which included the General Health Questionnaire (GHQ), the MMPI, the Eysenck Personality Inventory, and the Strong Vocational Interest Blank. About 9% of the sample scored as cases on the GHQ, having nonpsychotic emotional illness, and a further 5% scored as likely cases. These physicians had significantly higher neuroticism scores and MMPI depression, social isolation, schizophrenia, psychasthenia, and hypochondriasis scores. Their interests were less like those of other physicians or psychiatrists and more like those of bankers and office workers.

The General Health Questionnaire (GHQ) and the Schedule of Recent Events (SRE) were administered to a consecutive series of referrals to a general hospital psychiatric consultation service. Control groups of psychiatric and medical inpatients matched for age and sex were also evaluated. Significantly greater life change was found in the consultation group as compared to the medical controls, providing further support for the cluster theory of illness. The General Health Questionnaire was found to be an effective screening instrument for nonpsychotic emotional illness in a general hospital inpatient setting. A significant positive correlation between the GHQ scores and the SRE scores suggests a relationship which merits further study in the epidemiology of psychosomatic illness. The implications of the significant correlation of physical and emotional illness to clinical medical practice is briefly discussed.

Emotional illness in psychiatric residents and its relationship to psychiatric post-graduate training is examined. First, the pertinent literature is reviewed. Psychological and social factors which predispose, precipitate, and perpetuate these emotional disturbances are discussed. The significance of emotional illness in psychiatric residents to the teaching and learning of psychiatry and to the psychiatric profession is clarified. Second, the currently unresolved dilemma of the psychiatric resident “Teach or Treat?” is presented. It is the author's contention that by redefining “treatment” in terms of the goals and philosophy of public health this dilemma can be resolved to the satisfaction of resident, faculty, and the psychiatric profession.

Very few reports of depression occurring with sickle cell anemia have been documented. We have reported three cases of depression in patients with sickle cell anemia that were referred over a relatively brief period, and that were successfully treated with antidepressant medication and family therapy. We examined possible mechanisms of depression, and concluded that depression may accompany sickle cell anemia more commonly than previously suspected.

Emotional illness in psychiatric post-graduate trainees has been the topic of several papers in recent years (1, 2, 3). In summary, these papers suggest that emotional illness in psychiatric training is common. Anxiety and depression characterize these illnesses and occur most frequently in the first year of training. But, as Halleck and Woods have stated, ‘Information as to the prevalence of anxiety states, depression, suicide, psychoses or serious acting out is unavailable’ (4).

Psychiatric symptoms in association with S.L.E. have been reviewed, and their incidence, classification, pathology and psycho-dynamics have been discussed. The most useful classification is into, a) functional illness, usually depression, and b) toxic-organic illness. The incidence of the ‘functional disorders’ varies widely; it has been reported in up to 50 per cent of patients with S.L.E. In contrast, ‘toxic-organic illness’ shows remarkable consistency from study to study (four authors report an incidence of 29 per cent) in patients with S.L.E. The few pathological studies suggest the underlying etiology in the toxic-organic group may be, a) cerebrovasclar disease or, b) toxic states secondary to complications of S.L.E. such as uremia or, c) steroid treatment. This classification is of practical significance in that the natural history and prognosis differ in these two groups. The ‘toxic-organic’ group shows a higher incidence of cardiovascular and renal-vascular disease and increased morbidity. The dynamics of the ‘functional’ group have been discussed, particularly with reference to ego psychology. Finally, a case is presented which is one of the few reported of the presentation of psychiatric symptoms leading to the diagnosis of S.L.E. and demonstrating a response to empirical forms of treatment.