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The relationship between neurotransmitter metabolite concentrations and measurements of ventricular size on CAT scans and pneumoencephalographs was investigated in 15 patients with severe affective disorder. An association was identified between reduced levels of plasma free tryptophan and ventricular enlargement and also between raised ventricular CSF levels of 5 HIAA and ventricular enlargement.

The relationship between unemployment and parasuicide was examined amongst males and females in the City of Leeds between 1978 and 1982. The association between unemployment and parasuicide was found to be positive and significant in middle aged men. However, there was a negative and significant relationship between unemployment and parasuicide in older men aged between 55 and 59 years. For females between the ages of 20 and 25 years there was a significant negative relation ship between unemployment and parasuicide. The findings which are discussed are considered to provide evidence for the hypothesis that unemployment may exert a differing vulnerability effect on proneness to parasuicide in different age groups and between the two sexes.

A randomized double blind group comparison study of sulpiride and amitriptyline was carried out in 36 patients suffering from major depressive disorder (DSM III critieria). Sulpiride showed equivalent antidepressant activity to amitriptyline at 4, 6 and 12 weeks, using the Hamilton Rating Scale (HRS) and the Wakefield Self-Rating Scale for depression (WRS). However, at 24 weeks the antidepressant activity of amitriptyline was just statistically significantly better than that of sulpiride. Timing of onset of action was comparable in both drugs. The anxiolytic activity of sulpiride was equivalent to that of amitriptyline at 4, 6, 12 and 24 weeks using the Salkind Manifest Anxiety Inventory as a measure. There were no significant differences between the two groups, of variables measured by the Crown-Crisp Experiential Index, a life events scale and Paykel's Social Adjustment Scale.

SummaryThe pneumo-encephalographs and computerized axial tomography scans of fifty patients with severe affective disorder were studied. Measures of ventricular size were compared with those reported by other workers. Findings suggested that some patients suffering from severe affective illness showed abnormalities of brain structure as demonstrated by ventricular enlargement.

A special clinic was set up in an attempt to overcome the problem of accumulating a sufficient number of depressed patients for inclusion in clinical trials. Only 21 patients of the 81 patients referred during 1 year fulfilled the criteria for inclusion in the trials. The function of the special clinic did not prove successful as a similar proportion of depressed patients was found in a comparison group referred to the district psychiatric outpatient clinic.

The relationship of concurrent benzodiazepine administration to seizure duration in ECT was examined. Administration of a standard oral dose of 10 mg diazepam to a series of patients suffering from major depressive disorder produced a significant reduction in men seizure length during ECT compared to length of ECT-induced seizure in those patients when they were benzodiazepine free. This finding is discussed.

To assess the possible significance of cerebral ventricular size and the dexamethasone suppression test (DST) in the outcome of severe endogenous depression, 28 patients were followed up and reviewed 1 year after stereotactic subcaudate tractotomy. Neither ventricular size nor the dexamethasone suppression test predicted either a good or poor outcome. There was no relationship between ventricular size and the DST results.