Australian & New Zealand Journal of Psychiatry

A component of a large population study of a random sample of 750 Canberra residents is described, in which length of residence in Canberra is related to the quality and quantity of recent life experiences, and to indices of minor psychiatric morbidity (the General Health Questionnaire and the Zung Depression Scale). Life event frequency, but neither measure of morbidity, distinguished between persons with different lengths of residence in Canberra. It can be suggested that a random sample, containing an under-representation of migrants and persons moving from rural to urban environments, in whom the transition in shifting place of residence would be expected to be greatest, is an inappropriate sample to test hypotheses concerning length of residence and psychiatric morbidity. Future studies should give due emphasis to the adequate inclusion of these groups of persons.

With the progress of civilization cities, many of which originally developed in Mesopotamia and Egypt, spread northwards into Europe to proliferate there and, later, in the New World. The Industrial Revolution, a predominantly British phenomenon, was the original stimulus to Western urbanization, a process that continues to this day. City living has many advantages, but also many drawbacks including increased mortality and urban stress; psychiatry has had to concern itself with many of its difficulties. Rural-urban migration is also currently taking place in Asia, Latin America and Africa; in these continents the problems of urbanization, exacerbated by indigenous factors, have proved to be considerable. Some remedies for overurbanization are considered, as is also city development in the future.

It is proposed that negative capability, that is, the capacity for tolerating uncertainty, doubt and not-knowing, is a factor that contributes to a problem-solving approach utilizable in some aspects of the psychotherapeutic process. Negative capability can be demonstrated both in therapists and patients. An analysis of the functions of negative capability within the psychotherapeutic process shows five stages in its utilization. These are the activation of therapist's negative capability; which is followed by observations about the patient's response to his perception of the therapist's negative capability; then the therapist's clarification of the patient's problems contained within the patient's response; followed by a working-through by the patient and therapist of the problems which are demonstrated and clarified; and lastly, a transier to or enhancement of the patient's use of negative capability as a continuing behavioural mode. Some theoretical bases for the concept of negative capability and its application as a factor of problem-solving within the psychotherapeutic process, are proposed. Clinical excerpts from psychotherapeutic work are given to exemplify the stages as defined above.

Some studies associating pre-menstrual symptoms and personality characteristics are reviewed. The possible relationships of EPI Neuroticism and specific personality characteristics (assessed by the 16PF) with pre-menstrual symptoms were investigated. Possible differences between volunteer and non-volunteer subjects' 16PF results and changes in 16PF results during the menstrual cycle were also studied. The severity of some normal women's menstrual symptoms was assessed by (1) a specially constructed daily symptom rating scale and (2) four criteria of severe premenstrual symptoms.

A strong association between Neuroticism and high levels of pre-menstrual symptoms was found. There was also an association between high levels of symptoms and 16PF scores (high on factors L, O and Q₄, low on factors C, N and Q₃) but this finding was less clear cut. No systematic variation in 16PF scores was apparent during the menstrual cycle nor were there differences between volunteers and non-volunteers on 16PF results.

Findings suggest an association between pre-menstrual symptoms and psychological dysfunction and as revealed on the 16PF, personality characteristics of emotional instability, suspiciousness, guilt-proneness, apprehensiveness, unpretentiousness, tension and self-conflict.

Despite a large number of studies it remains unclear whether early parental loss or separation experiences from parents are associated with depression in adult life. In order to circumvent the possible confounding influence of psychiatric patient status, a non-clinical group was used to study any influence of early permanent parental loss and early parental separation on subsequent depressive experience in adulthood.

The depressive experience of 236 post-graduate students was assessed using measures of trait depression, self-esteem, alienation and incidence of depressive episodes. Depressive experience was not increased in those 27 subjects who had been permanently separated from a biological parent before the age of 16 years. When duration of separation from influential parent-figures was examined it was found that trait depression scores were increased in those who had experienced longer separation, but those subjects also rated their parent-figures as having been less caring. Findings are consistent with the view that it is the quality of any parental contribution, rather than its continuity, that is associated with subsequent depressive experience in adulthood.

Onset of mania was evaluated retrospectively in 48 bipolar manic-depressive patients. Mania occurred as the initial episode in 40% of cases. In patients with initial episode of depression, approximately 80% developed mania prior to their third episode of depression and within 5 years from the onset of this illness. Differences in type of illness onset were related to family history of bipolar illness and sex of the proband. Male patients with a positive family history were significantly more likely to manifest mania at onset of illness.

The patient described is a 33-year-old woman, L., who developed a transient dual personality while undergoing desensitization for contact phobia, the alternate personality, Toni, manifesting overtly aggressive behaviour. L. was taught how to behave angrily using role-playing techniques within 48 hours of Toni's first appearance and the alternate personality did not reappear after this treatment was commenced. It is suggested that behavioural psychotherapy may, in some instances of multiple personality, have advantages over psychodynamically oriented psychotherapy, which has frequently been advocated as the treatment of choice for this condition.

The case of a 36-year-old woman who developed a paranoid psychosis while abusing diethylpropion is reported. It is suggested that the newer appetite-suppressing drugs have a bigger abuse potential than was previously thought and may therefore be a hazard for a minority of susceptible subjects. The need to test separately for diethylpropion in cases of suspected drug-induced psychosis is emphasized.