SummarySuicide risks for psychiatric hospital in-patients may be described by empirical relationships that take account of sex, length of admission and diagnosis. Risks are highest in males, in the first week of admission, and in depressed patients. Hospital suicide rates do not follow the same pattern as those for the general population and it is suggested that this effect may be the result of current selection procedures. The standard mortality ratio, which compares hospital with general population suicides, has remained unchanged over fifty years.
Of two groups of 20 patients accepted for gender reassignment surgery, one was offered early operation and therefore had had surgery by follow-up two years later, while the second was still awaiting operation at two-year follow-up. Although the groups were similar initially, significant differences between them emerged at follow-up in terms of neuroticism and social and sexual activity, with benefits being enjoyed by the operated group.
The County Borough of Southend-on-Sea is a seaside town with an estimated population of 166,390 in 1965, approximately 24 per cent. of whom were over the age of 60, as compared with 17.8 per cent. of the total population of England and Wales, and 17.7 per cent. of the population of urban areas, outside the conurbations, with populations of 100,000 and over. As in other seaside towns of a similar character, the suicide rate is high: 181 per million population in 1965, as compared with 108 per million in England and Wales, and 120 per million in urban areas outside the conurbations with populations of 100,000 and over (Registrar-General, 1967). Of 237 (46.4 per cent.) consecutive suicides in Southend 111 were over the age of 60 at the time of death.
Rhinoplasty patients and matched elective-surgery controls completed the Facial Appearance Sorting Test, the General Health Questionnaire, a Repertory Grid and the Masculinity/Femininity Scale. Rhinoplasty applicants perceived appearance similarly to, and downrated their own appearance to the same extent as, controls. Impaired appearance and psychiatric symptoms are integral parts of the 'rhinoplasty applicant syndrome', but the degree to which they occur is not positively correlated. Interviews and tests were repeated 6 months after operation, when marked improvement in appearance was reported by the rhinoplasty patients, associated with the reduction of psychiatric-symptom scores. Control subjects showed no change.
In the treatment of depression “in all comparisons it is necessary to bear in mind that electroplexy carries a negligible mortality rate and that there are relatively few physical contraindications to its application” (Shepherd, 1959). Bruce et al. (1960) compared electroplexy and imipramine in 50 consecutive admissions and at one month the former is shown to give better results. Rees et al. (1961), whose cases were suitable for electroplexy, show only 35 per cent. with total remission or marked improvement after three weeks treatment with imipramine—a much lower figure than one would expect with E.C.T.
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