SYNOPSIS Monthly hospital admission rates (HA) for mania were classified by sex, type of admission (first, or re-admission) and by country (England and Wales or Scotland). Of the 8 classes thus created, all but one showed a statistically significant annual cycle with a peak in Summer and trough in Winter. There was no significant difference in phase or amplitude between male and female cycles. A linear increase in yearly re-admission rates was found during the 8 years of the English and the 11 years of the Scottish data.Current month's mean daily temperature (lag 0 ) and last month's (lagj) mean day-length and mean daily hours of sunshine correlated better with admission rate than did the values for other months. In a multiple regression analysis temperature made the other 2 climatic variables redundant in accounting for variation in HA.
The study relates to suicides occurring in Shropshire during 1965 to 1973 inclusive. Psychiatric patients who had committed suicide were compared with others, matched by sex and age who had not done so. The suicide group included a higher proportion of members who had behaved violently, experienced a broken marriage (through death, separation or divorce) or earlier had deliberately harmed themselves, often by dangerous means. Of the psychiatric patients who committed suicide 63 per cent had seen a doctor within a month beforehand, yet very few were receiving adequate physical treatment for depressive illness at the time of their death. Immigrants from eastern Europe were found to be particularly prone to suicide.
SynopsisTests of thyroid function and pathology were carried out on 133 patients before they were treated with lithium (Li+). Of the 12 patients who subsequently became hypothyroid during treatment with lithium 9 had, before the commencement of treatment, thyroid autoantibodies and/or an exaggerated thyroid stimulating hormone (TSH) response to thyrotropin releasing hormone (TRH), whereas 3 patients had neither of these indicators. Lithium administration was accompanied by a rise in thyroid antibody titre in 20 patients but a fall in only 5, a statistically significant difference. Evidence that it may be an immunostimulant is discussed. Li+-induced thyroid failure cannot be accurately predicted, and may occur suddenly. The best minimum safeguard, therefore, is serial thyroxine (T4) (or free T4) estimation, supplemented if equivocal by a free thyroxine index (FTI), a basal TSH and, if doubt remains, by a TRH test.
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