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1.  Letter: Psychosurgery on television. 
British Medical Journal  1976;1(6016):1018.
PMCID: PMC1639627  PMID: 1268525
2.  Antemortem measurements of neurotransmission: possible implications for pharmacotherapy of Alzheimer's disease and depression. 
Aspartic acid, 5-hydroxyindoleacetic acid, glutamic acid, homovanillic acid and 3-methoxy-4-hydroxyphenylethylene glycol was determined in samples of ventricular fluid from 82 subjects. Laminar distribution of the total number (Bmax value) of serotonin 1A receptors was determined on seven neurosurgical samples of neocortex. Apart from an association in a small subgroup of subjects between homovanillate concentration and corticosteroid medication, no complicating influences of treatment preceding operation were found. The content of the serotonin metabolite alone was significantly reduced in intractable depressive illness (bipolar and major depressive disorders) compared with neurological conditions subdivided into Alzheimer's disease, other dementias and other conditions. There was no other significant difference between these groups for the compounds measured. The total number of serotonin 1A receptors was highest in the superficial layers, being considerably higher than in the rat, irrespective of cortical layer. This part of the study indicated that these receptors are important for regulating activity of human corticocortical glutamatergic neurons. The results are discussed in relation to treating depression with serotonergic agents and targeting corticocortical glutamatergic neurons as well as acetylcholine in Alzheimer's disease.
PMCID: PMC1014771  PMID: 7679142
3.  Psychosurgery 
PMCID: PMC1439720  PMID: 20894515
4.  ‘Depression by any other name...’ 
Postgraduate Medical Journal  1976;52(605):130-135.
There is a popular conviction that psychological disturbance is invariably a reaction to environmental events. This approach is associated with total rejection of the so-called ‘medical model’. However, allowance must be made for the fact that contemporary knowledge of psychiatric illness is well behind what is now known about general medicine, and current ideas about psychiatric aetiology may be emotionally determined to give satisfying concepts which are often almost impossible to refute.
By tracing the progress of some hypotheses in general medicine, as they developed in the past, there are similarities with some current observations about the methods of action of physical treatments in psychiatry, treatments which have been discovered empirically.
There is a widespread assumption that psychological responses relate precisely to the degree of evoking stress or the patient's personal attitudes to the stress. However, emotional responsiveness may show an intrinsic individual variation so that many patients who over-respond to stress may do so because of enhanced responsiveness rather than necessarily because psychological events have brought about a state of vulnerability.
The exclusively dynamic approach to psychiatry has been perhaps unnecessarily encouraged by naming an illness ‘endogenous depression’ which could well be a primarily physical metabolic disturbance in the central nervous system but which happens to present with prominent depression, as well as other abnormalities. The emphasis on the component of depressed mood artificially delineates the illness and tends to impede consideration of its wider implications.
PMCID: PMC2496383  PMID: 1264933
5.  Psychosurgery. 
British Medical Journal  1973;3(5870):50.
PMCID: PMC1587981  PMID: 4577721
9.  The work of a psychosurgical unit 
Postgraduate Medical Journal  1973;49(578):855-859.
The widespread use of standard leucotomy terminated in the early 1950's with the advent of the phenothiazine group of drugs. But since then, psychosurgical techniques have been considerably refined and the indications for the newer operations are becoming increasingly precise. Knight's (1969) stereotactic tractotomy is probably the most frequently performed contemporary operation for the relief of some psychiatric illnesses, and the number of patients now referred for this treatment have justified the organization of a specific unit for the purpose.
The value of such a special unit, involving close co-operation between neurosurgeon and psychiatrist is emphasized. It provides a supportive environment for patients who are sharing a highly specialized treatment, and offers opportunities for studying outcome after operation with resulting improvement in selection. It also facilitates research possibilities in general. The clinical work of the Geoffrey Knight Psychosurgical Unit, probably in its way unique, is described and questions often encountered from doctors and from patients are considered. The importance of rehabilitation after operation is stressed and some aspects of the longer term post-operative psychiatric care involved are dealt with.
PMCID: PMC2495461  PMID: 4618904
10.  Psychological aspects of headache 
Postgraduate Medical Journal  1971;47(550):556-561.
Headache is one of the most common symptoms encountered in clinical practice. Its conceptual problems are those of pain in general and some of the theories concerning pain, especially those attempting to relate psychological and physical aspects, are considered.
The classifications which have been suggested for headaches associated with emotional causes are described and it is shown that these are of limited clinical value. Some of the psychogenic causes of headache are considered and the associations of the symptom with various psychiatric illnesses are described. Headache is especially likely to be found with depressive illnesses. The treatments for various psychological types of headache are reviewed.
PMCID: PMC2467254
11.  Relationships between some psychological assessments, body-build, and physiological stress responses 
A number of physiological responses to the psychological stress of an oral academic examination were observed, including heart rate, respiration rate, blood pressure, urinary 17-oxogenic steroid excretion, and plasma corticosteroid concentration. The results were related to body-build and to four psychological tests: Eysenck Personality Inventory, Taylor Manifest Anxiety Scale, IPAT Anxiety Scale, and Stimulus-Response Inventory. No significant associations were found between the psychological test results and anticipatory physiological activity just before the examination began, including excretion of 17-oxogenic steroids. Respiration rate was not increased by anticipatory stress, unlike the other variables, which were significantly higher than control values taken under resting conditions three months later. The students of primarily linear physique had significantly higher plasma corticosteroid values than the predominantly muscular subjects at the time of the examination, as found previously. They also had significantly higher analogue measures of the degree of anxiety experienced at the examination (assessed both by the subject and by an observer). Therefore, linear subjects appear to experience more anxiety than muscular students in a similar situation of psychological stress. Both the IPAT Scale and S-R Inventory results were significantly higher for the linear group but there were no significant differences for the EPI and TMAS scores, as used in previous studies. The importance of constitutional factors associated with body-build in relation to at least some aspects of personality is strongly suggested by the findings.
PMCID: PMC494470  PMID: 4753880
13.  Tryptophan metabolism in depression 
Psychiatric patients suffering from endogenous depression and a control group without endogenous depression were given oral loads of L-tryptophan and urinary excretion determined of the tryptophan metabolites on the pyrrolase pathway: kynurenine, 3-hydroxykynurenine, and 3-hydroxyanthranilic acid. Female endogenously depressed subjects excreted significantly more kynurenine and 3-hydroxykynurenine but not the subsequent metabolite 3-hydroxyanthranilic acid than did female control subjects. Variability of excretion of kynurenine and 3-hydroxykynurenine at different times by the same subject was much greater in the endogenously depressed than in the control group. There was no consistent temporal relationship between excretion of metabolites and severity of the depressive illness. The possible significance of the findings in relation to defective tryptophan metabolism in the brain in endogenous depression is commented upon.
PMCID: PMC493552  PMID: 5478953
14.  Psychiatric emergencies. 
Postgraduate Medical Journal  1967;43(503):599-604.
PMCID: PMC2466191  PMID: 6063826
17.  Psychiatry for all. 
PMCID: PMC1440213  PMID: 6502580
18.  Electroencephalographic changes as prognostic indicators after psychosurgery 
Thirty-five patients were studied by EEG with recordings taken the day before, two weeks after, and six months after psychosurgery. Most showed a characteristic frontal slow activity of varying degrees after operation with varying enhancement of background activity. The amount and spread of the frontal slow waves two weeks after operation showed a significant positive correlation with the clinical outcome one year later, which suggests a relatively objective and very early indication of the subsequent clinical response to psychosurgery.
PMCID: PMC490992  PMID: 7264694

Results 1-22 (22)