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The issue worth clarifying before going into the substance of the matter is what African psychiatry is, what Western psychiatry is, and what the temporal context is. In this context African psychiatry refers to traditional psychiatry practised by indigenous non-Western-trained specialists. Western psychiatry in the middle Ages was perhaps no different from African psychiatry last century. Since psychiatry is usually based on the concept of mental health and mental illness, and also on the cosmic view and the position of the individual within this, the differences in these areas could determine the difference in psychiatry. The concept of mental illness has gone through the stage of demon possession, the four different humours of the body, to the interaction between the individual and his genetic endowment on one hand and his social and physical environment on the other.

The chronicity and incurability of sickle cell anaemia reinforce the need to give particular attention to the psychosocial effect of the illness on the family. A 22-item schedule of burden with very high inter-rater reliability and modest validity is constructed and should be useful in the assessment of other similar chronic disorders. The phylogenetic origin of sickle-cell anaemia makes it essential that a psychological understanding of the disorder should be a component of the therapy arsenal of health professionals serving populations of African extraction.

Dr. Gittelman is Professor of Clinical Psychiatry, New York Medical College, 234 East 149th St., Bronx, NY 10451, USA, and Director, Advanced Institute for Psychosocial Rehabilitation. Dr. Dubuis is Chief, Villeurbanne Sector, Ministry of Health, France, and Co-director, Advanced Institute for Psychosocial Rehabilitation. Dr. Nagaswami is Assistant Director, Schizophrenia Research Foundation, Madras, India, and Assistant Director, Advanced Institute for Psychosocial Rehabilitation. Dr. Asuni is Professor of Psychiatry, University of Lagos Medical School, Lagos, Nigeria, and Vice President of the World Association for Psychosocial Rehabilitation. Dr. Falloon is Consultant, Buckingham Mental Health Service, and Senior Research Fellow, Oxford University Department of Psychiatry, Oxford, England. Dr. Publico is Assistant Professor, Department of Rehabilitation Medicine, University of the Philippines College of Medicine, and Consultant, Negros Occidental CBR Program, the Philippines.

Conditions of prisons in Africa are reviewed. Practical suggestions regarding improvement are indicated.

Modern psychiatric care in Nigeria is a fairly recent development which has overcome initial lack of treatment facilities and trained workers in the field. The work done at Aro Hospital in the western region reflects a major push to establish adequate facilities and satisfactory treatment for the population.

SummarySerum copper concentrations were determined by atomic absorption spectrophotometry in 102 schizophrenic patients and 95 healthy control subjects. The serum copper concentrations were significantly higher in the schizophrenic patients than in the normal control subjects. The average serum copper in schizophrenic females was higher than in schizophrenic males, but the difference was not statistically significant

Tropical neuropathies have been causally related to disturbances of pyruvate metabolism (Monekosso, 1963); like the neuropathy described by Wernicke, they are thought to be due to vitamin B deficiency. The clinical picture includes mental disturbances of the organic type, such as disturbance of memory, confabulation, apathy, disorientation, etc. Reports do not mention symptoms suggestive of functional psychosis.

Apart from cannabis abuse in northern and southern Africa and khat chewing in north-eastern Africa, the history of drug abuse in Africa is relatively short. The abuse of drugs in Africa is nevertheless escalating rapidly from cannabis abuse to the more dangerous drugs and from limited groups of drug users to a wider range of people abusing drugs. The most common and available drug of abuse is still cannabis, which is known to be a contributing factor to the occurrence of a schizophrenic-like psychosis. The trafficking in and abuse of cocaine and heroin are the most recent developments in some African countries that had had no previous experience with these drugs. Efforts should be made to design and implement drug abuse assessment programmes to determine the real magnitude and characteristics of the problem and to monitor its trends. A lack of funds and a shortage of adequately trained personnel have made it difficult to implement drug abuse control programmes. In addition to formal drug control involving the implementation of legislation, there is an informal system of drug abuse control operating through the family, church, school, neighbourhood and work environment, as well as healthy recreational activities. It is suggested that efforts in African countries should be directed towards strengthening not only the formal drug control system but also informal control in order to compensate for the insufficient funds and the shortage of personnel trained in implementing formal drug control measures. It is very likely that the drug problems in African countries will worsen in future unless more effective measures are implemented to arrest the current situation.

In a comparative study of a group of experimental and control subjects in Argentina, Brazil, Costa Rica, Japan, Jordan, Italy, Malaysia, Singapore and the United States of America (State of New York), and of the results of independent studies conducted in Sweden and the United Kingdom of Great Britain and Northern Ireland, a rather close association was found to exist between drug abuse, criminal behaviour and social attitudes to such problems. Both drug abuse and the socio-legal systems varied greatly in the countries involved. No correlation was found between the level of foreseen or actual harshness of the socio-legal system and the level of seriousness of drug abuse and its associated criminality, but there was a significant correlation between knowledge of the law and the efficacy of the socio-legal system. In each country informal control systems, such as the family, church, school, neighbourhood and work environment, were active. Approximately one half of the subjects that were interviewed from countries with the most punitive socio-legal systems perceived informal controls as harsh and punitive while in the other countries such controls were generally perceived as positive. The study encouraged the review, testing and implementation of alternative measures to penal sanctions, particularly with a view to creating a genuine therapeutic approach to correcting the deviant behaviour of drug abusers.

Forty-two cases of epilepsy in Nigeria have been studied and , 11 were found to have a schizophrenia-like psychosis. The clinical features are described and it is concluded that the psychoses do not differ significantly from those occurring in Europeans.