The Hospital Anxiety and Depression Scale (HADS) was administered to psychiatric outpatients with various diagnoses to assess its validity. The study was also designed to find out whether HADS can differentiate between diagnostic groups based on depression and anxiety symptoms. HADS was able to discriminate patients from controls at a sensitivity of 79% and specificity of 87%. HADS was much less sensitive, specific and diagnostically accurate in identifying anxiety and depressive disorders in the experimental group at a cut-off point of 13 and 10 respectively for both conditions. Possible psychological, social and psychiatric reasons for the results are discussed.

Six patients who had delusional convictions that they were malodorous were followed up for between six months and four years. Difficulties encountered in clinical settings in differentiating overvalued ideas, delusions, and hallucinations arise from lack of clarity of psychopathological terminology. Schizophrenia and depression are closely related to the syndrome.

Secondary school pupils and their parents were investigated using the scaled version of the General Health Questionnaire (GHQ-28) and by a questionnaire designed to study attitudes involved in inter-generational conflict in psychiatric patients. Parent-pupil and inter-parental conflict in answers to the attitude questionnaires were taken as measures of intergenerational and intra-generational conflicts respectively. The former significantly exceeded the latter. Parent-student conflict was higher when the students involved were females, Kuwaiti, or had less educated fathers. The tendency of the number of reported GHQ symptoms to be higher in members of families with higher inter-generational conflict did not reach statistical significance. There is an apparent discrepancy between this finding and the prominence of inter-generational conflict in clinical material.

One hundred and ninety four elderly subjects were studied, 133 of whom were living away from their families, in the only old people's home and in the only psychiatric hospital in Kuwait. They were compared to 61 consecutive elderly subjects attending a psychiatric out-patient clinic. Psychiatric, social and clinical characteristics of subjects admitted and those living with their families were analysed and related to recent socioeconomic changes and conditions prevailing in Kuwait. Higher admission rates were significantly related to female sex, the widowed and single status and Kuwaiti and Bedouin nationalities. Low income or housing problems, poor relationships to their families and/or relatives, absence of an interested family member, a small number of own children, referral by family members on account of disabilities, organic brain syndromes or chronic psychiatric disorder was also associated with higher admission rates. Sixty four percent of the residents of the old people's home had psychiatric illnesses in spite of the official policy of excluding the mentally ill from admission. Some of the above mentioned characteristics were similar to findings in other countries, but others e.g. the role of nationality and location of residence in admission to institutions were different. Planning social and medical services in Kuwait should take these findings into account.

Undesirable recent life events in the period of three months preceding primary depressive illness were studied in two Arabian Gulf countries: Qatar (235 patients) and Kuwait (164 patients). Transit population patients, who come to these countries from employment, differ from native patients in the significant predominance of work as a source of recent life events. The difference is discussed in relation to the existential committments and attitudes to work among native and transient populations. Intergenerational conflict as an undesirable recent life event is prevalent among family recent life events in native patients where rapid sociocultural changes are associated with conflict of traditional and modern value systems.