In previous papers (Pilowsky, Levine and Boulton, 1969; Pilowsky and Boulton, 1970; Pilowsky and McGrath, 1970) we have described the development of a depression questionnaire and its use in the classification and identification of depressed patients. In order to increase the flexibility of the questionnaire as a research tool we have derived a depression scale from the items in it and have investigated its validity as a measure of the depth of depression. The purpose of this paper is to describe the development of the depression scale and report the results of validation studies.

An account is given of an active treatment programme at a Canadian Provincial Mental Hospital. This programme was designed to reintegrate institutionalized patients, mainly schizophrenics, into the community.

During World War II psychiatric screening to exclude ineffective soldiers from active duty consisted of interviews of three to six minutes duration. These interviews were described as successful by Bloomberg and Hyde (1), and by Leavitt (2). But six years later Bloomberg admitted that induction screening had proved ineffective, and suggested continuous observation for the first six months of military service to separate those who would adjust from those who would not (3). This concept of prolonged observation was supported by the wartime findings of Egan et al. (4) and Aita (5). Egan's group examined the records of 2,054 men who had been psychiatrically rejected on the basis of a short interview, but who later served; 79.4 per cent rendered satisfactory service. Aita's five-year follow-up showed that of 100 soldiers considered borderline on interview 21 per cent failed to render satisfactory service and of 100 considered satisfactory 5 per cent failed. If the questionable risk hundred had been rejected the Army would have lost 49 average and 30 outstanding soldiers. It seemed, therefore, more profitable for the Army to risk retaining ineffectives than to attempt to weed them out completely on the basis of brief psychiatric interviews.

A centre for pre-school children being opened at Beechwood School, Aberdeen, will provide facilities for the assessment and care of young children suspected of delayed development and is the first of its kind to be established in Scodand. The centre will consist of an initial assessment unit, a special day nursery and a special nursery school and should be complete by September 1973. Up to 80 children will be cared for by a staff of about 40 including medical specialists and specialists in psychology, education, health visiting and social work. Family doctors, local authority doctors and hospital specialists will also participate in the scheme.

Studies on the relationship between physical constitution, personality and mental illness have been mostly confined to the Caucasian race. There has been no investigation, to our knowledge, of Oriental subjects, though a number of investigations of body type, composition and physiological functions without relation to mental aspects have been carried out on them. It is clearly important that work in this field should be extended to include subjects of different racial composition and socio-cultural background. The intercorrelations found between physical and mental characteristics in Caucasians may not apply to others.

Acute dystonic reactions, including oculogyric crises, were once thought to be pathognomonic of encephalitis lethargica, but the clinical use of the phenothiazines has led to the recognition that similar symptoms can be produced by these drugs. Some phenothiazines, such as trifluoperazine, fluphenazine, prochlorperazine and perphenazine (Ayd, 1960; Christian and Paulson, 1958; Hollister, 1957; Waugh and Metts, 1960), are thought to cause these effects more frequently, especially when given parenterally. Other non-phenothiazine tranquillizers, for example haloperidol, also produce these reactions. not un-commonly. Certain patients, particularly the young and perhaps the genetically predisposed, are more likely to be affected.

In a previous report records were studied of 256 in-patients who were discharged as undiagnosed, i.e. in-patients who at the time of discharge did not have a definable psychiatric illness (Welner, Liss, Robins and Richardson, 1972). In that study it was shown that when rigorous criteria for psychiatric research (Feighner, Robins, Guze, Woodruff, Winokur and Munoz, 1972) were used 68 per cent of these patients met the criteria for an established psychiatric disorder. It was concluded that: (1) The chart review diagnoses for a population of undiagnosed patients consisted of a variety of established psychiatric disorders and the population was not homogeneous. (The chart review diagnosis is a diagnosis obtained by review of the patients' hospital records and evaluating the information by using diagnostic criteria for psychiatric disorders.) (2) The most efficient way to arrive at a diagnosis was by structured rather than conventional narrative interview. This study is a follow-up study of these patients and attempts to evaluate the validity of the chart review diagnosis. A concordance between the chart review diagnosis and follow-up diagnosis supports the above conclusions. The follow-up study also served to establish diagnosis in patients who had too few symptoms initially to meet the criteria for a diagnosis.

The Netherne Resettlement Unit, established in 1957, has been described in detailed publications including those by Bennett et al. (1) and Folkard (15, 16). These authors stressed the Unit's dual function of assessment and preparation of disabled patients for resettlement, and described results of its first two years in terms of discharge, readmission and employment. The basic Unit aims of resettlement in optimum employment and accommodation have remained unchanged since that time. The programme has been geared towards minimizing the patients' handicaps by improving their coping abilities (24) so that they can manage in less protected situations, by utilizing the pooled experience of a multidisciplinary rehabilitation team (18) and by mobilizing community resources (36). Hospital living and working conditions are repeatedly scrutinized so that factors which might provoke, increase or reactivate the patients' symptoms (10) are reduced. The Unit's policies, therefore, remain dependent on the forward-looking hospital administration which has encouraged democratization, effective communication and clear definition of function (33).

Erythropoietic Protoporphyria (E.P.P.) may be classified along with the other erythropoietic syndromes of porphyria. It is inherited as an autosomal dominant (Taddeini and Watson, 1968). The condition was first clearly delineated by Magnus, Jarrett, Prankerd and Rimington (1961). They recorded a case with the presenting symptom of solar urticaria in whom faecal excretion of coproporphyrin and protoporphyrin was greatly increased while urinary porphyrins were normal. The red cells contained grossly abnormal amounts of protoporphyrin and coproporphyrin, the plasma increased levels of protoporphyrin. The absence of uroporphyrin distinguished this condition from congenital porphyria (Gunther's Disease).

Mentally handicapped patients from the City of London, and the London Boroughs of Hackney and Tower Hamlets have in the past had to go to St. Lawrence's Hospital, Caterham for hospital care, and the Board have always been anxious to rationalize this situation. As a first step in providing hospital services for the mentally handicapped in that area the Board propose to build a 28-bed residential unit at St. Leonard's Hospital, Shoreditch. This unit will cater initially for mentally handicapped men and women from the City of London, Hackney and Tower Hamlets, and in addition to the 28 residential places will provide day hospital facilities for a limited number of day patients. There will be close links with the local authority services.