A therapeutic group with eight members was studied, using psychometric tests, improvement ratings based on pre-treatment statements of patients' hopes, and of therapists' aims rated for achievement on the basis of post-treatment interviews, and two forms of repertory grid testing. The In-Group Grid yielded a number of measures relating to outcome and to aspects of the group process. Most patients improved by some criteria, and most measures of improvement intercorrelated positively but not, in most cases, highly. Few clear relations between process and outcome measures were demonstrated.

A hundred-and-twenty-five school phobic youngsters had been treated in a psychiatric in-patient unit for young adolescents of secondary school age over a seven-year period; a hundred of them were reviewed on average three years after discharge. About a third of cases were found to have improved little; they had persistent severe symptoms of emotional disturbance and continuing social impairment. Another third had improved appreciably and were affected by neurotic symptoms rather than social impairment. The remaining third had improved substantially or completely. School attendance difficulties had remained in about half of all cases. Subsequent difficulties in going to work were less pronounced. The best predictor of outcome was clinical state on discharge. High intelligence also emerged as a significant predictor of poor outcome. Five girls and a boy had already developed severe and persistent agoraphobic difficulties when reviewed. It was found that severe school phobia in early adolescence resembled adult affective disorders in some clinical features and in outcome.

Correlations were made between ratings on the Hamilton Rating Scale for depression and the Inventory for measuring depression devised by Beck. Satisfactory and significant correlations were observed in only two-thirds of the patients, and often very divergent results were found in the remaining third.

A postal inquiry of all senior registrars in general psychiatry in the United Kingdom gave a nearly 90 per cent response rate. Between a quarter and a fifth of the respondents will not be pursuing general psychiatry at consultant level in this country, most of these opting for a psychiatric specialty. Nearly all the overseas graduates will probably remain in this country. Slightly fewer women than men are aiming for a consultancy in general psychiatry, the rest of the women proposing to switch to one of the specialties. Some of the implications of these findings are discussed, including a proposal for a yearly follow-up of the respondents.

In a recent article, Everitt (1975) discussed several problems with multivariate techniques. However, two useful applications of multivariate techniques were not covered. The present paper describes the use of factor analysis to reduce a large array of outcome variables to a statistically manageable number, and multivariate analysis of variance to determine the relative effectiveness of several treatment regimes where a single outcome variable cannot be specified. It is concluded that the advantages of a multivariate approach outweigh the disadvantages, provided the researcher is careful in interpreting and reporting his results.

As part of a survey of agoraphobic women in the general population, it was found that school phobia occurred in their children to a greater extent than would be expected. The average incidence in children aged 11 to 15 was 14 per cent. The women with school phobic children had had school phobia themselves to an undue extent.

According to the medical model of the disease concept, a class of patients is homogeneous only when it is characterized by manifestations which have their ultimate intra-organismic origin in a particular kind of physiopathological cause. Most patient classes are still heterogeneous because we are still ignorant of that cause.

The medical model can be applied to the subdivision of all classes of patients, including classes of non-organic psychiatric patients. However, the successful application of the medical model depends on the acquisition of knowledge of relevant physiopathological facts. It is argued that the dimensional model of evaluating psychological abnormalities is not likely to help in acquiring that knowledge.

Hyperkinetic movement disorders may occur as side effects of antipsychotic drugs; and a hyperdopaminergic state induced by the neuroleptic compounds is thought to be a cause of extrapyramidal disorders such as tardive dyskinesia. We have observed two cases of the dyskinetic syndrome in patients receiving tricyclic antidepressants (TCA). Because the TCA are known to have little effect on striatal dopamine but do share with the neuroleptics potent anticholinergic activity, these cases appear to support the hypothesis that the drug-induced hyperkinetic disorders are related to a diminution of CNS acetylcholine activity as well as to an increase in dopamine activity.

The Symptom-Sign Inventory was administered to 57 long-stay psychiatric in-patients with the object of selecting a group of questions which would stimulate the production of delusional or other psychotic material. The scoring of the responses as positive was made on verbal affirmative and other specific behaviours which were thought to indicate emotional impact. It was found that the ten questions selected compared favourably with longer questionnaires in discriminating schizophrenic from normal subjects and from those with organic brain disease. It is suggested that these questions might be included in brief assessment interviews on which day-to-day management decisions are made.