The Uffculme Day Hospital was opened some two and a half years ago as part of an experimental scheme to treat psychiatric patients outside the confines of a mental hospital. The plan was to admit a small number of patients and gradually to develop and organize a group therapeutic technique in the light of experience. It was hoped that a Day Hospital conveniently situated within a large industrial city would help to meet an increasing need for diagnostic and therapeutic facilities. It might find a solution for those patients who could not be adequately treated as out-patients and yet were not likely to benefit from admission to already hard-pressed and overcrowded mental hospitals. While the present Day Hospital scheme is too small to have a significant influence on the total psychiatric problems of some one million and a half people living in the vicinity, it has so far shown signs of being a welcome addition to the mental health services of the region.

Much interest has been displayed in the past few years in the effect on human subjects of reduction, or as far as possible, abolition of sensory stimulation, so that virtual isolation from the environment is produced. Recent comprehensive reviews have appeared, dealing with experimental work (Solomon et al. 1957) and conditions arising incidentally in the course of various therapeutic procedures (Grünthal 1957), and it is therefore unnecessary to deal with the topic at length here.

The Maudsley Personality Inventory (MPI) that purports to assess the two personality dimensions, extraversion-introversion (E-I) and neuroticism-normality (N-N), has been used extensively in recent research work and a number of published papers in somewhat different spheres bear witness to the use made of the questionnaire (Eysenck, 1956a; Coppen, 1958; Franks, 1957; Bartholomew, Franks and Marley, 1958). A clear description of its construction and use has been presented by Eysenck (1956b) and a comparison between it and other personality scales, as well as some criticisms of its construction, has been set out by Jensen (1958). The particular interest this questionnaire has evoked is due in part to the fact that it is one of the few personality inventories constructed and standardized this side of the Atlantic. The importance of a reliable questionnaire of this type is noted by Eysenck (1958) in his attempt to produce a shortened version of the MPI that will be of value in such work as market research.

It is a well-known fact that patients dislike E.C.T. and that part of this dislike is based on the unpleasant period of waiting which occurs before all operative procedures. There may be indeed other features involved in E.C.T. as patients seem to have a fear and dislike of this treatment out of proportion to what would be expected. That this dislike of E.C.T. is an important matter is brought out by the difficulty in persuading patients who have suffered a recurrence of a depressive illness to undergo this treatment once again, and if any means could be devised to increase their readiness to accept medical advice on this subject then an advance would be made.

In spite of the vast literature concerning Haemophilia, I have been unable to find any reference to the concomitant occurrence of a psychosis with this condition.

In February, 1955, Howard D. Fabing described in Science (Fabing, 1955a) a clinical study using the drug azacyclonal hydrochloride (Frenquel), alpha-(4-piperidyl) benzhydrol hydrochloride. This drug is the gamma-isomer of Meratran which, although chemically similar, alpha-(2-piperidyl) benzhydrol hydrochlroide, has a rather different action. Brown and Werner (unpublished but referred to by Fabing, 1955a) reported that Frenquel prevents or diminishes central stimulation induced in the mouse by various agents, whereas Meratran has a stimulant action.

In the last few years a number of new pharmacological agents have been introduced into psychiatry and reserpine has been one of the most controversial of these. Reports have varied from the over-enthusiastic (Noce, Williams and Rapaport, 1954), to the cautiously optimistic (Moore, 1956) and even the frankly sceptical (Cutler, Monroe and Anderson, 1957). It would be true to say, however, that all mental hospitals use reserpine now to some extent and nearly all psychiatrists are agreed that some remarkable recoveries have occurred. However, many questions remain to be answered—What kind of case improves?—What is the nature of the improvement qualitatively?—How lasting is the effect? Time alone gives the answer to some of these questions which are constantly recurring phenomena in therapeutics.

The range of Phenothiazine tranquillizers continues to expand. Among more recent introductions is prochlorperazine (“Stemetil”) which incorporates a piperazine ring in the side chain.

The last few years have produced an extensive literature on the chemotherapy of schizophrenia (Foote, 1955; Shepherd and Watt, 1956; Wing, 1956; Kinross-Wright, 1957). Enthusiastic reports continue to appear in the American journals (Feldman, 1957; Winkelman, 1957) whereas a more cautious note is usually struck in psychiatric papers published in this country. The value of reserpine is now generally accepted (Moore and Mankin, 1957; Elkes, 1957) but it is not without dangerous side-effects (Wardell, 1957). Chlorpromazine is now used extensively and is probably a safer drug; the danger of jaundice has not proved to be a real contra-indication to the use of the drug. However, reports of deaths during treatment with chlorpromazine have been published (Stënback, 1956).