The literature on agreement between psychiatrists on the diagnostic assignment of cases has been extensively reviewed by Ley (1970). Percentage agreement figures ranged from 24 per cent and 28 per cent agreement for type of character disorder and type of neurosis respectively to 80 percent for type of organic illness. Taken at face value these findings suggested that psychiatric diagnosis may often be of little value.

The purpose of this collection of papers is to describe the present state of development of Chapter V (F) of the Tenth Revision of the International Classification of Diseases (ICD-10) (to be published by the World Health Organization, Geneva), and to discuss some related issues concerning psychiatric classification in an international setting.

Do psychiatrically disturbed teenagers tend to be physically immature? This paper describes an investigation designed to answer this question by formal methods and to test beliefs based on imperfect evidence. Through the development by Tanner, Whitehouse and Healy (1962) of a refined technique for the estimation of physiological maturity by measurement of skeletal age, it has been possible for an investigation to be carried out in this area with considerable confidence in the instrumentation. For the author, interest in physiological maturity was prompted by both clinical impressions and experimental findings, both of suspect validity, yet each pointing to the possibility that physiological maturation might be significantly different in normal and in disturbed adolescents.

The treatment of two chlorpromazine-medicated chronic schizophrenics with cimetidine resulted in excessive sedation, which necessitated a reduction in chlorpromazine dosage. Eventual discontinuation of cimetidine therapy led to a return of schizophrenic symptoms, which responded to an increase in chlorpromazine dosage to previous levels.

The well-developed community psychiatric services in the 13th Arrondissement use a large number of places in sheltered accommodation. Reasons for this are explored. It may be that there are areas in the U.K. where the need for such accommodation is greater than the Department of Health and Social Security has estimated.

The diagnostic index is a most valuable tool when using a hospital's records for research purposes. This paper describes an attempt to produce such an index suitable for use in a busy psychiatric hospital. It was felt that priority should be given to simplicity and ease of use, as otherwise few of those concerned would have been able to spare the time needed for its preparation. Later an attempt was made to assess its reliability in use at two hospitals.