The development and validation of a thirty item, Likert-type scale designed to measure medical students' attitudes to psychiatry-the ATP-30 (Attitudes Toward Psychiatry-30 items)-are described. We had hoped to demonstrate that 'attitude to psychiatry' was not a unitary matter but an amalgam of attitudes to a number of things to do with psychiatric practice. This hope was not fulfilled, as a unitary dimension was obtained. A positive change in the attitudes of students toward psychiatry was demonstrated in third and fourth medical year students in relation to exposure to psychiatry. Such a change was not demonstrable in two classes of occupational therapy students exposed to a course in psychiatry. The reasons for this difference between medical students and occupational therapy students are discussed-there possibly being important implications here for psychiatric curriculum planning in medical school. Lastly, we have demonstrated that the positive change in attitudes amongst medical students was transient rather than lasting-a matter which most studies of attitude change do not address. In spite of the apparent impermanence of the positive change in attitudes among medical students, there are a number of possible used to a scale such as the ATP-30, and these are discussed.

Summary Using a general hospital psychiatric population (CN =158) the following psychometric measures of depression were assessed: Minnesota Multiphasic Personality Inventory, D. Scale; Hamilton Rating Scale for Depression; Beck Inventory for Measuring Depression; Wechsler Depression Rating Scale; and Zung Self-Rating Depression Scale. The patients were grouped according to diagnoses in The Diagnostic and Statistical Manual of Mental Disorders (DSM II): Depressive Neurosis; Severe Depression (Manic-Depressive, Depressed and Psychotic Depressive Reaction); Schizophrenia and Organic Brain Syndrome; Personality Disorder; and Neuroses other than Depressive (mainly anxiety). A group comprising those who attempted suicide was also formed from the above groups. All the measures correlated well with one another. Younger patients tended to score higher on the Zung SDS and the Beck. Females scored higher on the D Scale (MMPI) and males scored higher on the Beck. The group of suicidal patients were predominantly young females. The Hamilton and the D Scale differentiated the groups clinically. These two scales and the Wechsler may be the inventories of choice, expecially since the Hamilton and Wechsler have the advantage of being completed by a psychiatrist.

A scale of measuring interviewing skill is described. The process of development of the scale, including the establishment of inter-rater reliability, is briefly sketched. Application of the scale to medical student performance in interviews revealed that capacity to diagnose and plan management has virtually no relationship to ability to carry out a ‘good’ interview.

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An approach to the management of the behavioural manifestations of Wilson's Disease by operant technique is outlined. There was considerable improvement in the patient's ability to perform autonomously on this program. When the contingencies were changed the patient's behaviour deteriorated markedly, thereby suggesting that improvement in behaviour was not due to medication alone.

The literature on silence in psychotherapy is somewhat diverse, and is confined almost entirely to its theoretical aspects. The following study presents a review of the subject, and considers some problems of management of silence in interview situations, with some suggestions for further investigations. For the purpose of this paper, silence has been defined in the following terms: ‘A period of time during a formal consultation between a therapist and a patient (or patients) when verbal communication ceases.’ Implicit in this definition is the fact that both parties participate in the silence. It is convenient to consider their roles separately.

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