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The diagnostic classificatory system in use in modern psychiatry appears to be the product of countless acts of “subjective factor analysis”. Psychiatrists have observed that particular symptoms tend to occur in clusters, and these clusters have been labelled and given a status akin to that of disease entities in general medicine. It is a continually developing empirical system, and it is customary to reexamine such systems periodically to assess the state of current practice and its validity.
Recent interest in the problems of long-stay mental hospital populations has led to a number of studies which have been concerned with rehabilitation and particularly the re-activation of chronic, deteriorated patients by deliberate and systematic modification of their environment. In some of these studies, attention has been focused on the hospital ward itself, both as the background against which personal and social deterioration may be assessed, and as the means of re-building desirable patterns of behaviour (Cameron, Laing and McGhie, 1955; May, 1956). Another group of rehabilitation studies has been concerned with the value of specific work programmes. Industrial-type workshops in Dutch mental hospitals have been discussed by Carstairs et al. (1955), and the value of industrial and productive work in hospitals in this country, as well as some of its therapeutic effects, have been described in other publications (Baker, 1956; Stern, 1959; Collins, Fynn, Manners and Morgan, 1959). Considerable developments in the rationale and organization of sheltered as well as financially viable industrial workshops or factories for chronic mental patients have been made more recently (Wadsworth, Scott and Tonge, 1958; Early, 1960; Cooper and Early, 1961; Wadsworth et al., 1961).
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