D.C. danger patrol.

Some patients at St. Elizabeths Hospital in Washington, D.C., are designated "White House cases." To gain that distinction, they first display some type of bizarre behavior at the White House or other prominent public building. They are then referred to the federal mental hospitaly by a Secret Service agent who considers them to be mentally disordered and potentially dangerous to a public official.

How dangerous, in fact, are these individuals? David Shore and colleagues at St. Elizabeths reviewed Secret Service records of 328

White House cases treated between 1971 and mid-1974. Although 22 percent of this group threatened a prominent politician before or after hospitalization, none of them had made an assassination attempt as of August 1984. One of the patients, however, shot and killed a Secret Service agent in 1980, and two others assaulted nonpoliticians. The typical White House case was an unmarried, white male with a diagnosis of paranoid schizophrenia, report the investigators in the March AMERICAN JOURNAL OF PSYCHIATRY. Many patients sought to advise or gain help from the President, who had been incorporated into their delusions as a benevolent authority.

Shore and co-workers are now examining whether White House cases were more likely than the general population to be arrested for violent crimes during the follow-up period.