Cognitive behaviour therapy is now widely accepted clinically as a treatment for depression and anxiety, and there is increasing research evidence to confirm its efficacy (Rush et al, 1977; Blackburn et al, 1981; Murphy et al, 1984; Butler et al, 1987; Beck, 1988). Of the various short term psychotherapies currently available, it is probably the most widely known and best researched. Despite this, and the recommendation of the Royal College of Psychiatrists (1986) that trainees receive training in cognitive therapy, there is little opportunity to gain a formal training in this psychotherapy. Short workshops are often available through the British Association for Behavioural Psychotherapy and from other sources, and ad hoc supervision from interested psychologists and psychiatrists may be available in some centres. Scott et al (1985) described a workshop and peer supervision training scheme in Newcastle. Macaskill (1986) reported a course for psychiatrists in training in Sheffield which extended over 20 weeks and combined Beck's cognitive therapy and Ellis' Rational Emotive Therapy.

Child sexual abuse has appeared as an epidemic of the 1980s. In our child psychiatry department we are acutely aware of the increased workload generated by referrals of complex and time-consuming cases. In this article we aim to look at the resource implications for a child psychiatry department which has teaching and regional commitments, as well as serving a district health authority.

This paper gives an overview of the first year of a project in which a psychoanalytic psychotherapist worked with the staff of the ophthalmic department of a general hospital to study some psychological aspects of disorders of the eye. The purpose was to see whether semi-structured interviews based on psychoanalytic insights could increase our understanding of the disorder and, if so, how this understanding might be used to help the patient.

The political and economic changes in Russia in the last five years have been enormous, however, Russian psychiatry remains isolated from the mainstream. This isolation started in the aftermath of allegations in the seventies about the misuse of psychiatry, and has been exacerbated by recent economic uncertainty. I was therefore interested to receive an invitation to stay with a Russian psychiatrist for a week in September 1994, to investigate the possibilities of research collaboration between the Institute of Clinical Psychiatry in Moscow and the Department of Psychiatry in Southampton.

The variants of frontotemporal dementia (FTD) require careful differentiation from primary psychiatric disorders as the neuropsychiatric manifestations can overshadow the unique cognitive deficits. The language variants of FTD are less readily recognised by trainees despite making up around 43% of cases.1 This educational article presents an anonymised case of one of the language variants: semantic dementia. The cognitive deficits and neuropsychiatric manifestations (delusions and hyperreligiosity) are explored in terms of aetiology and management. By the end of the article, readers should be able to differentiate FTD from Alzheimer's disease, understand the principles of management and associated risks, and develop a multifaceted approach to hyperreligiosity in dementia.

Motivational interviewing is a psychological intervention that could potentially give clinical staff working with older people a way of tackling ambivalence and/or resistance to change in therapy. Although it has been shown to be effective in various spheres of mental health, we are unaware of any publications on its use in the older population. In this paper we discuss the main principles of this intervention and some adaptations necessary to meet the needs of older people (i.e. those over 65 years old). Patients require the capacity to understand and retain new information in order to make use of this intervention, which hence limits its use to those who retain good cognitive functioning. We would like to encourage the practice of motivational interviewing both as an intervention in its own right but also in preparation for patients requiring more specific therapies such as cognitive – behavioural therapy (CBT) or interpersonal psychotherapy.

I would like to bring to light an apparent oversight in the new statutory rules relating to consent to treatment by the mentally ill and mentally handicapped. This will have very serious consequences for the management of patients who are on short-term detention orders. The provisions relating to consent to treatment set out in Part IV of the Mental Health Act 1983 are the first attempt to cover by statutory controls the doctor's clinical freedom to prescribe treatment for his compulsorily detained patient. In addition, certain of the new provisions (which take effect from 30 September 1983) apply to the voluntary patients as well.

Compliance with medication regimes is fundamental to successful treatment and hence familiarity with factors influencing the level of patient compliance is essential. In relation to the psychogeriatric population poor compliance is a major and worrying problem largely neglected by researchers.

The proposals outlined in the White Paper, Caring for People, are now law and were little affected by the wave of protest which greeted them when they were first published. So the time has probably come to see what can be made of them and how they might be turned to advantage, rather than continuing to worry about the politics of whether change was necessary at all.

A survey of 101 new attenders at a regional drug and alcohol service found that 46 adults had a total of 88 children at home. Twenty-three children were considered by their carers to show signs of emotional or behavioural disturbance. Difficulties had only been discussed with professionals in a minority of cases. Help for troubled children from primary care services was preferred to secondary services. Closer liaison between child psychiatry and primary health care workers should be considered.