To describe the extent and variation in the use of Guardianship nationally. The Directors of Social Services were asked to provide details about Guardianship cases on two separate occasions one year apart.

There were 428 new Guardianship cases in 12 months. At the second enumeration, 73% of cases were within the mental illness category and 47% of these had serious mental illness.

There is much variation in the use of Guardianship. Further developments of this study will explore the reasons for this variation and will ascertain clinicians' views on Guardianship, supervised discharge and other community treatment orders.

A questionnaire survey of all memory clinics in Scotland to obtain information about clinic characteristics, assessment techniques and prescribing practice.

Memory clinics are a common component of old age psychiatry services within Scotland. There is variability in clinic characteristics, assessment techniques and treatment approaches. Most clinicians appear to rely on their own clinical judgement rather than national guidelines when making decisions about investigations and the prescription of anti-dementia medications.

There is considerable variation in memory clinic practice across the country. Would standardisation of practice ensure equity in service provision/patient care? However, would such standardisation be at the cost of clinical autonomy?

The assessment of the future dangerousness of firesetters is problematical but psychiatrists may be requested to perform assessment of arsonists for the courts. We surveyed the views of psychiatrists and others (n=54) on how 11 candidate historical variables might contribute to future dangerousness.

Hierarchical cluster analysis indicated that variables fell into three groups related to level of perceived dangerousness. Apparent intention to endanger life and setting fire to an occupied building were the items thought by psychiatrists to most indicate highest future dangerousness. Having previously set fires that caused extensive damage, failure to extinguish previous fires or alert the authorities were perceived as indicating moderate future dangerousness.

The study adds to what is known about how psychiatrists formulate assessments of future dangerousness.

To describe physical sequelae of cylindrical battery ingestion and their management by description of recent cases and literature review.

X-rays should be performed to determine the position and integrity of the battery. In the absence of abdominal symptoms, immediate surgical opinion may not be indicated.

Conservative management of battery swallowing is frequently possible.

Accumulating evidence suggest that psychiatrists may be at greater risk of being stalked compared with the general population. We used a self-administered questionnaire to survey psychiatrists in Ireland about their experiences, practices and attitudes regarding work-related stalking.

We found that 25.1% of psychiatrists in Ireland had been the subject of stalking behaviour at some point in their career. At the time of the survey, 5.5% of respondents were actively being stalked. The majority of the stalking occurred in the workplace and most of the perpetrators were patients. Most of the victims were unaware of guidelines or other supportive mechanisms in their workplace. Of those who reported their experiences to authorities, almost half were not satisfied with the support they received.

Stalking of psychiatrists is not uncommon. Employers should put in place supportive structures backed up by education and training to reduce the incidence, associated morbidity and other wider consequences of stalking.

Dialectical behaviour therapy is an evidence-based treatment for people with borderline personality disorder. We describe implementation and outcomes of a new service.

Hospital use and frequency of self-harm were reduced dramatically with dialectical behaviour therapy. Moreover, the therapy can be implemented successfully in a relatively short time at modest costs.

Dialectical behaviour therapy provides a useful model of treatment for people with borderline personality disorder and/or self-harm in community mental health settings.

The aim of this study was to investigate the pattern of performance of candidates in the MRCPsych examinations in the period 1997–2002 inclusive. During this period 6306 candidates sat the MRCPsych part I and 4536 sat the MRCPsych part II.

The overall pass rates for MRCPsych part I was 44.7% and 48.9% for MRCPsych part II. The majority of those who passed either part of the examinations did so on their first attempt; females performed better than males and graduates of UK and Republic of Ireland medical schools performed better than foreign graduates in all component parts of the examinations.

The pattern of results suggests that clinical tutors and course organisers need to pay special care to the training needs of trainees who are foreign medical graduates.

To discuss the working of a new paediatric liaison service. To review paediatric referrals to a child and adolescent mental health service (CAMHS) 21 months before and 21 months after the establishment of this service.

One hundred and eighty-three children were discussed in the 21 months after the new service was set up. There was a rise in referral to CAMHS from 72 to 120. Non-attendance rates from paediatric referrals also rose. Likely reasons for these changes are discussed, and include an increase in referrals of children with somatisation.

Interdisciplinary liaison appears to carry many advantages, but is likely to increase referral rates to the CAMHS. This has both clinical and resource implications.

To build on previous research findings by examining engagement and problematic behaviours of patients in 10 residential rehabilitation units. Two measures were completed on patients in community rehabilitation, longer-term complex care and high-dependency units (109 patients in total). Data were analysed and categorised into higher-engagement ratings across the domains of engagement and behaviour over the past 6 months and lifetime in terms of presence of the behaviour and likelihood of resulting harm.

Data were available for 73% of patients. All aspects of engagement were consistently low for all units, with highest levels in community rehabilitation units. Levels of problematic behaviours were similar across all units. Socially inappropriate behaviours and failure to complete everyday activities were evident for over half of all patients and higher for lifetime prevalence. Verbal aggression was at significantly lower levels in community units. Lifetime behaviours likely to lead to harm were much more evident in high-dependency units.

Despite some benefits of this type of care, patients continue to present challenges in engagement and problematic behaviours that require new approaches and a change in focus.

The need for training in the management of personality disorder is now firmly established following publication of policy implementation guidance for the development of services for people with such disorders. We report on the development of a training course for people from a range of disciplines, which is group-based, psycho-analytically informed and experiential in nature.

Those attending the course rated it highly. They showed marked changes in attitude towards, and greater confidence to work with, the client group, and were more willing to communicate their own difficulties openly both within and between agencies, to pass on their skills and to develop further the networks they had formed.

Given a containing structure and reflective space, professionals from a number of agencies rapidly become able to use difficult theory to develop a ‘feeling language’ to communicate about clients with personality disorder. User presentations can be important to these changes. Repeating such a course over a number of years might lead to a more therapeutic culture within mental health services and associated agencies. The course format is likely to be transferable.