Qatar is an Arab country occupying a peninsula in the middle of the Western coast of the Gulf separating Persia from Arabia. It is an oil-exporting country with a population of about 400000, 70% of which live in the capital, Doha. The increase in wealth with the discovery of oil made it possible for many young members of extended families to move away and led to the emergence of nuclear families. In spite of this geographical separation, most nuclear families consider themselves extensions of their original extended families and maintain ties with them for the purpose of consultation, e.g. to arrange marriages, buffer disputes or mediate to secure benefits.

The Health of the Nation asserts that the suicide rate in England and Wales can be reduced by the provision of better health care services. In a sample of suicides in one district health authority, 61% had had contact with health services during the year prior to death, suggesting that improvements in these services could have an impact on the overall suicide rate. However, the proportion who had had prior contact varied between different age and sex groups and individuals in groups with the higher suicide rates tended to have the least contact. Therefore, the impact of health service improvements on the overall suicide rate may be limited.

An instrument for a systematic assessment of mental handicaps and associated disabilities has been needed for a long time. Recent legislation, for example the Education Act 1981 and the Disabled Person's Act 1986, introduced new statutory responsibilities for education and local authorities to assess an individual's needs. There is no standard assessment or screening tool currently available which covers all aspects of the lives of people with mental handicaps and their interaction with the environment. Ideally a data-base providing such knowledge will also be required by all professions concerned with mental handicap, particularly during the transition to community care.

There was a time when overseas psychiatrists considered themselves fortunate to come to this country to be an assistant in one of the well-known postgraduate departments. If they showed perseverance they could learn enough to obtain an English postgraduate qualification, and they could participate in the training of English psychiatrists. The more entrepreneurial of them could obtain full-time jobs in psychiatry, but otherwise hands on experience of patient care was limited.

Postgraduate psychiatric training is usually assessed by regular College visits. A number of training schemes, including the Liverpool training scheme, also scrutinise their training independently of the College. As far as we know, trainees as the ‘consumers’ of training have never assessed its quality themselves. The following account deals with two such audits in the Mersey region organised under the mantle of the Association of Liverpool Psychiatrists in Training (ALPIT).

Evaluation studios of community mental health services require the research, often in the form of interviews, to be carried out in private homes which poses a particular set of issues relating to the interview environment and the organisation of the work. This paper describes the experiences of interviewing patients, staff and informal carers as part of an evaluation study of the mental health services in two psychiatric sectors in South London and makes recommendations for more effective community based research.

Opinions on the value of measuring tricyclic plasma levels vary substantially. In the United States, plasma levels of several tricyclics are frequently used to ‘optimise’ therapy. In the UK, plasma level monitoring is less often undertaken and measured levels are more usually used simply to assure compliance rather than as a guide to dose adjustment.

The alcohol withdrawal syndrome is characterised by symptoms such as anxiety, insomnia, anorexia, nausea, tremor, sweating and disturbances in coordination. These symptoms tend to occur within 6 to 12 hours of alcohol-dependent patients stopping or reducing their alcohol intake. Less frequently, convulsions, hallucinosis and delirium tremens can occur. Delirium tremens (disturbed orientation, visual and auditory hallucinations, paranoid ideation and tremulousness) is the most serious complication of alcohol withdrawal and occurs in up to 5% of patients withdrawing from alcohol. If it is severe or poorly treated, death can occur. In the UK some clinicians use chlormethiazole while others favour chlordiazepoxide. This article will examine and compare the use of these two drugs.

The case-notes of all patients in a district general adult psychiatric unit were assessed for standards of recording selected key items. The results were presented at a departmental audit meeting, and the assessment repeated after four months. Initial audit revealed poor standards of notekeeping in certain areas. On repeat assessment, standards of documentation had improved for all the key items assessed, and reached statistical significance for physical examination. This audit was quick, easy and cheap, revealed unexpectedly poor standards of notekeeping, and evidently produced a measurable and significant improvement in practice.

The closure of large psychiatric hospitals and the opening of community-based mental health facilities is a central part of British health policy for the care of people with mental illness. The North East Thames Regional Health Authority's (NETRHA) psychiatric hospitals closure plan started in 1985. As part of this a programme was established to assess the closure process (Leff, 1993). This study was carried out between 1988 and 1992 and was designed to study the reactions of the public to the hospital closure decision (Reda, 1993).

In our evidence-based journal club we appraised an article investigating the use of the CAGE questions in screening psychiatric populations for alcohol misuse. We calculated a likelihood ratio of four for a score of two or more positive CAGE questions, suggesting the CAGE is a moderately useful screening instrument.

The function of the mental health review tribunal is defined in Part V of the Mental Health Act 1983. Together with statute and Common Law, it provides safeguards to those detained under the Act. The provisions of the Human Rights Act 1998 have strengthened these safeguards. The key articles in Schedule 1 of the Human Rights Act are 5(1)(e), relating to the lawful detention of persons of unsound mind; 5(4), providing that the lawfulness of such detention shall be decided speedily by a court; 6, providing for a fair and public hearing within a reasonable time by an independent and impartial tribunal established by law; and 8, establishing the right to respect for a private and family life. The latter is relevant to disclosure, nearest relatives' rights, and treatment.