I am just back from taking part in a fortnight's refresher course in Chengdu, Sichuan, People's Republic of China, attended by about 35 psychiatrists from other provinces and about 35 more from mental hospitals locally or from the host department of psychiatry of Sichuan Medical College. My part was to give six lectures and eight question-and-answer sessions on general adult psychiatry, and to hold four case conferences. With the help of good interpreters I learned that Chengdu patients are much like those in London, and are given the same psychotropic drugs in the same doses with similar effects. Although oral language is a barrier, facial expression, body posture and gesture appear to be international and one can learn a good deal from them.

One of the chief problems mentioned by the relatives of people suffering from schizophrenia is the difficulty in obtaining factual and practical advice. Many have struggled on for years, using trial-and-error methods, without knowing whether their lack of success was due to the immutable course of events, to ignorance, or to a deficiency in themselves of the ability to care. Some have made tentative enquiries but have been given a more or less polite brush-off. Although most relatives, like most sufferers, do eventually become aware of the diagnosis, it is rare for them to be given this information as part of a long-term plan of management which they are invited to share with professional staff and patient, and even more unusual for them to be told early in the course of the disorder.