We conducted a survey of the knowledge, attitudes and practices of sexual dysfunction and schizophrenia of general adult psychiatrists in Leicestershire and Lincolnshire mental health trusts.

Two-thirds of psychiatrists that we interviewed do not routinely enquire about sexual dysfunction in their patients and only 17% felt competent in assessing sexual dysfunction, despite 88% agreeing that good sexual function is important to patients. Most practitioners (81.6%) have had no training in this area and wanted some.

Sexual dysfunction is underrecognised and possibly under-treated; suggestions on how to address this are made in this paper.

The issue of elderly psychiatric patients remaining in hospitals after being declared medically fit is of concern to doctors, hospital managers and politicians alike. This article sets out the findings from a study involving elderly psychiatric patients at a district general hospital, undertaken to establish the actual lengths, reasons for and financial implications of delays in discharge. The study involved 50 in-patients, all of whom had been discharged over the 3-month study period.

More than half of the patients in the sample were subject to some delay in discharge and for patients waiting for Elderly Mentally Infirm (EMI) placements this averaged 50 days. Collectively, nearly 25% of the time spent in hospital was due to delay. The cost to the hospital was estimated at more than £700 000 in 1 year.

Patients are being put at extra risk in terms of their health by being delayed in hospital. Issues of institutionalisation, nosocomial infections and falls are of primary concern.

A postal survey was conducted to gauge opinion of consultant psychiatrists in the west of Scotland with regard to consultant appraisal.

We received 158 responses to our survey (a response rate of 77%). The results showed mixed feelings about appraisal – for example, its purpose was felt to be about the development of consultants (72%) rather than the protection of patients (53%). Practical problems were highlighted, like the provision of accurate data and the amount of time spent on the preparation for appraisal.

Participation in 360-degree appraisal was scant, and no consensus on the use of outcome measures was reached.

More work needs to be done on the appraisal process for it to gain the full confidence of the profession.

A cross-sectional qualitative survey was undertaken to compare the views and experiences of psychiatrists working in low- and middle-income, and high-income countries. Questionnaires were distributed to 110 psychiatrists attending the 2007 World Psychiatric Conference in Lahore, Pakistan.

Of the 110 psychiatrists from 13 countries, 81 were included in the analysis. Their views and experiences on mentoring were compared according to country of practice, age, gender, sub-specialty and grade. No significant differences were found on any of the variables studied.

Mentoring relationship, identified as an appropriate means of responding to personal and professional challenges of psychiatric practice is valued by psychiatrists regardless of the country they have had their practice in. Our findings warrant wider study.

Dressing in-patients in night attire during daytime is currently practised in many in-patient psychiatric units, despite the lack of evidence to support its benefit in reducing absconding or self-harm. Using a triangulation design, we investigated the prevalence of, attitudes towards and associations of this practice in an acute psychiatric in-patient setting in the Republic of Ireland.

Case-note review revealed a high prevalence of this practice (57%) and its significant association with involuntary admission. Nursing staff believed that using night attire was effective at reducing absconding and self-harm, and that only voluntary patients should retain the right to choose their clothes. Most patients interviewed were uncomfortable in night clothes and indicated that they should be entitled to choose what to wear.

Night attire is regularly used for risk-management, despite lack of evidence supporting its efficacy and negative attitudes towards it in many patients. This practice and the reasons for its implementation deserve medical documentation.

To ascertain the prevalence of epilepsy and understand the differences in the comorbidities of non-epileptic and epileptic patients with learning disabilities. A simple comparative survey was undertaken between the two main groups of patients: non-epileptic and epileptic.

The prevalence of epilepsy in the study group was 30%. A total of 70% of patients with any type of challenging behaviour were in the non-epileptic group compared with 59% in the epileptic group. Depression was the most common diagnosis in both groups, being slightly more in the non-epileptic group.

Our study suggests that there is no association between epilepsy and the prevalence of challenging behaviour of psychiatric conditions within the learning disabilities population.