The use of metaphors as the main marketing strategy in psychotropic drug advertising in journals and the quality of information provided in these advertisements has been criticised. We investigated marketing strategies and information provision in advertisements appearing in three different psychiatric journals. The majority of advertisements in two of the journals used metaphors as their main marketing strategy. The level of prescribing information varied between journals. Our findings suggest that improvements are needed in psychotropic drug advertising in journals.

A retrospective case note study explored readmissions to an acute psychiatric in-patient unit within six months of discharge. The study aimed to calculate a hospital readmission rate, to investigate the timing of readmissions, and to identify risk factors associated with readmission. The readmission rate was 27% with the majority of readmissions occurring within three months after discharge, suggesting the need for investigation of such early readmissions. The three factors found to predict readmission were: discharge against medical advice, number of previous admissions, and living alone or with family rather than in care. Implications for hospital service planning are considered.

Adolescent in-patient units within the NHS generally provide a broad range of services to large catchment areas and populations. ‘Pine Lodge’ Young People's Centre in Chester has piloted a new emergency admission service which it has run in conjunction with its existing treatment service. This paper sets out to discuss the potential difficulties in providing such a service in the setting of a general purpose adolescent unit; describe the specification of the piloted emergency service; and present the results of monitoring its use and efficacy during the first six months.

This study sought social workers' views on the mental health needs of a sample of foster children. Out of the sample 80% of the children were considered to require treatment from a child mental health professional but only 27% had received any input. The reasons given for not referring for treatment were placement instability, inadequate child mental health resources and insufficient local authority funding. The provision of consultation services to allocated social workers and the availability of child mental health professionals at local authority reviews should be considered.

In the light of recently published Royal College of Psychiatrists' guidelines on the use of high dose antipsychotic medication, electrocardiographic and blood investigations were performed on 11 patients with learning disabilities receiving such treatment. All patients had normal electrocardiograms (ECGs). Four patients had asymptomatic low white cell counts and mild anaemia was detected in three individuals. Three patients were hyponatraemic; liver function tests were essentially normal. Issues around routine monitoring of such patients are discussed.

The Mental Health Act as an instrument of statute law is unable to address practicalities of caring for mentally disturbed persons who are awaiting formal detention. The common law relevant to this area is ill-defined and depends on interpretation of precedent. The resulting confusion and consequent problems will become more apparent with the advancement of community care, and is a matter which warrants urgent review.

Direct access residents in an inner London homeless women's hostel were interviewed and asked to provide information on medical, personal and social history. For each a DSM–III–R diagnosis, General Health Questionnaire, CAGE and Global Assessment Scale score was assigned, and their views on future housing were sought. The effect of severe mental illness (SMI) and age on dependent variables was examined. A third of the sample (n=14) suffered from SMI, and a further quarter from other mental illness (n=10). A quarter had a DSM–III–R substance misuse disorder. The prevalence of SMI was similar across age groups. Younger women had a different pattern of service needs, with greater levels of psychological distress, substance misuse and residential instability, than older residents.

Good communication between general practitioners (GPs) and psychiatrists is important. An audit of new patient referral letters from GPs and the first assessment letter in reply from psychiatrists found that GP letters were short (mean 106 words) with limited information which increased with letter length. Psychiatrist's letters were longer (mean 849 words), of a high quality but with a negative relationship between length and information score. Use of the ‘preferred’ format derived from previous research was associated with shorter letters of higher quality. Communication between GPs and psychiatrists might be improved if GPs wrote more and psychiatrists wrote less.

Data on day time referrals to a liaison psychiatry team from an inner London accident and emergency department (A&E) were analysed over a two-year period. Despite the availability of local community-based alternatives for urgent assessment almost 5000 patients were seen. A quarter were self-referrals and two-thirds had had no previous contact with psychiatric services. The most common reason for referral was aggressive or disruptive behaviour. Characteristics of patients in this inner-city population suggest a continuing need for a high quality liaison service to the A&E department.

A survey is described of people presenting with psychiatric problems to a north London accident and emergency (A&E) department over three months. Forty per cent presented with deliberate self-harm and 25% of these left before being assessed. Twenty per cent of those with problems compatible with a diagnosis of severe mental illness also left before being seen by a doctor. Differences between presentations ‘out-of-hours' and ‘in-hours' are described. Factors predicting admission were: previous psychiatric admission, symptoms of a psychotic or affective disorder and non-permanent accommodation. The survey has implications for the process of triage in A&E departments and the organisation of mental health liaison services.

There is growing concern with psychiatrists' knowledge of mental health law, in particular with the introduction of new legislation and more complex statutory arrangements for after care. Despite this, little systematic research has been undertaken in the UK. This study was designed to determine the knowledge of a sample of doctors in psychiatry in Scotland, of part of the Mental Health (Scotland) Act 1984 which provides for urgent involuntary admission to hospital. A one in three sample of all non-consultant grade psychiatrists throughout Scotland was interviewed on the aspects of the Act considered essential to lawful detention. Knowledge of even this restricted part of the Act was poor regardless of experience. Evidence emerged which suggested that at times civil liberties might be compromised or the right to treatment denied. The findings clearly point to the need for increased emphasis on training in mental health law.

This study evaluates the effects of moving an acute psychiatric ward from a psychiatric hospital to a district general hospital. A repeated measures design is used covering the three phases of shortly before and after the move and a follow-up 10 months after the move. Eleven measures were used including daily measures of patient disturbance and staff stress, length of stay, diagnosis and a consumer survey. Overall there was little change from before the move to follow-up. Two second-order variables relating to staff stress did, however, show a clear reduction.

Section 135 of the Mental Health Act (1983) allows a Justice of the Peace, on information provided on oath by an approved social worker, to issue a warrant allowing any constable named in the warrant to enter, if need be by force, any premises in which there is reasonable cause to suspect that a person believed to be suffering from a mental disorder:

1. (a) has been, or is being, ill-treated, neglected or kept otherwise than under proper control: or

2. (b) being unable to care for himself, is living alone in any such place, and, if thought fit, to remove him to a place of safety.

The decision to use a neuroleptic in people with epilepsy (PWE) depends on the nature of the psychosis being treated. In some cases a neuroleptic is not required and an adjustment of the antiepileptic drug therapy may be all that is necessary. Antiepileptic drug therapy itself can cause psychosis and this, as well as other aetiologies, should be considered. The choice of neuroleptic in PWE depends on: the nature of the patient's psychosis, including the temporal relationship with seizures and/or any relationship to antiepileptic drug therapy; the epileptogenicity of the neuroleptic; antiepileptic drugs; the efficacy of the neuroleptic; and individual tolerability of side-effects.

Candidates' views regarding examinations in psychiatry have been highlighted in recent years. Few studies to date, however, have examined the views of the patients themselves toward the examination procedure. This study examines the knowledge and experience of a patient group participating in the College membership examinations. Providing patients with written information prior to the examinations significantly improves their knowledge and experience of the exam procedure.

Psychiatry in Uganda has a fine pedigree. Academic psychiatry was established in the late 1960s when the Makerere University Department of Psychiatry was founded. Academic medicine and psychiatry suffered during the Amin regime but, like the country as a whole, these have begun to rebuild themselves over the past 10 years. Problems still remain including poor facilities, lack of resources, and a need to revise the Mental Treatment Act and standards of treatment. The high prevalence of AIDS and post-traumatic stress disorder place added burdens on Ugandan psychiatry.