bluuebunny/crossref_metadata_2025 huggingface dataset:
Factors contributing to military casualty rates during war
Authors: Atkinson Jacqueline M.
Published: May 2008

Discussion of psychiatric casualty figures in military personnel tends not to distinguish between acute and chronic conditions. Combat-related stress (CRS) responds well to immediate, short-term intervention. Overall psychiatric casualties are approximately 30%. Contemplating the future in 1982, Romo & Schneider suggested casualty figures might be higher. This article considers factors contributing to the incidence of psychiatric casualties.
The demand for psychiatric services as a result of the Gulf war
Authors: Atkinson Jacqueline M.
Published: May 2008

Despite the brevity of the Gulf war, there is still the strong possibility that it will leave long-term problems for psychiatric services within the NHS. The low incidence of acute psychiatric problems in the Falklands conflict does not obviate long-term problems. Surgeon-Commander O'Connell of the Royal Navy, reported informally in the newspapers (Guardian, 7 May 1990) that up to 30% of the 28,000 Falklands veterans are still suffering from post-traumatic stress disorder (PTSD). Hughes (1990), medical officer with 2nd Paratroop Regiment at Goose Green, described his realisation that he had PTSD, his subsequent treatment by the NHS and transfer to a military hospital. The Royal Navy still has a counselling service, set up in 1987, but it is clear that military services cannot deal with all the current problems, let alone those to come. The advice of the Ministry of Defence is that the initial onus to recognise a problem lies with the family and that sufferers should seek treatment through their GP.
Diplomatic immunity and the Mental Health Act 1983
Authors: Pariente David
Published: May 2008

The UK, in common with all other countries party to the Vienna Convention on Diplomatic Relations, affords foreign diplomats a special status in law. Under the Diplomatic Privileges Act (1964) (DPA), accredited diplomats are accorded inviolability and cannot be detained compulsorily under any Act of Parliament, including the Mental Health Act 1983 (MHA).
The risks of motherhood
Authors: Ramsay Rosalind
Published: May 2008

The Marcé Society, a multidisciplinary group set up in 1980 to advance the understanding, prevention and treatment of post-partum mental illness, met in York for its biennial meeting last September to celebrate its tenth birthday. In the middle of the 19th century, Louis Marcé first drew attention to the special nature of psychiatric illness in the puerperium. Since then, as opening speaker, Dr Channi Kumar pointed out, although maternal morbidity has dropped dramatically, in particular over the last 40 years with improvements in obstetric care together with social, cultural and educational changes, psychiatric morbidity in the puerperium remains as prevalent as it was 100 years ago.
Behavioural Phenotypes Study Group Symposium
Authors: Berney T. P.
Published: May 2008

Apart from the degree of mental handicap, the traditional description of a genetic syndrome is limited to somatic characteristics, although occasionally noting some quirk of personality or behaviour. However, these subjective stereotypes become a memorable part of our concept of the syndrome. Although at times startlingly perceptive, more often they are misleading, particularly where there has been only a superficial contact. Latterly more systematic scrutiny, albeit using idiosyncratic rating scales, selected populations, and differing diagnostic standards, has highlighted earlier inadequacies. Consequently the last three years have seen the formation of an informal, multidisciplinary group interested in behavioural phenotypes: an initiative greatly helped by contact with parent groups. Their intention is to develop research and, by introducing some consistency to the observations, to allow comparisons across studies. From this has grown the more public and formal Society for the Study of Behavioural Phenotypes† which was launched at this symposium.
A survey of patients from five health districts receiving special care in the private sector
Authors: Coid Jeremy W.
Published: May 2008

There has been a rapid growth in the number of patients receiving secure and special care in private hospitals, although their overall numbers are still comparatively small. The behavioural modification unit at St Andrews Hospital, Northampton, has the largest concentration of detained patients outside the National Health Service (NHS), but there are plans to increase the number of beds at Kneesworth House, Royston, Herts, and Stockton Hall, Yorkshire. St Andrews Hospital has been run as a charitable trust but Kneesworth House and Stockton Hall are currently owned by a private French company, Generale de Santé division of Generale d'Eau, together with Langton House, Dorset, which provides places for disturbed adolescents. Marks & Thornicroft (1990) noted that recent entrants into the private sector have been from private for profit rather than voluntary non-profit providers, catering for what are seen as “market niches” such as eating disorders, impotence, alcohol or substance abuse, and stress reactions. They criticise these developments, claiming that few people benefit and that the “bull market” in private hospital development challenges the catchment area concept and seems to be producing a two-tier system of psychiatric care in Britain.
Your supported lodgings
Authors: Robson C. E.
Published: May 2008

Supported lodgings are an important means of achieving the successful rehabilitation and resettlement of the chronically mentally ill into the community (Anstee, 1978, 1985). In a survey of 15 psychiatric hospitals in England and Wales, it was estimated that 9.3% of the long-stay patients (i.e. in-patients from one to five years) under 65 years of age were ideally suited to less supervised accommodation outside the hospital. In Gloucestershire the Supported Lodging Scheme is provided by the Psychiatric Social Services Department. It was started to enable ‘new’ and ‘old’ long-stay patients at Coney Hill and Horton Road hospitals to be settled in the community. Now any psychiatric or mentally handicapped patient can also enter the scheme if appropriate.
Ode to the Code
Authors: Travers Ray
Published: May 2008

The Mental Health Act Code of Practice has recently been published. Its introduction has been discreet, low-key and virtually unnoticed. Yet in a quiet and determined way it points out the direction that all professionals involved in the case of mentally disordered people must now anticipate. It has a smart, blue cover and is eminently ‘user-friendly’. Its contents will make it essential reading. Indeed it would not be an exaggeration to suggest that it might soon be any ambitious lawyer's pocket vade mecum as he prepares his case. Its arrival has been anticipated since 1983. There have been a few miscarriages on the way which probably explains why its mother finally consented to artificial insemination techniques and conceived of her Code without formal consultation with its potential fathers.
Community care in crisis – homelessness and mental illness
Authors: Race Julian H.
Published: May 2008

One week before Christmas in the crypt at the Church of St Martin-in-the-Fields, Dr Malcolm Weller addressed a conference for CONCERN (Care of the Neglected: Combining Education, Rehabilitation and Nursing). The purpose of the conference was to highlight the plight of mentally ill, homeless people and to emphasise the strengths and shortcomings of the professional care available for them.
Are psychiatrists too “heartless”? ‘Affairs of the Heart'
Authors: Persaud Rajendra D.
Published: May 2008

‘The Heart has Reasons’, scheduled for broadcast on 21 February, is the film which launches a major new Channel 4 series of films called ‘Affairs of the Heart’. The series purports to be a broad view of how the health of the heart is “… central to our whole well-being, both spiritually as well as physically …”.
Phoney war psychology
Authors: Appleby Louis
Published: May 2008

One curious image of the earliest Gulf fighting was a TV journalist standing in front of an acre of rubble in Tel Aviv and insisting, “The main effect of this Scud attack was psychological.‘’. What made it more curious was that after what had gone before, it was easy to believe him. Because, deprived of substantial news by a lack of action and the censorship of both sides, journalists had for weeks presented a procession of “psychological” angles, although they were more a clue to what the word means to the press.
Cigarette smoking among psychiatric out-patients
Authors: Brown Steve
Published: May 2008

The dangers of cigarette smoking are well recognised, and a number of public health measures designed to reduce the level of smoking have been introduced over the past 20 years. These measures have been fairly successful, and there has been a steady decline in the prevalence of cigarette smoking in the UK over the period 1972–1988 (Office of Population Censuses and Surveys, 1990). A number of studies have shown a higher prevalence of cigarette smoking among psychiatric patients (Hughes et al, 1986); however, the majority of these have been of highly selected populations, or have failed to control for factors such as age, sex, socioeconomic status and alcohol abuse, all of which are known to affect the prevalence of smoking. This study compared the prevalence of cigarette smoking among a heterogeneous group of psychiatric out-patients with that of the general population with control for these confounding variables.
Setting up district audit meetings in psychiatry
Authors: Roy David
Published: May 2008

Charles Shaw, in a number of articles and his Hospital Handbook (Shaw, 1989, 1990) has played a key role in outlining the principles of medical audit. He arbitrarily divides the process of medical audit into four phases. The philosophical phase which seems to have been negotiated, is whether the medical profession should be involved; the organisational phase; who should lead the process, and the resources required; the practical phase, what should be audited and the methods used; and the invasive phase, how the general concepts and the details of audit are communicated through publication. He goes on to describe a variety of methods of audit including the review of adverse events and general statistics, the assessment of randomly selected records, and finally the review of a topic (which includes medical record review). Another approach in planning audit is through understanding of the organisation itself (Donabedian, 1966) and evaluating quality of care in terms of the structure of the organisation (bricks and mortar, staffing, beds, technology etc.), the process of care, and this may include length of stay, broad out-patients statistics, and perhaps more controversially, face to face contact, group interaction, home visits, day hospital attendance and so on. Finally, and most complex, is outcome.
9. Academic psychiatry
Authors: Black Dawn , Guthrie Elspeth , Deakin Bill
Published: May 2008

Careers in academic psychiatry can follow various paths but usually are aimed at achieving a university appointment at consultant grade; i.e. senior lecturer, reader, or professor.
A community based walk-in clinic for mentally handicapped adults — is there a need?
Authors: Nadarajah Jay , Gingell Kate
Published: May 2008

Mentally handicapped people have the same rights in terms of good quality and range of care as other members of society. This has been highlighted by the recent emphasis on community care for psychiatric patients irrespective of their disability.
The psychonutritional unit: An out-patient clinic for eating disorders — the first five years
Authors: Launer Michael A.
Published: May 2008

Before 1977 there was little work done with eating disorders in the psychiatric unit at Burnley General Hospital. The hospital dietetic department was aimed mainly at special diets for medical, surgical, and paediatric patients and services for the obese. Many patients with anorexia nervosa were treated on paediatric or medical wards, until in the early ‘80s, following the establishment of a clinical psychology department, a principal-grade psychologist was appointed.
Psychiatric audit
Authors: Hatton Paul , Renvoize Edward B.
Published: May 2008

Medical audit has been defined “as the systematic, critical analysis of the quality of medical care, including the procedures used for diagnosis and treatment, the use of resources, and the resulting outcome and quality of life for the patient” (Department of Health, 1989).
Psychiatric knowledge and attitudes in Nottingham medical students
Authors: Ryley J. Paul , Friedman Trevor
Published: May 2008

Psychological and psychiatric issues represent a significant proportion of the workload of all doctors. Nonetheless junior doctors often have an unsatisfactory knowledge of psychiatry. Previous studies have examined how hospital doctors say they manage psychological problems (Mayou & Smith, 1986), and attitudinal factors among medical students (Wilkinson et al, 1983).
Development of outcome measures in acute psychiatry
Authors: Oyebode Femi , Cumella Stuart , Garden Gill , Nicholls Judith
Published: May 2008

This study is an evaluation of the use of two health status measures for monitoring the outcome of acute psychiatric treatment. The measures are the Sickness Impact Profile (SIP) and the Classification of Illness States (CIS). The SIP is a measure of the impact of sickness on patients' daily activities and behaviour. The CIS was initially developed to measure ‘morbidity states’ after hospital treatment and can be used to generate the ‘Rosser Index’, both of which have been shown to be valid and reliable measures (Rosser, 1988).
Learning disabilities and the HIV epidemic
Authors: Brener Neil , Jadresic Danitza
Published: May 2008

It has been said that there is little likelihood of risk contact between people with learning disabilities in institutions and HIV infected people in the community and also that the shift of patients with learning disabilities from large institutions towards the community does not augur well for the prevention of HIV infection. There is little evidence for either of these views.
An introductory course
Authors: Williamson D. J.
Published: May 2008

As we have previously mentioned, the computer itself is simply a collection of chips and circuit boards which are useless without software. Application software is what you do work with, i.e. your word processor or database etc, but the application software itself needs an operating system to run within. The operating system, however, needs something called a basic input/output system (BIOS) to operate. This is software but stored in ROM (Read Only Memory) on chips, and tells the computer what to do when it is first switched on.
The relationship between hospital hostels in the community and the general practitioners who look after them
Authors: Allen Danny
Published: May 2008

As long-stay patients move into the community, the relationship with the psychiatrist gets diluted. One reason is the logistical problem of visiting widely spaced residences, but another is that patients are primarily under the care of general practitioners (GPs) who provide physical care in the majority of cases. The way in which psychiatric care is delivered is variable (Horder, 1991). For the system to function a modus vivendi has to develop between GPs, psychiatrists and care staff. This study looks at current practice in Gloucester.
Mona in the mirror
Authors: Quested Digby
Published: May 2008

In ‘Leonardo Da Vinci and a memory of his childhood’, Freud (1910) provided an analysis of the artist's personality and sexuality, with a description of his capacity to sublimate his libido into creative works. He discussed the Mona Lisa's ability to command attention and induce differing emotions within the viewer. In his paper he described the distinct elements of her expression, “The contrast between reserve and seduction, and between the most devoted tenderness and a sensuality that is ruthlessly demanding – consuming men as if they were alien beings”.
Horton Hospital, Epsom – the Royal connection
Authors: Rollin Henry R.
Published: May 2008

The history of Horton Hospital is best seen in the context of the socio-economic history of the late 19th century. London, as a result of the Industrial Revolution, had grown enormously so that the existing metropolitan mental hospitals could no longer cope with sheer numbers of mentally disordered arising within its boundaries. The Metropolitan Asylums Board, whose responsibility it then was, looked for suitable land within easy – but not too easy – reach of London. Epsom at the turn of the century was an exceedingly fashionable area boasting a number of large and elegant “Derby Houses” (some of which still exist, although now put to rather more plebeian use) to which the aristocratic racing fraternity transferred themselves for the races. It was known that this wealthy and influential body would oppose the sale of the private estate of Sir Thomas Powell Buxton in the parish of Horton, roughly one square mile in size, for the purpose of building mental hospitals. What added even more bitterness to the pill was that the hospitals were to house “pauper lunatics”, a sobriquet with obviously undesirable social connotations. The negotiations for the sale were carried out in secrecy and the fait accompli, when it was announced, created an outcry. But it was too late. In retaliation the “toffs of the turf” including, ironically perhaps, the Royal Family, transferred their establishments and training facilities mainly to Newmarket which grew in importance as Epsom declined.
Psychiatric patients and their medical care
Authors: Collings Sunny , Myers Sara
Published: May 2008

Informal discussions between psychiatric trainees reveal frequent difficulties and frustrations in providing adequate medical care to psychiatric patients. Our writing this article was prompted by the death of a patient who had been referred to casualty with behavioural and physical problems, and who, once labelled as a ‘psychiatric patient, did not receive the medical attention he required. Other trainees will have their own similar examples, at best resulting in only inconvenience to the junior doctor. This may seem surprising given the knowledge that people with psychiatric problems suffer increased physical morbidity. We were all taught as medical students that a physical presentation may mask a psychological problem and vice versa, and that both problems may co-exist. However, this knowledge does not always impinge on hospital clinical practice. From the viewpoint of junior psychiatrists, cross-specialty referral and consultation, and the provision of adequate medical care to our patients can be difficult. In this discussion, we will deal briefly with the contribution of ‘physical’ medicine to this state of affairs and then turn in more detail to the influence of psychiatry. Recommendations for improvement are made.
A holiday for long-stay psychogeriatric patients
Authors: McCarthy Jane , Ong Yong-Lock
Published: May 2008

In recent years there has been increasing interest in long-stay psychogeriatric patients. Hilton et al (1989) and Anderson (1990) have described the profile and characteristics of this population, confirming clinical impressions of the severe degree of cognitive impairment and high dependency levels among such patients. At the same time, there has been a trend towards more active intervention in the type of care provided, moving away from the traditional custodial approach and towards more supportive continuing care models.
The use of log-books during senior registrar training in child and adolescent psychiatry
Authors: Cassell Diana , Fellow-Smith Elizabeth
Published: May 2008

The aim of this paper is to continue a dialogue regarding the possible future use of log-books during training. The Royal College of Psychiatrists has been considering their use at various stages of training in psychiatry. Cole & Scott (1991) rejected log-books as a tool for self-audit during registrar training because they were often not kept up to date. The situation in higher professional training is more complex; there is not the clear focus of studying for the Membership examination and there are many more training components to cover during a four year period. Thus, we feel that a system for self-audit and monitoring could well prove valuable at the senior registrar level. There is a tension for senior registrars with whom we discussed this issue at the last Annual Meeting of the Section and among colleagues on our rotation.
A week in Zimbabwe
Authors: Piachaud M. J.
Published: May 2008

About five years ago I was seized by the idea of working in Africa. Now, nearing the end of a two year contract at the Department of Psychiatry, University of Zimbabwe, it is time to reflect.
National Health Service funding for trainee child psychotherapist posts
Authors: Isaacs Stephen
Published: May 2008

The Jubilee Room at the House of Commons on November 5th would seem a suitably explosive venue to launch a campaign to obtain organised funding for trainee child psychotherapy posts. A working lunch was sponsored by the Child Psychotherapy Trust and the Association of Child Psychotherapists, and hosted by Emma Nicholson, MP, a Vice-Patron of the Trust.
No twisted thought without a twisted molecule
Authors: Klemperer Frances
Published: May 2008

There can be no doubt that schizophrenia is associated with a variety of neurophysiological disturbances and disordered cognitive functioning. But we are only beginning to identify which brain areas are involved and to discover how abnormalities in these areas are related to abnormal psychological processes. This symposium, organised by Drs David and Cutting, offered an opportunity to learn about the work of both psychologists and psychiatrists in this field. Diverse research presented ranged from PET studies to the analysis of home videos, from epidemiological work to studies of cognitive performance.
A workshop for relatives of people with chronic mental illness
Authors: Mullen Richard , Bebbington Paul , Kuipers Liz
Published: May 2008

The District Services Centre of the Maudsley Hospital deals with the care and rehabilitation of people with chronic mental illnesses. Three independent teams of mental health professionals comprise nurses, occupational therapists, psychiatrists, psychologists, and social workers. A multidisciplinary team approach is used in the assessment and management of patients. Most of the patients are either day-patients or ‘supportive’ patients who attend less frequently. The service is thus very much community based and orientated, and the support and involvement of close relatives in the care of the patients is seen as both necessary and desirable.
Sentence writing in the cognitive assessment of the elderly
Authors: Howard Robert , Orrell Martin
Published: May 2008

Testing the ability to write a simple sentence has long formed part of the clinical assessment of the cognitive state in the elderly, and has even been incorporated into standard brief cognitive tests (Folstein et al, 1975). Writing a sentence tests a number of faculties including language skills and praxis. As part of a comparative study of four tests of cognitive function—the Felix Post Unit (Institute of Psychiatry, 1987), Mini Mental State Examination (Folstein et al, 1975), Abbreviated Mental Test (Qureshi & Hodkinson, 1974) and Medical Research Council (MRC, 1987) – sentences written by 158 elderly newly admitted psychiatric patients, as requested in the Mini Mental State, were collected. Our aims were to assess the value of sentence-writing in discriminating between dementia and depression, and to compare the style and content of what was written. Would the material chosen by the patients for their sentences be associated with their diagnoses? In particular, would depressives write miserable sentences and the demented be more likely to write nonsense?
Multidisciplinary audit in child and adolescent psychiatry
Authors: Leahy Andrew , Thambirajah M. S. , Winkley Linda M.
Published: May 2008

Recent guidelines recommend that where appropriate, procedures for the development of audit in medicine and professions allied to medicine can be replaced by comprehensive multidisciplinary audit of services. The Royal College of Psychiatrists (1990) suggests that clinical audit, involving the work of other staff in the multidisciplinary team, is preferable to purely medical audit. Given the importance of team work in child psychiatry, it seems appropriate to establish a system of audit which enables all disciplines to be involved.
ECT – current practical administration
Authors: Hill-Smith Andrew J. , Lee Martin S.
Published: May 2008

In the current climate of interest in audit (Standing Medical Advisory Committee, 1990) and a desire at our hospital to embark on criterion based projects, we set out to undertake a simple audit project surveying the practice of ECT. The aim was to audit the treatment facilities, the treatment procedure and the supervision and training. It was hoped that the full cycle of audit – setting goals, measuring activity, and then effecting change – would be achieved (Shaw & Costain, 1989)
Beyond the water tower: current demands upon consultant psychiatrists
Authors: Sims Andrew
Published: May 2008

“There they stand, isolated, majestic, imperious, brooded over by the gigantic water tower … the asylums which our forefathers built with such immense solidity to express the notions of their day. Do not for a moment underestimate their powers of resistance to our assault” (Enoch Powell, 1961).
General medical care of long-stay psychiatric patients: a pilot study
Authors: Allen Danny , Pugh-Williams Sally
Published: May 2008

Studies have shown that significant physical morbidity exist within psychiatric units (Honig et al, 1989), yet general medical care is often left in the hands of psychiatrists who may not always be the most appropriate people to deliver it (Colenda et al, 1988). The new general practice contract places certain obligations on the general practitioner (GP) with regard to his or her patients, especially the elderly, yet these provisions do not extend to many of our patients. Our study looks at four areas of health care and examines how they are delivered to long-stay patients in a district pyschiatric unit with no GP input.
Audit in psychotherapy: the concept of Kaizen
Authors: Feldman M. M.
Published: May 2008

When any organisation is exposed to pressure to change, this not only mobilises considerable anxieties within the organisation but calls a variety of defensive operations into play. The work of Jaques (1955) and Menzies Lyth (1959, 1988) has demonstrated that this can result in the central problem ceasing to be the focus of attention, with primitive defensive mechanisms (often of an obssesional or paranoid kind) being mobilised. This process may either lead to energy being devoted to isolated elements of the situation, or staff withdrawing into a state of passivity and hopelessness. Indeed, Jaques has observed that when changes are imposed on an institution in a way which fails to take account of the functions that existing structures serve in relation to the deeper needs and anxieties of those working within the institution, such changes are likely to be resisted, and may even fail.
The nature of out of hours admissions to a general psychiatric hospital
Authors: Gardner Justin
Published: May 2008

The organisation of psychiatric emergency services varies widely in the UK. These can usefully be viewed as a spectrum. At one end are traditional services where the GP acts as the primary filter to admissions. At the other extreme are crisis intervention teams aimed at managing the patient in the community. Somewhere along this spectrum of service provision lie the emergency walk-in clinics. There have been few studies on how effective these different arrangements are.
The problem with registrar research
Authors: Bartlett Annie E. A. , Drummond Lynne M.
Published: May 2008

In recent years registrars on psychiatric training rotations have been encouraged to begin their research careers early. Most of them are in such (training posts) for three and a half years. A few with extensive previous experience in other areas of medicine will be in post for less than this. The usual pattern of work with such schemes is to change both posts and accompanying routine every six months. At no point during this time will they have time allocated for research per se unless they are a fortunate member of some of the training rotations which include this in the weekly timetable. Such time has to be begged, stolen or borrowed from the hapless consultant who is all too aware of the service shortfall in his or her own area. If the registrar is fortunate enough to find an accommodating senior, this may not be the situation in his or her next post, which renders long term research well nigh impossible.
Medical manpower in Europe: from surplus to deficit?
Authors: van Beinum Michael
Published: May 2008

In the mid-1970s the Permanent Working Group (PWG) of European Hospital Doctors was formed when it became apparent that junior doctors in different European countries shared many common problems and experiences. The PWG now represents 17 national organisations of junior hospital doctors and is recognised by European institutions such as the European Commission; British doctors are represented by the British Medical Association. The PWG organised a conference in Maastricht in the Netherlands in 1982 bringing together politicians, planners and the medical profession to try to plan the future supply of doctors to match the anticipated demands for services at a time when large-scale unemployment was beginning to appear in a number of western European countries. From this developed a major study of medical manpower in western European countries which formed the core of a conference on ‘Medical Manpower in Europe: from surplus to deficit?’ on 31 October 1991, hosted by the PWG in Florence. Europe in this context was defined as the member states of the EEC and EFTA.
The research option: educators' attitudes
Authors: Adams Sue
Published: May 2008

An understanding of research methodology and design including the appropriate use of statistics is considered by the Royal College of Psychiatrists to be an essential part of the education of psychiatrists. The report of the working party for the review of the MRCPsych examination emphasises this by mentioning statistics and research methods as one of the major areas that will be examined as part of the sciences basic to psychiatry (Royal College of Psychiatrists, 1985). They point out that over recent years there has been an increase in the number of questions devoted to this subject, and state that this trend should continue. Pre-membership psychiatric trainees are often encouraged to undertake or participate in research (Sims, 1988), but many commence projects which never come to fruition (Hollyman & Abou-Saleh, 1985); lack of adequate supervision seems to be the cause (Royal College of Psychiatrists, 1991). The Royal College of Psychiatrists is unique among the Royal Colleges in that it enables candidates for the membership examination to be exempted from the essay paper by submitting a dissertation in advance based on a piece of original research. This is known as the research option.
Working with psychiatric problems in probation
Authors: Rix Keith J. B.
Published: May 2008

Recent public concern about prisoners with psychiatric disorder, the deliberations of the Department of Health and Home Office Review of Health and Social Services for Mentally Disordered Offenders (the Reed Review) and the allocation by HM Government of funds for magistrates' courts to pay for duty psychiatrist schemes like the experimental scheme at Clerkenwell Magistrates' Court (James & Hamilton, 1991) are raising the profile of the mentally disordered offender and focusing attention on a group of people not only handicapped by mental disorder but also caught up in the criminal process. Probation officers have a key role in the care of many mentally disordered offenders and in the recent Home Office circular (1990) Provision for Mentally Disordered Offenders a reference is made to two courses for probation officers run by the Regional Staff Development Organisation for the Northern Region of the Probation Service. These courses are ‘Working with High Risk Offenders’ and ‘Working with Psychiatric Problems in Probation’. The former is run by Professor Herschel Prins and the latter by me. Judged by the number of applications, these are the two most popular courses run by RSD, but, as part of the process of evolving training to local probation areas, RSD closed in November 1991 and it has now organised its last course ‘Working with Psychiatric Problems in Probation’. This therefore seems an opportune time to describe the aims, format and evolution of the course and promote discussion concerning its implications for psychiatrists.
Mental Health Review Tribunals
Authors: Saad K. F. G. , Sashidharan S. P.
Published: May 2008

Following the 1983 Mental Health Act, Mental Health Review Tribunals (MHRT) now provide the opportunity for patients to have their detention reviewed and give a right of appeal against compulsory hospital detention or guardianship (Bluglass, 1983).
A ‘core curriculum’ for management training
Authors: Gadd E. M. , England S. J.
Published: May 2008

It is increasingly recognised that all consultants have to undertake management responsibilities at several levels. Consultants are an expensive resource and it is therefore fundamental that they manage themselves and their time effectively. Secondly, consultants need to manage their resources, both the clinical team and the facilities available to it. Thirdly, the consultant has a strategic role in developing the service to meet the changing needs of the population served. Finally, some consultants may choose to undertake executive management roles such as clinical director or unit general manager. In these roles a broader view of overall service provision is necessary.
“Approach”: the Harlow mental health information service
Authors: Hillam Jonathan , Stansfeld Stephen
Published: May 2008

An important emphasis in developing community psychiatric services has been to increase accessibility of psychiatric services to the public (Department of Health, 1989). This might mean not simply informing people about available services but also providing advice about mental illness and where individuals might seek further help, either for themselves or for others about particular problems.
An introductory course
Authors: Williamson D. J.
Published: May 2008

You have all used a database at some time or other, although perhaps not on a computer. For example, every time you look up someone's phone number in your address book, or look up a patient's registration number in the card index file in medical records, you are using a database. Information of any type is easier to sort and find if it is organised into categories.
Thirty years on: the Glenside Hospital Surveys 1960–1990
Authors: Eastley Rebecca J. , Lucas Philip
Published: May 2008

Since 1960, there has been a five yearly review of the population resident for more than three months at Glenside Hospital, Bristol (Cooper & Early, 1961; Early & Magnus, 1966; Early & Nicholas, 1971; 1977; 1981; Ford et al, 1987). These surveys have particularly focused on the accommodation and employment needs of the in-patients, but have also documented the nature of the changes that have occurred in the mental hospital over the last 30 years. The results of the seventh quinquennial survey are reported.
Mental Health (Detention) (Scotland) Act 1991
Authors: Chiswick Derek
Published: May 2008

This Act, effective from 9 March 1992, contains amendments to the Mental Health (Scotland) Act 1984. It provides an extension to 28-day short term detention, requires sheriffs to hear applications for full detention within five days of their submission and authorises detention of patients until the outcome of such an application is known.
3. Introduction to electronic telecommunication
Authors: Johnson Bankole A.
Published: May 2008

Electronic telecommunication (networking) is a complex, and growing field in computer technology. It allows the user to link up with a more powerful machine such as a mainframe, exchange information through a Bulletin Board Service (BBS), access a remote database (on-line service), or send electronic mail (E-mail). This basic guide explains the main concepts, and how to get started.
A community treatment order in practice
Authors: Moate Toby , Ward Barbara , Evans Gwyn
Published: May 2008

The Island of Jersey is a separate country from the United Kingdom and has its own laws. In the Jersey Mental Health Law, 1969, there is a community treatment order in which the guardian appointed has the powers of a father over a child (under 16). This law was implemented on 1 January 1972 and in this paper we look at the way in which it has been used in the 18 years between 1 January 1972 and 31 August 1990. We are not suggesting that the way in which we have used it has been the right or only way. We are engaged in description not prescription.
Can a card mailing system help to reduce the waiting list at an alcohol problems clinic?
Authors: Goldbeck R.
Published: May 2008

Non-attendance at new patient clinics is a well-known problem in psychiatry and particularly common in alcohol treatment units. Reported non-attendance rates in this field range from 12.3% (Addenbrooke & Rathod, 1990) to 52% (Wanberg & Jones, 1973). A number of factors may contribute to this failure to attend including a long waiting time, lack of consent to the referral (e.g. by the GP), postal and administrative problems and the nature of the disorder itself. Hyslop & Kershaw (1981) contacted patients who failed to attend an alcoholism referral clinic in an attempt to establish their reasons for non-attendance. Out of the 39 patients contacted 23 appeared to have good reasons for not attending while 16 gave poor reasons and refused the offer of a second appointment. Ways of increasing attendance at new patient clinics have included reduction of waiting time (Hyslop & Kershaw, 1981) and telephone and written prompts prior to the appointment (Bourgoyne et al, 1983; Grover et al, 1983).
The EEG in psychiatry
Authors: Fenton George W. , Standage Kevin
Published: May 2008

Although the EEG has been in constant clinical use for over 40 years, there have been surprisingly few systematic studies of the pattern of referral and clinical use of electroencephalography in a NHS psychiatric service. In view of the current concern about medical audit and cost effective use of special investigation facilities, it is an opportune time to audit the use of clinical electroencephalography in psychiatry. The current study examines the clinical use of electroencephalography in a district psychiatric service that provides comprehensive care for the population of Dundee (population 180,000).
The silent twins
Authors: Kellam Alexander M. P.
Published: May 2008

This name has been given by the media to two young women born in the early 1960s who, from the age of 2 or 3, had spoken almost exclusively to each other and to no-one else. This resulted in considerable communication problems at school and a turbulent adolescence; eventually they set fire to some empty buildings and were sent to Broadmoor.
Rational emotive behaviour therapy restated
Authors: Spencer John
Published: May 2008

During the 1970s the names Fritz Perls, Carl Rogers and Albert Ellis were all prominent, as were their schools of Gestalt, client centred and rational emotive therapies. Of these three celebrities only Albert Ellis continues to teach and extol the superiority of his particular therapy. This is not just because he has outlived his contemporaries but also because, as he rightly states on his recent European tour, rational emotive therapy is a legitimate challenge and competitor to the present schools of cognitive therapies of Beck, Gelder and others. To emphasise this point, Ellis commences his day-long one-man workshop by announcing that rational emotive therapy has been renamed rational emotive behaviour therapy (REBT).
Carbamazepine monitoring
Authors: Paton Carol , Procter Andrew W.
Published: May 2008

Background of the study

Rationale for monitoring carbamazepine levels

Carbamazepine fulfils some of the criteria required in order to render a drug suitable for serum level monitoring in that there is poor inter-individual reproducibility of the serum levels achieved with fixed dosage regimes, interbrand differences in bioavailability are known to occur and serum levels can be raised significantly by several commonly prescribed drugs; dextropropoxyphene (a constituent of coprozamol), erythromycin, isoniazid and cimetidine.
A self-help group for women drinkers – a trainee's perspective
Authors: Riordan Denise
Published: May 2008

While working as a registrar on a Regional Alcoholism Treatment Unit (ATU), I took part in a weekly support group for women. This afforded a valuable insight into the way in which alcoholism affects women, and showed how a group could be used by its members in a variety of ways. It was an important and valuable learning experience which is not commonly available to trainees in psychiatry.
Lund beck Teaching Fellowship
Authors: Cox John
Published: May 2008

Fellows and Members of the Royal College of Psychiatrists, working overseas, are invited to apply for a Teaching Fellow from the UK to come to their country to provide a course of teaching in a designated specialist psychiatric subject. Overseas Fellows and Members may suggest a named teacher, but more importance will be given to the topic of their choice than to any individual.
4. On artificial intelligence (Al): is there a ghost in the machine?
Authors: Johnson Bankole Akindeinde
Published: May 2008

“I am superior in many ways but would gladly give it up to be human.”

Lieutenant-Commander Data – on android and serving officer on the Starship Enterprise Circa the 25th century atEncounter Farpoint.(See Fig. 1).

Striking advances in artificial intelligence (AI) have brought to life philosophical debates about the concept of the mind, and of consciousness. Strong advocates of AI suggest the symbiosis of man and computers is the next step in our evolution, and to control this process, we need to address the “Big Question”: what is the meaning of life, and specifically, what are we? Understanding what we are is of great interest to us all; for psychiatrists, philosophers, and psychologists it is their life's work. In this paper, I shall introduce some of the main ideas about AI under the following headings. Can computers have a mind, improve our understanding of, or be integrated with our mental processes?
Benzodiazepine withdrawal among chronic daytime users in general practice
Authors: Ashworth Mark , King Michael
Published: May 2008

Withdrawal of chronic day-time users from benzodiazepines is rarely attempted in general practice because patients are considered more dependent on their medication than analogous night-time users. Our aim was to evaluate two forms of brief intervention by general practitioners to reduce intake of benzodiazepines in chronic day-time users. A subsidiary aim was the development of a booklet to help patients with benzodiazepine withdrawal.
Training in the psychiatry of mental handicap
Authors: Lewin Jona
Published: May 2008

Over recent years there has been an increase in the number of training schemes in general psychiatry which offer posts in the psychiatry of mental handicap. I will describe my experience as a registrar during a nine month full-time placement in psychiatry of mental handicap as part of the Charing Cross Rotational Training Scheme in Psychiatry.
Hypnosis in psychiatry
Authors: Mathew V. M.
Published: May 2008

This paper aims to give a very brief outline of the vast subject of hypnosis in the context of psychiatry. The word hypnosis, which was derived from Hypnos meaning the God of sleep, has long been associated with magical practices, superstition, witchcraft, occult and many other esoteric practices. The forerunner of hypnosis was the theory of animal magnetism proposed by Franz Anton Mesmer in the 1770s. He began to experiment with magnetic metals and gradually elaborated the theory of animal magnetism. According to Mesmer, a magnetic fluid spread throughout the entire universe and its disturbed balance in the human body resulted in illness. He claimed that a beneficial magnetic fluid could be transmitted from one subject to another by ‘passes’. Braid (1843) refuted the fluidist theory, since according to him hypnosis could be induced by visual fixation. He believed the condition to be a form of sleep and called the technique neurypnology, later to become hypnology and hypnosis. Liebeault (1866) for the first time used verbal suggestion to induce hypnosis. Bernheim stated that “There is no such thing as hypnotism, there is only suggestibility”, and concluded that suggestibility was the process by which the brain “accepts the idea and transforms it into action”.
The arrogance of insight?
Authors: Perkins Rachel , Moodley Parimala
Published: May 2008

People's beliefs about illness, distress and disability profoundly influence their experience of, and responses to, such problems. Medical anthropologists have long recognised the importance of explanatory models of physical illness and the impact of these on the provision and use of health services. Similarly, psychological models of physical illness and related behaviour stress the importance of the ways in which people conceptualise or understand their difficulties. These are central in determining emotional responses to illness, help-seeking and illness-related behaviours, attitudes towards and compliance with treatment. Eisenbruch (1990) argues that, “the culturally constructed ideas held by the patient about the cause and nature of disease” are as important in relation to mental distress and disturbance. Help-seeking behaviour, attitudes towards and compliance with treatment are of central concern in psychiatry and all of these are influenced by people's understandings of their difficulties. Yet relatively little attention has been paid to the ways in which people conceptualise their mental distress.
Guardianship – a case for wider use
Authors: Symonds R. L.
Published: May 2008

Few psychiatrists have had much experience of guardianship (Section 7, Mental Health Act, 1983). The two cases described have been successful and suggest wider use of this section. It seems apposite in view of the Royal College of Psychiatrists' advice on discharge of patients from hospital, and discussion on a community treatment order; the continuing drive to community care, as codified in the ‘Care Programme Approach’; and the need in the future to treat increasingly disturbed individuals in the community as envisaged in the Reed report.
Patients transferred from a regional adolescent unit to adult wards within the same hospital
Authors: Rothery D. J. , Parmar R. , Broughton M.
Published: May 2008

In 1986 the report Bridges over Troubled Waters (NHS Health Advisory Service, 1986) stated quite categorically that patients under the age of 16 should not be treated in adult psychiatric wards. The National Association for Children in Hospital has also worked tirelessly against children and adolescents being treated in adult hospital wards, although this has mainly concerned the paediatric, medical and surgical fields. However few guidelines were laid down about the function of psychiatric units for children and adolescents when the majority of such units were first being established in the late 1960s and early 1970s. Indeed in the circular from the Ministry of Health (1964) about the need for such units it was stated that some adolescent patients could suitably be treated in adult wards. However no age limits were specified in the circular. There have been no specific guidelines issued subsequently by the Department of Health about the use of adult psychiatric beds for adolescents.