A community treatment team, offering rapid assessment and intensive home treatment as an alternative to admission is described. The relationship between diagnosis and outcome was examined, in terms of initial ‘take on’ rates, admissions to in-patient areas at both initial assessment and subsequently.

There was a significant relationship between diagnosis and outcome, with marked variation between diagnostic categories.

Home treatment teams prevent admissions with the majority of people from all diagnostic groups, but less successfully with people with personality disorder.

The recurrence rate of major depression can be decreased by the use of maintenance drug treatment. This paper describes a survey of Scottish psychiatrists' attitudes to prescribing maintenance therapy. Questionnaires were sent to all Scottish psychiatrists at consultant and associate specialist grade.

It is evident that there are major differences in prescribing practices. How patients are managed would appear to depend on to whom they are referred.

Psychiatrists do not appear to be practising evidence-based medicine in this context. There is perhaps a need for greater consensus on the prevention of recurrence.

The aim was to examine why the legal category of psychopathic disorder does not appear in the Mental Health (Scotland) Act 1984 and to review selected literature relating to differences between prison and special hospital populations in Scotland from those elsewhere.

There is now some emerging evidence to suggest that the legislation north of the border might reflect the notion that there may be fewer people with psychopathic disorders in Scotland.

With devolution and the advent of a Scottish Parliament the Mental Health (Scotland) Act 1984 is likely to be reviewed. At that time it would be inappropriate to consider including ‘psychopathic disorder’ but some alternative to the current rather narrow definition of ‘mental disorder’ may be required.

The aim of the study was to investigate changes in service utilisation following therapeutic community treatment for patients with severe personality disorder. The study examined service usage, in the form of acute psychiatric admissions, of a series of 52 admissions to a residential therapeutic community in the three years before and year after admission.

There was a reduction in the mean duration of acute psychiatric admissions after treatment, this was greater for extra-contractual referral patients than local district patients.

This study replicates results from previous studies. It also suggests that more accessible local services may be able to intervene earlier in patients' psychiatric careers preventing heavy use of acute services. We argue for greater provision of therapeutic community treatment for severe personality disorder.

A postal survey of 81 general practitioners (GPs) who were Involved in lithium monitoring was undertaken, to compare their views on lithium therapy with their monitoring practice, and with the practice of psychiatrists.

Forty-seven replied (response rate 50.6%). There was considerable variation in GP knowledge of lithium therapy. GPs made fewer requests but wanted more information.

Written reminders and information on lithium would be useful to GPs.

Recruitment of trainees and consultants into psychiatry is a major concern. A questionnaire survey of trainees within the psychiatry of learning disability was conducted to highlight attitudes about training and career issues.

Ninety per cent of trainees decided on a career in learning disability as a result of completing a junior post in this speciality. Forty-three per cent were seeking dual accreditation and nearly half of these were experiencing problems relating to this; 84% expressed fears about becoming a consultant; and 63% felt they needed more advice on how to find a consultant post.

Increased exposure to learning disability at the basic training grade is required to ensure recruitment. In addition issues related to dual accreditation and anxieties about consultant posts need to be addressed.

A questionnaire was sent to members of the Psychotherapy Section of the Irish Division of the Royal College of Psychiatrists to assess psychotherapy training.

Members from Northern Ireland, compared with those from the Republic, had more mandatory psychotherapy experience in a variety of psychotherapies, had attended more lectures on the theories of the psychotherapies, had cases longer in analysis and were more satisfied with their level of supervision. Few non-consultant hospital doctors had obtained mandatory psychotherapy training as outlined by the College guidelines and they were also generally dissatisfied with their basic training in psychotherapy.

Although there were clear qualitative differences in psychotherapy training between Northern Ireland and the Republic, 100% of members believed there should be improvements in the training of psychotherapy in Ireland. If the Royal College guidelines are to be adhered to, these results would imply that changes in the structure of psychotherapy training in Ireland particularly for non-consultant hospital doctors are required.

Retrospective information on advice and information received post-diagnosis was obtained from 40 carers of younger people with dementia, using a semi-structured interview.

Twelve carers received services from old age psychiatry, the remaining 28 from predominantly adult psychiatry or neurology. Those in receipt of old age services reported greater adequacy of diagnostic information, higher levels of advice giving and more frequent referral to social services.

While old age services were more successful on the parameters examined, the gradually emergent nature of the diagnosis may be a crucial factor in the lack of information and advice received by the comparison group.

In this paper an experience of facilitating a weekly support group for nursing staff on an oncology ward is described. A brief overview of burnout among oncology nurses is followed by a description of the processes by which the support group was established.

Some of the functions that the group has come to provide and recurring themes are highlighted along with a more theoretical understanding of the nature of groups within institutions.

Support groups can help prevent isolation and demoralisation.