To explore the views of Egyptian psychiatrists on physician-assisted suicide, focusing on demographical, spiritual, legal and clinical domains. We surveyed the views of psychiatrists in four Egyptian counties using a structured questionnaire with a five-point Likert response scale.

A total of 160 psychiatrists completed the questionnaire (response rate 82%). Of these, 50% described the influence of their religious beliefs on their medical practice as very strong/strong and 12.5% as weak/nil. The majority (75%) said they would disagree or strongly disagree with supporting physician-assisted suicide for a terminally ill patient; a similar proportion (76%) were against passive euthanasia. The majority (77%) felt that physician-assisted suicide was against their religious beliefs; there was no significant difference between Muslims and Christians. The majority (82.4%) believed that physician-assisted suicide could/will be abused.

Careful consideration should be given to the safeguarding of psychiatric patients if physician-assisted suicide is legalised. Future studies on the views of clinicians should explore the influence of cultural differences rather than religious beliefs.

To compare the frequency of experiences of stigma reported by people with schizophrenia and by people with other health problems (depression and malignancies). The Stigma section of the Consumer Experiences of Stigma Questionnaire (CESQ) was administered to 153 people with schizophrenia, 106 people with depression and 85 people with malignancies.

Using multiple regression analysis we showed that after controlling for the differences in the participants' background characteristics, people with depression did not differ significantly in terms of the frequency of self-reported stigma experiences from patients with schizophrenia (β = − 0.064, P < 0.05). However, patients with malignancies felt stigmatised significantly less often than patients with schizophrenia β= − 0.240, P < 0.05).

Our findings confirm that the stigma of mental illness is more pronounced than the stigma associated with physical health problems. Contrary to expectations, however, we were not able to demonstrate that people with depression are treated more favourably and experience less stigma than people with schizophrenia.

To assess attitudes of general practitioners (GPs) on who should be responsible for managing metabolic dysregulations associated with the use of antipsychotics prescribed by psychiatrists. A total of 121 GPs in West Galway catchment area were surveyed using a simple questionnaire.

A total of 104 GPs responded (86% response rate). The vast majority of responders (82%) believed that medical management should be provided within primary care. However, 46% indicated that initial screening and simple non-pharmacological management should be provided by mental health services.

The vast majority of GPs appear willing to take over the medical management of metabolic dysregulations emerging from antipsychotic prescribing in secondary care. Clearly defined roles for mental health services and primary care in the management of metabolic complications are of paramount importance, and individual mental health services should implement protocols for screening, non-pharmacological management and referral to primary care.

A cross-sectional survey was conducted to assess patient knowledge and information provision about opioid substitution treatment among individuals with opiate dependence receiving treatment at four treatment centres in South London.

In total 118 people were recruited to the study. Participants answered a mean of 14 out of 34 questions assessing a range of factors such as medication, blood-borne viruses and overdose correctly. Participants overestimated their performance on average by almost 40%. Individuals with a history of previous treatments scored significantly higher than those in their first treatment episode. The majority reported having been given written information on most of the topics assessed.

The results of this study highlight the need to improve education about opioid dependence and its treatment. Poorly informed patients are unlikely to make optimal treatment choices. Improving patients' knowledge and understanding about treatment may lead to better engagement, retention, treatment adherence and, ultimately, better health outcomes.

Tackling discrimination, stigma and inequalities in mental health is a major objective of the UK government. The project aimed to determine the effect of presenting a person with a mental illness as having either a biological illness or a disorder that arose from psychosocial stress to a randomised representative panel of members of the general public. The 20-point Attitude to Mental Illness Questionnaire (AMIQ) was used to assess stigmatised attitudes.

Overall, 187 individuals returned their questionnaires (74% response rate). The mean AMIQ stigma score for the ‘ill’ group was 1.4 (s.e. = 0.3; n = 94). The mean AMIQ score for the ‘stress’ group was 0.5 (s.e. = 0.3; median n = 106; P = 0.0837, median difference = 1; power (for 5% significance) 81%).

There was no difference in the stigmatised attitudes towards a person with mental illness regardless of whether they were presented as biologically ill or as having an illness that was a response to psychosocial stress.

We looked at the contribution of psychiatric disorders to occupancy of National Health Service (NHS) beds in England in the past 11 years, using publicly available data on Hospital Episode Statistics from the financial years 1998–1999 to 2008–2009.

Patients with psychiatric disorders occupied between 14 and 16% of NHS beds in each year examined, and schizophrenia and mood disorders were among the top ten medical diagnoses of people occupying beds in every year. In terms of duration of admission, many individuals with psychiatric disorders, including schizophrenia and mood disorders, had a longer length of admission than those with other medical conditions. In 2008–2009 mean duration of admission for people with schizophrenia was 108 days and for people with mood disorders 42 days. In comparison, people with cerebrovascular disease stayed in hospital for 20 days on average.

Despite modern treatments, people with psychiatric disorders occupy a large proportion of NHS beds and stay in hospital for considerably longer than those with other medical conditions. Since the independent sector is providing increasing amounts of long-term in-patient care, these figures are likely to underestimate the total burden and costs of treating psychiatric disorders. Community services designed to reduce admissions have yet to have any substantial impact on bed use.

A cross-sectional study aiming to assess the prevalence of trauma and post-traumatic stress disorder (PTSD) in a community substitution treatment sample, and to assess and compare the characteristics of traumatic experience, substance use, and psychological and social factors in those with and without PTSD. All assessments were completed during the interview which took approximately 1.5 h.

The prevalence for current PTSD was 26.2% and for lifetime PTSD 42.9%. Traumatic experiences were extremely common, with two or more reported by 92.9% of the sample. The two groups differed significantly on the majority of psychological functioning and social variables, with women experiencing higher rates of PTSD and the non-PTSD group having lower rates of psychological impairment.

The research supported findings from previous studies. The very high incidence of traumatic experiences has not been reported before. Training and information about trauma and PTSD for substance misuse workers are therefore necessary so that PTSD can be more easily detected and treated.

This study was conducted to ascertain the clinical characteristics of patients who repeatedly attend accident and emergency (A&E) department seeking psychiatric assessment and care. We identified 24 individuals who attended frequently and compared them with 72 matched single attenders using data abstracted by chart review.

Individuals who attended frequently made up 5.3% of all patients who attended the A&E department for psychiatric care but accounted for 19% of all such presentations. Compared with controls, they were younger at first psychiatric contact and had higher rates of schizophrenia and psychiatric admissions.

A small but distinctive group of patients repeatedly seek and obtain hospital-based psychiatric care. Early identification of these patients and targeting them with effective, community-oriented strategies, such as home treatment, could improve their quality of life and prognoses as well as reduce the cost of their care.

To examine the effects of implementing the individual placement and support (IPS) approach within four community mental health teams (CMHTs). Demographic, clinical and vocational data were collected through a repeated cross-sectional survey. Additionally, a service user experience survey was conducted.

The IPS approach appears to have a significant effect on the employment rates of service users; a higher proportion felt able to return to employment and a smaller proportion believed they were unable to work because of their mental health problems. Employment rates for service users appear to be independent of general employment rates.

Implementing IPS appears to increase the employment rates in CMHTs resulting in increased service user expectations of being able to return to work.

The provision of 24-hour specialist child and adolescent mental health services (CAMHS) is a key target for service commissioners. However, a lack of data exist on models of service delivery or levels of need for out-of-hours specialist CAMHS to guide service development. We aim to describe a model of 24-hour service provision and provide information on the demand for and outcome of assessments of a service in Dublin, Ireland, using a 6-year retrospective case study design.

A total of 468 emergency presentations occurred during the study period; 80% presented with self-harm or suicidal ideation. Two-thirds presented outside of working hours. All presentations received a specialist CAMHS consultation. Over 50% required admission to a paediatric ward and 80% required onward referral to specialist CAMHS.

There is a need for a 24-hour specialist CAMHS and this allows increased rates of specialist assessment and onward referral for a high-risk group.

To report the rates of violent and aggressive incidents at a drug treatment clinic using a newly introduced incident reporting tool (STARSWeb) and to describe the management strategies currently employed in the management of incidents at the centre. This involved the review of all completed incident reports for the year 2008 and the examination of relevant patient factors.

There were 276 documented incidents at the centre in 2008. The majority of incidents (72.4%) involved verbal abuse and threatening behaviours. Males were responsible for the majority of incidents. Two-thirds of the clients' urine samples were positive for illicit substances at the time of the incidents.

Violent and aggressive incidents in healthcare settings continue to pose a real challenge to both service providers and service users. An accurate system of reporting of such incidents is indispensable in guiding policy development and management strategies. The STARSWeb system offers a significant improvement in incident reporting towards the attainment of these goals.

Relapse in schizophrenia carries a heavy burden. This study aimed to describe the characteristics of patients admitted to hospital for relapse and to explore the treatment, length of stay and associated in-patient costs. The sample comprised individuals discharged from a London National Health Service trust following a relapse of schizophrenia. The costs of hospital treatment were obtained by applying referenced unit costs.

The cohort comprised 71 patients. Treatment non-adherence was implicated in 76% of relapses. Mean length of hospital stay was 138.9 days (range 1 week-1.8 years). Mean admission cost was £25 852 (range £1270-120 000). Over 97% of costs were hospital costs and less than 3% drug costs.

Hospital treatment for relapse of schizophrenia carries a considerable economic burden, as shown in this study. Treatment non-adherence is a significant factor contributing to relapse.

We examined learning outcomes, practice impacts and implementation processes for a training intervention in diagnostic skills delivered to multidisciplinary child and adolescent mental health service practitioners (n = 63).

Training was viewed positively by most participants and associated with significant increases in practitioner self-efficacy, with the effect sustained at 8-month follow-up. A comparative audit before and after training indicated that clinicians were significantly more likely to assign an Axis I diagnosis following the training intervention. However, absolute rates of Axis I classification remained relatively low (< 40%) both before and after training. Practitioners were moderately successful at following through on personal plans for implementing new learning; inconsistent support for implementation was provided within teams.

A brief training workshop may have limited effects in changing practitioners' behaviour so that diagnoses are made more promptly and appropriately recorded. Future workforce development initiatives should consider more comprehensive and diversified strategies, including targeted post-training support, if increased self-efficacy following training is to be translated into sustained changes in diagnostic practice.

To establish the views of child and adolescent psychiatrists (n = 52) regarding the conceptual and empirical validity, clinical utility and acceptability of the diagnosis of borderline personality disorder in child and adolescent populations. A questionnaire survey was carried out.

The child and adolescent psychiatrists' perception of the validity of borderline personality disorder for adult populations was relatively high (82% felt it to be valid). Significantly fewer of those considered borderline personality disorder to be valid for adolescent populations (37%). Strikingly different results were obtained when the questions related to child (<12 years) populations (2%).

Given the views expressed by these consultant child and adolescent psychiatrists, it would seem appropriate to approach with caution suggestions that the borderline personality disorder category should have extended use with adolescent and child populations.