Scant clinical attention is usually paid to (a) forensic patients' reading interests or (b) the potential that library services may offer in providing information and therapy to patients. We undertook a cross-sectional service evaluation of patients' library attendance and use at Rampton high secure hospital in a 12-month period between July 2009 and June 2010.

We collected information for 326 patients across all 28 wards. Almost 79% used the library service in some way, 66% borrowing music, 67% borrowing books and some borrowing both. Factual books were borrowed more than fiction, with graphic novels, talking books and self-help books about mental disorder all proving popular.

Reading and library use should be considered by clinicians in terms of the positive impact of improving literacy to enhance wider recovery, in relation to the impact of illness and medication effects on reading ability and the potential for providing health-related messages, illness education and reading therapy.

To inform the development of a new, recovery-oriented rehabilitation service, identify local needs and create a pathway for appropriate referrals, accelerating the build up of case-load. We surveyed 1353 secondary service users using a purpose-made needs assessment and case identification questionnaire, completed by nominated care coordinators.

Significant unmet need for rehabilitation and recovery-oriented interventions was found. The results were used to invite referrals, create a case-load of 150 and allocate the appropriate resources for the new team.

The results highlight the untapped recovery potential among users of mainstream secondary mental health services and support investment in rehabilitation at a time of resource restriction. This work also supports a similar, evidence-based approach to targeting appropriate referrals during the development and the early stages of rehabilitation services.

To examine the association between the use of paroxetine during pregnancy and the risk of cardiovascular defects in the newborn. A systematic review of nine electronic databases was carried out and bibliographies were hand-searched for other relevant articles. Inclusion criteria for studies were the use of selective serotonin reuptake inhibitors in the first trimester of pregnancy, with separate data available for paroxetine and cardiovascular defects in newborn babies. A random-effect model was used to combine the data.

A total of 11 studies were included in the analysis, concerning 4515 offspring who were exposed to paroxetine in the first trimester and 1 469 302 controls. In pooled analysis, paroxetine in the first trimester of pregnancy was slightly, but significantly, associated with a risk of cardiovascular malformations in the offspring (relative risk= 1.25, 95% CI 1.01–1.54). Separate analyses of case-control and cohort studies made this difference non-significant.

This meta-analysis supports current guidelines advising not to use paroxetine in early pregnancy.

To determine the provision of teaching in psychiatry for foundation doctors up to the point of making specialty applications. Data for the cohort of foundation doctors entering training in 2010 were collected from teaching programmes across the Mersey Deanery and North Western Foundation Schools.

In the 17 hospitals that provided data, ‘protected teaching’ totalled 2354 h; 1.8% of time was dedicated to psychiatry, with 4 hospitals providing no teaching on mental health topics. The mean duration of psychiatry teaching was higher in university teaching hospitals (3 h 34 min) than district general hospitals (2 h 57 min); and almost a quarter of teaching sessions were titled only ‘psychiatry’.

For many foundation doctors their only experience of psychiatry will be through teaching sessions, and this is potentially the only time to change opinions and build interest in the specialty. Psychiatrists need to take a more active role in the provision of high-quality teaching for foundation doctors and become the visible role models which are currently lacking.