To examine the propriety of the use of melatonin in child and adolescent psychiatry based on findings retrieved from multiple electronic databases including the Cochrane Library resource, covering 1950–2007.

There is evidence for the effectiveness of melatonin in the initiation of sleep in children with a variety of neurodevelopmental disorders but its value in improving quality of sleep is doubtful. Like hormones in general, melatonin has multifarious action sites and hence potential for many side-effects. Posological issues and long-term side-effects are yet to be validly determined.

Sleep hygiene should be a major component of the routine intervention programme for insomnia and melatonin judiciously prescribed until the safety of long-term use is known.

To assess the quality of prescriptions for alcohol detoxification and vitamin prophylaxis for in-patients who were alcohol-dependent in a general hospital, before and after the introduction of prescribing guidelines. We assessed 27 prescription charts before and 22 after intervention against standards based on national guidelines.

There was an increase of 43% (95% CI 20–65%) in the proportion of alcohol detoxification prescriptions that met the guidelines. for vitamin prophylaxis there was an increase of 64% (95% CI 42–85%).

The pharmacological management of alcohol withdrawal in the general hospital can be significantly improved by promoting and making readily available a prescribing guideline. In turn, this may reduce alcohol-related brain damage.

This study looked at patient aggressive behaviour on an Irish psychiatric intensive care unit, and whether it was related to diagnosis, patient's insight and symptomatology. Each aggressive incident was recorded throughout the patient's stay using the Staff-Observed Aggression Scale.

Ninety-nine individuals were admitted to the unit during the study. We recorded 82 aggressive incidents, with most occurring during the daytime and on weekdays. There was no statistical difference in BPRS scores between the aggressive and non-aggressive groups. the aggressive patient group had a lower insight score than the non-aggressive group (P < 0.05) as measured on the Schedule of the Assessment of Insight. However, when gender and verbal aggression only were included in the analysis, the difference in insight was less significant (P=0.07).

Aggression is common on a psychiatric intensive care unit. Low levels of insight in patients may increase the risk of aggression.

To describe the effect of a postal reminder system on UK adult psychiatry clinic attendance. A literature review was completed and a serial cross-sectional survey of patient attendance records in an inner-city psychiatric hospital during 2006 and 2007 was undertaken.

A simple postal prompt reduces non-attendance by up to 50% and data from the serial cross-sectional survey of attendance records (n=36) powered at 77% supported this finding. Postal prompts in the survey accounted for 30% improvement in the variance (r2).

A simple postal prompt that takes less than 30 s to read, sent up to 2 weeks prior to the appointment improves attendance by up to 50% and is useful for maintaining standards of excellence.

To identify psychiatric conditions that may require psychiatric treatment in individuals referred from a diabetes centre to a liaison psychiatry diabetes clinic and to examine the referral pattern and reasons for referral. the study was a prospective case-note survey over a 12-month period.

The most common reason for referral was low mood (37.5%) and the most common psychiatric diagnosis was adjustment disorder (28.6%). Most individuals were referred by diabetes specialist nurses (53.1%). the majority (85.7%) were seen by a clinical psychologist after an initial assessment by a psychiatrist.

Common mental disorders occur frequently in individuals referred to a liaison diabetes clinic, hence the importance of early diagnosis. the involvement of psychiatrists in specialist diabetes clinics is very limited and better involvement is desirable.

To investigate whether psychiatrists' views of the Mental Health (Care and Treatment) (Scotland) Act 2003 had changed over time, we repeated our survey of psychiatrists' views and experiences of the Act, 1 year after our original study; 356 College members were surveyed by postal questionnaire.

A response rate of 66% was achieved. More than half (53%) of respondents were reasonably satisfied with the Act and 51% would choose to use it in preference to the previous Act. the majority (89%) felt that their daytime workload had increased as a result of the Act; 17% received payment for Mental Health Act-related work.

Satisfaction with the Act has improved since its introduction; however, areas of concern remain.

A questionnaire survey of all memory clinics in Scotland to obtain information about clinic characteristics, assessment techniques and prescribing practice.

Memory clinics are a common component of old age psychiatry services within Scotland. There is variability in clinic characteristics, assessment techniques and treatment approaches. Most clinicians appear to rely on their own clinical judgement rather than national guidelines when making decisions about investigations and the prescription of anti-dementia medications.

There is considerable variation in memory clinic practice across the country. Would standardisation of practice ensure equity in service provision/patient care? However, would such standardisation be at the cost of clinical autonomy?

Following the 2007 Modernising Medical Careers process, an online survey of applicants for psychiatry training posts in Scotland was undertaken. Views on short-listing, interview, communication and future recruitment were sought, qualitative and quantitative analyses being employed.

Of 200 doctors, 115 responded, representing all regions and grades. Over 75% (n=84) expressed lack of confidence in short-listing. There was no significant difference between responses of successful and unsuccessful candidates (χ2=3.66, d.f.=2, P > 0.05). A total of 45% perceived interviews as invalid (n=55). About two-thirds (66%, n=69) felt communication was poor. Constructive suggestions for 2008 were made.

Although highlighting inadequacies in the 2007 process, trainees offered valid suggestions for future recruitment into specialty training, information being obtained quickly and efficiently.