For the purpose of this article, I am using a definition of whistle blowing which was used at a conference in November 1995 at the Royal Society of Medicine:

A 25-year-old Bengali man was taken to casualty by relatives who were concerned about his unpredictable and dangerous behaviour. He lived close to his parents and five younger siblings, and there was no family history of mental disorder.

The severity of anorexia nervosa can vary from mild to life threatening. It is sometimes transient but often chronic. Such variety of disorder requires variety of response. The clinician must choose the right treatment to offer at the right time. The literature contains plenty of advice but most of this is based upon experience and opinion rather than on systematic research and treatment trials. For the most part, this paper will be no exception. Anorexia nervosa is a disorder which is distinct from other psychiatric syndromes but is of uncertain cause. In the face of this uncertainty, treatment tends to be informed by the favoured formulation of the clinician, usually some sort of ‘multifactorial theory’. Again this paper is no exception. It will concentrate upon the management of anorexia nervosa in late adolescence and adulthood. The treatment of children requires a different approach (Lask & Bryant-Waugh, 1993). The emphasis of the paper will be upon what can go wrong as well as what may be the best interventions to offer. Often the things that go wrong have more to do with the context of treatment and the way in which it is offered rather than with the treatment intervention itself.

The first target of the government's mental Health of the Nation strategy is to improve the health and social functioning of mentally ill people. Most health service professionals would agree with the implication that there is substantial room for improvement. It is as important to be aware of the extent to which a service is failing as it is to know that needs are being met.

The forensic psychiatry of learning disability is a subspeciality which exists on the ‘borderlines’ between other areas. It takes in information from forensic psychiatry, learning disability, child and adolescent psychiatry, psychology, genetics and pharmacology to name but a few.

Three recent advances have increased the importance of obsessive–compulsive disorder (OCD) for the general psychiatrist. It is a more common disorder than previously realised, there are effective treatments, and the basic neurobiological substrate for the condition is being identified. This review will consider these advances but focus mainly on the practical aspects of assessing the condition and planning treatment.