Hostage situations differ greatly – in the aims and goals of the hostage-takers, the frequency and intensity of maltreatment, the type and quality of conditions, the duration of captivity, and the processes by which they are ultimately resolved and concluded. Although there is a paucity of research-based data about hostage reactions, clinical management, and outcome, there are general descriptive accounts in the medical and popular literature. A number of key texts are highlighted in the references, and examples of different conditions are briefly summarised in Box 1.

Somatisation remains a matter of bewilderment in medicine. Medical students have trouble defining it, psychiatry trainees wilt in its presence, and all doctors are prone to become entangled in it. The current spate of reviews on the topic is appropriate (Mayou et al, 1995a; Barsky, 1996; Gill & Bass, 1996). There is a great need for those required to manage patients with ‘medically unexplained symptoms’ to be informed sufficiently to take a stance on the theoretical issues involved and develop appropriate management plans.

Social, cultural, emotional and biological influences determine whether people drink to excess and whether they then experience harm or cause harm to others (Cook, 1994). Psychosocial treatments for alcohol dependence are only modestly successful, with most studies finding that at least 50% of patients return to harmful drinking in the following year. In the past decade there has been new evidence for the role of pharmacological treatments in reducing harm from drinking and in preventing relapse.

Prevalence and incidence rates of dementia in people under the age of 65 are difficult to determine. Surveys differ in design, examine different population samples and include varying levels of disease in estimating rates. Most of the surveys are small and are conducted through case note review.

Since the formation of the College in 1971 and the introduction of the examination for membership of the College in 1973, preparation of candidates for the examination has been subject to a wide range of influences which have shaped all aspects of psychiatric training. Possibly the most important factor has been the consensus that membership of the College should mark the end of general training and the beginning of specialist training in psychiatry. This is in contrast to some similar diplomas which may be required as an entry qualification to postgraduate medical training (e.g. MRCP) or others which may mark the end of specialist training and be awarded only shortly before achieving consultant status (e.g. MRCPath).

Historically, depressive disorders in adolescents have been conceptualised as variants of the nonspecific class of childhood emotional or neurotic disorder, which encompassed depressive, anxiety, hysterical and obsessional disorders. Over the past decade, however, the field has shifted towards greater diagnostic refinement. Research evidence has shown that severe depressive disorders differ from other mental disorders in this age group in their epidemiology, outcome and correlates (Harrington & Wood, 1995). Treatment therefore includes not only general techniques of clinical management, but also a variety of treatments targeted at the symptoms of depressive disorder.