The aim of the study was to obtain numbers of adult patients with attention-deficit hyperactivity disorder (ADHD) on consultant adult and adolescent psychiatrists' case-loads. A brief semi-structured confidential postal questionnaire was sent to 1947 consultant psychiatrists in England and Wales.

There were 1030 consultants who responded (52.9%), which clearly indicates that there is an increasing demand and need for a service, and the resources, to treat adult ADHD. Only 197 consultants offered a service for adults with ADHD. Adult ADHD is more commonly diagnosed in males (n=995, 73%), and the total number of patients with a diagnosis of adult ADHD was 1345. Most patients were aged 18–25 years (n=209, 54%). The most commonly prescribed stimulant medication was methylphenidate (n=251, 55%).

There is a clear need to improve services and funding for adults with ADHD. The study shows there are already services available for adult ADHD patients in some areas of the country. However, more research is needed to establish the prevalence of adult ADHD in England and Wales.

To describe the formation and function of ‘stress-busting’ groups and report a survey on work-related stress among a small cohort of consultant psychiatrists.

Of 37 questionnaires, 25 were returned and 16 respondents (64%) rated their overall level of stress at work as moderate or severe. Stressful factors included lack of staff, paperwork, high-risk patients, difficult/hostile relatives and job demands interfering with family life. The most helpful stress-reducing strategies were talking to colleagues for support and catharsis, outside interests, support from family and friends, effective time management and exercise. Among 15 current members of ‘stress-busting’ groups, 14 (93%) found these to be helpful. The most successful format in the ‘stress-busting’ groups was one of ‘problem-solving with ventilation of stresses'.

‘Stress-busting’ groups may constitute a helpful approach to work-related stress and a utilisation of the skills of psychiatrists to our mutual benefit.

Dialectical behaviour therapy is an evidence-based treatment for people with borderline personality disorder. We describe implementation and outcomes of a new service.

Hospital use and frequency of self-harm were reduced dramatically with dialectical behaviour therapy. Moreover, the therapy can be implemented successfully in a relatively short time at modest costs.

Dialectical behaviour therapy provides a useful model of treatment for people with borderline personality disorder and/or self-harm in community mental health settings.

To ascertain the views of people with personality disorder on their clinical interactions with professionals, to identify potential solutions to problematic interactions and to compile guidelines on how professionals could improve their interactions with these service users. Qualitative methodology was employed, comprising a modified nominal group technique with two iterative groups and ranking by importance the issues and themes raised.

There were 13 service users from three separate personality disorder services who actively participated in a group discussion and iterative process. Collectively they indicated considerable areas of deficiency in the quality of their interaction and communication with professionals. These deficits were defined clearly enough to allow the construction of guidelines aimed at preventing or remedying such deficiencies.

The contribution of those people with personality disorder who took part in this study was sufficiently thoughtful to allow the development of guidelines that might help staff improve their interactions with such service users. From these guidelines, further training tools are being developed, which will be evaluated in the future. However, because not all those approached chose to participate, the views expressed might not be representative of this group as a whole.

The association in the media of mental illness with violence is well established. This study looks at whether there are differences in the portrayal of schizophrenia in the local newspapers of Nottingham, an area with a high crime rate and Dorset, an area with a low crime rate.

We analysed 98 newspaper articles, 55 from Nottingham and 43 from Dorset, and found no statistically significant difference in the portrayal of schizophrenia. Overall, 36.1% of articles were negative in tone, 56.7% were neutral and 7.2% were positive. In 6 of the 98 articles (6.1%) a person with schizophrenia or their carer was interviewed. These articles were either positive or neutral in tone. Schizophrenia has entered the language as a metaphor.

Local levels of crime do not appear to influence the portrayal of schizophrenia in local newspapers. Associations with dangerousness continue to predominate and the lay public continues to receive a distorted image of people living with schizophrenia. More interviews with patients and carers might help to address this imbalance. It is important to explore what the word schizophrenia means to patients and carers.

To determine the prescribing patterns for antipsychotics in care homes for the elderly, a cross-sectional study was carried out using data from the intervention group of a randomised controlled trial of medication review in care homes.

Of 331 residents studied, 67 (20%) were prescribed an antipsychotic (70% atypical); 57 of these (85%) did not have a diagnosis of a psychotic disorder. The antipsychotic prescribing rate was 32% (46 out of 146) for those with dementia and 10% (17 out of 174) for those without dementia. A quarter (82 out of 331) had received a medication review by the general practitioner in the preceding 12 months.

One-fifth of residents were prescribed an antipsychotic with little evidence of review. Systems should ensure residents' treatment is reviewed regularly.

A naturalistic study was conducted to examine the outcome on self-report and observer-rated measures in patients with severe, chronic, resistant obsessive–compulsive disorder (OCD) admitted to a specialised in-patient unit.

Twenty-six patients were admitted over the study period. The mean age of all patients was 37 years (s.d.=13.8, range 18–61 years) and they had a mean duration of OCD of 18.4 years (s.d.=10.9, range 4–40 years). Instruments measuring severity demonstrated a 37–67% reduction in obsessive–compulsive symptoms and a 64% reduction in depressive symptoms after an average of almost 15 weeks in hospital.

This study demonstrates that specialised in-patient care can benefit a small group of severely ill patients with OCD who fail to respond to treatment in primary and secondary care.

We observed levels of social interaction and activity among in-patients on 16 acute psychiatric wards in 6 hospitals in a large mental health trust. Each ward was observed for 1 week and attendance at organised activities was audited over 3-week periods.

At any time during the day 84% of in-patients were socially disengaged and mainly inactive. On average only 4% of in-patients' time was spent in an organised group activity, with many in-patients opting out altogether. Provision and take-up of group activity programmes varied widely between wards.

Provision of organised activity needs to be a higher priority in acute services, and there should be national and local standards for what should be provided. Concerted organisational strategies and assertive approaches by staff are needed to engage in-patients in group activity programmes.

This study provides an overview of the development of early intervention services for psychosis across England in February 2005. A bespoke self-report audit tool was completed by key informants across the eight regional development centres of the National Institute for Mental Health in England.

Out of 117 teams identified, 86 have funding, of which 63 are operational with case-managed patients (as of February 2005). Only 3 teams meet all 10 audited early intervention fidelity requirements and there are variations in service model, delivery setting and resources across teams.

Current inequity of access and the early, fragile nature of service development means that early intervention in England has reached a critical phase requiring consolidation.

To investigate changes to admissions, compulsory detentions, diagnosis, length of stay and suicides following introduction of crisis resolution home treatment and assertive outreach teams.

There was a 45% reduction in admissions with an increase in the median length of stay from 15.5 to 25 days. Bed occupancy fell by 22%. The number of suicides remained constant. Detentions under sections 2 and 3 of the Mental Health Act 1983 increased whereas those under sections 5(2) and 5(4) declined.

The introduction of crisis and assertive outreach teams was followed by a reduction in admissions, particularly short admissions. The impact differed according to gender (reduction in female bed occupancy). This and the increased length of stay need to be considered when determining the number of acute psychiatric beds needed.

A cross-sectional survey was conducted to investigate the safety of rooms used by medical staff to interview patients in out-patient and in-patient settings of a mental health trust. An assessment tool was designed, and examined the features of an interview room that were likely to promote safety.

The survey included 112 rooms and demonstrated shortcomings that compromised interview room safety. Rooms were frequently overcrowded with furniture (n=30), cluttered with loose objects (n=101, 90%) and used for multiple purposes (n=82, 73%). Room layout often compromised either access to alarm systems (n=51, 46%) or exit from rooms (n=99, 88%). Necessary facilities for summoning assistance were found to be lacking.

The safety of interview rooms has not been emphasised sufficiently within everyday working practice and should be revisited.

The aims of the project were to develop a simple, low-cost patient satisfaction questionnaire with face validity and to obtain patient feedback on a range of service areas in a community addiction team. A questionnaire was designed and revised after feedback from multidisciplinary team members and a pilot sample. The questionnaire was distributed until 100 correctly completed forms were received.

The survey took approximately 30 h of authors' time from commencement to completion and costs were minimal. The majority of the 12 areas evaluated were rated by patients as good or very good. Overall quality of care was rated as good or very good by 88% of participants. There was no enthusiasm in this sample for more active participation in service development.

All National Health Service staff and services are now enjoined to engage with service users and carers for the purposes of evaluation and development. Simple, affordable methods for obtaining such information about community services can contribute to this process.