New variant Creutzfeldt–Jakob disease is a novel prion disease of humans that may be causally linked to bovine spongiform encephalopathy. Psychiatric symptoms occur in the early stages of the illness and may be difficult to distinguish from the symptoms of more common psychiatric disorders. Cases of new variant Creutzfeldt–Jakob disease are identified through the national surveillance system. Information on psychiatric features has been obtained by review of case notes and, in the majority of cases, by interview of relatives by a member of the surveillance staff.

Thirty-five cases of new variant Creutzfeldt–Jakob disease have been identified in the UK and detailed information on the clinical features and investigations is currently available in 33 of these cases. All but one of the cases exhibited prominent early psychiatric symptomatology, but the diagnosis of an underlying neurological disease was not possible in the majority of cases until the development of neurological symptoms and signs. Early indications of an underlying neurological disorder included cognitive impairment, persistent sensory symptoms or limb pain and, in a minority, gait imbalance, dysarthria or visual symptoms. Limited evidence suggests that investigations such as electroencephalogram or brain imaging are unlikely to provde useful diagnostic information during the ‘psychiatric’ phase of the illness.

The early recognition of an underlying neurological disorder may be impossible in the early psychiatric phase of new variant Creutzfeldt–Jakob disease, but the suspicion of this diagnosis may be raised by the occurrence of associated neurological symptoms. The development of early diagnostic markers is an important objective.

Suicides in the Fife region were investigated over a two-year period. The timing of the final contact with general practitioners and psychiatric services was ascertained. Data were collected from procurators fiscal records, general practices, and where applicable, psychiatric records.

There were 74 suicide victims during the study period. Forty-six per cent of suicide victims saw their general practitioner in the month before death, and 55% had a history of previous contact with psychiatric services, although only 27% of this group saw a psychiatrist in the month before death.

Clinical audit of suicide is an important task for psychiatric services. Practitioners must continually assess risk and attempt, where possible, to reduce risk factors.

While Youth Access attempts to organise voluntary counselling services for young people on a national level research describing such agencies is lacking. In order to investigate their activity with a view to multi-agency collaboration, a questionnaire was distributed to eight agencies in Hampshire.

The responses demonstrate a strong emphasis on accessibility and informality. Although agencies have reported increasing numbers of service user contacts little attempt has been made to quantify and evaluate the service provided.

Efforts to organise, evaluate and improve accountability in the voluntary sector might spoil these fundamental components for the disaffected adolescent.

Leaflets are commonly used as a way of providing information to users. In this study, we use a simple index of ‘readability’ to compare a range of leaflets available to people with mental health problems.

The majority of the leaflets contained passages that are likely to be beyond the comprehension of people with mental health problems.

Leaflets are a cost-effective way of providing information, but only if the text can be understood by the target audience.

A cross-sectional, interview survey of the beliefs, knowledge, attitudes and practice towards mental illness of 29 traditional healers in the Pallisa district of Uganda was carried out.

Many of the healers had experienced emotional problems that had been treated by other healers. Almost all had a family member who was also a traditional healer. They treated a wide range of conditions and all dealt with mental illness. Most believed that mental disorders were caused by supernatural processes. Many recognised the role of environmental agents. Their diagnosis and management of mental illness was eclectic. The healers were either traditional herbalists or spirit diviners or a mixture of both. Almost all referred patients to the district hospitals and were willing to work with government health services.

The results of the survey suggest the presence of fertile ground on which to build cooperation between traditional healers and medical services. Such cooperation may harness primary care resources more effectively. Sequential or simultaneous models of collaboration (or combinations of both) may be considered. Further work on specific treatments, their outcomes and the evaluation of collaborative models is needed.

This study investigated the effects of gender and nationality on performance in various aspects of the undergraduate final examination in psychiatry. Results in all sections of the final examination were analysed in the case of 140 students from the same year.

There were no statistically significant differences between performances by males and females, however non-nationals performed less well in all aspects of the examination.

Teaching programmes need to identify which aspects of the undergraduate course cause particular difficulty for non-nationals. This information would usefully inform future developments in undergraduate teaching.

The aim of the paper is to describe the pre-registration house officer training in psychiatry available in Sheffield. The report is the result of a postal questionnaire, involving all of those who undertook pre-registration house officer training in psychiatry, since the inception of this option.

The results suggest that the psychiatry option as part of pre-registration house officer training was regarded as useful by almost all undertaking this training. Some of the suggestions to improve the experience are already incorporated into the current posts.

The findings support the development of further posts of this type, and such developments may assist in overcoming some of the difficulties in recruitment into psychiatry as a career.

To highlight the problems in the delivery of psychiatric services in rural New Zealand. We describe the innovative collaboration between the University of Otago Medical School in Dunedin and the Southland Hospital in Invercargill.

Forging of academic links between the regional medical schools and rural hospitals is one way of delivering specialist psychiatric services in rural areas.