Greetings cards (wishing patients well) appear less abundant on psychiatric wards than other in-patient facilities. We tested this hypothesis in three cross-sectional surveys of teaching hospitals in Sheffield.

On each occasion, psychiatric wards contained significantly fewer card recipients (χ2 test, P<0.001). Individual recipients in psychiatric wards received significantly fewer cards than recipients in general hospitals (Kruskal–Wallis test, P<0.05).

Although receiving a card might seem a trivial matter, it nevertheless denotes the outcome of an altruistic act, which may be appreciated by its recipient. Psychiatric in-patients receive fewer such acts of kindness than other in-patients. These data concur with other recent reports suggesting that the stigma of mental illness extends to expressions of altruism.

This is a descriptive study of the admissions of new long-stay patients and their outcome in a district with minimal access to longer-stay in-patient beds. Cases were identified through an ongoing in-patient census and information was gathered by retrospective case-note review.

Thirty-nine new long-stay admissions were identified. High rates of living alone, early readmission following previous discharge and use of the Mental Health Act 1983 were noted. The 39 admissions occupied 12% of the unit's capacity. Four patients returned to a family residence but 27 went into residential or in-patient care. Of those discharged to settings not providing patient care, 48% were readmitted in the year after discharge.

New long-stay admissions continue to absorb a high proportion of the bed resources of an in-patient unit for their numbers and these patients are at risk of unsuccessful discharge.

The study examined the prevalence of psychiatric disorders in people with HIV/AIDS attending the AIDS Support Organisation (TASO) clinic at Mulago Hospital, Kampala, Uganda and the preparedness of AIDS counsellors to deal with mental disorders. Forty-six patients were interviewed using the Mini International Psychiatric Interview to ascertain DSM–IV diagnoses. All 15 counsellors working at the clinic were interviewed.

The total prevalence of psychiatric disorder was 82.6 (38 out of 46 patients). Depressive and anxiety disorders were common. Non-affective psychoses were present in eight patients (17.4%), bipolar affective disorder in eight (17.4%) and major depression with melancholic features in five (10.9%); 8 (13%) had current suicidal thoughts. None of the people with psychiatric disorders were receiving mental health treatment. The prevalence of disorder as estimated by the counsellors ranged from 0 to 33%. Only one counsellor had received any formal training in mental disorders and only two thought that they could deal with these if they arose. The attitudes of counsellors towards people with mental disorders were mixed, but most believed that they should be trained to provide care.

There is a need to provide additional mental health services to the TASO clinic through appropriate training of TASO counsellors to improve their awareness of psychiatric disorders, delivery of some psychological therapies and liaison with the psychiatric services at Mulago Hospital, in addition to public mental health education. The psychiatric disorders experienced by those attending the clinic might put them at greater risk of contracting HIV/AIDS.

The aims of this study were to describe the characteristics of substance misuse services prescribing methadone for maintenance treatment of opioid dependence and to determine the average daily doses of methadone prescribed across England. A postal questionnaire survey of all substance misuse treatment centres in England was carried out.

A total of 298 treatment centres were identified and contacted, 212 of which responded to the survey (response rate of 71%). Of these, 157 were prescribing methadone for maintenance treatment; the majority (71%) were community-based and 125 centres had doctors attached. The most common formulation of methadone prescription was oral methadone mixture (152 centres, 97%). The mean daily dose of methadone prescribed was 47 mg. Surprisingly, 37 (24%) of the respondents felt that methadone maintenance treatment should be time-limited and 21 teams (13%) stated that patients should receive only drug substitution and no psychosocial interventions.

There is currently a move among substance misuse services towards community-based treatment. In our survey, the mean daily dose of methadone prescribed was less than the dosage recommended by the Department of Health. This suggests that specialist addiction services are continuing to underprescribe heroin substitutes. The inadequate understanding of some of the respondents of the basic principles of methadone maintenance treatment also raises concerns, and highlights the need for further training and education.

To review and clarify the large number of psychophenomenological terms used to describe thought disorder. The most recent editions of the major psychiatric textbooks and medical dictionaries in the library of a London teaching hospital were used to compile a list of such terms. The various, often conflicting definitions were compared.

There were 68 terms identified. There was significant redundancy in these terms (i.e. more terms than significantly different concepts described). Different sources gave different definitions for the same terms.

The understanding of many of the terms used to describe thought disorder is poor. This is confusing for clinicians, trainees and patients.

This paper describes the clinical activity of a district neuropsychiatry service over a 1-year period. The data presented are drawn from a clinical database with individuals classified according to the following diagnostic groups: acquired brain injury, early-onset dementia, Huntington's disease, epilepsy, other neurological disorders, developmental disorders and non-organic disorders. Information is presented on out-patient case-load, new out-patient referrals, general hospital referrals and in-patient admissions.

The total out-patient case-load was 451; 189 new out-patient and 99 liaison referrals were seen and 90 individuals were admitted. Acquired brain injury was the most common neurological diagnosis in all groups.

The demand for this service indicates that there is a market for neuropsychiatry, even at a district level, and particularly in the management of the sequelae of acquired brain injury.