Objective: The aim of this study was to examine the working of the 1945 Irish Mental Treatment Act in relation to compulsory admission and detention and to establish issues that will need to be addressed in imminent new legislation. Method: A 3 year retrospective study was carried out on all compulsory admissions to the Cavan/Monaghan Psychiatric Service using case note material. The circumstances surrounding application for compulsory admission in one year of the study period were further investigated by delivery of a schedule to Relative-Applicants. Results: The study revealed rates of compulsory admission equivalent to other Irish regions but much higher than neighbouring jurisdictions. There was no evidence of deliberate abuse of the act. Indications emerged of excessive and inappropriate recourse to certification by some relatives and General Practitioners. Excessive length of detained stay and lack of specific procedures for informing patients of their rights were evident. Conclusions: A new Mental Treatment Act will need to place much greater emphasis on patients' civil rights while facilitating access to treatment.

Objective: To investigate factors influencing general practitioner referrals of children with psychiatric disorders to specialist services. Method: One hundred and sixty seven general practitioners were asked to complete a detailed questionnaire concerning their referral practices. Results: Emotional disorder, conduct disorder, drug abuse and habit disorder were the problems most likely to be referred to the child psychiatric clinic. Parental concern and the severity of the child's illness were considered to be more important than social circumstances in determining referral to specialist services. Conclusions: Many general practitioners indicated that they would have referred children with psychiatric disorders to specialist services other than child psychiatry. Proactive liaison work is needed to increase the awareness and confidence of general practitioners in child psychiatric services.

Objective: The assessment of the personality status of Adolf Hitler using a structured interview schedule, the Personality Assessment Schedule, with two informants, one a psychiatrist with an interest in psychohistory and the other a historian with special knowledge of the Third Reich and Weimar Republic. Method: The Personality Assessment Schedule was given in two forms to the two informants at different times; on each occasion Hitler was assessed as he was in 1937. Results: There was considerable discrepancy between the ratings of the two informants, the historian recording less-personality disturbance in all areas of function, although correlations between the two sets of ratings were relatively high (R1 0.5-0.6), with rater bias accounting for the differences in severity. Both informants regarded Hitler as having a dissocial personality disorder (using the new ICD-10 criteria), but the psychiatrist's rating also scored the diagnosis of paranoid and histrionic personality disorders. Conclusions: Interview schedules which use informants to assess personality disorder can be of value in examining the personality status of historical figures.

Objective: To assess the preparedness of psychiatric nurses to care for patients with Acquired Immune Deficiency Syndrome (AIDS). Method: Voluntary anonymous questionnaires were sent to psychiatric and general nurses in a district general teaching hospital. The behaviour, knowledge and attitudes towards AIDS of both groups were then compared with those of three experts specialising in the care of AIDS patients. Results: No inter group differences were found but a majority of nurses differed from the experts on two statements. Contrary to expert opinion nurses believed AIDS could be spread by needle stick injury and if given a choice they stated they would not volunteer to work on an AIDS ward. On controversial issues such as testing and where best to treat psychiatrically disturbed AIDS patients there was wide variation. Conclusion: While this study shows an improvement in health professionals knowledge, behaviour and attitudes towards AIDS, there remain underlying anxieties that need to be addressed with continuing education and training.

We report a case of carbon monoxide poisoning where symptoms of Neuroleptic Malignant Syndrome developed following use of neuroleptic medication. Literature review has failed to reveal a previous report of neuroleptic malignant syndrome following carbon monoxide insult.

A patient suffering from psychotic morbid jealousy is reported and a formulation to understand the psychopathology cognitively is presented demonstrating that cognitive formulation can be utilized for understanding of psychotic morbid jealousy patients as well.

A case report of father-son incest is described. A review of the literature suggests that father-son incest may be significantly under-reported. We suggest that this may be because it is seldom sought after and even less readily recognised. The possibility of the male incest victim should be considered in males who present with depression, severe anxiety, low self-esteem and difficulties with sexual orientation.

A seventeen year old man attended the National Drug Treatment Centre with a paranoid psychosis following ingestion of Methylene dioxy methamphetamine (MDMA). He had been taking MDMA on a recreational basis over a five month period. Although chronic psychosis after heavy use of MDMA has been reported there are no pervious reports of psychosis following recreational use. This report highlights the psychological dangers of this drug, which has become widely misused in Dublin over the last two years.

William Sealy Gosset [1876-1937] was a brewer in Arthur Guinness and Co. Dublin from 1899 to 1935 when he moved to London. In 1907, writing under the nom de plume Student he published his paper on “the probable error of a mean” which was later developed by R A Fisher into Student's test of significance now in everyday use in biology and industry.