Early intervention in psychosis services serving the 14–35 age range often receive input from psychiatrists from both child and adolescent as well as adult mental health services. Differences in staff attitudes or practices could potentially affect the experience of care that an individual with first-episode psychosis receives on the basis of their age. In order to investigate such potential variation a questionnaire-based survey was conducted targeting the relevant psychiatrists working in a large mental health trust in north-east England.

Only subtle differences in attitudes between the two staff groups were noted. However, a number of significant differences in prescribing preferences were reported.

Attitudes towards first-episode psychosis show marked variation between psychiatrists but may not be especially associated with sub-specialty. Further national guidance should be drawn up, disseminated and implemented to help ensure that service users across the age range receive the safest and most effective medications for an episode of psychotic illness, regardless of age.

Buckinghamshire crisis and home treatment team was struggling to meet its commissioned care episodes and found itself detached from community mental health teams (CMHTs) and acute day hospitals. An operations management consultant, using ‘lean’ principles developed in industry, worked alongside staff to redesign the service.

Improvements in staff capacity and ability contributed to more care episodes and reduced ward-stay times, compensating for the impact of a ward closure. Re-examination of individuals needs through case-review led to the development of ‘patient typing’, facilitating clear care pathways according to need. Finally, two proven modalities of community-based service were fused together.

Placing value to patients, carers and referrers ahead of old demarcations and practices has enabled a more flexible and responsive service to develop and grow.

To estimate the proportion of attrition at which results of drug trials for people with schizophrenia lose enough credibility to become mistrusted by relevant groups of stakeholders. A piloted questionnaire was sent to 128 local clinicians, 100 relevant researchers and 104 service users and carers.

We received the biggest number of responses from the service user and carer group (n=81, 76%); 43% of clinicians and 32% of researchers responded. All three groups suggested that the follow-up rate for a 12-week schizophrenia drug trial should be around 70–75% for the trial to be credible.

This survey suggests that relevant stakeholders, including researchers, fundamentally mistrust results of the majority of drug trials in schizophrenia. Adopting a more pragmatic trial design can help address this.

The Impact of Events Scale was administered to 104 in-patients detoxing from alcohol or opiates to determine the prevalence of psychological trauma, the severity of its symptoms and the types of trauma responsible for symptoms.

Out of the 104 in-patients undergoing detoxification, 75 had symptoms of psychological trauma; in 60 patients the symptoms were in the treatable range. Patients with alcohol-dependence were more severely affected. ‘Life events’ traumatised a higher proportion of individuals than ‘traumatic events’.

Psychological trauma requiring treatment is commonly found in substance misusers. This is rarely addressed despite the cormorbid disorder running a complicated clinical course. There are conflicting opinions about best practice, but consideration should be given to providing patients with accessible treatments for psychological trauma.

To explore user perspectives on the content and delivery of the undergraduate curriculum in psychiatry. the study design was qualitative and used focus groups. Four focus groups were run with a total of 28 participants.

The key finding was that participants were clearer about the attitudes they felt students should convey than they were about the skills and knowledge required.

Service user perspectives on the content of the undergraduate psychiatry curriculum need to be considered as curricula are developed.