To ascertain the prevalence of metabolic syndrome in individuals with chronic enduring mental illness attending community psychiatric day centres, and to identify the prevalence of individual cardiometabolic risk factors and the rate of screening for these abnormalities. One hundred participants with chronic enduring mental illness were recruited and investigated using physical assessments and comprehensive laboratory testing.

Of the 100 participants recruited, 55% met the criteria for metabolic syndrome. There were similar prevalence rates between those with psychotic and non-psychotic disorders. Forty-four per cent of the patients had not been screened for metabolic parameters in the previous 12 months, and 43% of these met criteria for metabolic syndrome.

Chronic enduring mental illness is associated with high prevalence rates of metabolic syndrome regardless of diagnosis or use of antipsychotic medication. A substantial proportion of this standard cohort of patients attending day centres carry cardiovascular risk factors that remain unidentified, but should be screened for and intensively managed.

To measure the take-up of formal crisis plans in a specialist home treatment team (HTT) serving an ethnically diverse urban population; and to implement a quality improvement programme and measure its impact on crisis plan completion. Two audits were completed of patients before and after the implementation of a quality improvement programme. Descriptive data are shown by ethnic group, by gender, and for people with multiple hospital admissions.

At baseline, 16.7% of patients at high risk of admission had an HTT crisis plan, compared with 26.7% of a comparison group. Only 23.1% of the crisis plans for patients with a history of frequent admission mentioned the prevention of future admissions. Crisis plan completion improved following the quality improvement programme, when 80.0% of discharges had an HTT crisis plan; of these, 73.0% mentioned admission prevention. In the follow-up audit, 22.7% of patients in the multiple admission group had been readmitted to hospital at least once. Crisis plan completion did not appear to differ by ethnic group or gender and did not appear to be related to hospital readmission.

Crisis plan completion improved with simple practical methods, but completion was unrelated to gender, ethnicity or later readmission.

To assess how common the subjective experience of coercion is in psychiatric care and what affects its prevalence. A review of published data was undertaken to assess prevalence of coercion and potential confounding variables. The heterogeneity of results was studied using meta-regression to quantify the relative impact of four potential explanatory variables.

The raw prevalence of perceived coercion ranged from 16 to 90%. A quarter of legally detained patients did not feel coerced into psychiatric care, whereas a quarter of voluntary in-patients reported coercion in care. Coercion was more common in studies outside the USA, among patient populations subject to legal detention and populations studied using the MacArthur Perceived Coercion Scale as opposed to other measures. Timing of the interview was not associated with coercion.

Coercion in psychiatric care remains highly prevalent but varies widely by study. Consistency in measurement is necessary to allow better comparison between studies.

We assess and compare: (a) the attitudes of final-year medical students in 2010 to their 1994 counterparts; (b) the attitudes of third-year medical students with those of their final-year colleagues; (c) the impact of two different teaching modules on students' attitudes. All students completing the year 3 psychiatry preclinical module and the final-year clinical clerkship were asked to anonymously complete three well-validated attitudinal questionnaires on the first and final day of their module in psychiatry.

These data indicate that Irish medical students have a positive attitude to psychiatry even prior to the start of their clinical training in psychiatry. This attitude is significantly more positive now than it was in 1994. A positive attitudinal change was brought about only by the final-year psychiatric clerkship. Students who have completed a degree prior to medicine are less likely to express an interest in a career in psychiatry.

If we are to address the recruitment difficulties in psychiatry we need to look at innovative and specific ways of translating these positive attitudes into careers in psychiatry.