This study examined the impact of caring on women who were primary care-givers to those with schizophrenia. From the 46 women and 21 men carers assessed for the study, women were considered primary care-givers more often than men (83% v. 57%). Higher levels of burden among women primary carers were associated with living with patients, and more hours in contact with them. Worse perception of patients' social functioning was associated with higher levels of burden. The findings of the study showed that women primary carers have particular needs, and services should consider how to provide support for them in their multiple roles, and over longer periods of time.

HIV infection is a relatively new disease affecting families (Pizzo & Wilfert, 1994). As with other chronic and life-threatening illnesses, families are faced with many changes and losses as well as much uncertainty about the future (Eiser, 1990). Unlike most other conditions, however, there can be extra stigma-related stresses, such as fear and secrecy, which can compound existing burdens of illness and coping (Richmond & Ross, 1995). As further knowledge of the full impact on HIV on families evolves, there is a need to consider the effects of multiple loss and changes on the mental health and adjustment of the children as well as their parents (Melvin & Sherr, 1995; Reidy, 1995).

In childhood sexual abuse cases, the non-abusing parent (usually the mother) is often seen as colluder, helpless bystander or victim. These negative views may be based on misconceptions about incestuous families and can lead to treatment bias and neglect of the other ‘victims' of abuse. Mental health professionals and support agencies should ensure that the needs of the non-abusing parent are met as well as those of the victim and perpetrator.

The work of NEWPIN was pioneered in the London Borough of Southwark in 1982. It was influenced by the rising child abuse figures, which were higher than the national average, and the low take-up of ante- and postnatal services in the district. A study of mothers with young children in Camberwell (Brown & Harris, 1978) had revealed that there was a high incidence of maternal depression within the group. This also influenced the direction NEWPIN was to take.

This study compared the mean change in the total Health of the Nation Outcome Scales (HoNOS) with the general practitioners' (GPs) assessment of clinical improvement and satisfaction, in a shifted psychiatric out-patient clinic. The total HoNOS fell significantly between the first and last appointment, suggesting that it was sensitive to change even in patients with a lower level of morbidity. There was a weak association between change in the total HoNOS and the GPs' assessment of clinical improvement (r=0.4; P=0.06), and a trend towards a greater HoNOS fall in patients that the GPs assessed as having improved clinically (5.3) compared with those the GP thought had not changed (2.5), but this difference was not significant (95% Cl, 6.6 to −1.1). There was no evidence of a relationship between change in HoNOS and GP satisfaction, and no trend towards a greater fall in the HoNOS in cases where the GP was satisfied, despite a lack of improvement being the commonest reason given by GPs for dissatisfaction. The results suggest that the fall in total HoNOS relates to some degree with GPs' own assessment of clinical improvement in their patients, and that the HoNOS may be regarded as useful by GP fundholders.

Across the UK counselling and support services are being developed as an extension of emergency planning for major incidents, with the aim of offering psychological help in the immediate aftermath of a disaster. In Strathclyde, Social Work and Mental Health Services Jointly established Liaison Teams with the task of planning and preparing for a major incident. We describe the response of a Liaison Team to a serious bus accident and present reflections from a psychodynamic perspective on some of the factors which may bear on planning and delivery of services.

The responses of somatisation disorder (SD) patients to reading their main clinical summary were compared with those of general psychiatric patients, to assess whether the sharing of information and psychiatic opinion might help in the management of SD. Overall the SD patients responded favourably on 8 out of 11 measures; 28 of the 30 (93%) thought it was a good idea to have read the summary and 26 (87%) thought it had provided helpful information. Significantly more of the SD patients (57% compared with 27% of the general psychiatric patients) had their concerns about undiagnosed illness increase as a result of reading their clinical summary.

Over the six years since the introduction of clozapine to the UK, the number of people prescribed this medication and living in the community has steadily increased. Coordination of blood monitoring and dispensing of clozapine to people dispersed throughout a district can be problematic. In Newcastle-upon-Tyne a steering group of healthcare professionals was established to address this situation. The outcome was the establishment of the Newcastle Clozapine Clinic. This paper describes the development of this service, which has improved administrative efficiency and given the opportunity to develop associated new services for people in the city with enduring mental health problems.

There is an increasing body of research literature investigating the effects of parental mental illness on children. This study investigates the views of psychiatric in-patients on consequences of their admission to hospital and their mental illness for their children. The results suggest that the parents do not readily acknowledge that their children have problems, and that interventional approaches require good liaison between adult mental health services and child-focused agencies.

Few recent studies have investigated the prescription of electroconvulsive therapy (ECT) to depressed patients and their progress thereafter under ordinary clinical conditions. From case records, 412 courses of ECT were studied. ECT was efficacious in the short term, especially for patients with psychotic depression and for those over 65 years of age. Fifty-three per cent of patients required readmission in the six months following the index course. Neither age nor psychosis predicted whether readmission occurred. While short-term outcome is good, notably for the elderly and the psychotically depressed, patients are highly liable to relapse after ECT. High quality after-care is thus of paramount importance.

In a survey of services conducted by the Section of Old Age Psychiatry in 1993, Wolverhampton was identified as one of 24 Districts with no consultant Old Age Psychiatrist in post (Benbow & Jolley, 1996). This encouraged the newly formed NHS Trust responsible for mental health and other community services to arrange for the secondment of D. J. from South Manchester, for a period of two years, with a view to setting up and running an appropriate service for older people with mental illnesses (Jolley, 1996). We are reporting here some of the changes which have occurred during the first year of this secondment.

Myanmar, until recently known as Burma, is a developing nation in south-east Asia. Burmese kings and emperors ruled this land until 1885, when it fell into the hands of the British. It gained its independence in 1948. Burma has a mainly agricultural economy and has a rich fertile soil. At one stage in the post-war history Myanmar was renowned as ‘the rice bowl of the world’. It is blessed with abundant natural resources such as teak and precious stones. Myanmar covers a land area twice that of the British Isles with a population of around 42 million.