Objective: To provide contemporary information on sexual behaviour and knowledge among normal Irish children, as perceived by their parents.

Method: The study was carried out in an Eastern Health Board urban Community Care Area. The parents of a random sample of all three year olds, and all seven and 12 year olds attending mainstream primary schools within the community care area formed the study population. A semi structured interview was used, covering demographic data, general play, sexual knowledge, sexual behaviour and family behaviour.

Results: A total of 233 parents participated, giving a 67% response rate. Approximately 40% of children in each age group were reported by their parents as showing interest in their own genitalia, this being significantly more common in boys. Approximately one half of three year olds were reported by parents as engaging in play with their own genitalia, this activity becoming increasingly uncommon in the older age groups. Sexual play with other children was reported by 12.5% of parents, and was significantly more likely among the three year olds and amongst boys. Explicit sexual behaviour involving older children, such as oral genital contact or attempted intercourse, were not reported for any child. Interest in genitalia of family members was very common in three year olds, while touching genitalia of family members was unusual. Approximately one third of parents had had some discussion with their older girls about pubertal bodily changes, but male adolescent bodily changes were rarely discussed. Mothers were the usual source of information on sexual matters to children of both sexes.

Conclusions: Sexual interest and exploration are common is young children, while explicit sexual behaviours which come to adult attention are unusual. Little discussion takes place between parents and older children, particularly boys, about specific aspects of reproduction including pubertal bodily changes.

Objective: To measure the level of commitment by mental health care professionals within the Eastern Health Board to the concept of community mental health.

Methods: An adapted version of the Baker-Schulberg Community Mental Health Ideology Scale was administered to a random sample of professionals (psychologists, psychiatrists, psychiatric nurses, community psychiatric nurses, social workers and occupational therapists).

Results: Psychiatrists within this study had the lowest scores indicating the least level of commitment, and were also found to focus upon extrinsic issues, such as economic barriers, as possible obstacles to the development of a community mental health service in Ireland.

Conclusion: Policy and decision making committees need to address the balance of the mental health care professionals represented on those committees.

Objective: To investigate assertions that Celts have higher rates of alcoholism and mental illness than non-Celts.

Method: The records of 3,000 admissions to Northwick Park Hospital Psychiatric Unit, Harrow (a North West London suburban middle class borough research hospital with a strictly defined catchment area – the London Borough of Harrow: population 200,000), from June 1987 for three years under the clinical care of four consultant psychiatrists, were examined.

Results: There were 683 with non-Celtic names and 175 with Celtic names (16.7%) (data on 10 patients incomplete). 306 (35%) of non-Celts and 88 (50%) of Celts were aged under 40 years. Alcohol dependence (ICD 303) was significantly commoner (p<0.001) among the Celts (35.3%) than among the non-Celts (12.9%). There were highly significant excesses (p<0.001) of native-born Celts with ICD 303 (54%) compared with non-Celts 12.9% or with Celts born outside Celtdom (23%). Patients with Norman names tended to follow the Celts in these respects. There were no differences with respect to the prevalence of psychosis or other ICD categories among Celts and non-Celts.

Conclusion: Doctors should be aware of the high prevalence of alcoholic dependence among people with Celtic names, whether these were born in Celtic countries or not, entertain a high index of diagnostic suspicion and take preventative measures accordingly. However, we found no excess of other categories of psychiatric disorder among Celts as compared with non-Celts. Patients with Norman-derived names seemed to follow the Celts in these respects.

Objectives: To validate the hospital anxiety and depression scale (HAD) in an outpatient alcohol treatment centre.

Methods: Forty three patients referred to an alcohol outpatient treatment centre completed the HAD which was validated against the external criteria of the Montgomery-Asberg Depression Rating Scale and the Clinical Anxiety Scale.

Results: The HAD performed well operating at a cut-off of 7/8 for the depression scale and for the anxiety scale of the HAD the optimal cut-off value was 10/11.

Conclusion: The HAD is acceptable to patients and its use in alcohol treatment clinics is recommended as a screening instrument for anxiety and depression which can easily be administered by non-psychiatrists.

Eleven case histories, including diagnoses and outcome, are presented of patients who made, or were the subject of, allegations of sexual abuse, but where these allegations were subsequently withdrawn or disproved. How such situations come about is discussed, with special reference to the false memory syndrome, a term made popular by recent media coverage. Given the complexity of this ‘syndrome’, an argument is put forward that diagnostic guidelines be established so that direct studies of its natural history and treatments may be undertaken.

A patient with severe long-standing panic disorder who made a full recovery whilst pregnant, only to relapse during the postpartum period, is presented. Sex steroids may have a role in the aetiology and management of panic disorder. This is potentially an important area which requires further research.

We report on a patient with a rare type of dissociative disorder, dissociative psychosis (hysterical psychosis), in whom gustatory, olfactory, visual and auditory hallucinations occurred. Auditory and visual hallucinations have been described in previous cases of dissociative psychosis, and olfactory and gustatory hallucinations have been described associated with sexual assault but this case is unusual in that hallucinations occur in all modalities in one patient, as yet not described in the literature The basis of the dissociative disorder lay in a childhood sexual trauma and therefore the traditionally advocated treatment for such a case is the psychotherapeutic abreaction of these previous traumatising events. This approach caused worsening symptomatology and the patient experienced frequent lapses into dissociative psychosis. However, focused cognitive-analytic therapy concentrating on the patient's personal conflicts at the time of presentation resulted in a resolution of symptoms and a return to health.

In Ireland patients who are found unfit to plead are automatically detained in the Central Mental Hospital (CMH) at the pleasure of the court. The CMH is the only high security psychiatric hospital in the Republic of Ireland. There is no limit on the length of detention and no review system in place. We reviewed the case notes of all the prisoners admitted to the CMH since 1937 who were found unfit to plead. We identified 24 cases which included only one female. The mean age was 33.5 years. Nearly 25% had a criminal record and over 60% had a past psychiatric history. The primary diagnoses were schizophrenia (12), mental handicap (4), personality disorders (3), psychotic episode (2), dementia (2) and manic depression (1). The average length of stay in the CMH was 18 years. We review the situation in the UK and in the USA and we make recommendations about legislation.