The aim of the study was to examine treatment for the initial acute phase of first-episode psychosis at the Early Psychosis Prevention and Intervention Centre. Information regarding treatment was collected from file notes for all patients (n=112). For a subsample of patients (n=68), remission of positive psychotic symptoms was assessed using standardised ratings at 3-month follow-up.

Treatment provided was largely in accordance with recommended treatment strategies. The majority (72%) of patients achieved rapid remission of positive symptoms.

Restrictive practices other than in-patient admission, such as in-patient seclusion, police transport or a community treatment order, can be minimised. The use of low-dose antipsychotic medication is an effective treatment strategy for the initial acute phase of first-episode psychosis.

To investigate whether patients with dementia are referred to specialist services earlier in the disease since the launch of acetylcholinesterase inhibitors and the publication of the National Institute for Clinical Excellence (NICE) guidelines for the use of these drugs. All referrals to old age psychiatry services in two 6-month periods in 1996 and 2003 were surveyed retrospectively for diagnosis, Mini-Mental State Examination (MMSE) score and use of acetylcholinesterase inhibitors.

The mean MMSE score at referral increased from 18.8 to 21.5 (P=0.0005) between 1996 and 2003. Acetylcholinesterase inhibitors were prescribed for 35% of all patients and 58% of patients that would be suitable according to NICE guidelines in the 2003 group.

The earlier referral of patients with dementia to mental health services is encouraging.

To develop and assess the viability of a self-completion version of the Maudsley Addiction Profile for assessing and monitoring the functioning of opioid-dependent patients. A total of 206 treatment-seeking opioid-dependent patients completed the Maudsley Addiction Profile interview and a self-completion version at a single clinic appointment at a substance misuse facility. Scores from both formats were compared using correlation coefficients.

Non-parametric correlation coefficients between interview and self-completion version for alcohol, drug, psychiatric, family and legal problems correlated in excess of 0.7 for the majority of the 20 items that were compared.

A short, self-administered questionnaire version of the Maudsley Addiction Profile is a feasible alternative to the interview for assessing and monitoring treatment of opioid-dependent patients. The questionnaires were usually completed by clients within 15 min. These would be particularly useful in services with very limited staffing time, such as primary care.

We undertook a postal questionnaire survey of drug action teams in England and Wales with the aim of clarifying the nature of statutory specialist drug services.

Of 159 drug action teams, 110 (69%) responded; 64 (58%) reported that mental health trusts exclusively provided their specialist drug services. Other providers were primary care and acute trusts, the non-statutory sector and social services. The majority of medical leads were psychiatrists (123 senior posts with 20% vacant/occupied by a locum), then general practitioners (GPs) (42) and other specialists (4).

Specialist drug services are offered by a range of treatment providers, with the medical lead being taken by GPs and other specialists in some areas. In view of the current difficulty in recruiting psychiatrists, we propose that alternative training pathways are considered for addiction specialists.

Ten people with a diagnosis of schizophrenia were interviewed. The interviews were analysed qualitatively with the aim of examining the concept of patient satisfaction in the context of a recent in-patient admission.

The analysis identified two themes that influenced the expression of patient satisfaction: external factors and internal factors. The theme of external factors contained four categories: fear of violence, communication with staff, lack of autonomy and ward routines. The theme of internal factors comprised participants' conceptions and expectations.

This small study suggests the complexity of the concept of patient satisfaction should be respected in assessing experiences of people with a diagnosis of schizophrenia.

To describe a targeted domiciliary drug treatment service for dementia and to establish clinical outcomes for its patients. All new referrals in a 6-month period were included. Data on clinical and demographic background, service performance and cognitive, functional and behavioural outcomes were recorded.

Of 96 patients initiated on antidementia drugs, most had dementia of mild to moderate severity, and had heterogenous diagnoses. Significant improvements in cognition, behaviour and function were found.

A dedicated domiciliary drug treatment service for dementia achieved high levels of clinical activity and outcomes at least as good as clinical trials. This service model may be an attractive choice.