A postal survey assessed current views of a random sample of 154 British psychiatrists on aetiological factors in depression and schizophrenia.

Genetics, biochemical abnormalities and substance misuse were considered important factors in both illnesses. Beyond that, psychiatrists varied widely in their views. Depression was viewed as a more multifactorial condition with psychological/social factors more important, whereas biological factors were considered more important in schizophrenia. Aetiological factors were thought to vary more in depression than in schizophrenia and discussing them was seen as more important in patients with depression.

Psychiatrists' attitudes are likely to influence treatment. Patients may encounter different views depending on their illness and on the particular psychiatrist's views.

A confidential questionnaire was mailed to all trainers and trainees on the UCL/North London rotation (n=127), asking about the content and ways of improving supervision.

Seventy-six per cent of trainees received regular, timetabled supervision. Ninety-four per cent of trainees felt it was a good idea, but identified improvements, including more planning, setting an agenda and flexibility. There were differences between reports from trainers and trainees regarding the content of supervision. Respondents' comments are included.

Although supervision is popular and widely practised, this survey suggests that it is still not universally practised despite College stipulations. The content of supervision could be broadened to include more non-clinical matters such as teaching and careers guidance.

To examine treatment response in traumatised refugees, we compared routine outcome monitoring data (Harvard Trauma Questionnaire) of two refugee populations with those of individuals experiencing profession-related trauma who were treated at a specialised psychotrauma institute.

Asylum seekers/temporary refugees (n = 21) and resettled refugees (n = 169) showed significantly lower post-traumatic stress disorder (PTSD) symptom reduction between intake and 1 year after intake than did a comparison group of non-refugees (n = 37), but the interaction effect was clinically small (partial η2 = 0.03). Refugees who had more severe symptoms at intake showed significantly greater symptom reduction after 1 year.

Therapists and refugee patients should have realistic expectations about response to treatment as usual. Additional treatment focusing on improving quality of life may be needed for refugees whose PTSD symptom severity remains high. At the same time, novel approaches may be developed to boost treatment response in refugee patients with low responsiveness.

To survey the forensic psychiatry training and experience received by a sample of successful MRCPsych candidates. A questionnaire was sent to all 208 candidates who passed the Spring 2001 MRCPsych Part II examination.

A total of 99 candidates replied. Of the 42 who had not trained in forensic psychiatry posts, two-thirds had never visited a prison.

More supervised visits to prisons should be provided for basic specialist trainees.

To examine research productivity of staff working across 57 National Health Service (NHS) mental health trusts in England. We examined research productivity between 2010 and 2012, including funded portfolio studies and all research (funded and unfunded).

Across 57 trusts there were 1297 National Institute for Health Research (NIHR) studies in 2011/2012, involving 46140 participants and in the same year staff in these trusts published 1334 articles (an average of only 23.4 per trust per annum). After correcting for trust size and budget, the South London and Maudsley NHS Foundation Trust was the most productive. In terms of funded portfolio studies, Manchester Mental Health and Social Care Trust as well as South London and Maudsley NHS Foundation Trust, Oxford Health NHS Foundation Trust and Cambridgeshire and Peterborough NHS Foundation Trust had the strongest performance in 2011/2012.

Trusts should aim to capitalise on valuable staff resources and expertise and better support and encourage research in the NHS to help improve clinical services.

This study examines prescription and monitoring of lorazepam on three acute adult psychiatric wards at a university teaching hospital. Retrospective data from 102 consecutive in-patients were analysed.

There were 83 patients (81.4%) who were prescribed lorazepam, however 45 of these (46%) were never administered it. Indication for lorazepam prescription was documented by the doctor in 35 patients (42.2%). Administration by nursing staff was documented in the medical notes on 86 occasions (60.0%) and on 32 of these (37.0%) the indication was unclear. On 21 occasions (14.7%) more than 2 mg was given; 13.7% of prescriptions were not reviewed and 64% of those reviewed after more than 4 weeks.

Lorazepam was overprescribed and inadequately monitored, which may increase the risk of dependence.

Dialectical behaviour therapy (DBT) is associated with particularly high drop-out rates in the National Health Service (NHS). This paper seeks to investigate the characteristics of patients with borderline personality disorder dropping out from DBT and the role of care coordination in this phenomenon. Data for the 102 patients receiving DBT in east London, 58% of whom had dropped out of treatment prematurely, were analysed.

In a multivariable analysis, a history of care coordination was the only variable significantly correlated with drop out: 88% of patients with a history of care coordination dropped out prematurely compared with 52% of patients without such history.

The experience of comprehensive care within the care programme approach, particularly care coordination at the start of DBT, affects the retention of patients in DBT. Further qualitative research is required to understand how care coordination and DBT drop out are related, which could lead to changes in how the therapy is delivered in the UK and influence decisions regarding the use of care coordination with patients with borderline personality disorder.