The National Health Service Plan stated that all correspondence between clinicians would be copied to patients by April 2004. We wanted to find out whether this practice reflected the true desires of their patients. A questionnaire survey was therefore performed in older adults and their carers attending a psychiatric out-patient clinic.

A total of 88 participants were recruited; 50 patients and 38 carers. The majority of patients and carers wanted a letter about their care but most preferred a separate, simple letter rather than a copy of the letter sent to their general practitioner.

Although this study supports the existing evidence that patients would like written information about their care, it indicates that certain patient groups might not want this in the form of copies of their medical correspondence. Further research into patient and carer preference is needed before the implementation of this policy.

The project gathered data from a cohort of 300 flexibly trained female consultants in psychiatry in order to understand how their careers had progressed since the completion of their training. A postal questionnaire was used to gather this information.

These consultants were generally satisfied with their training, and were succeeding in pursuing their careers. Flexible training was developed to enable people with family commitments to train in psychiatry, and this is what it is being used for.

Flexible training is an important avenue for an increasing number of psychiatrists to continue in their profession. With the current shortfall in consultant numbers, flexible training should be maintained and developed, and should be seen as a useful route to a consultant position.

The aim of this survey was to examine staff views on smoking at work in a large psychiatric hospital. A postal questionnaire was sent to all clinical staff (n=1471) asking about their smoking habits and attitudes to smoking at work.

The response rate was 40.7%. Overall, 22.0% of respondents were smokers, with unqualified nursing staff having the highest rate (31.0%). The majority of staff did not favour a total ban on smoking by staff, patients or visitors. Smoking habit and profession influenced responses. Smokers and nurses were more permissive in their attitude towards smoking on wards than non-smokers and psychiatrists.

Implementation of the government's recommendations on tobacco control in psychiatric units is likely to require considerable preparatory work with staff to ensure full compliance.

The study aimed to determine whether medical students who participated in a student psychotherapy scheme aimed at helping them learn about the doctor-patient relationship were more likely to choose psychiatry as a career than a control group who did not participate. One hundred and ninety-eight medical students who participated in the University College and Middlesex School of Medicine (UCMSM) Psychotherapy Scheme between 1982 and 1992, and 200 randomly selected students of the same period who did not, were sent a questionnaire asking about career choice.

Seventy-seven of 163 participants in the scheme who sent back the questionnaire had not thought about doing psychiatry before entering the scheme. Of these, 11 became psychiatrists (14.3%), compared with only two (1.6%) of the 128 controls (of 152 respondents) who had not considered psychiatry as a career at the same stage. This difference is highly significant (P<0.001). Many of the participants, including those who did not specialise in psychiatry, emphasised how the scheme had helped them understand the doctor-patient relationship.

Participating in the Student Psychotherapy Scheme encouraged medical students to choose psychiatry as a career. This knowledge is important, particularly in view of the current recruitment crisis in psychiatry.

To review the efficacy and safety of melatonin in the treatment of insomnia in children and adolescents, through a Medline search covering the years 1966 to November 2003.

Five placebo-controlled studies and several case series were identified. Melatonin reduces sleep latency, but does not consistently improve other aspects of sleep disturbance. Safety, particularly in the medium- and long-term, is poorly evaluated; short-term concerns include exacerbation of epilepsy and asthma.

Melatonin might be effective in the short-term treatment of sleep onset insomnia. The optimal dose is unknown. It cannot currently be recommended for the treatment of other forms of sleep disturbance or for routine long-term use. Melatonin is not a licensed medicine in the UK.

A postal survey was conducted to ascertain the prevalence of bullying behaviour experienced by psychiatric trainees in the West Midlands. Questionnaires were sent to 232 junior doctors, 76% of whom responded.

In the preceding year, 47% of trainees had experienced one or more bullying behaviours. Only 46% reported that they knew whom to contact if they were bullied. Foreign doctors were significantly less likely to take action when bullied than local doctors.

Workplace bullying is commonly experienced by psychiatric trainees and other junior doctors in the National Health Service. This behaviour could have adverse effects for both the individual and the employer. To tackle this problem, awareness needs to be raised, and action is required at a number of levels.