Surveys suggest that UK drug services under-prescribe methadone to opiate-dependent patients. This study investigated methadone prescribing for 169 patients on long-term methadone at a specialist drug service.

The mean methadone dose for patients on maintenance was 65.8 mg, and 67.7% were taking 50 mg or more. Mean doses in relation to methadone formulation varied substantially: mixture 57.4 mg, tablets 81.8 mg and ampoules 113.0 mg. These figures are higher than those reported from national surveys. The proportion of urine screens positive for illicit opiates was inversely related both to methadone dose and length of time in treatment.

This survey shows the levels of methadone prescribing at an inner-city drug service and gives support to the effectiveness of high-dose methadone maintenance.

To describe the outcomes of electroencephalography requested by general adult psychiatry over a 12-month period.

187 electroencephalograms (EEGs) were performed. In 71%, the request was to look for evidence of epilepsy. In 22%, it was to determine whether there was organic brain dysfunction. In only one patient was unequivocal evidence of an epileptic focus found. A further 11 patients demonstrated a liability to epilepsy. In none of the 33 patients where aggression was mentioned on the request form were any diagnostic features found.

The yield of EEG in psychiatry is low. To diagnose epilepsy, clinicians should continue to rely on the clinical history of attacks and not the EEG. The presence of aggression is rarely associated with meaningful EEG changes.

Recent government legislation has highlighted the importance of implementation of the Care Programme Approach (CPA) within prisons, as part of the expectation that prisoners receive equivalent standards of healthcare to those provided by the National Health Service. To effectively plan the service provision at HMP Belmarsh, we retrospectively established the number of prisoners in a one-year period who would have fulfilled the criteria for enhanced CPA.

Of the 91 prisoners found to fulfil the criteria for enhanced CPA, the majority (77%) had a diagnosis of schizophrenia, schizoaffective or delusional disorder, and 58% required transfer to a psychiatric hospital. Of those who required hospital treatment, 75% needed conditions of high- or medium-security.

Successful implementation of the CPA for all prisoners who meet enhanced CPA criteria is likely to have significant resource implications, both for mental health teams working within prisons and local psychiatric services.

To ascertain employers' attitudes to interviewing and hiring job applicants with a history of mental illness and, in particular, to assess the potential effect on job prospects for applicants with a history of admission under the Mental Health Act 1983. A postal tick-box questionnaire was sent to 174 companies; there was a 32% response rate.

The main factors influencing employers' hiring decisions were medical opinion regarding an applicant's fitness to work and their employment and sickness records. In about three-quarters of small companies and half of large companies, questions about mental illness are simply never asked.

Approved social workers have no reason to caution people assessed under the Mental Health Act 1983 that being detained could harm their job prospects.

A postal questionnaire was circulated to all psychiatrists who had completed their basic specialist training on the Royal London Hospital training scheme within the last 7.5 years. The aim of the questionnaire was to explore their psychotherapy experience while on the rotation.

The response rate was 95%. The respondents had a broad experience of both didactic and case work that they valued highly. Over half of them wished for an even greater exposure to psychotherapy during their basic training.

The results of our survey suggest that with the dedication of both the trainees and trainers, it is possible to have a comprehensive psychotherapy experience while working on a busy inner-city rotation.

Young people attending the Maudsley obsessive–compulsive disorder (OCD) children's clinic had expressed an interest in meeting other similar young people with OCD. A group was set up comprising 6-weekly sessions focusing on psycho-education and support.

Seven young people (mean age: 14 years 4 months; age range: 11 years 11 months to 16 years 6 months) took part. Feedback questionnaires showed that all the participants found the group helpful and enjoy-able. They felt less isolated and more confident about dealing with OCD.

Establishment of groups may be a valuable way of increasing awareness and knowledge on aspects of OCD, as well as providing much-needed psycho-social support to patients.

To evaluate whether new pre-registration house officer posts in psychiatry deliver training leading to increased confidence in target skills, based on General Medical Council requirements, and to evaluate trainees' satisfaction with these posts. A structured questionnaire was filled out by the first nine incumbents of the PRHO posts before and after the placements.

Trainees' confidence improved in all the target skills and the posts were all rated as good or excellent. The posts attracted trainees who were potentially interested in a career in psychiatry or general practice.

PRHO posts in psychiatry deliver training that meets General Medical Council objectives, and trainees' confidence with core psychiatric skills improves after undertaking the placements.