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Social and clinical risk factors for completed suicide occurring shortly after discharge from a psychiatric hospital were examined in this case-control study. Seventy-seven individuals who received "suicide" or "undetermined death" verdicts at inquest, and who had been previously discharged from psychiatric hospitals in Bradford, U.K., were compared with a control group. A history of deliberate self-harm was significantly associated with early suicides compared with both late suicides and controls. A diagnosis of mood disorder, specifically depression, and longer case-notes were also significantly associated with early suicides compared to controls. This study has implications for risk management of recently discharged psychiatric patients.

Background: Looked after children in residential children's homes constitute a particularly vulnerable group who are known to have high rates of mental health problems and limited access to services. Method: A survey was undertaken in Leeds to determine what proportion of these children are involved with mental health services, and to look at the different ways in which child and adolescent mental health services across the city are currently working with this group. Results: Of the 177 children in residential children's homes in August 2000, 64% had had some contact with child mental health services in the previous 5 years and 27% were in current contact. Thirty‐six percent had had no contact with services over the past five years. Conclusions: It was anticipated from a review of the literature that a higher proportion of children would have been currently in contact with services. The findings suggest that the pattern of services offered to this group of children is changing, with an increase in consultation with, and training of, staff in residential children's homes. The paper ends with a discussion of whether or not this is a positive change and how CAMH resources might best be utilised in the future.

Aims: To ascertain from paediatricians and child psychiatrists their views regarding the aetiology, assessment, and diagnosis of attentional difficulties in children, and the prescribing of stimulant medication for such difficulties. Methods: Using a questionnaire devised by the authors, 465 paediatricians and 444 child psychiatrists were surveyed. Results: The overall response rate was 73%. Some 94% of child psychiatrists and 29% of paediatricians routinely dealt with attentional difficulties. Views on aetiology, classification, and diagnosis were varied. More than 60% of both groups were prepared to prescribe stimulant medication without a formal diagnosis being made. Comorbid conduct disorder and the views of other professionals and of parents have an impact on practice.Conclusions: This survey demonstrates that there is a range of approaches to attentional difficulties by both paediatricians and child psychiatrists.

The prospect of looking for a consultant post in child and adolescent psychiatry can be anxiety provoking. The ideal job should be balanced and fulfilling, with scope for personal and service development, and should minimise the likelihood of frustration and burn-out. It is not uncommon for newly appointed consultants to become dispirited by the discrepancy between the job description and the reality of the post.

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Dramatherapy has been used in group therapy for adults with eating disorders with some success. We describe how we adapted the structure of one such group for adolescents with eating disorders. The advantages and disadvantages of the use of dramatherapy techniques in this client group are discussed.