SYNOPSISA sample of general practitioner referrals to a Psychiatric teaching centre was investigated by means of standard interviews, first with the practitioners and subsequently with the patients. Hospital treatment and disposal were examined in the light of the doctors' reasons for referral, and of the expectations which they and the patients had held of the hospital service. The findings are related to previous work in this field, and the implications for service planning discussed.

Rhinoplasty patients and matched elective-surgery controls completed the Facial Appearance Sorting Test, the General Health Questionnaire, a Repertory Grid and the Masculinity/Femininity Scale. Rhinoplasty applicants perceived appearance similarly to, and downrated their own appearance to the same extent as, controls. Impaired appearance and psychiatric symptoms are integral parts of the 'rhinoplasty applicant syndrome', but the degree to which they occur is not positively correlated. Interviews and tests were repeated 6 months after operation, when marked improvement in appearance was reported by the rhinoplasty patients, associated with the reduction of psychiatric-symptom scores. Control subjects showed no change.

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