As mental health care policies increasingly emphasize treatment and care in community settings, there has been concern over the burden that families of mentally ill people might suffer as a result. We conducted a study of the prevalence of abuse faced by relatives of patients admitted during a 6-month period to the acute psychiatric unit of a busy general hospital, who had previously been living with a relative. Patients and their relatives were assessed using semi-structured interview schedules. The experience of burden and the specific experiences of abuse since the onset of their relative's illness were recorded. In total, 32 (32%) of the 101 relatives had been struck on at least one or two occasions. Verbal abuse, threats and temper outbursts were reported by over 50% of the relatives. Principal correlates of abuse were diagnosis, concurrent drug misuse and a poor pre-morbid relationship between carer and patient.

No abstract

AimsTo compare plasma and red-cell selenium concentrations of schizophrenic patients treated with clozapine, with healthy controls and patients with mood disorders. Methods Plasma and red-cell selenium concentrations were measured in random venous blood samples from four groups: mood disorder ( n = 36), schizophrenics treated with clozapine ( n = 54), schizophrenics not treated with clozapine ( n = 41) and a healthy control group ( n = 56). Assays were performed by an independent laboratory that was blinded to the patient groups and specializes in estimating trace metal concentrations. Results Selenium concentrations in plasma and red cells were found to be significantly lower in schizophrenic patients treated with clozapine as compared with all other groups. Conclusions Selenium is an essential antioxidant. Its deficiency has been implicated in myocarditis and cardiomyopathy. Low selenium concentrations in clozapinetreated patients may be important in the pathogenesis of life threatening cardiac side-effects associated with clozapine. Further clinical studies are being conducted to explore this important clinical observation and its therapeutic implications.

No abstract

The aim of the investigation was to study medication-taking using dosetts by inpatients in a 25-bed rehabilitation assessment ward. Data were obtained on 39 predominantly schizophrenic patients over a three month period during which there were nearly 3,000 separate occasions when tablets were required to be taken. Recorded problems included: needing a reminder, requiring personal individual dispensing, refusal to take medication, taking from the wrong dosett slot, taking another patient's dose, and not taking medication home on weekend leave. Tablets were taken without problem on 78% of occasions; the most common problem noted was needing a reminder. Certain differences between days of the week and times of day were observed. Patients varied greatly in how satisfactorily they managed their dosetts. Those who managed poorly were rated worse on a wide variety of daily living skills and social behaviours. The implications for the return of patients to the community are discussed.