This paper reports on 20 women born in the Caribbean whose birth mothers left them there as young children in the care of grandmothers or other members of their extended family. This was in order to migrate to Great Britain during the late 1950s through the 1970s in search of economic prosperity, and reunification with the father/husband already working in the UK. The reunions occurred typically more than a decade later, in the child's adolescence, when mother and child were meeting as if for the first time. The sample of women was divided into two groups, one who was receiving or had received counselling or psychotherapy, and those who had no experience of therapy. Using a semi-structured Interview Schedule (the Separation Reunion Interview Schedule developed for this study), the narratives obtained suggested coherence and reflection. There was little difference in the reactions to the separation -- reunion experience of the women in both groups. They all expressed difficulties in trusting others. They also expressed longing to be loved by their own mothers and they felt less wanted than any children (siblings) born in Britain to their mothers. They attributed their resilient stance and survival to their ability to recall the memories of care received during their early years. The study raises many questions and highlights the need for further research on broken attachments, separation, and loss among entire Caribbean families.

SUMMARYEating disorders are considered to primarily afflict young people to the exclusion of the elderly. However, reports in the recent literature have challenged this view, with both anorexia nervosa and bulimia nervosa being described in later life. Although in some reports the diagnosis appears doubtful, the majority appear to demonstrate the classical features of these conditions. They have many similarities with younger sufferers, including clinical features, maladaptive psychological functioning, and a close relationship with other psychiatric conditions, such as depression and obsessive-compulsive disorder. The aetiology of eating disorders in the elderly appears to be multifactorial, involving both vulnerability factors and precipitating factors. The outcome is often poor, although behavioural modification leads to a significant benefit in most cases. It is probable that these disorders are poorly recognized in the elderly, possibly because of a lack of suspicion and because the symptoms are often assumed to be secondary to an alternative physical or psychiatric cause.

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One hundred and fifty-nine patients attending a geriatric medical outpatient clinic were screened for depression using the geriatric depression scale (GDS) and brief assessment schedule depression cards (BASDEC). Twenty-two (13.8%) patients screened positive with one or other test, 13 (8.2%) being positive with both screening tests. There was a highly significant correlation between the two screening tests but the BASDEC instrument was quicker and easier to administer. Eighteen of 22 patients who screened as positive proved to have clinical depression. On subsequent re-testing of 17 of these patients 4-6 weeks later, eight were still positive, but nine patients were now negative and subjectively felt better. These findings suggest the possibility of a transient mood disturbance occurring in elderly patients akin to recurrent brief depression seen in younger subjects, and have implications for starting therapy in apparently depressed elderly people.