SUMMARYConsultants in old age psychiatry were sent a questionnaire concerning their practice in informing dementia patients and their carers about the diagnosis and prognosis. The results showed a wide variation in practice. Carers almost invariably were told of the diagnosis. Patients with severe dementia were almost never told. There was more of a tendency to tell moderately affected sufferers but for patients with mild dementia practice was variable. There was a significant difference between all categories of dementia and the carer category for both diagnosis and prognosis giving. Informing patients of diagnosis differed from informing of prognosis only in the mild dementia category, with the tendency to give diagnosis more frequently than prognosis. Carers were also given diagnosis more frequently than prognosis. The article discusses some of the issues involved in giving information on diagnosis and prognosis to patients with dementia.

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The number and diversity of rating scales and tests of psychiatric status has increased dramatically in the last 20 to 30 years. Tests are in screening, e.g. for dementia the Mini Mental State Examination and the Abbreviated Mental Test; to aid clarification of the diagnosis in difficult cases, e.g. Walton-Black New Word Learning Test, to differentiate between depression and dementia; and in assessing severity of symptoms, e.g. Hamilton Depression Rating Scale.

The natural grouping of training rotations in psychiatry into those based on a central University Teaching Hospital and those in a peripheral location invites comparison between the two groups. Training perspectives in two neighbouring schemes, one in each category, have been explored recently (McWilliam & Morris, 1988). It was noticed that, although styles differ, resulting clinical competence is comparable. An important part of clinical training is out-of-hours experience. For approval of a rotational scheme, experience of on-call duties and emergencies is necessary (Royal College of Psychiatrists, 1987). We were interested in comparing on-call duties in two different types of scheme, one in Sheffield, the other in Chichester.