No abstract

IN addressing the question of subject matter for this study, I would first point out that I, a woman maturing during a time in history when we as a race, I refer to the human race, are experiencing an enormous effort on the part of a sector of our race, specifically the female sector, to progress towards a position more equivalent to the position of the other sector, the male sector, cannot claim to be detached from the Women's Liberation movement -ideologically nor practically. I am a woman, therefore I live with the inequities. Logically, it is to my advantage to co-operate with my Sisters in the struggle toward what we hope to be a future characterized by a truly equitable co-existence and a more profound comprehension between ourselves and our Brothers. My choice of subject matter is a simple question of cooperation with that struggle.

SUMMARYPeople in a first episode of psychosis are receiving increasing attention. This study describes the demographic and clinical diagnostic features of a cohort of 84 cases of first episode psychosis presenting in North Derbyshire from October 1999 to October 2000. Forty‐two cases falling within the schizophrenia spectrum diagnosis were identified, an incidence rate of 0.17 per 1000 population. The rate for all psychoses, including drug‐induced psychoses, was 0.35 per 1000 population aged 15–64. More than 50% of the cases were from the main urban centre, which contains around one third of the population. There were high rates of substance misuse in all diagnostic groups. The majority of patients (73%) presented via their general practitioners, but 18% presented via accident and emergency (13%) or the police (5%). The median duration of untreated psychosis for the whole group was two months. Within the schizophrenia spectrum group, however, there was a wide distribution, with duration of untreated psychosis of up to 10 years. The median duration of unteated psychosis in the schizophrenia spectrum group was three months. About half the cases in this cohort were aged more than 35 (all diagnostic categories). Further work exploring the outcome in this cohort is currently under way. As the configuration of mental health services is set to change rapidly in the next few years, there is a crucial need to develop further observational studies assessing how services deliver care to people with severe mental illness.