War-related experiences, occupational status before migration and current Qat use are risk factors for psychiatric symptoms among Somali refugees.

Because non-compliance with antipsychotic drug therapy is both common and associated with a substantially increased risk of acute relapse, depot medication must be preferred for most schizophrenic out-patients. Yet there is a perception that depot medication is unpopular among patients. In the survey of out-patients reported here, the great majority of patients receiving either oral or depot neuroleptics (with or without oral augmentation) would, given a free choice, elect to continue with their present dose form (94% and 87%, respectively). In virtually all cases, the choice of route was made by the treating physician and readily accepted by the patient. These findings suggest that physicians should more often recommend and prescribe depot medication when antipsychotic maintenance therapy is indicated.

Background: Psychiatric intensive care facilities have previously been poorly defined, with uncertainty existingabout the appropriateness of admissions. Aim: To offer the first large-scale systematic survey describing the clinical characteristics of patients admitted to Psychiatric Intensive Care Units. Method: A questionnaire was sent to ward managers of every Psychiatric Intensive Care Unit in London for completion on a chosen census day. Individual demographic and clinical patient characteristics were collected, along with admission and discharge pathways. Results: Of 186 patients on 17 NHS PICUs in London, we obtained data for 172. 80% of patients were male, with a mean age of 33; 50% were Black and all but 2 were involuntarily detained. 66% had a diagnosis of schizophrenia and 55% of admissions were due to physical aggression. 73% of the sample had at least one 'complex need',which was most commonly substance misuse. Black patients were younger, more likely to be male and to have a forensic history (54% vs. 31%) than white patients. A slightly lower percentage (70% vs. 79%) of Black patients were described as having complex needs. White patients were more likely to have a personality disorder or a second diagnosis. Conclusions: Patients admitted to psychiatric intensive care units were most likely to have major psychosis, complex needs and to use illicit substances. Ethnic variations warrant further study.

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