'Excited Delirium', acute behavioural disturbance, death and diagnosis.

In the 1980s the traditional Hippocratic term excited delirium was transplanted from the bedsides of febrile, agitated and disoriented patients to the streets of Miami. Deaths in custody of young men who were intoxicated with cocaine and who were restrained by the police because of their erratic or violent behaviour were attributed to excited delirium. The blood concentrations of cocaine in these subjects were approximately ten times lower than the lethal level and other factors which might have contributed to the fatal outcome, such as the police use of neck-holds, choke-holds or 'hog-tying', were relegated to a minor role compared with the reframed 'diagnosis' of excited delirium.

Psychiatry 50 years ago.

The 1960s was a period of reform and innovation in the provision of care for people with mental health problems. The most important development was the move away from residential institutions and the development of community services based on district general hospitals.

Assessing Parenting Capacity in Psychiatric Mother and Baby Units: A case report and review of literature.

Aims And Hypothesis: This review aimed to improve infant risk assessments in the context of maternal mental illness by identifying key predictors of poor parenting outcomes.

Background: Inadequate parenting as a result of severe and persistent mental illness is a common reason for courts terminating parental rights. However, the current practice of parenting capacity assessments in the setting of perinatal psychiatry is fraught with risks and uncertainty.

Excited delirium: A psychiatric review.

The term 'excited delirium' (ED) is used to explain sudden and unexpected restraint-related deaths. Since the 1990s, ED has often been identified as the principal cause of death in restrained individuals, rather than the restraint procedure itself. Forensic pathologists and psychiatrists attach different meanings to the term delirium.

Understanding the social context of violent and aggressive incidents on an inpatient unit.

The English National Service Framework for Mental Health stipulates that the highest quality of health care should be provided for mental health service users. Incidents of aggression and violence militate against achieving that goal, yet such incidents are frequently reported in inpatient settings. Much research in this area reflects a dualistic, perpetrator/victim conceptualization of incidents.

Discourses of blame: accounting for aggression and violence on an acute mental health inpatient unit.

The English National Service Framework for Mental Health stipulates that the highest quality of health care should be provided for mental health service users in the most efficient and effective manner. Incidents of aggression and violence militate against achieving that goal, yet such incidents are frequently reported in inpatient settings. Traditionally, research in this area has focused on the extent of the phenomenon, the individual characteristics of those involved and precursors to the incident.

An evaluation of the use of interactive television in an acute psychiatric service.

This study reports the results of the use of a low-cost videoconferencing system (LCVC) for communication in an acute psychiatric service. Qualitative research methodology was used to examine the use of the LCVC in interactions between psychiatrists, patients and nursing staff, including information on refusals. One hundred and five clinical interactions were studied over four months.

A comparison of communication modes in adult psychiatry.

The process and outcome of clinical tasks in an acute psychiatric unit were compared using four different communication modes: face to face, telephone, hands-free telephone, and a low-cost videoconferencing system. Six doctors and six patients took part in the study. Four assessment measures were used.

A preliminary survey of Italian intravenous heroin users in London.

The present study analyses the phenomenon of the migration to London of Italian intravenous drug users. Using structured questionnaires and prevalence data it was estimated that a significant number of Italian intravenous drug users (at least 1000) were living in London at the time of the study (1990), of whom 30% were HIV positive. Risk-taking behaviour was disturbingly high.

Preliminary evaluation of a low cost videoconferencing system for teaching in clinical psychiatry.

The use of a digitized low cost videoconferencing system (LCVC) for the teaching of clinical medical students on clinical attachment to a psychiatric ward is described. This work was performed as part of the Telemed project which is evaluating the use of the LCVC in a range of tasks in clinical psychiatry. Any move towards greater reliance on communications technology in psychiatry should take account of the requirements of clinical teaching.

Another trial that failed.

A double-blind comparison of clonidine and lofexidine in the management of the opioid withdrawal syndrome encountered several difficulties of a non-scientific nature which eventually forced termination of the trial. There were, for example, problems with research beds, self-discharges, staff attitudes, access to haematological monitoring, and worries about exposure to staff to human immunodeficiency virus. The trial collapsed when the manufacturers stopped making lofexidine on commercial grounds and the charitable foundation which was backing the trial withdrew its support.