Productivity in research is now an almost mandatory requirement for trainee psychiatrists. There is an increasing awareness among psychiatric trainees of the necessity to participate in and indeed publish research in order to ensure career progression (Junaid & Staines, 1990). This paper describes the research activity of psychiatrists in the training grades, during the year October 1988 to September 1989.

The relocation of chronic psychiatric patients in the community may be of unexpected benefit to town planners. Many Victorian mental hospitals, largely redundant in terms of medical use, are high quality buildings – some are listed or otherwise of architectural merit – and they are often set in mature landscaped grounds. Architect John Burrell has developed the idea of using former psychiatric hospital sites on the edges of cities as a basis for establishing a new urban core to outer suburban areas. His plans for the Woodford Green site won him the top prize in a national competition ‘Tomorrow's New Communities’, which was organised earlier this year by the Town and Country Planning Association and the Joseph Rowntree Trust, with the backing of the Prince of Wales.

‘The Heart has Reasons’, scheduled for broadcast on 21 February, is the film which launches a major new Channel 4 series of films called ‘Affairs of the Heart’. The series purports to be a broad view of how the health of the heart is “… central to our whole well-being, both spiritually as well as physically …”.

Advertisements are biased. This is not a statement of ideology, but a statement of fact. They are neither public service announcements nor balanced debates. They exist solely to encourage the consumer to buy one product in preference to another. The importance of this is that, as clinicians, we often place ourselves apart from others when considering what influences our practice. On the one hand our training emphasises a combined approach of pharmacological, psychological, and social therapies, but on the other, it is only the pharmacological approach that has the ability to finance full-colour advertisements in learned journals. In 1982 the pharmaceutical industry spent £150 million on drug promotion in the UK (Medawar, 1984). We have attempted to take an objective view of drug advertisements by examining the words used in all advertisements that have appeared in the British Journal of Psychiatry over the last 30 years.

We intend to discuss recent developments in Japanese psychiatry and matters of major concern, i.e., psychiatric services following the amendment of Japan's Mental Health Law, schizophrenia, dementia and culture-specific problems to Japan.

The 1991 annual meeting of the American Psychiatric Association (APA)∗ one of the world's most influential psychiatric organisations with a membership of over 35,000, and an annual budget of $24 million, was attended by over 12,000 persons from all over the world. (The cost of the meeting itself was about $2.5 million). Over 230 workshops and symposia were presented together with lectures from distinguished researchers, video presentations, debates and 600 posters. With up to 25 concurrent sessions, it was impossible for any one individual to attend more than a fraction of the programme. The theme, chosen by outgoing president, Dr Elissa Benedek, Professor of Child Psychiatry at Michigan, was ‘Our Children - Our Future’.

About 70 senior registrars from the United Kingdom and the Republic of Ireland spent a weekend at the Manchester Business School. The weekend started with a ‘keynote’ address by Professor John Wing on Measuring Psychiatric Morbidity: symptoms, diagnosis, handicaps, needs and outcomes. This lecture introduced us to the conceptual issues surrounding the ICD-10 classification and the need for sensitive and valid research criteria and instruments.

Wednesday, 17 April 1991, advertised on the Paris Metro as ‘la première journée de la minceur’ was, by an appropriate coincidence, also the morning Professor Philippe Jeammet welcomed over 800 participants from 34 countries to this bilingual conference at which 298 papers and posters were presented. In 1859 Louis Marcé, described by Dr Joseph Silverman as the “forgotten man of anorexia nervosa”, wrote the first description of the syndrome. Today anorexia nervosa is common, expensive and life threatening, responsible for an estimated 200 British deaths every year.

One curious image of the earliest Gulf fighting was a TV journalist standing in front of an acre of rubble in Tel Aviv and insisting, “The main effect of this Scud attack was psychological.‘’. What made it more curious was that after what had gone before, it was easy to believe him. Because, deprived of substantial news by a lack of action and the censorship of both sides, journalists had for weeks presented a procession of “psychological” angles, although they were more a clue to what the word means to the press.

The above quotation comes from the general public group discussions which were part of MORI's survey on public attitudes to mental health. This investigation was commissioned by the Mental Health Foundation as part of the events making the charity's 40th anniversary appeal.

Of all the decisions taken by psychiatrists with or on behalf of their patients, few are as potentially far-reaching as the decision to repatriate a mentally ill person to his or her country of origin. Although many psychiatrists have anecdotal experience of individual cases, published research on repatriation is surprisingly sparse. Burke (1973) reported 66 persons repatriated from Britain to Jamaica over a four year period, and Asuni (1968) found 82 returning via Aro Hospital, Nigeria, over a similar period. Although it is difficult to extrapolate an estimate of the number leaving the UK each year, these figures suggest that the practice is not uncommon and that significant, possibly increasing, numbers of people are affected.

Once upon a time there were clear-cut career pathways for ambitious doctors, what are now called ‘inside tracks’. Forward-looking people in the UK, for example, realised early that in order to become a consultant or professor in a teaching hospital, it was essential to be well qualified and published. In psychiatry, this meant proof of being truly renaissance with qualifications in medicine, psychiatry and research. How this was achieved was up to the individual. At places like the Maudsley Hospital people often arrived bristling with degrees. About half the entrants had passed College exams or had research doctorates. During psychiatric training the others went for the extra qualifications. They had to; otherwise they would not make it to senior registrar. Some characters practised brinkmanship and passed the MRCP on the umpteenth occasion. Thereafter things varied, with some moving into personal analysis (no degree) and others into wet and dry laboratory research. Many eschewed both and headed for clinical work. There was a period, perhaps between 1945 and 1975, although the limits are arguable, which was halcyon. Medical trainees were actually committed to research. There were twin pathways; the scholarly going to the MRC unit or the Chair and the entrepreneurial to the teaching hospital consultant job and Harley Street practice. The teaching hospital wallahs needed about ten papers to be acceptable. An engaging feature of the system was that the pay was not particularly discrepant between researchers and clinicians. The somewhat subfusc role of researchers was, in any case, redressed in the mid 1960s and parity achieved. Amazingly, then, it was possible to have a career in research without losing money. To what did it all add up? In modern parlance, was it cost-effective and efficient? Did the clinicians with their ten papers or the MRC medical scientists give value for money? After all, with what can they be compared?