Ashok V. Bhat

Section 136 and African/afro-Caribbean minorities

Social, demographic and clinical information was collected retrospectively on all 99 people referred to a South London hospital in 1986 under Section 136 of the Mental Health Act (1983), this being the last complete year before local changes in the procedure for assessment of Section 136 cases were initiated. An over-represen tation of Afro-Caribbeans was confirmed and this seemed to be accounted for largely by young men under the age of 30 who with Africans had very high rates of previous Section 136 referral, were more likely to be perceived as threatening, incoherent and disturbed but less clearly diagnosed with a mental illness, and were more likely than the Caucasian sample to be living in stable accommodation. The implications of these results are discussed.

The neuro-endocrine impact of 3-hydroxy-diazepam (temazepam) in women.

The benzodiazepines have been considered largely free of neuro-endocrine effect. However, in a double-blind, random assignment, placebo controlled study of six young women in the first half of their menstrual cycle oral temazepam (20 mg) was found to significantly lower plasma cortisol and raise plasma prolactin. The impact on cortisol was significant at 40 min and persisted for 3 h (P<0.01) after oral ingestion. Prolactin was significantly raised at 1 h after ingestion only (P<0.05). No impact on FSH or LH was noted. These findings are compatible with recent reports of γ-aminobutyric acid and benzodiazepine binding sites in human pituitary tissue. The positive and negative aspects of these findings for the clinician are discussed.This research has important implications for biological studies such as the dexamethasone suppression test, since the patients involved are commonly allowed benzodiazepine treatment.

Why do some anorexics steal? Personal, social and illness factors

There is a recognised association between anorexia nervosa and stealing. Anorexics who steal are usually also bulimic. However, not all bulimic anorexics steal. The question of why some do and others do not is explored with respect to features of the illness and personal and social variables. Bulimic anorexics who stole differed from their non-stealing counterparts in older age at presentation and in terms of greater sexual activity. These and other findings are discussed with reference to clinical understanding and aetiological theories of other aberrant behavior displayed by the adolescent female.

Psycho-social stress, insomnia and temazepam: a sleep laboratory evaluation in a “general practice” sample

Taking a population of women most of whom were about to seek medication from their general practitioner for stress-induced insomnia, this sleep laboratory study examined — both electro-physiologically and psychologically — the immediate impact of temazepam, at normal prescribed dosage, on sleep. The study was double-blind, controlled with random allocation. Temazepam 20 mg, prepared as a liquid in a soft gelatin capsule, reduced sleep latency and prolonged total sleep time. A reduction in stage shifts to Stages I and II and a reduction in time spent in Stages 0+I suggest more restful sleep. The sleep “architecture” (including REM/NREM cycling, total SWS and REM time) was relatively undisturbed. Temazepam would seem to be effective as a first-line hypnotic for short-term use in stressed patients.

Attitudes of Health Care Professionals towards Patients who Take Overdoses

The attitudes of health care professionals in Malta towards patients who take drug overdoses were studied. It was found that the intention of the overdose had a marked effect on the attitude of the health care professional towards the patients. Differences between different profes sionals were noted and the Maltese results were compared with those of a similar study in London.

The Irish in Britain: intermarriage and fertility levels, 1971-1976.

Data from the 1971 British census are used to analyze fertility and intermarriage of the Irish in Great Britain. The demographic characteristics of the Irish population in Great Britain are also examined, and comparisons are made with the population as a whole.

The Causes of and Solutions for Rioting in Britain in the Summer of 1981

The background to the present study was the emotional environmentcreated by a series of events which may have been temporally related to the New Cross fire in January 1981. The media had. become involved in an analysis of the factors which may have contributed to this fire in which 13 youngsters, all of West Indian origin, had died. The debate became somewhat intensified after a march which created a small disturbance in its route from Deptford, the scene of the fire, to Hyde Park Corner. This received full publicity and was to be followed by the first series of riots in April only a few days before the inquest into the fire. By the summer, rioting had spread to include wide areas of South London of which Deptford is a part, other parts of London and other urban areas in the country. The intensity of feeling in the work environment of the hospital and medical school may have been similar to that in the general society. However, there were factors which suggested that feeling may have been greater among certain sectors of the staff Thus the main hospital of this group provides services for multi-ethnic populations in inner city areas. Rooming houses are numerous and during this period of social change it was believed that social unrest had increased throughout the area. An inevitable feature of a situation which may have had racial overtones might be that staff may have become rather withdrawn and ineffective in their management of patients from other ethnic groups. A further factor may be an increase in inter-staff tension based on ethnic differ-

WHY DO SOME ANOREXICS STEAL? PERSONAL, SOCIAL AND ILLNESS FACTORS

There is a recognised association between anorexia nervosa and stealing. Anorexics who steal are usually also bulimic. However, not all bulimic anorexics steal. The question of why some do and others do not is explored with respect to features of the illness and personal and social variables. Bulimic anorexics who stole differed from their non-stealing counterparts in older age at presentation and in terms of greater sexual activity. These and other findings are discussed with reference to clinical understanding and aetiological theories of other aberrant behaviour displayed by the adolescent female.

Psychiatric workers as emotional beings: the emotional reactions of staff following the Brixton riots.

The present paper provides further results on the study of staff attitudes and emotions to the 1981 riots which were found among workers in psychiatric hospitals in one part of South London. In the previous paper data had been presented to indicate that racial factors may have been of some importance with regard to the causes and solutions of these riots. There was no association of race with emotional reaction. Nonetheless it was found that there was a low response rate to the questionnaire among black workers most of whom are nurses. Black responders seemed rather similar to others in their attitudes to the disturbances. This was not true regarding the racial element which received greater support by blacks than whites. Together the findings suggest to us that psychiatric workers may have the need to explore their emotional reactions and it is the purpose of this present paper to provide data on the kinds of emotions that may be present and how these relate to stereotyped modes of thought.