Determination of pipothiazine in human plasma by reversed-phase high-performance liquid chromatography.

A method is described for the determination of pipothiazine in human plasma, based on reversed-phase HPLC. The method has been applied in a pharmacokinetic study of pipothiazine in six psychiatric patients receiving repeated depot intramuscular injections for six months. A number of compounds likely to be taken concurrently by patients were tested for potential to interfere with the assay. There was no evidence of "dose-dumping" in the period following injection. Comparison of the pharmacokinetic profiles after the first and sixth injections showed no evidence of drug accumulation.

Outcome of patients committed to hospital under the Mental Health (Scotland) Act 1960.

All patients formally detained in a Scottish psychiatric hospital between 1974 and 1979 were identified and their outcome determined 2 1/2-8 1/2 years later. A matched group, detained under Emergency Orders only, were also followed-up. Those formally detained had more previous psychiatric contact: functional psychoses were significantly more common in them. They remained in hospital longer, and required extensive community support when discharged. Those detained under Emergency Orders only, consisted of two sub-groups--one who left the area within two years of admission and could not be traced, and the remainder, who continued to require hospital treatment but for shorter times and with less continuous support. Amongst those detained, lack of insight was a predominant feature, which may create difficulty with regard to informed consent to treatment, given the present Amendments to the Mental Health Acts.

The development of an integrated psychiatric service in a Scottish community.

The deployment of a specialist psychiatric team and closer integration with primary health care practitioners has led to a greater proportion of first contacts as out-patients being seen compared with national data, and a relatively lower in-patient admission rate. The increase was in those patients seen in health centres rather than in additional out-patient clinics. Despite this there is evidence of a slow accumulation of patients with psychosis whose main requirements is suitable supported accommodation. Such a deployment into the community is a more economic use of resource and can, with advantage, assist the traditional hospital-based services in the transition from a custodial role.

Anxiety states: a preliminary report on the value of connective tissue massage.

Five patients who presented with symptoms of tension and anxiety were subsequently referred to a physiotherapist and treated with Connective Tissue Massage. Psychophysiological recordings of heart rate, frontalis EMG, skin resistance and forearm extensor EMG were taken before and after treatment. All patients showed a significant response to treatment in one or more of the psychophysiological parameters. Results are discussed in relation to the hypothesis that each individual has a unique stress response pattern. Preliminary findings proved interesting and supported clinical findings with regard to the effectiveness of this treatment for some patients suffering from Anxiety States.

Psychiatric services in primary care: specialized or not?

We compare referrals made to a psychiatric service by two comparable general practices. One practice made its referrals through conventional channels; the other referred patients to a multi-professional team who saw patients at a clinic held on the practice premises. The members of the team and the general practitioners in the second practice also met regularly to discuss matters of mutual interest. More patients were referred by this method, which also made greater use of the multiple disciplines involved in psychiatric care.Patients referred through conventional channels were more likely to have had previous contact with the psychiatric service, were more likely to be admitted to hospital and spent 70 per cent more time as inpatients.These results confirm the findings of other workers in demonstrating that there are tangible benefits in a multidisciplinary specialist team working in primary care.

Psychiatric illness in the elderly. A comparison of GP records and survey findings.

The GP records of 200 elderly people living at home were scrutinized and estimation made of physical and psychiatric disability. These estimations were compared with those made independently by a psychiatrist interviewing the subjects at home. There was a reasonable agreement between the two assessments of functional disorder and between the two assessments of physical disabilities. Whereas the survey psychiatrist's diagnoses of mental disorder correlated positively with the presence of physical illness, this did not hold for those considered to have evidence of psychiatric illness using GP records alone. The duration of a positive psychiatric history obtained from GP records was consistent with a discrimination between late onset (recent) and chronic neurosis.