Robert Kendell: his career and contribution to psychiatric diagnosis.

This paper reviews the career of Robert Kendell with emphasis on his contribution to diagnosis in psychiatry. His studies on the classification of depression showed that symptoms were distributed on a continuum and that division of depression into sub-types was not justified. Similarly he showed there was no clear-cut distinction between symptoms of schizophrenia and affective psychoses. He examined Scadding's definition of disease as it applied to psychiatry and questioned whether some conditions such as neuroses and personality disorders would qualify as illnesses. He concluded that available evidence supported a dimensional rather than a categorical approach to diagnosis.

A history of liaison psychiatry in the UK.

Aims and method To record the development of liaison psychiatry in the UK and to summarise the current levels of activity. We also highlight the challenges the specialty may face if it is to develop further. History since the 1970s is reviewed by early pioneers and those involved in the present day, with a focus on the key role played by members of the Royal College of Psychiatrists. Results We describe the development of training guidelines, the publication of joint documents with other Royal Colleges, establishing international collaborations and defining service specifications. We emphasise the importance of collaboration with other medical organisations, and describe successes and pitfalls. Clinical implications Much has been achieved but challenges remain. Liaison psychiatry has a potentially important role in improving patient care. It needs to adapt to the requirements of the current National Health Service, marshal evidence for cost-effectiveness and persuade healthcare commissioners to fund services that are appropriate for the psychological needs of general hospital patients.

Crohns disease: a case report.

BACKGROUND: Inflammatory bowel disease (IBD) was previously regarded as a disease of the Western Countries. A number of studies showed a high incidence and prevalence of inflammatory bowel disease in United States, United Kingdom and Northern Europe, whereas it was considered uncommon in Asians population and rare in Africa. OBJECTIVES: To report case of crohns disease that is rare in the tropic like Nigeria so as to create a high index of awareness that inflammatory bowel disease may be present but not correctly diagnosed

Psychosexual function in women who have undergone reduction mammaplasty.

BACKGROUND: Reduction mammaplasty substantially alleviates physical and psychological symptoms of mammary hyperplasia, but the effect on psychosexual function has not been analyzed so far. The aim of this study was to assess the impact of this common procedure on both operative and psychosexual satisfaction. METHODS: All women who underwent reduction mammaplasty (n = 90) at the Royal Free and University College London Hospitals between 1997 and 2000 were sent a series of questionnaires on their psychosexual health and satisfaction with operative outcome and postoperative sexual function. RESULTS: Of the 80 women who responded (response rate, 89 percent), 76 percent were satisfied with their operative results. Postoperative sexual satisfaction was improved in 28 percent, worsened in 19 percent, and unchanged in 53 percent of patients. Nobody dissatisfied with surgical outcome reported improved sexual satisfaction. A strong correlation was found between these two main outcome measures and General Health and Female Sexual Function Index scores. Significant correlations were also noted for breast shape, sensation, and symmetry (p < 0.001) and change in nipple sensation (p < 0.01). In contrast, breast size and scars did not significantly affect patient operative and sexual satisfaction (p > 0.1). When compared with the satisfied group, women unhappy with surgical results were more likely to suffer from postoperative anxiety (58 versus 18 percent) and depression (42 versus 8 percent). CONCLUSIONS: This study confirms that operative outcome following breast reduction does correlate with postoperative psychosexual function, mental health, and some breast parameters. Now that the link is identified, a prospective analysis may clarify the precise relationship between the patient's preoperative psychological status and operative and psychosexual satisfaction.