The effect of catalytic converter legislation on suicide rates in Grampian and Scotland 1980-2003.

OBJECTIVE: To examine the effect of catalytic converter legislation on suicide rates in Grampian and Scotland since its implementation in 1993. METHODS: (1) Population study in Grampian and Scotland using national population and mortality statistics for 1980 to 2003. (2) Retrospective, controlled cohort study of individualswho had unsuccessfully attempted suicide by motor had unsuccessfully attempted suicide by motor vehicle exhaust gassing to examine the theory of method substitution. method substitution. RESULTS: There was a significant fall in suicides by motor vehicle exhaust gas inhalation in Scotland and Grampian following the introduction of compulsory catalytic converter legislation. However, in the same time period, there was a significant increase in numbers of suicides by hanging and total suicide rates in Scotland. There was a non-significant trend in a small sample of patients from a local hyperbaric unit for an increased rate of subsequent completed suicide between those who had previously attempted suicide by motor vehicle exhaust gas inhalation and controls. CONCLUSIONS: Catalytic converter legislation has resulted in a decrease in the number of suicides by motor vehicle exhaust gas inhalation. Overall suicide rates have not decreased. There is evidence to suggest that those who would have previously committed suicide by motor vehicle exhaust gas inhalation find alternative methods of suicide, so called 'method substitution'. Initiatives to reduce suicide rates should be directed at those means that are used by impulsive suicide attempters, as other, determined individuals, will commit suicide by another method.

A survey of Attention Deficit Hyperactivity Disorder follow-up services provided by child and adolescent psychiatry departments in Scotland.

BACKGROUND/AIM: Current clinical guidelines offer few recommendations for follow-up of patients diagnosed with Attention Deficit Hyperactivity Disorder (ADHD). We aimed to establish what follow-up services were in place for children and young people with ADHD across Scotland, to highlight variations within these services and to examine their level of adherence to those national guidelines on follow-up which do exist. METHOD: A postal survey of child and adolescent psychiatry departments across Scotland was carried out. Seventeen departments were contacted and the response rate was 100%. We compared results from areas with and without designated ADHD follow-up teams. We looked specifically at numbers and type of professional involved and the structure of the follow-up services provided. RESULTS AND CONCLUSION: Forty one percent of services had a designated ADHD follow-up team. These services held a significantly higher proportion of regular ADHD clinics and involved more staff from different professional groups. There were wide variations in services provided by child and adolescent psychiatrists for ADHD follow-up across Scotland. Further research on the effects on prognosis and outcome of designated ADHD services would allow for the enhancement of current clinical guidelines and more effective service planning and provision.