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Highlights

  • Sir: Harvey Gordon’s paper (Psychiatric Bulletin, August 2002, 26, 285-287) was refreshing on a worrying topic

  • Sir: We agree with McCaffery et al (Psychiatric Bulletin, September 2002, 26, 332-334) that there is little consensus among psychiatrists as to how to manage intoxicated patients when they present

  • Opinions on appropriate care protocols for intoxicated patients presenting at accident & emergency (A&E) departments or psychiatric emergency clinics were sought

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Summary

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Sir: People with dangerous severe personality disorder have long been recognised by psychiatrists to be beyond the remit of the psychiatric services This point is nicely illustrated by a case summary of a patient admitted in 1838 to the newly opened Northampton Asylum ( St Andrew’s Hospital). A 26-year-old labourer said to be suffering from ‘insanity caused by intoxication and sleeping at night in the open’ was transferred to the asylum from Oakham Gaol He had a history of violent assault and in prison had been kept heavily ironed. Prichard applied to the hospital governors for permission to discharge the patient This being granted, 6 weeks after admission he was sent home and nothing more was heard of him.

Assessing alcoholintoxicated patients
Findings
Monitoring patients on lithium
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