Q fever in Northern Ireland.

All the patients showed emotional symptoms reactive to stress. Intermittent delirious or subdelirious reactions were seen and the patients often showed evidence of increased cerebral dysfunction during or just after dialysis. Assessment of mental status and previous personality was of value in understanding the responses to the illness and its treatment. The role of the nursing staff is crucial, team approach in management is needed, the services of a medical social worker are valuable, and the psychiatrist has a role in treatment.