Differences in the ICD–10 and DSM–IV definitions for the same disorder impede international communication and research efforts. The forthcoming parallel development of DSM–V and ICD–11 offers an opportunity to harmonise the two classifications.

This paper aims to facilitate the harmonisation process by identifying diagnostic differences between the two systems.

DSM–IV–TR criteria sets and the ICD–10 Diagnostic Criteria for Research were compared and categorised into those with identical definitions, those with conceptually based differences and those in which differences are not conceptually based and appear to be unintentional.

Of the 176 criteria sets in both systems, only one, transient tic disorder, is identical. Twenty-one per cent had conceptually based differences and 78% had non-conceptually based differences.

Harmonisation of criteria sets, especially those with non-conceptually based differences, should be prioritised in the DSM–V and ICD–11 development process. Prior experience with the DSM–IV and ICD–10 harmonisation effort suggests that for the process to be successful steps should be taken as early as possible.

Specific cortico-striato-thalamic circuits are hypothesised to mediate the symptoms of obsessive–compulsive disorder (OCD), but structural neuroimaging studies have been inconsistent.

To conduct a meta-analysis of published and unpublished voxel-based morphometry studies in OCD.

Twelve data-sets comprising 401 people with OCD and 376 healthy controls met inclusion criteria. A new improved voxel-based meta-analytic method, signed differential mapping (SDM), was developed to examine regions of increased and decreased grey matter volume in the OCD group v. control group.

No between-group differences were found in global grey matter volumes. People with OCD had increased regional grey matter volumes in bilateral lenticular nuclei, extending to the caudate nuclei, as well as decreased volumes in bilateral dorsal medial frontal/anterior cingulate gyri. A descriptive analysis of quartiles, a sensitivity analysis as well as analyses of subgroups further confirmed these findings. Meta-regression analyses showed that studies that included individuals with more severe OCD were significantly more likely to report increased grey matter volumes in the basal ganglia. No effect of current antidepressant treatment was observed.

The results support a dorsal prefrontal–striatal model of the disorder and raise the question of whether functional alterations in other brain regions commonly associated with OCD, such as the orbitofrontal cortex, may reflect secondary compensatory strategies. Whether the reported differences between participants with OCD and controls precede the onset of the symptoms and whether they are specific to OCD remains to be established.

An individual's right to self-determination in treatment decisions is a central principle of modern medical ethics and law, and is upheld except under conditions of mental incapacity. When doctors, particularly psychiatrists, override the treatment wishes of individuals, they risk conflicting with this principle. Few data are available on the views of people regaining capacity who had their treatment wishes overridden.

To investigate individuals' views on treatment decisions after they had regained capacity.

One hundred and fifteen people who lacked capacity to make treatment decisions were recruited from a sample of consecutively admitted patients to a large psychiatric hospital. After 1 month of treatment we asked the individuals for their views on the surrogate treatment decisions they received.

Eighty-three per cent (95% CI 66–93) of people who regained capacity gave retrospective approval. Approval was no different between those admitted informally or involuntarily using Mental Health Act powers (χ2 = 1.52, P = 0.47). Individuals were more likely to give retrospective approval if they regained capacity (χ2 = 14.2, P = 0.001).

Most people who regain capacity following psychiatric treatment indicate retrospective approval. This is the case even if initial treatment wishes are overridden. These findings moderate concerns both about surrogate decision-making by psychiatrists and advance decision-making by people with mental illness.

Studies of diet and depression have focused primarily on individual nutrients.

To examine the association between dietary patterns and depression using an overall diet approach.

Analyses were carried on data from 3486 participants (26.2% women, mean age 55.6 years) from the Whitehall II prospective cohort, in which two dietary patterns were identified: ‘whole food’ (heavily loaded by vegetables, fruits and fish) and ‘processed food’ (heavily loaded by sweetened desserts, fried food, processed meat, refined grains and high-fat dairy products). Self-reported depression was assessed 5 years later using the Center for Epidemiologic Studies – Depression (CES–D) scale.

After adjusting for potential confounders, participants in the highest tertile of the whole food pattern had lower odds of CES–D depression (OR = 0.74, 95% CI 0.56–0.99) than those in the lowest tertile. In contrast, high consumption of processed food was associated with an increased odds of CES–D depression (OR = 1.58, 95% CI 1.11–2.23).

In middle-aged participants, a processed food dietary pattern is a risk factor for CES–D depression 5 years later, whereas a whole food pattern is protective.

Negative parenting practices may be an environmental risk factor for subsequent conduct problems. Research on the association between parenting practices and callous–unemotional traits, a risk factor for conduct problems, has produced mixed findings.

To investigate whether negative parental discipline is a non-shared environmental risk factor for the development of conduct problems and callous–unemotional traits.

Longitudinal, multi-informant data from a community sample of twins were analysed using the monozygotic (MZ) twin differences design for 4508 twins (2254 twin pairs).

Within MZ twin pairs, the twin receiving more negative parental discipline at 7 years had more conduct problems (but not more callous–unemotional traits) at 12 years.

During the transition to early adolescence, negative parental discipline operates as a non-shared environmental risk factor for development of conduct problems, but not for the development of callous–unemotional traits.

There has been continued interest in the extent to which women have positive and negative reactions to abortion.

To document emotional reactions to abortion, and to examine the links between reactions to abortion and subsequent mental health outcomes.

Data were gathered on the pregnancy and mental health history of a birth cohort of over 500 women studied to the age of 30.

Abortion was associated with high rates of both positive and negative emotional reactions; however, nearly 90% of respondents believed that the abortion was the right decision. Analyses showed that the number of negative responses to the abortion was associated with increased levels of subsequent mental health disorders (P<0.05). Further analyses suggested that, after adjustment for confounding, those having an abortion and reporting negative reactions had rates of mental health disorders that were approximately 1.4–1.8 times higher than those not having an abortion.

Abortion was associated with both positive and negative emotional reactions. The extent of negative emotional reactions appeared to modify the links between abortion and subsequent mental health problems.

There has been no reported research comparing Jewish Israeli and Palestinian adolescents regarding the effect of ongoing political violence on adolescent psychosocial, family, post-traumatic stress disorder (PTSD) and aggression problems.

To compare Israeli and Palestinian responses regarding the relationship between exposure to traumatic events and psychosocial, behavioural, emotional and family problems.

A cluster sample of youths aged 14–18 years, including 442 Jewish Israeli adolescents in Ariel, Haifa and Tel-Aviv, and 450 Palestinian adolescents in Gaza cities, villages and refugee camps were surveyed in 2006 using our Traumatic Events Questionnaire (TEV), the Brief Symptoms Inventory (BSI), the PTSD Symptom Scale – Interview (PSS–I), the Index of Peer Relations scale (IPR), Buss–Perry Aggression Questionnaire (BPAQ) and the MacMaster Family Assessment Device (FAD).

Palestinian respondents had higher scores in the TEV, BSI, PSS–I and BPAQ questionnaires, and greater problems in functioning as revealed in the IPR and FAD. The social functioning of the adolescents with their peers predicted mental health symptoms and PTSD symptoms. Lower socioeconomic status predicted mental health symptoms, PTSD, pathology of participants' family functioning and the social functioning of the adolescents with their peers. Parents' education positively effected the FAD score and the avoidance item on the PSS–I, and religiosity improved the score on the FAD. Females reported more symptoms on the BSI and PSS–I than males, and males more symptoms on the FAD and IPR than females.

Both respondent groups had significant emotional and behavioural problems. Individual and community treatment, and community and social development, are likely to be useful for both populations, particularly Palestinians.

There is little evidence of the feasibility, acceptability and impact of services for the care of people with psychotic disorders in low- and middle-income countries.

To describe the scaling up and impact of a community-based rehabilitation programme for people with psychotic disorders in a very-low-resource setting.

Longitudinal study of people with psychotic disorders who had been ill for an average of 8 years in a rural Indian community. All individuals received a community-based intervention package comprising psychotropic medications, psychoeducation, adherence management, psychosocial rehabilitation and support for livelihoods. The primary outcome was change in disability scores.

The cohort consisted of 256 people with psychotic disorders (schizophrenia, bipolar affective disorder and other psychosis) of whom 236 people completed the end-point assessments (92%), with a median follow-up of 46 months. There were significant reductions (P<0.05) in the levels of disability for the cohort, the vast majority (83.5%) of whom engaged with the programme. On multivariate analyses, lower baseline disability scores, family engagement with the programme, medication adherence and being a member of a self-help group were independent determinants of good outcomes. Lack of formal education, a diagnosis of schizophrenia and dropping out of the programme were independent determinants of poor outcomes.

Community-based rehabilitation is a feasible and acceptable intervention with a beneficial impact on disability for the majority of people with psychotic disorders in low-resource settings. The impact on disability is influenced by a combination of clinical, programme and social determinants.

Internet-delivered self-help programmes with added therapist guidance have shown efficacy in social anxiety disorder, but unguided self-help has been insufficiently studied.

To evaluate the efficacy of guided and unguided self-help for social anxiety disorder.

Participants followed a cognitive–behavioural self-help programme in the form of either pure bibliotherapy or an internet-based treatment with therapist guidance and online group discussions. A subsequent trial was conducted to evaluate treatment specificity. Participants (n = 235) were randomised to one of three conditions in the first trial, or one of four conditions in the second.

Pure bibliotherapy and the internet-based treatment were better than waiting list on measures of social anxiety, general anxiety, depression and quality of life. The internet-based therapy had the highest effect sizes, but directly comparable effects were noted for bibliotherapy augmented with online group discussions. Gains were well maintained a year later.

Unguided self-help through bibliotherapy can produce enduring improvement for individuals with social anxiety disorder.

Screening for alcohol use disorders identifies a wide range of needs, varying from hazardous and harmful drinking to alcohol dependence. Stepped care offers a potentially resource-efficient way of meeting these needs, but requires evaluation in a randomised controlled trial.

To evaluate the feasibility, effectiveness and cost-effectiveness of opportunistic screening and a stepped care intervention in primary care.

A total of 1794 male primary care attendees at six practices in South Wales were screened using the Alcohol Use Disorders Identification Test (AUDIT). Of these, 112 participants who scored 8 or more on the AUDIT and who consented to enter the study were randomised to receive either 5 minutes of minimal intervention delivered by a practice nurse (control group) or stepped care intervention consisting of three successive steps (intervention group): a single session of behaviour change counselling delivered by a practice nurse; four 50-minute sessions of motivational enhancement therapy delivered by a trained alcohol counsellor; and referral to a community alcohol treatment agency.

Both groups reduced alcohol consumption 6 months after randomisation with a greater, although not significant, improvement for the stepped care intervention. Motivation to change was greater following the stepped care intervention. The stepped care intervention resulted in greater cost savings compared with the minimal intervention.

Stepped care was feasible to implement in the primary care setting and resulted in greater cost savings compared with minimal intervention.