Migration is a risk factor for the development of schizophrenia.

To examine whether migration is also a risk factor for bipolar affective disorder, unipolar depressive disorder and mood disorders in general.

Medline was searched for population-based incidence studies concerning mood disorders among migrants and mean relative risks were computed using a mixed-effects statistical model.

Only a few studies of unipolar depressive disorder were retrieved. The mean relative risk of developing bipolar affective disorder among migrants was 2.47 (95% C11.33–4.59). However, after excluding people of African-Caribbean origin in the UK this risk was no longer significantly increased. The mean relative risk of mood disorders of unspecified polarity was 1.25 (95% CI 1.04–1.49) and that of any mood disorder was 1.38 (95% CI 1.17–1.62).

There is no conclusive evidence for a large increase in the risk of mood disorders associated with migration.

With almost a million people dying by suicide worldwide each year, reducing the rate of suicidal behaviour is a priority in many countries.

To examine whether additional psychosocial interventions following an episode of self-harm reduce the likelihood of subsequent suicide.

We conducted a systematic review and meta-analysis of data from randomised controlled trials of interventions for people following self-harm. Likelihood of suicide was compared by calculating the pooled root difference in suicide rate with 95% confidence intervals.

We obtained suicide data from 18 studies with a total population of 3918. Eighteen suicides occurred among people offered active treatment and 19 among those offered standard care (pooled root difference in suicide rate 0.0, 95% CI – 0.03 to 0.03). The overall rate of suicide among people participating in trials was similar to that reported in observational studies of people who self-harm.

Results of this meta-analysis do not provide evidence that additional psychosocial interventions following self-harm have a marked effect on the likelihood of subsequent suicide.

Little is known of the epidemiology and care needs of people with adolescent-onset psychosis.

To examine prevalence and the cross-sectional disability, needs and service provision for adolescent-onset psychosis in areas of central Scotland with a total population of 1.75 million.

We identified and contacted 103 young people using an opt-out research design. Fifty-three participants and their carers and keyworkers were interviewed using a modified version of the Cardinal Needs Schedule.

The 3-year prevalence was 5.9 per 100 000 general population. Twenty-one (20%) adolescents were not in contact with mental health services; 80% of first admissions were to adult acute psychiatric wards. Those interviewed had high levels of morbidity: 29 (55%) had serious to pervasive impairment of functioning; there were relatively high levels of side-effects, negative symptoms, anxiety, occupational, friendship and family difficulties. Care provision was better for ‘clinical' than for ‘social' domains; 20% had five or more unmet needs; 17% had at least one intractable problem.

This low-prevalence disorder requires an assertive multi-agency approach in the context of a national planning framework.

Reported prevalence of mental ill-health among adults with intellectual disabilities ranges from 7 to 97%, owing to methodological limitations. Little is known about associations.

To determine the prevalence of mental ill-health in adults with intellectual disabilities and to investigate factors independently associated with it.

Population-based study (n=1023) with comprehensive individual assessments modelled using regression analyses.

Point prevalence of mental ill-health was 40.9% (clinical diagnoses), 35.2%(DC–LD), 16.6% (ICD–10–DCR) and 15.7% (DSM–IV–TR). The most prevalent type was problem behaviours. Mental ill-health was associated with more life events, female gender, type of support, lower ability, more consultations, smoking, incontinence, not having severe physical disabilities and not having immobility; it was not associated with deprived areas, no occupation, communication impairment, epilepsy, hearing impairment or previous institutional residence.

This investigation informs further longitudinal study, and development of appropriate interventions, public health strategy and policy. ICD–10–DCR and DSM–IV–TR undercount mental ill-health in this population compared with DC–LD.

Depression is common in Pakistan but no research on this subject has been reported from the North West Frontier Province (NWFP), host to numerous Afghan refugees.

To measure depressive symptoms and associated features in a population-based sample.

A Pushto translation of the Self Reporting Questionnaire (SRQ) was administered to 471 adults living in a village in one of the federally administered tribal areas. Respondents were also assessed with a life events checklist for social problems, a social support questionnaire and the Brief Disability Questionnaire.

Sixty per cent (95/158) of women and 45% (140/313) of men scored 9 or more on the SRQ. High SRQ score was associated with few years of education, higher social problem score, less social support and greater disability. High social problem score was the strongest correlate.

This population reports more depressive symptoms than other communities in Pakistan and this probably reflects the very high degree of social stress experienced in the NWFP, which has been affected by years of turmoil in neighbouring Afghanistan.

Few studies have prospectively examined psychosocial and psychiatric predictors of adolescent substance use disorders simultaneously.

To identify psychosocial and psychiatric predictors of substance use disorders in adolescence.

School children aged 12 years (s. d. =0. 3) free from any substance use disorder at grade7(n=428) were assessed in three consecutive years, using a standardised psychiatric interview. Their baseline psychosocial information was also collected. The outcome was the onset age of a substance use disorder. The Cox regression model was used for data analysis.

The most significant predictive factors for adolescent substance use disorder included male gender, attention-deficit hyperactivity disorder, conduct disorder and sibling use of tobacco. Three protective factors against such morbidity included living in a household with two parents, a good academic grade at grade 7 and objection to the use of substances.

Early intervention for disruptive behaviour disorders and specific psychosocial risk factors might prevent substance use disorders in early adolescence.

Few psychosocial interventions have been developed in China that are suitable for use in the community.

To evaluate the effectiveness of the Chinese version of the Community Re-Entry Module (CRM; a module of a standardised, structured social skills training programme devised at the University of California, Los Angeles) for patients with schizophrenia compared with standard group psychoeducation.

Patients with schizophrenia (n=103) were randomly allocated to CRM or psychoeducation groups and followed up for 24 months. Outcome measures included social functioning, psychiatric symptoms, insight, re-employment, relapse and re-hospitalisation rates.

The CRM group significantly improved in terms of social functioning, insight and psychiatric symptoms compared with the psychoeducation group; the re-employment rate was significantly higher and relapse and rehospitalisation rates were significantly lower in the CRM group.

The findings support the feasibility and effectiveness of CRM as a psychosocial intervention for Chinese patients with schizophrenia in the community.

Hallucinations are perceptions in the absence of a corresponding external sensory stimulus. However, during auditory verbal hallucinations, activation of the primary auditory cortex has been described.

The objective of this study was to investigate whether this activation of the auditory cortex contributes essentially to the character of hallucinations and attributes them to alien sources, or whether the auditory activation is a sign of increased general auditory attention to external sounds.

The responsiveness of the auditory cortex was investigated by auditory evoked potentials (N100) during the simultaneous occurrence of hallucinations and external stimuli. Evoked potentials were computed separately for periods with and without hallucinations; N100 power, topography and brain electrical sources were analysed.

Hallucinations lowered the N100 amplitudes and changed the topography, presumably due to a reduced left temporal responsivity.

This finding indicates competition between auditory stimuli and hallucinations for physiological resources in the primary auditory cortex. The abnormal activation of the primary auditory cortex may thus be a constituent of auditory hallucinations.

Although electroconvulsive therapy (ECT) is widely used to treat psychiatric disorders such as depression, its precise neural mechanisms remain unknown.

To investigate the time course of changes in cerebral blood flow during acute ECT.

Cerebral blood flow was quantified serially prior to, during and after acute ECT in six patients with depression under anaesthesia using[15O]H2O positron emission tomography (PET).

Cerebral blood flow during ECT increased particularly in the basal ganglia, brain-stem, diencephalon, amygdala, vermis and the frontal, temporal and parietal cortices compared with that before ECT. The flow increased in the thalamus and decreased in the anterior cingulate and medial frontal cortex soon after ECT compared with that before ECT.

These results suggest a relationship between the centrencephalic system and seizure generalisation. Further, they suggest that some neural mechanisms of action of ECT are mediated via brain regions including the anterior cingulate and medial frontal cortex and thalamus.

Although measures of psychopathology are designed for use in clinical populations, their meaning derives from comparison with normal populations.

To compare the distribution of scores on the Clinical Outcomes in Routine Evaluation — Outcome Measure (CORE-OM) from a general population sample with the distribution in an aggregated clinical sample to derive recommended cut-off points for determining clinical significance.

The CORE-OM general population sample was based on a weighted subsample of participants in the psychiatric morbidity follow-up survey who completed valid CORE-OM forms following their interview (effectiven=535).

Comparison of the CORE-OM general population sample with a clinical sample aggregated from previous studies (n=10761) yielded a cut-off score of 9.9 on the 0–40 scale of the CORE-OM. The CORE-OM was highly correlated (r=0.77) with the Clinical Interview Schedule — Revised, supporting convergent validity.

We recommend rounding the CORE-OM cut-off score to 10. However, cut-off scores must be used thoughtfully and adjusted to fit context and purpose.