We present a revised Beliefs About Voices Questionnaire (BAVQ–R), a self-report measure of patients' beliefs, emotions and behaviour about auditory hallucinations.

To improve measurement of omnipotence, a pivotal concept in understanding auditory hallucinations, and elucidate links between beliefs about voices, anxiety and depression.

Seventy-one participants with chronic auditory hallucinations completed the BAVQ–R, and 58 also completed the Hospital Anxiety and Depression Scale.

The mean Cronbach's α for the five sub-scales was 0.86 (range 0.74–0.88). The study supports hypotheses about links between beliefs, emotions and behaviour, and presents original data on how these relate to the new omnipotence sub-scale. Original data are also presented on connections with anxiety and depression.

The BAVQ–R is more reliable and sensitive to individual differences than the original version, and reliably measures omnipotence.

Strong links exist between juvenile and adult depression but comorbid conduct disorder in childhood may mitigate this continuity.

To test the impact of comorbid conduct disorder on psychiatric adult outcomes.

A group of 149 subjects assessed at the Maudsley Hospital in the period 1970–1983 and meeting DSM–IV criteria for major depressive disorder with (n=53) or without (n=96) conduct disorder were interviewed 20 years later. Data were collected on the lifetime history of psychiatric disorders.

Adult depressive recurrence was high for major depression (62.4%) and any depression (75.2%), and survival analyses showed no difference between the two groups. The group with conduct disorders had higher rates of drug misuse and dependence, alcoholism and antisocial personality disorders.

Adolescent depression carries an elevated risk of adult depression irrespective of comorbidity. Comorbid conduct disorder in childhood is associated with raised rates of other psychiatric outcomes.

There is an excess of death from natural causes among people with schizophrenia.

Schizophrenia and its treatment with neuroleptics were studied for their prediction of mortality in a representative population sample of 7217 Finns aged ⩾30 years.

A comprehensive health examination was carried out at baseline. Schizophrenia was determined using the Present State Examination and previous medical records.

During a 17-year follow-up, 39 of the 99 people with schizophrenia died. Adjusted for age and gender, the relative mortality risk between those with schizophrenia and others was 2.84 (95% CI 2.06–3.90), and was2.25 (95%CI1.61–3.15) after further adjusting for somatic diseases, blood pressure, cholesterol, body mass index, smoking, exercise, alcohol intake and education. The number of neuroleptics used at the time of the baseline survey showed a graded relation to mortality. Adjusted for age, gender, somatic diseases and other potential risk factors for premature death, the relative risk was 2.50 (95% CI1.46–4.30) per increment of one neuroleptic.

There is an urgent need to ascertain whether the high mortality in schizophrenia is attributable to the disorder itself or the antipsychotic medication.

The number of asylum seekers, refugees and internally displaced people worldwide is rising. Western countries are using increasingly restrictive policies, including the detention of asylum seekers, and there is concern that this is harmful.

To investigate mental health outcomes among adult, child and adolescent immigration detainees.

A systematic review was conducted of studies investigating the impact of immigration detention on the mental health of children, adolescents and adults, identified by a systematic search of databases and a supplementary manual search of references.

Ten studies were identified. All reported high levels of mental health problems in detainees. Anxiety, depression and posttraumatic stress disorder were commonly reported, as were self-harm and suicidal ideation. Time in detention was positively associated with severity of distress. There is evidence for an initial improvement in mental health occurring subsequent to release, although longitudinal results have shown that the negative impact of detention persists.

This area of research is in its infancy and studies are limited by methodological constraints. Findings consistently report high levels of mental health problems among detainees. There is some evidence to suggest an independent adverse effect of detention on mental health.

Depression is common in later life.

To determine whether exercise is effective as an adjunct to antidepressant therapy in reducing depressive symptoms in older people.

Patients were randomised to attend either exercise classes or health education talks for 10 weeks. Assessments were made ‘blind’ at baseline, and at 10 and 34 weeks. The primary outcome was seen with the 17-item Hamilton Rating Scale for Depression (HRSD). Secondary outcomes were seen with the Geriatric Depression Scale, Clinical Global Impression and Patient Global Impression.

At 10 weeks a significantly higher proportion of the exercise group (55% v. 33%) experienced a greater than 30% decline in depression according to HRSD (OR=2.51, P=0.05, 95% Cl 1.00–6.38).

Because exercise was associated with a modest improvement in depressive symptoms at 10 weeks, older people with poorly responsive depressive disorder should be encouraged to attend group exercise activities.

There is concern about the stigma of mental illness, but it is difficult to measure stigma consistently.

To develop a standardised instrument to measure the stigma of mental illness.

We used qualitative data from interviews with mental health service users to develop a pilot scale with 42 items. We recruited 193 service users in order to standardise the scale. Of these, 93 were asked to complete the questionnaire twice, 2 weeks apart, of whom 60 (65%) did so. Items with a test–retest reliability kappa coefficient of 0.4 or greater were retained and subjected to common factor analysis.

The final 28-item stigma scale has a three-factor structure: the first concerns discrimination, the second disclosure and the third potential positive aspects of mental illness. Stigma scale scores were negatively correlated with global self-esteem.

This self-report questionnaire, which can be completed in 5–10 min, may help us understand more about the role of stigma of psychiatric illness in research and clinical settings.

Prediction of suicidal behaviour is an aspirational goal for clinicians and policy makers; with patients classified as ‘high risk’ to be preferentially allocated treatment. Clinical usefulness requires an adequate positive predictive value (PPV).

To identify studies of predictive instruments and to calculate PPV estimates for suicidal behaviours.

A systematic review identified studies of predictive instruments. A series of meta-analyses produced pooled estimates of PPV for suicidal behaviours.

For all scales combined, the pooled PPVs were: suicide 5.5% (95% CI 3.9–7.9%), self-harm 26.3% (95% CI 21.8–31.3%) and self-harm plus suicide 35.9% (95% CI 25.8–47.4%). Subanalyses on self-harm found pooled PPVs of 16.1% (95% CI 11.3–22.3%) for high-quality studies, 32.5% (95% CI 26.1–39.6%) for hospital-treated self-harm and 26.8% (95% CI 19.5–35.6%) for psychiatric in-patients.

No ‘high-risk’ classification was clinically useful. Prevalence imposes a ceiling on PPV. Treatment should reduce exposure to modifiable risk factors and offer effective interventions for selected subpopulations and unselected clinical populations.

Suicide is a leading cause of death worldwide; however, little information is available about the treatment of suicidal people, or about barriers to treatment.

To examine the receipt of mental health treatment and barriers to care among suicidal people around the world.

Twenty-one nationally representative samples worldwide (n=55 302; age 18 years and over) from the World Health Organization's World Mental Health Surveys were interviewed regarding past-year suicidal behaviour and past-year healthcare use. Suicidal respondents who had not used services in the past year were asked why they had not sought care.

Two-fifths of the suicidal respondents had received treatment (from 17% in low-income countries to 56% in high-income countries), mostly from a general medical practitioner (22%), psychiatrist (15%) or non-psychiatrist (15%). Those who had actually attempted suicide were more likely to receive care. Low perceived need was the most important reason for not seeking help (58%), followed by attitudinal barriers such as the wish to handle the problem alone (40%) and structural barriers such as financial concerns (15%). Only 7% of respondents endorsed stigma as a reason for not seeking treatment.

Most people with suicide ideation, plans and attempts receive no treatment. This is a consistent and pervasive finding, especially in low-income countries. Improving the receipt of treatment worldwide will have to take into account culture-specific factors that may influence the process of help-seeking.

Investigations of the Korsakoff syndrome by researchers from different disciplines have proliferated in recent years, making it apposite to review the various findings.

This review is based on the author's knowledge of reports in the major clinical and neuropsychological journals, supplemented by Medline searches to update particular subtopics.

The Korsakoff syndrome is defined as a disproportionate impairment in memory, relative to other aspects of cognitive function, resulting from a nutritional (thiamine) depletion. The initial manifestations of the disorder are variable, and a persistent memory impairment can result from a non-alcoholic aetiology, although this seems to happen much less commonly than in the past – presumably because of generally higher standards of nutrition. Although there is agreement on the underlying neuropathology, the critical lesion sites for memory disorder have been debated. Recent evidence suggests that the circuit involving the mammillary bodies, the mammillo-thalamic tract and the anterior thalamus, rather than the medial dorsal nucleus of the thalamus, is particularly critical in the formation of new memories. The relationship of these deficits to thiamine depletion remains a topic of current investigation, as does the purported role of neurotransmitter depletions in the cholinergic, glutamate/GABA and catecholamine and serotonergic systems. Neuro-imaging studies have confirmed autopsy findings of more widespread structural and metabolic abnormalities, particularly involving the frontal lobes.

The relationship of these neuropathological, neurochemical, and metabolic abnormalities to cognitive functioning, with particular reference to specific aspects of memory processing, has been considered in some detail. Whereas structural and/or neurochemical abnormalities within the limbic/diencephalic circuits account for anterograde amnesia, some other factor, such as frontal lobe dysfunction, must underlie the severe retrograde memory loss which is characteristically found in this syndrome.

Few studies have examined the relative risks of switching into hypomania or mania associated with second-generation antidepressant drugs in bipolar depression.

To examine the relative acute effects of bupropion, sertraline and venlafaxine as adjuncts to mood stabilisers.

In a 10-week trial, participants receiving out-patient treatment for bipolar disorder (stratified for rapid cycling) were randomly treated with a flexible dose of one of the antidepressants, or their respective matching placebos, as adjuncts to mood stabilisers.

A total of 174 adults with bipolar disorder I, II or not otherwise specified, currently in the depressed phase, were included. All three antidepressants were associated with a similar range of acute response (49–53%) and remission (34–41%). There was a significantly increased risk of switches into hypomania or mania in participants treated with venlafaxine compared with bupropion or sertraline.

More caution appears indicated in the use of venlafaxine rather than bupropion or sertraline in the adjunctive treatment of bipolar depression, especially if there is a prior history of rapid cycling.

It is unclear how the recurrence of major depression in adolescence affects later life outcomes.

To examine the associations between the frequency of major depression at ages 16–21 and later outcomes, both before and after controlling for potentially confounding factors.

Data were gathered from a 25-year longitudinal study of a birth cohort of New Zealand children (n=982). Outcome measures included DSM–IV symptom criteria for major depression and anxiety disorders, suicidal ideation and attempted suicide, achieving university degree or other tertiary education qualification, welfare dependence and unemployment, and income at ages 21–25 years.

There were significant (P<0.05) associations between the frequency of depression at ages 16–21 years and all outcome measures. After adjustment for confounding factors, the association between frequency of depression and all mental health outcomes, and welfare dependence and unemployment, remained significant (P<0.05).

The frequency of depression in adolescence and young adulthood is associated with adverse mental health and economic outcomes in early adulthood.

One factor contributing to impaired awareness of illness (poor insight) in psychotic disorders may be neurocognitive deficits.

A systematic review and meta-analysis were conducted after data extraction. Following an overall analysis, in which measures of different cognitive domains were taken together, more finegrained analyses investigated whether there was a specific relation with frontal executive functioning, and whether this was influenced by diagnosis or the insight scales used.

There was a significant mean correlation between insight ratings and neurocognitive performance (mean weighted r=0.17, 95% CI 0.13–0.21, z=8.3, P < 0.0001), based on 35 studies with a total of 2354 individuals. Further analyses revealed that the effect of general intellectual impairment was smaller than the specific association with executive function. This was only the case for psychosis in general, and not in an analysis limited to schizophrenia, where all cognitive domains were associated with impaired insight to a similar degree.

Neuropsychological dysfunction, specifically impairment of set-shifting and error monitoring, contributes to poor insight in psychosis. Specific relations with different dimensions of insight and the putative role of metacognitive functions require further study.

Frontotemporal dementia accounts for up to 20% of cases of dementia in the presenium, yet remains poorly recognised. Diagnostic criteria have been devised to aid clinical diagnosis.

To provide an overview of clinical and pathological characteristics of frontotemporal dementia and its nosological status.

The review summarises consensus diagnostic criteria for frontotemporal dementia and draws on the authors'clinical experience of 300 frontotemporal dementia cases, and pathological experience of 50 autopsied cases.

Frontotemporal dementia is characterised by pronounced changes in affect and personal and social conduct. Some patients also develop motor neuron disease. Mutations in the tau gene account for some but not all familial cases of frontotemporal dementia.

Frontotemporal dementia is a focal form of dementia, which is clinically and pathologically distinct from other dementias. It represents an important model for understanding the functions of the frontotemporal lobes.