Drugs that potentiate brain serotonin (5-HT) neurotransmission are effective in the treatment of obsessive–compulsive disorder (OCD), but it is unclear whether disturbances in brain 5-HT function play a role in the pathophysiology of OCD.

We studied the prolactin response to the selective 5-HT releasing agent d-fenfluramine in 14 non-depressed, drug-free OCD patients, and 14 healthy controls matched for age and gender.

The prolactin response to d-fenfluramine was significantly increased in OCD patients compared with controls.

The disparate results of studies of 5-HT neuroendocrine function in OCD make it unlikely that disturbances of brain 5-HT function play a central role in the pathophysiology of OCD. Increased brain 5-HT neurotransmission in non-depressed OCD subjects may represent an adaptive neurobehavioural mechanism which can be amplified to therapeutic advantage by treatment with 5-HT potentiating drugs.

An increased focus in research specific to first-episode schizophrenia has provided a rapidly growing body of evidence that can be directly translated to clinical practice.

To provide clinical recommendations specific to effective pharmacotherapy of first-episode schizophrenia.

Evidence from clinical trials focused on the first-episode population is combined with data from other areas of investigation.

In first-episode psychosis, when to initiate treatment is not always clear, being intimately linked to challenges regarding early detection and diagnosis. There may be differences in antipsychotic dosing, patterns of response and sensitivity to side-effects. Adherence appears to be even more problematic at this stage.

Clinicians currently treating early psychosis have considerably more information to guide their decision-making. However, the speed at which the field is growing is a reminder totreatthis knowledge as a work in progress.

Attempts have been made to improve the efficiency of in-patient acute care. A novel method has been the development of a ‘triage system’ in which patients are assessed on admission to develop plans for discharge or transfer to an in-patient ward.

To compare a triage admission system with a traditional system.

Length of stay and readmission data for all admissions in a 1-year period between the two systems were compared using the participating trust's anonymised records.

Despite reduced length of stay on the actual triage ward, the average length of stay was not reduced and the triage system did not lead to a greater number of readmissions. There was no significant difference in costs between the two systems.

Based on our findings we cannot conclude that the triage system reduced length of stay, but we can conclude that it does not increase the number of readmissions as some have feared.

Low birth weight is associated with adult mental health, cognitive and socioeconomic problems. However, the causal nature of these associations remains difficult to establish owing to confounding.

To estimate the contribution of birth weight to adult mental health, cognitive and socioeconomic outcomes using two-sample Mendelian randomisation, an instrumental variable approach strengthening causal inference.

We used 48 independent single-nucleotide polymorphisms as genetic instruments for birth weight (genome-wide association studies’ total sample: n = 264 498) and considered mental health (attention-deficit hyperactivity disorder (ADHD), autism spectrum disorder, bipolar disorder, major depressive disorder, obsessive–compulsive disorder, post-traumatic stress disorder (PTSD), schizophrenia, suicide attempt), cognitive (intelligence) and socioeconomic (educational attainment, income, social deprivation) outcomes.

We found evidence for a contribution of birth weight to ADHD (OR for 1 s.d. unit decrease (~464 g) in birth weight, 1.29; 95% CI 1.03–1.62), PTSD (OR = 1.69; 95% CI 1.06–2.71) and suicide attempt (OR = 1.39; 95% CI 1.05–1.84), as well as for intelligence (β = −0.07; 95% CI −0.13 to −0.02) and socioeconomic outcomes, i.e. educational attainment (β = −0.05; 95% CI −0.09 to −0.01), income (β = −0.08; 95% CI −0.15 to −0.02) and social deprivation (β = 0.08; 95% CI 0.03–0.13). However, no evidence was found for a contribution of birth weight to the other examined mental health outcomes. Results were consistent across a wide range of sensitivity analyses.

These findings support the hypothesis that birth weight could be an important element on the causal pathway to mental health, cognitive and socioeconomic outcomes.

Empathy is a basic human ability, and patients with schizophrenia show dysfunctional empathic abilities on the behavioural and neural level.

These dysfunctions may precede the onset of illness; thus, it seems mandatory to examine the empathic abilities in individuals at clinical high risk for psychosis.

Using functional magnetic resonance imaging, we measured 15 individuals at clinical high risk of psychosis (CHR group) and compared their empathy performance with 15 healthy volunteers and 15 patients with schizophrenia.

Behavioural data analysis indicated no significant deficit in the CHR group. Functional data analysis revealed hyperactivation in a frontotemporoparietal network including the amygdala in the CHR group compared with the other two groups.

Despite normal behavioural performance, the CHR group activated the neural empathy network differently and specifically showed hyperactivation in regions critical for emotion processing. This could suggest a compensatory mechanism reflecting emotional hypersensitivity or dysfunctional emotion regulation. Further investigations should clarify the role of these neural alterations for development and exacerbation of psychosis.

It is unclear whether common affective disorders and anxiety disorders increase the risk of alcohol dependence and alcohol misuse.

To investigate whether affective disorders and anxiety disorders increase the risk of alcohol dependence and alcohol misuse.

This study is a retrospective cohort study based on data collected from the 2007 Australia Mental Health and Well-Being survey. Both Poisson and logistic regression models were used for multivariate analysis.

Participants with affective disorders (relative risk (RR) = 5.46, 95% CI 4.08–7.31 for alcohol dependence within 5 years of onset; RR = 2.77, 95% CI 1.93–3.99 after first 5 years) and anxiety disorders (RR = 3.33, 95% CI 2.37–4.68 for alcohol dependence within first 5 years of onset; RR = 3.56, 95% CI 2.72–4.64 after first 5 years) were at higher risk of alcohol misuse and alcohol dependence.

Common affective disorders and anxiety disorders may increase the risk of alcohol dependence and alcohol misuse among the Australian population.

In order to understand studies of psychiatric epidemiology focusing on the ‘genome’ and ‘envirome’, basic knowledge of the logic and methods is necessary.

To provide a review of typical methods used in genetic epidemiology.

Reviews of the research designs usually employed in quantitative and molecular genetic studies. Genotype-environment correlation and interaction are also discussed.

Quantitative genetic studies indicate that genetic influences are important for both psychiatric disorders and behavioural traits. Specific gene loci can be tested for associations with both psychiatric risk and behavioural traits by means of molecular genetic techniques. There has been little examination of genotype-environment correlation and interaction, although the few reports that have appeared suggest that these complex relationships are important.

Advances in quantitative and molecular genetics now permit more careful examination of genotype-environment interaction and correlation. Studies combining molecular genetic strategies with measurement of the environment are still at an early stage, however, and their results must be awaited.