There has been evidence that psychopathology in schizophrenia consists of three separable syndromes: reality distortion, disorganisation, and psychomotor poverty. The objective of this study was to explore the relationship between planning and execution of movement and each of the syndromes in schizophrenia.

Twenty-one right handed DSM–III–R schizophrenic patients performed a total of 80 trials of a motor movement task, varying distance of movement × size of the target × hand. Times taken to plan the movement (RT) and to carry it out (MT) were examined for their relationship with contemporaneous as well as lifetime profiles of the three syndromes in schizophrenia.

Significant correlations are reported between RT and current as well as lifetime measures of disorganisation syndrome. Somewhat weaker correlations are reported between RT and psychomotor poverty, but only for the right-handed tasks. Partial correlations suggest that the influence of neuroleptic medication explains all but one of the correlations between psychomotor poverty and RT, but does not account for the relationship between disorganisation and RT. No other relationship emerged between any of the movement and symptom measures.

These findings indicate that dysfunction in movement planning is related primarily to concurrent disorganisation, as well as to the prominence of disorganisation over the patient's history.

The increasing complexity of psychiatric research, including recent attempts to evaluate mental health legislation, suggests legal advice may be valuable in a wide range of research contexts.

We aim to illustrate both the legal pitfalls of research in psychiatry and the potential for solutions if the methods are carefully chosen.

Two examples of research are subject to legal analysis, one involving advance directives, the other the random discharge of compulsory out-patients.

This analysis illustrates that participation in research may expose clinicians to additional forms of liability, but the legal risks can be minimised through changes in the methods or additional safeguards.

Collaboration between academic law and psychiatry can enrich research agendas and avoid serious legal pitfalls. We argue that sound legal advice should be sought at the planning stage of research in psychiatry, but the fear of liability should not lead to overly defensive research practices. The aim should be to strike the right balance between avoiding unacceptable exposure to liability and stifling innovative research.

A reduction in suicide in England and Wales has been reported after the attacks of 11 September 2001 in the USA. It may be plausible therefore to expect a much greater impact on suicide in the UK in response to the events of 7 July 2005, caused by the first suicide terrorist attack by Islamic extremists on British soil.

To examine the effect of the 7 July 2005 terrorist attacks in London on suicide rates in England and Wales.

Analysis of number of suicide (ICD–10 codes X60–X84) and undetermined injury deaths (ICD–10 codes Y10–Y34) reported in England and Wales in the 12 weeks before and after 7 July 2005. We used Shewhart Control Charts based on Poisson rates to explore adjusted daily and weekly suicide rates and rate differences with respect to 7 July 2005.

A brief but significant reduction in daily suicide rate was observed a few days after the terrorist attack in London on 7 July 2005. Further reduction was also observed on the 21 July 2005, coinciding with the second wave of attacks. No similar reduction in suicide was seen during the same period in the previous 4 years. Poisson regression models with indicator variables for each day in July 2005 revealed a reduction of 40% of the expected daily rate for these 2 days only. We found no evidence of any longer-term effect on suicide.

The study findings are contrary to our expectation and only weakly support Durkheim's theory that periods of national threat lower the suicide rate through the impact on social cohesion. It is possible that previous experience of IRA terrorism in the UK may have limited the effect of the 7 July 2005 attacks on suicide in England and Wales. The shock value of suicide terrorism and its psychological potency appear to diminish over time as the tactic becomes overused.

Research on the effectiveness of pharmacotherapies for schizophrenia and comorbid substance use disorder (SUD) is very sparse, and non-existent on the prevention of the development of SUDs in patients with schizophrenia.

To compare the real-world effectiveness of antipsychotics in schizophrenia in decreasing risk of developing an initial SUD, and psychiatric hospital admission and SUD-related hospital admission among patients with an SUD.

Two independent national cohorts including all persons diagnosed with schizophrenia (N = 45 476) were followed up for 22 (Finland: 1996–2017) and 11 (Sweden: 2006–2016) years. Risk of developing an SUD was calculated with between-individual models, and risks of psychiatric and SUD-related hospital admission were calculated with within-individual models, using Cox regression and adjusted hazard ratios (aHRs) for using versus not using certain antipsychotics.

For patients with schizophrenia without an SUD, clozapine use (Finland: aHR 0.20, 95% CI 0.16–0.24, P < 0.001; Sweden: aHR 0.35, 95% CI 0.24–0.50, P < 0.001) was associated with lowest risk of developing an initial SUD in both countries. Antipsychotic polytherapy was associated with second lowest risk (aHR 0.54, 95% CI 0.44–0.66) in Sweden, and third lowest risk (aHR 0.47, 95% CI 0.42–0.53) in Finland. Risk of relapse (psychiatric hospital admission and SUD-related hospital admission) were lowest for clozapine, antipsychotic polytherapy and long-acting injectables in both countries. Results were consistent across both countries.

Clozapine and antipsychotic polytherapy are most strongly associated with reduced risk of developing SUDs among patients with schizophrenia, and with lower relapse rates among patients with both diagnoses.