Although there are consistent reports of higher psychosis rates among immigrants, the information on mood disorders is limited.

To review and quantify the difference in incidence of mood disorders in first- and second-generation immigrant (FGI and SGI) groups v. non-immigrants.

PubMed, EMBASE and PsycINFO were searched for articles from cohort studies reporting incidence of mood disorders among FGIs and SGIs.

Eighteen studies met our inclusion criteria. The summary relative risk (RR) for FGIs was 1.25 (95% CI 1.11–1.41), based on 17 effect sizes and 6120 cases, and 1.16 (95% CI 0.96–1.40) for SGIs based on three effect sizes. Men seemed at higher risk (RR = 1.29, 95% CI 1.06–1.56).

Clinicians should view FGIs as a group at risk of mood disorders, especially men. Further research is needed to understand immigrants' risk, especially in SGI.

Childhood maltreatment has been discussed as a risk factor for the development and maintenance of depression.

To examine the relationship between childhood maltreatment and adult depression with regard to depression incidence, severity, age at onset, course of illness and treatment response.

We conducted meta-analyses of original articles reporting an association between childhood maltreatment and depression outcomes in adult populations.

In total, 184 studies met inclusion criteria. Nearly half of patients with depression reported a history of childhood maltreatment. Maltreated individuals were 2.66 (95% CI 2.38–2.98) to 3.73 (95% CI 2.88–4.83) times more likely to develop depression in adulthood, had an earlier depression onset and were twice as likely to develop chronic or treatment-resistant depression. Depression severity was most prominently linked to childhood emotional maltreatment.

Childhood maltreatment, especially emotional abuse and neglect, represents a risk factor for severe, early-onset, treatment-resistant depression with a chronic course.

Maternal anxiety negatively influences child outcomes. Reliable estimates have not been established because of varying published prevalence rates.

To establish summary estimates for the prevalence of maternal anxiety in the antenatal and postnatal periods.

We searched multiple databases including MEDLINE, Embase, and PsycINFO to identify studies published up to January 2016 with data on the prevalence of antenatal or postnatal anxiety. Data were extracted from published reports and any missing information was requested from investigators. Estimates were pooled using random-effects meta-analyses.

We reviewed 23 468 abstracts, retrieved 783 articles and included 102 studies incorporating 221 974 women from 34 countries. The prevalence for self-reported anxiety symptoms was 18.2% (95% CI 13.6–22.8) in the first trimester, 19.1% (95% CI 15.9–22.4) in the second trimester and 24.6% (95% CI 21.2–28.0) in the third trimester. The overall prevalence for a clinical diagnosis of any anxiety disorder was 15.2% (95% CI 9.0–21.4) and 4.1% (95% CI 1.9–6.2) for a generalised anxiety disorder. Postnatally, the prevalence for anxiety symptoms overall at 1–24 weeks was 15.0% (95% CI 13.7–16.4). The prevalence for any anxiety disorder over the same period was 9.9% (95% CI 6.1–13.8), and 5.7% (95% CI 2.3–9.2) for a generalised anxiety disorder. Rates were higher in low- to middle-income countries.

Results suggest perinatal anxiety is highly prevalent and merits clinical attention. Research is warranted to develop evidence-based interventions.

Many patients with depressive disorders demonstrate resistance to psychological therapy. A frequent finding is hypothalamic–pituitary–adrenal (HPA) axis alterations. As cortisol is known to modulate cognitive processes, those patients may be less likely to profit from psychological therapy.

To conduct a systematic review and meta-analysis on cortisol as a predictor of psychological therapy response.

The Cochrane Library, EMBASE, MEDLINE and PsycINFO databases were searched. Records were included if they looked at patients with any depressive disorder engaging in psychological therapy, with a pre-treatment cortisol and a post-treatment symptom measure.

Eight articles satisfied our selection criteria. The higher the cortisol levels before starting psychological therapy, the more symptoms patients with depression experienced at the end of treatment and/or the smaller their symptom change.

Our findings suggest that patients with depression with elevated HPA functioning are less responsive to psychological therapy.

The majority of survivors of mass violence live in low- and middle-income countries (LMICs).

To synthesise empirical findings for psychological interventions for children and adolescents with post-traumatic stress disorder (PTSD) and/or depression in LMICs affected by mass violence.

Randomised controlled trials with children and adolescents with symptoms of PTSD and/or depression in LMICs were identified. Overall, 21812 records were found through July 2016 in the Medline, PsycINFO and PILOTS databases; 21 met the inclusion criteria and were reviewed according to recommended guidelines.

Twenty-one studies were included. Active treatments for PTSD yielded large pre-treatment to post-treatment changes (g = 1.15) and a medium controlled effect size (g = 0.57). Effect sizes were similar at follow-up. Active treatments for depression produced small to medium effect sizes. Finally, after adjustment for publication bias, the imputed uncontrolled and controlled effect sizes for PTSD were medium and small respectively.

Psychological interventions may be effective in treating paediatric PTSD in LMICs. It appears that more targeted approaches are needed for depressive responses.

Since bipolar disorder seems to be associated with purinergic system dysfunction, allopurinol might be effective in treating symptoms of mania.

To estimate the efficacy and tolerability of allopurinol as adjunctive treatment for mania symptoms in people with bipolar affective disorder.

We conducted a systematic review and meta-analysis of randomised controlled trials (RCTs) comparing the effects of adjunctive allopurinol and placebo on mania symptom changes.

Five RCTs were included in the meta-analysis. Participants with allopurinol augmentation had a significantly greater decrease in mania symptoms than those with placebo (SMD= −0.34, P = 0.007), especially in people with the most severe forms of mania. Remission rates, although based on only two studies (n = 177), were significantly higher among individuals receiving allopurinol, whereas for discontinuation and side-effects no difference was found.

Our finding of a small to moderate effect size and overall low evidence for add-on allopurinol in reducing mania symptoms indicate that its use in routine practice needs further elucidation.

The influence of baseline severity has been examined for antidepressant medications but has not been studied properly for cognitive–behavioural therapy (CBT) in comparison with pill placebo.

To synthesise evidence regarding the influence of initial severity on efficacy of CBT from all randomised controlled trials (RCTs) in which CBT, in face-to-face individual or group format, was compared with pill-placebo control in adults with major depression.

A systematic review and an individual-participant data meta-analysis using mixed models that included trial effects as random effects. We used multiple imputation to handle missing data.

We identified five RCTs, and we were given access to individual-level data (n = 509) for all five. The analyses revealed that the difference in changes in Hamilton Rating Scale for Depression between CBT and pill placebo was not influenced by baseline severity (interaction P = 0.43). Removing the non-significant interaction term from the model, the difference between CBT and pill placebo was a standardised mean difference of –0.22 (95% CI –0.42 to –0.02, P = 0.03, I 2 = 0%).

Patients suffering from major depression can expect as much benefit from CBT across the wide range of baseline severity. This finding can help inform individualised treatment decisions by patients and their clinicians.

Negative symptoms observed in patients with psychotic disorders undermine quality of life and functioning. Antipsychotic medications have a limited impact. Psychological and psychosocial interventions, with medication, are recommended. However, evidence for the effectiveness of specific non-biological interventions warrants detailed examination.

To conduct a meta-analytic and systematic review of the literature on the effectiveness of non-biological treatments for negative symptoms in psychotic disorders.

We searched for randomised controlled studies of psychological and psychosocial interventions in psychotic disorders that reported outcome on negative symptoms. Standardised mean differences (SMDs) in values of negative symptoms at the end of treatment were calculated across study domains as the main outcome measure.

A total of 95 studies met our criteria and 72 had complete quantitative data. Compared with treatment as usual cognitive–behavioural therapy (pooled SMD −0.34, 95% CI −0.55 to −0.12), skills-based training (pooled SMD −0.44, 95% CI −0.77 to −0.10), exercise (pooled SMD −0.36, 95% CI −0.71 to −0.01), and music treatments (pooled SMD −0.58, 95% CI −0.82 to −0.33) provide significant benefit. Integrated treatment models are effective for early psychosis (SMD −0.38, 95% CI −0.53 to −0.22) as long as the patients remain in treatment. Overall quality of evidence was moderate with a high level of heterogeneity.

Specific psychological and psychosocial interventions have utility in ameliorating negative symptoms in psychosis and should be included in the treatment of negative symptoms. However, more effective treatments for negative symptoms need to be developed.

Nutrition interventions would appear fundamental for weight management and cardiometabolic risk reduction in people experiencing severe mental illness (SMI). Comprehensive evaluation of nutrition interventions is lacking.

To subject randomised controlled trials of nutrition interventions in people with SMI to systematic review and meta-analysis, and to measure anthropometric and biochemical parameters and nutritional intake.

An electronic database search identified trials with nutrition intervention components. Trials were pooled for meta-analysis. Meta-regression analyses were performed on anthropometric moderators.

Interventions led to significant weight loss (19 studies), reduced body mass index (17 studies), decreased waist circumference (10 studies) and lower blood glucose levels (5 studies). Dietitian-led interventions (6 studies) and studies delivered at antipsychotic initiation (4 studies) had larger effect sizes.

Evidence supports nutrition interventions as standard care in preventing and treating weight gain among people experiencing SMI.

Screening for depression in older adults is recommended.

To evaluate the diagnostic accuracy of the Two-Question Screen for older adults and compare it with other screening instruments for depression.

We undertook a literature search for studies assessing the diagnostic performance of depression screening instruments in older adults. Combined diagnostic accuracy including sensitivity and specificity were the primary outcomes. Potential risks of bias and the quality of studies were also assessed.

A total of 46506 participants from 132 studies were identified evaluating 16 screening instruments. The majority of studies (63/132) used various versions of the Geriatric Depression Scale (GDS) and 6 used the Two-Question Screen. The combined sensitivity and specificity for the Two-Question Screen were 91.8% (95% CI 85.2–95.6) and 67.7% (95% CI 58.1–76.0), respectively; the diagnostic performance area under the curve (AUC) was 90%. The Two-Question Screen showed comparable performance with other instruments, including clinician-rated scales. The One-Question Screen showed the lowest diagnostic performance with an AUC of 78%. In subgroup analysis, the Two-Question Screen also had good diagnostic performance in screening for major depressive disorder.

The Two-Question Screen is a simple and short instrument for depression screening. Its diagnostic performance is comparable with other instruments and, therefore, it would be favourable to use it for older adult screening programmes.

Few trials have compared psychosocial therapies for people with bipolar affective disorder, and conventional meta-analyses provided limited comparisons between therapies.

To combine evidence for the efficacy of psychosocial interventions used as adjunctive treatment of bipolar disorder in adults, using network meta-analysis (NMA).

Systematic review identified studies and NMA was used to pool data on relapse to mania or depression, medication adherence, and symptom scales for mania, depression and Global Assessment of Functioning (GAF).

Carer-focused interventions significantly reduced the risk of depressive or manic relapse. Psychoeducation alone and in combination with cognitive–behavioural therapy (CBT) significantly reduced medication non-adherence. Psychoeducation plus CBT significantly reduced manic symptoms and increased GAF. No intervention was associated with a significant reduction in depression symptom scale scores.

Only interventions for family members affected relapse rates. Psychoeducation plus CBT reduced medication non-adherence, improved mania symptoms and GAF. Novel methods for addressing depressive symptoms are required.

Clinical trials have examined the efficacy of drugs to prevent relapse in patients with bipolar disorder, however, their design often limits generalisation to routine clinical practice.

To estimate the effectiveness of drugs used for maintenance treatment in bipolar disorder.

We used national registers to identify 35022 individuals diagnosed with bipolar disorder and information on lithium, valproate, carbamazepine, lamotrigine, quetiapine and olanzapine treatment from 2006 to 2009. The main outcome was psychiatric hospital admissions. We used stratified cox regression to compare periods on and off medication within the same individual.

Medication with lithium, valproate, lamotrigine, olanzapine and quetiapine was associated with reduced rates of admission to hospital. Lithium was more effective than quetiapine and olanzapine. The effects of specific drugs depended on the polarity of the mood episode.

Our findings complement results from randomised controlled trails, but suggest that lithium is more effective than both quetiapine and olanzapine in routine clinical practice.