To investigate the reasons behind difficulties in recruiting patients to randomized controlled trials (RCTs) in psychiatry and to examine a database of RCTs for differences between studies in mental health and other specialities.

A discussion of recent changes in research governance in the UK and Europe followed by an examination of the database of all trials supported by the Health Technology Assessment programme of the National Institute of Health Research in the UK between 1993 and 2007 to determine if three different measures, (i) time between grant approval and study start date, (ii) percentage of additional time given to extend recruitment and (iii) percentage of planned recruitment achieved, changed over the time period studied and differed between mental health, cancer and other medical disciplines.

Despite attempts in the UK to accelerate the process of clinical trials in recent years, there was a significant increase in the extension time for trials to be completed (p = 0.038) and the percentage of planned recruitment to mental health studies (71%) was significantly less than for cancer (90.3%) and other studies (86.1%) (p = 0.032).

These results suggest that, despite the priority afforded to the advancement of RCTs in healthcare, such studies are encountering increasing difficulty in recruiting to time and target. We suggest that this difficulty can be attributed, at least in part, to the excessively byzantine regulation and governance processes for health research in the UK, and unnecessary bureaucracy in the current National Health Service system. Mental health studies appear particularly vulnerable to delay and better systems to facilitate recruitment are required urgently for the evidence base to be improved and facilitate new cost-effective interventions.

To compare Child Behavior Checklist (CBCL) findings for a large Brazilian general population sample with those for US children considering: (a) mean problem item ratings; (b) fit of the US-derived CBCL 8-syndrome model; (c) scale internal consistency measured by Cronbach's alphas; (d) effects of society, age, gender on CBCL problem scores; and (e) ability to discriminate referred from non-referred children.

Parents of 1228 non-referred 6-to-11-year-olds from three different regions of Brazil and 247 referred 6-to-11-year-olds from one clinic rated their children's behavioural and emotional problems using the CBCL/6–18.

Results for mean item ratings and scale internal consistencies were very similar to those found in the US and in Uruguay. Confirmatory factor analysis indicated that Brazilian data showed the best fit to the US 8-syndrome model of all countries studied to date. Gender patterns were comparable to those reported in other societies, but mean problem scores for non-referred Brazilian children were higher than those for US children. Therefore, the CBCL discriminated less well between non-referred and referred children in Brazil than in the US.

Overall, our findings replicated those reported in international comparisons of CBCL scores for 31 societies, thereby providing support for the multicultural robustness of the CBCL in Brazil.

During the last two decades, the change from custodial care provided by large institutions to community-focused services made considerable progress in Germany. However, nothing is known about how this is reflected in the public's acceptance of community psychiatry services.

The study is based on data from two population surveys among German citizens aged 18 years and over, living in the ‘old’ German States. The first was conducted in 1990 (n = 3067), the second in 2011 (n = 2416). With the help of identical questions, respondents’ attitudes towards psychiatric units at general hospitals and group homes for mentally ill people were assessed.

While the proportion of the public that explicitly welcomed establishing psychiatric units at general hospitals and opening group homes for mentally ill people decreased, the proportion of those who reacted with indifference increased. The proportion of the German population that explicitly rejected the implementation of these services remained unchanged.

While community psychiatry services expanded considerably over the last few years, the public's attitude towards them has not changed substantially.

This study examined the associations of social support, loneliness and locus of control with depression and help-seeking in persons with major depression.

Twelve-month help-seeking for emotional problems was assessed in a cross-sectional 2006 Estonian Health Survey. Non-institutionalized individuals aged 18–84 years (n = 6105) were interviewed. A major depressive episode was assessed using the Mini-International Neuropsychiatric Interview. Factors describing social support, social and emotional loneliness and locus of control were assessed, and their associations with depression were analysed. The associations with reported help-seeking behaviour among people identified as having a major depressive episode (n = 343) were explored.

Low frequency of contacts with one's friends and parents, emotional loneliness, external locus of control and emotional dissatisfaction with couple relations were significant factors predicting depression in the multivariate model. External locus of control was associated with help-seeking in the depressed sample. Interactions of emotional loneliness, locus of control and frequency of contacts with parents significantly predicted help-seeking in the depressed sample.

Depression is associated with structural and functional factors of social support and locus of control. Help-seeking of depressed persons depends on locus of control, interactions of emotional loneliness, locus of control and contacts with the parental family.

To determine the prevalence of women of childbearing age with schizophrenia and bipolar disorder exposed to antipsychotic (AP) drugs and mood stabilizers (MS) in Lombardy, a European region of 10 million inhabitants and 1 752 285 women of childbearing age.

The data concerning psychiatric care, drug treatments and pregnancy outcomes were retrieved from local administrative databases during a 12-month census period.

During a 12-month census period, 2893 women of childbearing age with schizophrenia (74.8% of all women of childbearing age with schizophrenia) and 918 with bipolar disorder (80.1% of all women of childbearing age with bipolar disorder) were exposed to AP drugs or MS, yielding a prevalence of exposure for women with schizophrenia of 1.65 (95% confidence interval (CI) 1.59–1.71) per 1000 female inhabitants, and for women with bipolar disorder of 0.52 (95% CI 0.49–0.55) per 1000 female inhabitants. Persistent exposure to potentially teratogenic medications accounted for one in every 1000 women of childbearing age. Of the 57 pregnancies in women with schizophrenia, normal delivery was recorded in 23 (40%) cases; of the 26 pregnancies in women with bipolar disorder, normal delivery was recorded in 10 (38%) cases.

In women of childbearing age with severe mental disorders, exposure to psychotropic drugs is substantial, which suggests that the issue of reproductive health is epidemiologically relevant and a major public health concern.