The cover of this issue heralds a series of articles in which a visual image derived from cell biology or neuroscience is used to promote understanding of the biological mechanisms fundamental to psychiatry. ‘Images in neuroscience’ are intended to demonstrate the structures and mechanisms of the basic building blocks of brain function, including ionotropic and metabotropic receptors, second messenger systems, specialised ion channels, transmitter pathways, transporters, neuroglial function, and the complex mechanisms within cells that are being revealed, as new genetic associations for mental illness are discovered.

Remission is a new research outcome indicating long-term wellness. Remission not only sets a standard for minimal severity of symptoms and signs (resolution); it also sets a standard for how long symptoms and signs need to remain at this minimal level (6 months). Individuals who achieve remission from schizophrenia have better subjective well-being and better functional outcomes than those who do not. Research suggests that remission can be achieved in 20–60% of people with schizophrenia. There is some evidence of the usefulness of remission as an outcome indicator for clinicians, service users and their carers. This article reviews the literature on remission in schizophrenia and asks whether it could be a useful clinical standard of well-being and a foundation for functional improvement and recovery.

Attention-deficit hyperactivity disorder (ADHD) is an established diagnosis in children but there is a lack of agreement about its validity as a distinct entity in adults. Literature suggests that between one-third and two-thirds of children diagnosed with ADHD continue to manifest symptoms into adulthood. An adult diagnosis should be done on the basis of a thorough assessment, structured and semi-structured clinical interview, and with a complete understanding of the symptoms that manifest in adults. This may be supplemented by the use of rating scales. We present a review of the literature covering aetiology, clinical presentations, diagnostic evaluation and management of ADHD in adults.

The humane treatment of prisoners has long been considered a mark of a civilised society. Early prison reformers such as Elizabeth Fry and John Howard campaigned vigorously for the improvement of conditions for inmates and for institutions to be focused as much on reform and rehabilitation as on punishment. This progressive improvement in conditions for those imprisoned has been further advanced by the European Convention on Human Rights and its incorporation into UK law. The Human Rights Act 1998 is playing an ever-increasing role in determining the standards of treatment of those detained by the state. Article 3 of the Act – freedom from torture and inhuman and degrading treatment – is of particular importance for those detained in prisons, hospitals and other institutions. As Article 3 case law has evolved, so its interpretation has broadened to include a thorough scrutiny of prison conditions, prison healthcare and the treatment of prisoners in general.

A significant number of people who come into contact with the police have a mental disorder. Attending the police station to assess detainees forms a significant part of most psychiatrists' work. The role of the psychiatrist includes assessing for the presence of mental disorder, advising on diversion from custody and assessing detainees' fitness to be interviewed. This article, based on data primarily from the UK, looks at issues involved for psychiatrists attending police stations, including pathways to care, epidemiology, assessment of detainees under the Mental Health Act 1983, fitness of detainees to be interviewed and aspects of training.

Immigration is increasing and government policies are shifting. Clinicians need to be aware of the mental health needs of immigrants and the challenges of delivering appropriate care. In certain circumstances there are potential conflicts between doctors' clinical, ethical and legal responsibilities. Detention of refugees and asylum seekers may have a detrimental effect on mental health and can result in significant psychiatric morbidity. Ongoing management of foreign nationals following hospital treatment may be complicated by the threat of deportation and its implications for the patient's mental health.

The internet abounds with promises of ‘miracle cures’ for autism and within the published research literature there are numerous claims and counter-claims for the effectiveness of specific therapies. Systematic evaluations, however, indicate that few treatment programmes have a sound evidence base, and even those interventions that do produce positive findings are not successful for all children. To date, the best researched programmes are those involving intensive, early, home-based intervention, and those with a focus on communication and parent–child interaction. This article assesses the evidence base for some of the better evaluated therapies. There is, as yet, no evidence that any one programme is superior to all others. Indeed, large individual differences in response to intervention suggest that the focus of research now needs to shift to the study of which components of therapy work best for which children and under which conditions.

Most children and young people who have a parent with mental illness will not think of themselves as carers. They may think of themselves as surviving, as lonely and isolated, and of suffering all the common experiences listed in this article. Many parents with mental illness will not acknowledge that their child has become their carer rather than the converse. So many children and young people may be left vulnerable to sometimes extremely damaging and distressing situations but without a role that recognises their contribution or even commands appropriate respect. There is a danger that simply defining these children and young people as ‘young carers’ may provide a cloak of acceptability for allowing quite intolerable demands to be made on them. However, young carers do have some level of support in the UK in the form of young carers' groups. So, with the above provisos, that is the focus of this article.

Bipolar disorder is a complex disorder of mood and behaviour that requires a multimodal treatment approach. In the past 10 years there has been growing interest in psychoeducational interventions delivered as adjuncts to conventional management. Several studies have tested the effectiveness of psychoeducational treatments delivered in a variety of formats. In this article we assess the evidence for the efficacy of these interventions and consider the likely future role of structured psychoeducational treatments in clinical practice.