Self-harm (intentional self-poisoning or self-injury) is common, often repeated, and strongly associated with suicide. This is an update of a broader Cochrane review on psychosocial and pharmacological treatments for self-harm, first published in 1998 and previously updated in 1999. We have now divided the review into three separate reviews. This review is focused on pharmacological interventions in adults who self-harm.

This is an updated version of a Cochrane review first published in Issue 3, 2006 (Perry 2006). The review represents one in a family of four reviews focusing on the effectiveness of interventions in reducing drug use and criminal activity for offenders. This specific review considers interventions for female drug-using offenders.

Approximately 25% of people will be affected by a mental disorder at some stage in their life. Despite the prevalence and negative impacts of mental disorders, many people are not diagnosed or do not receive adequate treatment. Therefore primary healthcare has been identified as essential to improving the delivery of mental healthcare. Consultation liaison is a model of mental healthcare where the primary care provider maintains the central role in the delivery of mental healthcare, with a mental health specialist providing consultative support. Consultation liaison has the potential to enhance the delivery of mental healthcare in the primary care setting and, in turn, improve outcomes for people with a mental disorder.

Young children with autism spectrum disorders (ASD) have impairments in the areas of communication and social interaction and often display repetitive or non-compliant behaviour. This early pattern of difficulties is a challenge for parents. Therefore, approaches that help parents develop strategies for interaction and management of behaviour are an obvious route for early intervention in ASD. This review updates a Cochrane review first published in 2002 but is based on a new protocol.

Self-harm (SH; intentional self-poisoning or self-injury) is common in children and adolescents, often repeated, and strongly associated with suicide. This is an update of a broader Cochrane review on psychosocial and pharmacological treatments for SH published in 1998 and updated in 1999. We have now divided the review into three separate reviews; this review is focused on psychosocial and pharmacological interventions for SH in children and adolescents.

Considering the ample evidence of involvement of the glutamate system in the pathophysiology of depression, pre-clinical and clinical studies have been conducted to assess the antidepressant efficacy of glutamate inhibition, and glutamate receptor modulators in particular. This review focuses on the use of glutamate receptor modulators in unipolar depression.

Self-harm is a significant social and healthcare problem, with substantial morbidity and healthcare costs. It has strong links to further self-harm and to suicide. The current review is one of three that investigate interventions in preventing recurrence of self-harm, and it focuses on pharmacological treatment. The conclusions are limited by the small number and size of trials identified, and the low quality of evidence. No benefit on recurrence of self-harm was detected in three small trials of antidepressants, but the types studied are ones that are now less commonly used. A small trial of flupentixol suggested a possible benefit on repetition, but this has not been replicated. One small trial of lithium showed no benefit, but this was in contrast to a recent large meta-analysis showing a significant anti-suicidal effect of lithium when used to treat mood disorder. The review highlights important areas for further research.

Rates of detected autism spectrum disorder (ASD) are currently rising, and there is a need for effective treatments to manage the symptoms. In this commentary I outline the challenges that autism presents to service delivery and consider a Cochrane review that evaluates one of the best-known classes of treatment for ASD, parent-mediated early intervention. I discuss effect size and bias in the interpretation of the review's results, and consider also the rationale for low- and high-intensity intervention at both the individual level and, from a public health perspective, at population level.

‘Collaborative care’ (involving a case manager) and ‘primary care liaison’ or ‘consultation liaison’ (with no case manager) are models of liaison psychiatry in primary care. Here, I briefly consider the evidence for collaborative care, discuss Gillies et al 's Cochrane review on consultation liaison, and suggest avenues for future study and development of liaison psychiatry in primary care.

Female drug-using offenders are a large but under-researched and vulnerable population with specific needs. Only a handful of randomised controlled trials of interventions for this population are of sufficient quality to shed light on what might work to reduce their criminal activity and drug use, and interpretation of the results of most of these trials is limited by an ‘unclear’ risk of bias due to a lack of descriptive information. Better-quality research is needed to inform practitioners and policy makers. In the meantime, this month's Cochrane Corner review provides cautious support for the use of some psychosocial treatments, particularly if delivered in a gender-responsive way addressing issues of abuse and victimisation, in the expectation that re-imprisonment can be prevented, even if there is no proven effect on re-arrest rates and only uncertain effects on substance use.

As in adults, self-harm in children and young people is common. It results in much distress to families and carers, and considerable morbidity among children and young people. Although much more common than completed suicide, it is strongly linked to repeated self-harm and suicide. The conclusions in this review are limited by the small number of studies included, no studies of pharmacological interventions at all and most of the included interventions being evaluated in a single study. One moderately sized study of mentalisation in adolescents with comorbid depression showed a significant effect on scores on a self-harm measure, indicating fewer self-reported episodes of self-harm. No other intervention showed a significant reduction in reported self-harm, although trials may have been too small to show statistical significance.

There is emerging evidence that glutamatergic system dysfunction might play an important role in the pathophysiology of bipolar depression. This review focuses on the use of glutamate receptor modulators for depression in bipolar disorder.

Psychiatric assessments on medical wards of a general hospital are complicated by various factors, including the lack of privacy, medical illness-related factors such as cognitive deficits and communication barriers, and the vagueness of the referral question asked. In this article, we try to guide general psychiatrists who do not routinely carry out such assessments through practical steps from receiving the referral to signing off the case. The key differences in the process and content of psychiatric assessments are discussed, as are diagnostic dilemmas. Subtle aspects of communicating the outcome of the assessments to patients and referrers are emphasised with specific guidance on writing consultation notes. We conclude with a discussion of the principles of biopsychosocial management and judging the outcomes of consultations on medical wards.

This article examines the clinical, epidemiological and nosological aspects of short-lived psychotic disorders as currently classified under ‘acute and transient psychotic disorders' in ICD-10 and ‘brief psychotic disorder’ in DSM-5. After describing earlier diagnostic concepts such as bouffée délirante, cycloid psychosis, reactive psychosis and schizophreniform psychosis, we present an overview of the literature and discuss implications for classification, diagnosis and treatment of these conditions, pointing out differences from longer-lasting psychotic disorders.