According to the World Health Organization, 450 million people in the world currently suffer from some form of mental or brain disorder, including alcohol and substance misuse. Within this huge number, 121 million people suffer from depression, and more than 800 000 people die by suicide each year, with young people accounting for well over half of these. Projections from 1990 to 2020 suggest that, in future, the proportion of the global burden of all disease accounted for by mental and brain disorders will increase to 15%.

Trauma can have both acute and insidious effects upon children's mental health. We present four articles, each of which offers a new perspective on this important topic. As Daniel Pine points out, in the first paper, as many as one in five children in the developed world can expect to experience a truly traumatic event, while half those in developing countries may do so. Such experiences can be either personal – such as emotional or sexual abuse – or impersonal – being shot or blown up in a conflict of which one understands little, except the misery it brings. How do children cope? We know that there are at least two important influences that moderate the impact of trauma on the developing child: the persistence and severity of the experience, and the degree of social support available. Beyond these broad generalisations, little is understood about what should be done or what could be done to minimise the long-term consequences of growing up in an environment characterised by cruelty, exploitation and death.

Interest concerning the effects of trauma on the mental health of children has grown markedly during the past few years. At least three factors contribute to this growing concern.

Children exposed to violence are at high risk of developing a range of mental health problems, predominantly post-traumatic stress disorder (PTSD) and depression (Yule, 1999). Children in war zones can be affected not only directly but also indirectly, for example through their basic health needs not being met, the loss of family members, disruption of social networks, internal displacement and their parents’ responses.

Unfortunately, terrorism, violence and other acute adverse life events have become a world-wide problem. There is no country today that is protected from these phenomena and people can no longer feel safe anywhere. This new situation has increased both the scientific interest in post-traumatic stress disorder (PTSD) and the amount of research conducted on this issue.

The international community has been slow to appreciate the growing problem of the participation of armed children and youths in non-political disputes, encountered in both developed and developing countries, from Haiti to Northern Ireland. While there is widespread recognition of the issue of ‘child soldiers’ (e.g. www.childsoldiers.org/) there are also many children who participate in organised armed groups that function outside traditionally defined war zones. Nowhere is this issue more acute than in Rio de Janeiro, Brazil. There may be more people (and specifically children) dying from small-arms fire in Rio de Janeiro than in many armed conflicts elsewhere. Most are bound up in the relentless conflicts involving factions of drugs traffickers fighting within and between Rio's favelas, or shanty towns, and their burgeoning drugs trade.

How many members of the College know about the state of psychiatry in Nigeria or Egypt? Perhaps just a few. How many would be interested in knowing more? Perhaps many. The country profiles section of International Psychiatry attempts to narrow this information-and-awareness gap.

Nigeria is a huge country. It covers an area of 924 000 km2 on the west coast of Africa. It has a population of about 110 million, which means that every one in six Africans is a Nigerian. It is a country of diverse ethnicity, with over 200 spoken languages, even though three of those are spoken by about 60% of the population. Administratively, it is divided into 36 states and operates a federal system of government, with constitutional responsibilities allocated to the various tiers of government – central, state and local. There are two main religions, Islam (predominantly in the north) and Christianity (predominantly in the south). However, a large proportion of the people still practise traditional religions exclusively or in addition to either Islam or Christianity.

For over a thousand years, the Hippocratic system of medicine prevailed in Europe. It went into oblivion during the Dark Ages, when there was a reversion to the demoniacal theories of mental illness. Hippocrates’ works survived, however, in the library at Alexandria, where they were translated into Arabic. These and other classical works were retranslated into Latin and Greek from the 12th century on, ushering in the Renaissance.

Italian psychiatry is probably more debated than known in the international arena. Law 180 of 1978, which introduced a radical community psychiatry system, has drawn worldwide attention and debate, with comments ranging from the enthusiastic to the frankly disparaging (Mosher, 1982; Jones et al, 1991). More recently, this interest was marked by a well-attended symposium ‘Lessons Learned from Italian Reforms in Psychiatry’ held at the 2003 annual meeting of the Royal College of Psychiatrists in Edinburgh.

According to the most recent data provided by the World Health Organization (2001), there are presently in Europe more than 77 000 psychiatrists, more than 46 000 clinical psychologists active in the mental health field, more than 285 000 psychiatric nurses, and more than 91 000 social workers operating in the mental health sector. Are these professionals being adequately updated on recent clinical and service developments in mental health? What is the role of international channels (in particular, those of international professional associations) in this process? These are difficult questions to answer, in the absence of a European systematic survey (which, of course, would be a very worthwhile initiative). I try, however, to provide here a framework for a discussion of these issues, as a background to the presentation of the programme of itinerant educational courses run by the Association of European Psychiatrists (AEP).