Some problems of prognosis in patients with head injury are reviewed, and a case of late and unexpected recovery from post-traumatic dementia presented. The possible mechanism of recovery is discussed with particular reference to normal pressure hydrocephalus.

This study aimed to systematically review and synthesise the available evidence on the prevalence and associations between psychotic-like experiences (PLEs) and substance use in children and adolescents aged ⩽17 years, prior to the typical age of development of prodromal symptoms of psychosis. As substance use has been associated with earlier age of psychosis onset and more severe illness, identifying risk processes in the premorbid phase of the illness may offer opportunities to prevent the development of prodromal symptoms and psychotic illness. MEDLINE, PsycINFO, and CINAHL databases were searched for chart review, case-control, cohort, twin, and cross-sectional studies. Study reporting was assessed using the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklist, and pooled evidence was evaluated using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. Searches identified 55 studies that met inclusion criteria. Around two-in-five substance users reported PLEs [rate = 0.41, 95% confidence interval (CI) 0.32–0.51; low quality evidence], and one-in-five with PLEs reported using substances (rate = 0.19, 95% CI 0.12–0.28; moderate-to-high quality evidence). Substance users were nearly twice as likely to report PLEs than non-users [odds ratio (OR) 1.77, 95% CI 1.55–2.02; moderate quality evidence], and those with PLEs were twice as likely to use substances than those not reporting PLEs (OR 1.93, 95% CI 1.55–2.41; very low quality evidence). Younger age was associated with greater odds of PLEs in substance users compared to non-users. Young substance users may represent a subclinical at-risk group for psychosis. Developing early detection and intervention for both substance use and PLEs may reduce long-term adverse outcomes.

Recent technological advances enable the collection of intensive longitudinal data. This scoping review aimed to provide an overview of methods for collecting intensive time series data in mental health research as well as basic principles, current applications, target constructs, and statistical methods for this type of data.

In January 2021, the database MEDLINE was searched. Original articles were identified that (1) used active or passive data collection methods to gather intensive longitudinal data in daily life, (2) had a minimum sample size of N ⩾ 100 participants, and (3) included individuals with subclinical or clinical mental health problems.

In total, 3799 original articles were identified, of which 174 met inclusion criteria. The most widely used methods were diary techniques (e.g. Experience Sampling Methodology), various types of sensors (e.g. accelerometer), and app usage data. Target constructs included affect, various symptom domains, cognitive processes, sleep, dysfunctional behaviour, physical activity, and social media use. There was strong evidence on feasibility of, and high compliance with, active and passive data collection methods in diverse clinical settings and groups. Study designs, sampling schedules, and measures varied considerably across studies, limiting the generalisability of findings.

Gathering intensive longitudinal data has significant potential to advance mental health research. However, more methodological research is required to establish and meet critical quality standards in this rapidly evolving field. Advanced approaches such as digital phenotyping, ecological momentary interventions, and machine-learning methods will be required to efficiently use intensive longitudinal data and deliver personalised digital interventions and services for improving public mental health.

Background. Little is known about the correspondence between persistent self-reported disaster-related psychological problems and these problems reported by general practitioners (GPs). The aim of this study is to analyse this correspondence and to identify the factors associated with GPs' detection of persistent psychological problems.

Method. This study was conducted in a sample of 879 adult disaster-affected victims, taken from two longitudinal sources: the Enschede Firework Disaster Study and the GP-Monitor Study. Participants filled out a questionnaire 2–3 weeks and 18 months post-disaster and these data were combined with data from a GP-monitor collected up to 18 months post-disaster. The correspondence between persistent self-reported and GP-reported psychological problems was analysed with cross-tabulations. Logistic regression analyses were performed to identify variables which predicted GPs' detection of psychological problems.

Results. The correspondence rate among victims who visited their GP 18 months post-disaster was 60·4% for persistent intrusions and avoidance reactions, 72·6% for persistent general psychological distress and less than 20% for persistent depression and anxiety symptoms or sleep disturbances. Characteristics that predict GPs' identification of post-traumatic reactions or psychological distress were the level of self-reported post-traumatic symptoms/mental health, the number of contacts the victims had with their GP and the level of the victims' disaster-related experiences.

Conclusions. In general, there is a considerable correspondence between GP-reported and persistent self-reported incidences of post-traumatic stress and general psychological distress in disaster-affected victims. However, the correspondence declines in the case of more specific psychological symptoms.

Three videotapes of diagnostic interviews were rated by psychiatrists at several different centres in the British Isles. Audiences were asked to use a number of rating schedules including a list of 116 technical psychiatric terms. They were also asked to make a provisional diagnosis. The influence of the psychiatrists' concepts of normality and the type of training and other factors such as age on the perception and quantitative assessment of psychiatric symptoms and the use of technical terms is discussed. Maudsley-trained raters tended to see fewer symptoms of all kinds in all three patients, while Glasgow psychiatrists made more ratings of affective symptoms–both manic and depressive—on two of the three tapes. Dublin raters use more ‘dynamic’ terms in their daily routine than do raters from the United Kingdom. Raters over 40 years of age tended to use ‘dynamic’ terms more often than raters under 40 years. Raters trained in university departments differed only slightly in the terms they used from those trained in area mental hospitals. This study points to the problems of psychiatric communication within one culture.

Background. There is as yet little evidence available regarding the long-term outcomes of people with severe and enduring mental illness who have been cared for primarily in the community.

Methods. A 12-year follow-up was carried out of the clinical and social problems and needs for care of a group of long-term mentally ill patients (N=81) who were heavy users of psychiatric services when originally assessed in the Camberwell High Contact Survey between 1983 and 1985. The MRC Needs for Care Assessment Schedule used in the original baseline study was repeated at follow-up.

Results. The clinical and social functioning of the group had remained relatively stable, with high levels of problems and needs at both time points and little evidence of significant improvement or deterioration. The majority had remained in contact with services. There was some increase in levels of unmet as well as met needs, and a decrease in ratings of unmeetable needs, which may have been due to changes in clinical practice.

Conclusion. The challenge for current service providers is not only to keep clients stable, but also to help improve the clinical and social functioning of people who may no longer be the highest priority of current community mental health services. This could be approached by identifying the continuing needs of this group, and persistently delivering active treatments.

Background. We present results of a study of treated rates of schizophrenia among the Iban of Sarawak, Malaysia. Most Iban live in longhouses, each comprising a kindred group of up to 300 individuals. Cultural practices such as minimal intermarriage with members of adjacent ethnic groups and in-depth genealogical knowledge make them a population suitable for genetic investigation. Iban culture is conducive to a focus on symptoms and illness, and to patterns of treatment-seeking behaviour that are enthusiastic and persistent.

Method. We identified all known cases of psychotic disorder within a defined catchment area based on an exhaustive survey of available medical records. From corresponding Malaysian census data (91056 persons), we report rates of treated schizophrenia in the Iban population, using three diagnostic systems, as well as the demographic and clinical characteristics of these individuals.

Results. The most frequent presenting complaints were insomnia and aggression. We found higher treated rates for narrowly defined schizophrenia among males, but no significant gender difference for age of onset. Estimates of treated rates to age 55 years (per 10000) for narrow schizophrenia were 41·9 (ICD-10), 56·5 (DSM-IV), and 83 (RDC), while the rates for broad schizophrenia were 105·5, 103·2, and 107·5 respectively.

Conclusions. Treated rates of schizophrenia were higher than the reported prevalence for many populations at risk, including many small-scale societies, although different methodological approaches may partly explain these findings. Given the cultural patterns of Iban treatment-seeking behaviour, treated rates of schizophrenia reported here may closely approximate the population prevalence of this disorder.

Test and retest scores on the Symptom Rating Test (SRT), Manifest Anxiety Scale (MAS) and Maudsley Personality Inventory (MPI) were obtained from 45 non-psychotic psychiatric in-patients. The change in scores and the score distributions were examined to assess the extent to which these tests meet Foulds' criteria for measures belonging respectively to the universes of personality and personal illness. MPI Extraversion emerged as a stable, normally distributed, personality trait in contrast to the SRT which showed the characteristics of a symptom-state measure. MPI Neuroticism and MAS scores could not be allocated definitively to either universe and seemed to be hybrids. It is suggested that more attention must be paid to the ‘ purity’ of scales if meaningful interpretation is to be made in treatment assessment.

Background. This article provides evidence about the relationship between psychiatric disorders, physical disorders and hospital use in the general medical sector using a broadly based survey of the US population.

Methods. The data are from the 1989 National Health Interview Survey. This survey contains medical and mental health evaluations for the entire sample. In a multivariate framework, the author estimates the effect of mental illness on the probability of being admitted to a general hospital, the number of admissions and the length of stay.

Results. Hospital use in the general medical sector is significantly higher for persons with coexisting physical and psychiatric conditions than for those with no psychiatric disorders. For a wide range of medical conditions, the predicted number of hospital admissions and the length of a hospital stay increase substantially when the physical illness is accompanied by a psychiatric condition.

Conclusions. One implication of this finding is that economic evaluations of alternative psychiatric treatments should consider any differences in hospital costs related to the treatment of coexisting medical conditions. Another implication pertains to health care systems where insurers have some discretion over which individuals to insure. In the absence of adequate adjustments in insurance payments for high-risk potential enrollees, psychiatrically disabled persons may have more limited access to health insurance.

Background. Although communication disturbances (CD) have been associated with poor cognitive control, it is unclear whether they are associated specifically with poor cognitive control or with poor cognition in general. The current research examined whether (a) two specific components of cognitive control, working memory and interference resolution, were associated with CD, and (b) associations between CD and cognitive control could be accounted for by generalized poor cognitive performance.

Method. In this study, as healthy volunteers spoke, the level of cognitive demands was experimentally increased, thereby simulating cognitive deficits (i.e. a reduction in the degree to which certain types of cognitive processes could be used for speech). Hence, this research examined whether simulated cognitive deficits would cause an increase in CD. Participants also completed separate cognitive tasks that assessed working memory, interference resolution and general cognitive ability.

Results. An increase in working memory demands caused an increase in CD. Moreover, working memory demands interacted with interference resolution demands, with the greatest amount of CD caused by both high working memory and high interference resolution demands. By contrast, increasing another cognitive demand, sustained attention, did not increase CD. Furthermore, performance on separate working memory and interference resolution tasks interacted to predict CD on the experimental speech task. However, performance on a psychometrically matched cognitive task did not predict CD.

Conclusion. Overall, the current study provides evidence that working memory and interference resolution may be specifically associated with CD and that manipulations of these cognitive control processes can cause an increase in CD.