Computerised cognitive–behavioural therapy (CCBT) is used for treating depression and provides a potentially useful alternative to therapist cognitive–behavioural therapy (CBT).

To systematically review the evidence for the effectiveness of CCBT for the treatment of mild to moderate depression.

Electronic databases were searched to identify randomised controlled trials. Selected studies were quality assessed and data extracted by two reviewers.

Four studies of three computer software packages met the inclusion criteria. Comparators were treatment as usual, using a depression education website and an attention placebo.

There is some evidence to support the effectiveness of CCBT for the treatment of depression. However, all studies were associated with considerable drop-out rates and little evidence was presented regarding participants' preferences and the acceptability of the therapy. More research is needed to determine the place of CCBT in the potential range of treatment options offered to individuals with depression.

The baseline findings from a controlled study of the effect of a public education campaign on community attitudes to mental illness are presented.

A census of attitudes to mental illness was conducted in two areas, prior to the opening of supported houses for the mentally ill Factor analysis of the Community Attitudes toward the Mentally III (CAMI) inventory revealed three components: Fear and Exclusion, Social Control and Goodwill.

The only determinant of Fear and Exclusion was having children. The main determinants of Social Control were social class, ethnic origin, age, having suffered mental illness and having children. The main determinant of Goodwill was educational level The attitude factors were predictive of respondents' behavioural intentions toward the mentally ill. Respondents with children and non-Caucasians were more likely to object to the mentally ill living in their neighbourhood.

Any intervention aimed at changing attitudes to mentally ill people in the community should be targeted at people with children and non-Caucasians, as these groups are more likely to object.

Culture-bound syndrome is a term used to describe the uniqueness of some syndromes in specific cultures. Dhat (semen-loss anxiety) has been considered to be an exotic ‘neurosis of the Orient’.

To ascertain the presence of similar symptoms and syndromes in different cultures and historical settings.

Electronic and manual literature searches were used to gather information on the existence and description of semen-loss anxiety in different cultures and settings.

Most of the empirical studies on dhat syndrome have emerged from Asia, whereas its concepts have been described historically in other cultures, including Britain, the USA and Australia. The different sources indicate the universality of symptoms and global prevalence of this condition, despite its image as a ‘neurosis of the Orient’.

It appears that dhat (semen-loss anxiety) is not as culture-bound as previously thought. We propose that the concept of culture-bound syndromes should be modified in line with DSM–IV recommendations.

Research on gene×environment interaction in major depressive disorder (MDD) has thus far primarily focused on candidate genes, although genetic effects are known to be polygenic.

To test whether the effect of polygenic risk scores on MDD is moderated by childhood trauma.

The study sample consisted of 1645 participants with a DSM-IV diagnosis of MDD and 340 screened controls from The Netherlands. Chronic or remitted episodes (severe MDD) were present in 956 participants. The occurrence of childhood trauma was assessed with the Childhood Trauma Interview and the polygenic risk scores were based on genome-wide meta-analysis results from the Psychiatric Genomics Consortium.

The polygenic risk scores and childhood trauma independently affected MDD risk, and evidence was found for interaction as departure from both multiplicativity and additivity, indicating that the effect of polygenic risk scores on depression is increased in the presence of childhood trauma. The interaction effects were similar in predicting all MDD risk and severe MDD risk, and explained a proportion of variation in MDD risk comparable to the polygenic risk scores themselves.

The interaction effect found between polygenic risk scores and childhood trauma implies that (1) studies on direct genetic effect on MDD gain power by focusing on individuals exposed to childhood trauma, and that (2) individuals with both high polygenic risk scores and exposure to childhood trauma are particularly at risk for developing MDD.

There are no community services for the majority of the estimated 10 million persons with schizophrenia in India. Community-based rehabilitation (CBR) is a model of care which has been widely used for physical disabilities in resource-poor settings.

To compare CBR with out-patient care (OPC) for schizophrenia in a resource-poor setting in India.

A longitudinal study of outcome in patients with chronic schizophrenia contrasted CBR with OPC. Outcome measures were assessed using the Positive and Negative Symptom Scale and the modified WHO Disability Assessment Schedule at 12 months.

Altogether, 207 participants entered the study, 127 in the CBR group and 80 in the OPC group. Among the 117 fully compliant participants the CBR model was more effective in reducing disability, especially in men. Within the CBR group, compliant participants had significantly better outcomes compared with partially compliant or non-complaint participants (P<0.001). Although the subjects in the CBR group were more socially disadvantaged, they had significantly better retention in treatment.

The CBR model is a feasible model of care for chronic schizophrenia in resource-poor settings.

Metabolic and cardiovascular health problems have become a major focus for clinical care and research in schizophrenia.

To evaluate the content and quality of screening guidelines for cardiovascular risk in schizophrenia.

Systematic review and quality assessment of guidelines/recommendations for cardiovascular risk in people with schizophrenia published between 2000 and 2010, using the Appraisal of Guidelines for Research and Evaluation (AGREE).

The AGREE domain scores varied between the 18 identified guidelines. Most guidelines scored best on the domains ‘scope and purpose’ and ‘clarity of presentation‘. The domain ‘rigour of development’ was problematic in most guidelines, and the domains ‘stakeholder involvement’ and ‘editorial independence’ scored the lowest. The following measurements were recommended (in order of frequency): fasting glucose, body mass index, fasting triglycerides, fasting cholesterol, waist, high-density lipoprotein/low-density lipoprotein, blood pressure and symptoms of diabetes. In terms of interventions, most guidelines recommended advice on physical activity, diet, psychoeducation of the patient, treatment of lipid abnormalities, treatment of diabetes, referral for advice and treatment, psychoeducation of the family and smoking cessation advice. Compared across all domains and content, four European guidelines could be recommended.

Four of the evaluated guidelines are of good quality and should guide clinicians' screening and monitoring practices. Future guideline development could be improved by increasing its rigour and assuring user and patient involvement.

The prevalence and course of mental disorders among Vietnamese refugees were studied, using a model including variables from different research traditions.

A consecutive community cohort of 145 Vietnamese boat refugees aged 15 and above were personally interviewed on their arrival in Norway and three years later.

Three years later, there was, unexpectedly, no decline in self-rated psychological distress (SCL-90-R), almost one in four suffered from psychiatric disorder and the prevalence of depression was 17.7% (Present State Examination). Female gender, extreme traumatic stress in Vietnam, negative life events in Norway, lack of a close confidant and chronic family separation were identified as predictors of psychopathology.

The effects of war and persecution were long-lasting, and compounded by adversity factors in exile. A uniform course of improvement in mental health after resettlement cannot be expected in all contexts. The affected refugees need systematic rehabilitation.

Published studies of prevalence of depression in old age in Taiwan have yielded equivocal results.

To study the prevalence of depressive disorders among community-dwelling elderly; further, to assess socio-demographic correlates and life events in relation to depression.

A randomised sample of 1500 subjects aged 65 and over was selected from three communities. Research psychiatrists conducted all assessments using the Geriatric Mental State Schedule. The diagnosis of depression was made with the GMS–AGECAT (Automated Geriatric Examination for Computerised Assisted Taxonomy); data on life events were collected with the Taiwanese version of the Life Events and Difficulties Schedule.

One-month prevalence of psychiatric disorders was 37.7%, with 15.3% depressive neurosis and 5.9% major depression. A high risk of depressive disorders was found among widows with a low educational level living in the urban community, and among those with physical illnesses.

Contrary to most previous reports, we found that the prevalence of depressive disorders among the elderly in the community in Taiwan is high and comparable to rates reported in some studies of UK samples.

There is concern in the community about increasing cannabis use and its potential effect on health.

To ascertain the prevalence of cannabis use among Australian adolescents, associations with mental health problems, risk behaviours and service use.

Examination of data from a national representative sample of households comprising 1261 adolescents aged 13–17 years. Parents completed a psychiatric interview and questionnaires while adolescents completed questionnaires.

One-quarter of the adolescents in the sample had used cannabis. There were no gender differences. Use increased rapidly with age, was more common in adolescents living with a sole parent and was associated with increased depression, conduct problems and health risk behaviours (smoking, drinking) but not with higher use of services.

Cannabis use is very prevalent. The association with depression, conduct problems, excessive drinking and use of other drugs shows a malignant pattern of comorbidity that may lead to negative outcomes.

Studies in schizophrenia suggest that a longer initial period of untreated illness is associated with a poorer clinical outcome.

To determine whether, in first-episode schizophrenia, a longer duration of untreated psychosis (DUP) or of untreated illness (DUI) (DUP plus any prodrome) is associated with clinical variables that could mediate a poor prognosis.

Clinical, social, neuropsychological and oculomotor function data on 53 patients with first-episode schizophrenia were related to the DUP and DUI.

Comparing short and long DUP groups split around the median showed no statistically significant differences (except age); patients in the latter group tended to perform worse on an executive attentional set-shifting task, and were more likely to be unemployed, and living alone or homeless.

There was little evidence of any association between either DUP or DUI and progressive deterioration in the schizophrenic illness or the development of resistance to initial drug treatment. Social variables that augur a poor prognosis may be associated with delayed presentation of schizophrenia to psychiatric services.

Thoughts about death and self-harm in old age have been commonly associated with the presence of depression, but other risk factors may also be important.

To determine the independent association between suicidal ideation in later life and demographic, lifestyle, socioeconomic, psychiatric and medical factors.

A cross-sectional study was conducted of a community-derived sample of 21290 adults aged 60-101 years enrolled from Australian primary care practices. We considered that participants endorsing any of the four items of the Depressive Symptom Inventory - Suicidality Subscale were experiencing suicidal thoughts. We used standard procedures to collect demographic, lifestyle, psychosocial and clinical data. Anxiety and depressive symptoms were assessed with the Hospital Anxiety and Depression Scale.

The 2-week prevalence of suicidal ideation was 4.8%. Male gender, higher education, current smoking, living alone, poor social support, no religious practice, financial strain, childhood physical abuse, history of suicide in the family, past depression, current anxiety, depression or comorbid anxiety and depression, past suicide attempt, pain, poor self-perceived health and current use of antidepressants were independently associated with suicidal ideation. Poor social support was associated with a population attributable fraction of 38.0%, followed by history of depression (23.6%), concurrent anxiety and depression (19.7%), prevalent anxiety (15.1%), pain (13.7%) and no religious practice (11.4%).

Prevalent and past mood disorders seem to be valid targets for indicated interventions designed to reduce suicidal thoughts and behaviour. However, our data indicate that social disconnectedness and stress account for a larger proportion of cases than mood disorders. Should these associations prove to be causal, then interventions that succeeded in addressing these issues would contribute the most to reducing suicidal ideation and, possibly, suicidal behaviour in later life.

A large collaborative 8-week study has shown fluoxetine to be effective and safe in treating patients with bulimia nervosa. The present study evaluated fluoxetine over 16 weeks.

Fifteen US out-patient psychiatry clinics conducted a double-blind parallel study in men and women with DSM–III–R bulimia nervosa (483 patients entered, 398 randomised [3:1 ratio, fluoxetine 60 mg/day or placebo], 225 completed). Outcome measures included change in vomiting and binge-eating episodes per week, Eating Disorder Inventory, Clinical Global Impressions and Patient's Global Impression.

Compared with placebo, fluoxetine treatment resulted in significantly greater reductions in vomiting (F [1,360] = 14.73, P< 0.0001) and binge-eating (F [1,360] = 14.39, P=0.0002) episodes per week at endpoint and improvement in other outcome measures. Adverse event, vital sign and laboratory analyses indicated that fluoxetine was safe.

Fluoxetine appeared to be safe and effective in patients with bulimia nervosa for up to 16 weeks.