Education Not Discrimination (END) is the component of the Time to Change programme intended to reduce mental health stigma among professionals and professional trainees.

To investigate the impact of the END anti-stigma programme on medical students immediately and after 6 months with regard to knowledge, attitudes, behaviour and empathy.

A total of 1452 medical students participated in the study (intervention group n = 1066, control group n = 386).

Participants completed questionnaires at baseline, and at immediate and 6-month follow-up. Groups were compared for changes in stigma outcomes.

All measures improved in both groups, particularly among students with less knowledge and more stigmatising attitudes and intended behaviour at baseline. At immediate follow-up the intervention group demonstrated significantly greater improvements in stigma-related knowledge and reductions in stigma-related attitudes and intended behaviour, relative to the control group. At 6 months' follow-up, however, only one attitude item remained significantly better.

Although the intervention produced short-term advantage there was little evidence for its persistent effect, suggesting a need for greater integration of ongoing measures to reduce stigma into the medical curriculum.

Previous studies show that among Black Caribbeans there is a higher prevalence of schizophrenia and higher levels of both voluntary and compulsory admissions. These suggest that Black Caribbean patients may find psychiatric services less appropriate to their needs. The aim of this study was to establish the satisfaction with mental health services of representative psychosis patients in South London, especially in relation to ethnic group.

A random sample of all cases of psychotic disorder identified in the two sectors was interviewed using the Verona Service Satisfaction Schedule. Questionnaires from 50 Black Caribbean patients and 134 White patients were analysed.

Black Caribbean patients, particularly those of second generation born in the UK, were significantly less satisfied with almost every aspect of the services that they received than either older Black Caribbean patients born in the Caribbean or White patients. Using multiple regression analysis it was found that among the younger Black Caribbean patients, unlike the other patients, the number of previous admissions was a significant predictor of dissatisfaction.

Patients' ratings of satisfaction with mental health services are significantly worse for UK-born Black Caribbean than other patients with psychotic disorder in South London.

Twin studies have found that childhood attention-deficit hyperactivity disorder (ADHD) has a strong genetic component. Estimates of heritability the extent of non-additive genetic effects and of ‘sibling contrast’ effects vary between different studies.

To use multiple informants to assess the extent to which observer effects influence such estimates in an epidemiological sample of twins.

Questionnaire packs were sent to the families and teachers of twins aged 5–16 years in the Bro Taf region of South Wales. The twins were ascertained from community paediatric registers.

Both parent— and teacher-rated data showed a high degree of heritability for ADHD measured as a symptom dimension, but the correlation between the two types of rater was modest. Bivariate analyses suggested that parent and teacher ratings reflect the effects of different genes. Self-report data from twins aged 11–16 years showed no evidence of genetic effects.

Although ADHD is shown to be highly heritable by both parent— and teacher-rated data, the underlying genotypes may be substantially different. This has implications for study designs aiming to find genes that contribute to the disorder.

There have been changes to the criteria for diagnosing post-traumatic stress disorder (PTSD) in DSM-5 and changes are proposed for ICD-11.

To investigate the impact of the changes to diagnostic criteria for PTSD in DSM-5 and the proposed changes in ICD-11 using a large multisite trauma-exposed sample and structured clinical interviews.

Randomly selected injury patients admitted to four hospitals were assessed 72 months post trauma (n = 510). Structured clinical interviews for PTSD and major depressive episode, as well as self-report measures of disability and quality of life were administered.

Current prevalence of PTSD under DSM-5 scoring was not significantly different from DSM-IV (6.7% v. 5.9%, z = 0.53, P = 0.59). However, the ICD-11 prevalence was significantly lower than ICD-10 (3.3% v. 9.0%, z =–3.8, P<0.001). The PTSD current prevalence was significantly higher for DSM-5 than ICD-11 (6.7% v. 3.3%, z = 2.5, P = 0.01). Using ICD-11 tended to show lower rates of comorbidity with depression and a slightly lower association with disability.

The diagnostic systems performed in different ways in terms of current prevalence rates and levels of comorbidity with depression, but on other broad key indicators they were relatively similar. There was overlap between those with PTSD diagnosed by ICD-11 and DSM-5 but a substantial portion met one but not the other set of criteria. This represents a challenge for research because the phenotype that is studied may be markedly different according to the diagnostic system used.

Interpersonal psychotherapy and cognitive–behavioural therapy are widely accepted as effective treatments for major depression. There is little evidence on how personality disorder or personality traits affect treatment response.

To determine whether personality disorder or traits have an adverse impact on treatment response to interpersonal psychotherapy or cognitive–behavioural therapy in people receiving out-patient treatment for depression.

The study was a randomised trial in a university-based clinical research unit for out-patients with depression.

Personality disorder did not adversely affect treatment response for patients with depression randomised to cognitive–behavioural therapy Conversely, personality disorder did adversely affect treatment response for patients randomised to interpersonal psychotherapy.

Despite the two therapies having comparable efficacy in patients with depression, response to interpersonal psychotherapy (but not cognitive–behavioural therapy) is affected by personality traits. This could suggest the two therapies are indicated for different patients or that they work by different mechanisms.

Although youths in many countries have been exposed to terrorism, few studies have examined early risk and protective factors for the subsequent development of mental health problems.

To investigate the levels of post-traumatic stress in survivors of the 2011 massacre on Ut⊘ya Island compared with the general population in Norway, and to identify predictive factors.

Four hundred and ninety survivors were invited to participate. Structured face-to-face interviews were performed 4–5 months after the attack.

There were 325 study participants (response rate 66%). Survivors had been highly exposed to danger and loss. Post-traumatic stress levels were more than six times higher in survivors than in the general population. Predictors were female gender, minority ethnic status, high level of trauma exposure, pain, the loss of someone close and social support.

Survivor characteristics that can be assessed in the early aftermath of a terrorist attack strongly predict the subsequent mental health problems of exposed youths. The highly elevated symptoms observed were largely attributable to the traumatic experience and reflect the mental health costs of the terrorist attack.

An increased rate of premorbid impairment has been reported in both child- and adolescent-onset schizophrenic and affective psychoses.

To examine the evidence for a specific association between premorbid impairment and child- and adolescent-onset schizophrenia, and whether specific continuities exist between premorbid impairments and psychotic symptom dimensions.

Retrospective case note study of 110 first-episode child- and adolescent-onset psychoses (age 10–17 years). DSM–III–R diagnoses derived from the OPCRIT algorithm showed 61 with schizophrenia (mean age 14.1 years) and 49 with other non-schizophrenic psychoses (mean age 14.7 years).

Premorbid social impairment was more common in early-onset schizophrenia than in other early-onset psychoses (OR 1.9, P=0.03). Overall, impaired premorbid development, enuresis and incontinence during psychosis were specifically associated with the negative psychotic symptom dimension.

Premorbid social impairments are more marked in child- and adolescent-onset schizophrenia than in other psychoses. There appears to be developmental continuity from premorbid impairment to negative symptoms.

It is argued that coping theory may be useful in attempting to understand how relatives adapt to the demands of living with a schizophrenia sufferer.

In a prospective study, univariate and multivariate relationships were explored between appraisal variables (appraisal of symptom threat (primary appraisal) and perceived symptom control (secondary appraisal)) and (a) expressed emotion, and (b) psychological distress in relatives of schizophrenic patients. The profile of relatives who showed sustained distress over time was also examined.

The appraisal variables were found to be related to both the concurrent distress (GHQ scores), EE ratings of relatives at the time of the patients relapse and hospitalisation, as well as the subsequent GHQ scores of relatives when the patient was discharged back home. Relatives who showed sustained distress were likely to show high EE and have a longer caring history.

The study gives some support to the theory that appraisal processes underlie how relatives react to having a family member with schizophrenia, and may have implications both for identifying those at risk of poor adaptation, and for understanding strategies that improve well-being.

Knowledge of the course of psychopathology from adolescence into adulthood is needed to answer questions concerning origins and prognosis of psychopathology across a wide age range.

To investigate the 10-year course and predictive value of self-reported problems in adolescence in relation to psychopathology in adulthood.

Subjects from the general population, aged 11–19 years, were assessed with the Youth Self-Report (YSR) at initial assessment, and with the Young Adult Self-Report (YASR), the Composite International Diagnostic Interview (CIDI) and three sections of the Diagnostic Interview Schedule (DIS) 10 years later.

Of the subjects with deviant YSR total problem scores, 23% (males) and 22% (females) had deviant YASR total problem scores at follow-up. Subjects with initial deviant YSR total problem, internalising and externalising scores had higher prevalences of DSM–IV diagnoses at follow-up.

Adolescent problems tended to persist into adulthood to a moderate degree. High rates of problems during adolescence are risk factors for psychiatric disorders in adulthood.

Little is known about conversion disorder in childhood.

To document clinical incidence, features, management and 12-month outcome of non-transient conversion disorder in under 16-year-olds in the UK and Ireland.

Surveillance through the British Paediatric Surveillance Unit and Child and Adolescent Psychiatry Surveillance System.

In total, 204 cases (age range 7-15 years) were reported, giving a 12-month incidence of 1.30/100 000 (95% CI 1.11-1.52). The most common symptoms were motor weakness and abnormal movements. Presentation with multiple symptoms was the norm. Antecedent stressors were reported for 80.8%, most commonly bullying in school. Most children required in-patient admission with frequent medical investigations. Follow-up at 12 months was available for 147 children, when all conversion disorder symptoms were reported as improved. Most families (91%) accepted a nonmedical explanation of the symptoms either fully or partially.

Childhood conversion disorder represents an infrequent but significant clinical burden in the UK and Ireland.

An earlier study of 291 world famous men had shown that only visual artists and creative writers were characterised, in comparison with the general population, by a much higher prevalence of pathological personality traits and alcoholism. Depressive disorders, but not any other psychiatric conditions, had afflicted writers almost twice as often as men with other high creative achievements. The present investigation was undertaken to confirm these findings in a larger and more comprehensive series of writers, and to discover causal factors for confirmed high prevalences of affective conditions and alcoholism in writers.

Data were collected from post-mortem biographies and, where applicable, translated into DSM diagnoses. The frequencies of various abnormalities and deviations were compared between poets, prose fiction writers, and playwrights.

A high prevalence in writers of affective conditions and of alcoholism was confirmed. That of bipolar affective psychoses exceeded population norms in poets, who in spite of this had a lower prevalence of all kinds of affective disorders, of alcoholism, of personality deviations, and related to this, of psychosexual and marital problems, than prose fiction and play writers.

A hypothesis is developed, which links the greater frequency of affective illnesses and alcoholism in playwrights and prose writers, in comparison with poets, to differences in the nature and intensity of their emotional imagination. This hypothesis could be tested by clinical psychologists collaborating with experts in literature on random samples of different kinds of writers.

Cannabis policy continues to be controversial in North America, Europe and Australia.

To inform this debate, we examine alternative legal regimes for controlling cannabis availability and use.

We review evidence on the effects of cannabis depenalisation in the USA, Australia and The Netherlands. We update and extend our previous (MacCoun & Reuter, 1997) empirical comparison of cannabis prevalence statistics in the USA, The Netherlands and other European nations.

The available evidence indicates that depenalisation of the possession of small quantities of cannabis does not increase cannabis prevalence. The Dutch experience suggests that commercial promotion and sales may significantly increase cannabis prevalence.

Alternatives to an aggressively enforced cannabis prohibition are feasible and merit serious consideration. A model of depenalised possession and personal cultivation has many of the advantages of outright legalisation with few of its risks.

Psychiatric patients have a higher suicide risk following hospital discharge.

To identify social, clinical and health-care delivery factors in recently discharged patients.

Retrospective case-control study of 234 patients who died within 1 year of hospital discharge, matched for age, gender, diagnosis and admission period with 431 controls. Odds ratios for identified risk factors were calculated using conditional multiple logistic regression.

Independent increased-risk factors were: not being White; living alone; history of deliberate self-harm (DSH); suicidal ideation precipitating admission; hopelessness; admission under different consultant; onset of relationship difficulties; loss of job; in-patient DSH; unplanned discharge; significant care professional leaving/on leave. Reduced-risk factors were: shared accommodation; delusions at admission; misuse of non-prescribed substances; and continuity of contact.

Continuity of contact may reduce suicide risk. Discontinuity of care from a significant professional is associated with increased risk of suicide.