This issue contains two reviews, one on how well the Beck Hopelessness Scale can predict suicide and self-harm, and one on the validity of the distinction between bereavement-related and non-bereavement-related depression. Other sets of papers examine various aspects of suicide and depression.

This issue contains a commentary on the paper by Degenhardt et al. and one review on participant distress in psychiatric research. Other sets of papers examine various aspects of cannabis and other substance use disorders, borderline and other personality disorders, and six individual papers examine a variety of topics.

This issue contains two reviews, one on the question of ‘what is a mood stabilizer?’, and one on genetic influences on measures of the environment. Other sets of papers examine various aspects of genetics, bipolar disorder, and five individual papers examine a variety of topics.

This issue contains one review, on predicting costs of mental health care. Other sets of papers examine various aspects of psychosis.

This issue contains a review of studies of the effectiveness of compulsory interventions in the community. Other sets of papers report findings from twin studies and population surveys, and six individual papers examine a variety of topics.

This issue contains two reviews, one on the concept of recovery in major depression and one on internet-based cognitive behavioural therapy (CBT) for depression and anxiety. Four papers report findings from randomized controlled trials (RCT) of interventions for depression and other sets of papers examine various aspects of depression, suicide, and co-morbid generalized anxiety disorder (GAD) and major depression (MD).

This issue contains one review, on the endophenotype concept in psychiatric genetics. Three papers examine various aspects of post-traumatic stress disorder (PTSD), two use historical methods to address aspects of military psychiatry and dissociation, and five individual papers examine a variety of topics.

The concept of mood stability is attractive to both patients and clinicians alike, and hence the term ‘mood stabilizer’ has widespread currency. However, its worldwide acceptance and use in clinical practice is at odds with the absence of official recognition by regulatory authorities. The ideal mood stabilizer is said to have efficacy in the treatment of acute manic and depressive episodes, and also be effective in the prevention of recurrences. However, in reality, few drugs with perhaps the exception of lithium, come close to this gold standard; yet many agents aspire to the title, and some have arguably achieved it prematurely. It is, therefore, important to reconsider the definition of a mood stabilizer and critically review which agents, if any, satisfy the necessary eligibility requirements by reference to reasonable criteria and comparator data. The term mood stabilizer is an important label. It needs to be applied judiciously because it confers clinical credibility and qualifies long-term use in maintenance and prophylaxis. It is also important with respect to developing guidelines for treatment and the further development of novel agents. Most importantly, however, it is a term that is innately appealing because of what it promises: for this reason alone it should encompass only those agents that can deliver.

Attention deficit hyperactivity disorder (ADHD) is a common, childhood-onset neurodevelopmental disorder with adverse consequences during adult life. Family, twin and adoption studies show that genetic factors contribute to the aetiology of ADHD and that environmental factors also play a role. Family and twin studies have shown the importance of genetic influences on continuity in ADHD over time and in accounting for the co-occurrence of ADHD and conduct disorder problems. In meta-analyses of molecular genetic studies, the 48-bp variable number tandem repeat (VNTR) variant in the dopamine D4 gene and the CA(n) microsatellite marker in the D5 receptor gene have been found to be repeatedly associated with ADHD. Results from meta-analyses of the 480-bp VNTR in the dopamine transporter gene are mixed. Several genetic studies have also identified genetic variants that are related to specific clinical and developmental features of ADHD. In the next few years, a new generation of much larger-scale genetic studies should lead to the identification of further ADHD susceptibility genes. Such studies will also need to be integrated with other areas of neuroscience, clinical and epidemiological research to investigate how specific gene variants exert risk effects, interact with environmental factors and enable identification of the underlying causal mechanisms that lead to ADHD.

The idea that some phenotypes bear a closer relationship to the biological processes that give rise to psychiatric illness than diagnostic categories has attracted considerable interest. Much effort has been devoted to finding such endophenotypes, partly because it is believed that the genetic basis of endophenotypes will be easier to analyse than that of psychiatric disease. This belief depends in part on the assumption that the effect sizes of genetic loci contributing to endophenotypes are larger than those contributing to disease susceptibility, hence increasing the chance that genetic linkage and association tests will detect them. We examine this assumption by applying meta-analytical techniques to genetic association studies of endophenotypes. We find that the genetic effect sizes of the loci examined to date are no larger than those reported for other phenotypes. A review of the genetic architecture of traits in model organisms also provides no support for the view that the effect sizes of loci contributing to phenotypes closer to the biological basis of disease is any larger than those contributing to disease itself. While endophenotype measures may afford greater reliability, it should not be assumed that they will also demonstrate simpler genetic architecture.

Diatheses confer vulnerability to disorder but are not necessarily manifest overtly or consistently. It is suggested that the main empirical findings of studies with abnormal personality support the notion that they are diatheses rather than disorders. This includes their onset early in life, their variability of expression dependent on setting, their greater association with more severe disorders and their acceptance as intrinsic components of functioning by most suffering from these conditions. It is argued that a separate axis of classification for personality diatheses rather than disorders is justified.

Background. There is limited randomized controlled trial (RCT) evidence for compulsory community treatment. Other study methods may clarify their effectiveness. We reviewed RCT and non-RCT evidence for the effect of compulsory community treatment on hospital admissions, bed-days, compliance and out-patient contacts.

Method. A systematic review of RCTs, controlled before-and-after (CBA) studies, and interrupted time series (ITS) analyses. Meta-analysis of RCTs.

Results. Eight papers covering five studies (two RCTs and three CBAs) met inclusion criteria (total n=1108). There was no statistical difference in 12-month admission rates between subjects on involuntary out-patient treatment and controls. Survival analyses of time to admission were equivocal. All five studies reported decreases in the number of bed-days following involuntary out-patient treatment but this only reached statistical significance in one situation; patients receiving the intervention were less likely to have admissions of over 100 days. There was no difference in treatment adherence between the intervention and control groups in either RCT or two of the CBA studies. However, the third CBA study reported a statistically significant increase of nearly five visits in the mean number of overall contacts in the involuntary out-patient treatment group.

Conclusions. The evidence for involuntary out-patient treatment in reducing either admissions or bed-days is very limited. It therefore cannot be seen as a less restrictive alternative to admission. Other effects are uncertain. Evaluation of a wide range of outcomes should be included if this type of legislation is introduced.