Rising adult mortality is an essential feature of the mortality transition. Vulnerability to disease and infection decreases with age, and adult mortality is more likely to be from unnatural causes such as suicide, homicide and road traffic accidents. This study aimed to assess the patterns of unnatural deaths in India as a whole and for various population subgroups. Data were obtained from the fourth wave of the National Family Health Survey (NFHS-4) conducted in 2015–16 in 29 states and 7 union territories of India. The survey collected information on deaths in households occurring in the 3 years before the survey. Rate of unnatural mortality and years of life lost were calculated separately for males and females as well as for urban and rural populations. Unnatural mortality in India was found to make up 10.3% of total deaths, and was greater among the population aged 10 to 45 years. The unnatural mortality rate in India was 0.67 per 1000 population: 0.84 per 1000 among the male population and 0.49 per 1000 among the female population. A strict positive association was found between the unnatural mortality rate and a state’s development level. In addition, a substantial loss of person-years of life due to unnatural mortality was observed. The results serve as a reminder of the need to adopt measures to reduce this avoidable loss of life in India. Prevention strategies should be targeted at the most vulnerable populations to limit young-age fatality, with its resulting loss of productive years of life.

Each year a large number of children and adolescents develop significant posttraumatic symptoms after being involved in road traffic accidents (RTA). Consequently there is a need to develop effective interventions to prevent or minimize such reactions. The use of symptom monitoring with adults has found promising results. This pilot study explores the use of symptom monitoring with children and young people involved in RTAs. Twelve young people who met criteria on screening questionnaires for significant posttraumatic symptoms completed symptom monitoring diaries. Following completion of a diary once a day for 3 weeks, 3/12 children (25%) fell below criteria, suggesting significant posttraumatic symptoms. Feedback about self-monitoring was generally positive and suggests that symptom monitoring may be a helpful yet simple intervention for use with child trauma victims.

Two single case studies are described of driving phobia treated with cognitive therapy. Assessment, formulation, risk and practical treatment of this common problem are reported. Self-report measures and a behavioural test evaluated results. Both cases improved significantly and reported that the treatment was acceptable. Recommendations for future research are also made.

One hundred and seventy children attending a hospital accident and emergency department following everyday trauma were interviewed and completed the Post-traumatic Stress Disorder (PTSD) screening battery suggested by Yule and Udwin (1991). Diagnostic interviews (CAPS-C) confirmed that 39 (22.9%) fulfilled the DSM-IV criteria for PTSD. There were significant differences between children with and without PTSD on each individual component of the screening battery. Various criteria for caseness were evaluated and at 6 weeks post trauma the screen identified up to 90% of children diagnosed with PTSD and 73% with borderline conditions. A subset of 36 children were reassessed 8 months post trauma and all children with persistent PTSD were correctly identified by initial screen scores. The limitations of the study and the role of screening for PTSD in the absence of proven psychological interventions are discussed.