Formal communication skills training is the norm at UK medical schools, and evidence is mounting that it is effective in a number of domains, including patient satisfaction and shared decision-making, leading to improved treatment adherence. However, applying these models in mental health settings is challenging, despite the fact that positive therapeutic relationships and an ability to actively manage consultations are the cornerstone of psychiatric practice. Communication skills training is still too often regarded as better suited to physical health consultations than more complex psychiatric interviews. Here, it is considered why this might be, with reference to the one eligible randomised controlled trial identified in this systematic literature review.

Family or systemic therapy is often contrasted with psychoeducational approaches, but their historical differences have become blurred with the increasing development of integrated family interventions for psychosis. This article describes the theoretical context for the development of integrated family interventions and provides a framework for practice. It presents a collaborative, resource-oriented integrated family intervention for working with families and wider support networks within seven phases: the sharing of information and provision of emotional and practical support; identification of patient, family and wider network resources; encouraging mutual understanding; identification and alteration of unhelpful patterns of interaction; improving stress management, communication and problem-solving skills; coping with symptoms and relapse prevention planning; ending and ensuring that each session is a mini-intervention. It also includes guidelines for family intervention practice, as well as ideas for service development.

Burbach describes the content of a phased approach to delivering family work in psychosis. Clinicians would find it helpful to have guidance on how to address the challenges they face in clinical practice, such as engaging all family members in the process and how to deal with confidentiality conflicts. Implementation challenges are also likely to affect their ability to deliver this intervention. It may also be useful to consider the role that family members can play in co-production and training, and in delivering support to other families through a carer peer support model.

This article looks at the use of large datasets of health records, typically linked with other data sources, in mental health research. The most comprehensive examples of this kind of ‘big data’ are typically found in Scandinavian countries, although there are also many useful sources in the UK. There are a number of promising methodological innovations from studies using big data in UK mental health research, including: hybrid study designs, data linkage and enhanced study recruitment. It is, however, important to be aware of the limitations of research using big data, particularly the various pitfalls in analysis. We therefore caution against abandoning traditional research designs, and argue that other data sources are equally valuable and, ideally, research should incorporate data from a range of sources.

Holding a medical degree does not magically protect the individual from ever becoming unwell or needing medical help. However, for various reasons, most of which relate to personal, professional and institutional stigma, doctors are often denied the care they so readily provide to their own patients. The author has been running a ‘sick doctor’ service for 10 years and this article describes, from the practitioner-patient perspective, the barriers to care and what can be done to improve doctors' access to services.

This is a review of three of the more common medically unexplained syndromes that present for treatment to liaison psychiatry services in general medical hospitals: chronic fatigue syndrome, fibromyalgia and irritable bowel syndrome. The three are interrelated, extremely disabling and comorbid mood disorders are frequent. In general, treatment, whether psychological or medical, has very modest impact. The disputed classification of medically unexplained syndromes is also reviewed. There is a clear gulf between the views and experiences of patients with these syndromes and the medical establishment. In this article I summarise give the evidence for pharmacological, psychosocial and ‘alternative’ or ‘complementary’ interventions for a range of disorders, about which there is some dispute. I leave it to the reader to decide which interventions hold the most promise.

This article initially highlights that although the prevalence of alcohol use disorders in people with intellectual disability (PWID) appears to be low, it is a significant issue. This group can be more vulnerable to the adverse effects of alcohol and it is likely that many PWID who have alcohol use disorders are not being identified. We go on to review the limited existing literature on treatment for PWID who have alcohol use disorders and the challenges in meeting the needs of this patient group. We explore how assessment and treatment of alcohol use disorders in this population can be and needs to be tailored to the needs of PWID on an individual basis. There is also discussion about the use of incapacity legislation to treat this group.

Sleep medicine is a truly multidisciplinary field that covers psychiatric, neurological and respiratory conditions. As the field has developed it has become increasingly clear that there is a great deal of overlap between sleep and psychiatric disorders and it is therefore essential for psychiatrists to have some knowledge of sleep medicine. Even those disorders, such as obstructive sleep apnoea, that may seem to be outside the remit of psychiatry can have complex and important interactions with psychiatric conditions. In this article we give a brief overview of the range of sleep disorders a psychiatrist might encounter, how they are recognised, investigated and treated, and how they relate to psychiatric conditions.

Addressing inequalities between mental and physical healthcare in older adult healthcare is imperative for safe patient care. This evaluation of services at The Harbour mental health hospital, Blackpool, UK gives insight into parity of esteem and prompts investigation into the clinical decisions of doctors working in older adult mental healthcare.