Pharmacological treatment is widely used for post-traumatic stress disorder (PTSD) despite questions over its efficacy.

To determine the efficacy of all types of pharmacotherapy, as monotherapy, in reducing symptoms of PTSD, and to assess acceptability.

A systematic review and meta-analysis of randomised controlled trials was undertaken; 51 studies were included.

Selective serotonin reuptake inhibitors were found to be statistically superior to placebo in reduction of PTSD symptoms but the effect size was small (standardised mean difference −0.23, 95% CI −0.33 to −0.12). For individual pharmacological agents compared with placebo in two or more trials, we found small statistically significant evidence of efficacy for fluoxetine, paroxetine and venlafaxine.

Some drugs have a small positive impact on PTSD symptoms and are acceptable. Fluoxetine, paroxetine and venlafaxine may be considered as potential treatments for the disorder. For most drugs there is inadequate evidence regarding efficacy for PTSD, pointing to the need for more research in this area.

Previous research suggests that many people receiving mental health treatment do not meet criteria for a mental disorder but are rather ‘the worried well’.

To examine the association of past-year mental health treatment with DSM-IV disorders.

The World Health Organization's World Mental Health (WMH) Surveys interviewed community samples of adults in 23 countries (n = 62 305) about DSM-IV disorders and treatment in the past 12 months for problems with emotions, alcohol or drugs.

Roughly half (52%) of people who received treatment met criteria for a past-year DSM-IV disorder, an additional 18% for a lifetime disorder and an additional 13% for other indicators of need (multiple subthreshold disorders, recent stressors or suicidal behaviours). Dose–response associations were found between number of indicators of need and treatment.

The vast majority of treatment in the WMH countries goes to patients with mental disorders or other problems expected to benefit from treatment.

In low- and middle-income countries little is known about changes in women's mental health status from the perinatal period to 15 months postpartum or the factors associated with different trajectories.

To determine the incidence and rates of recovery from common mental disorders (CMD) among rural Vietnamese women and the risk and protective factors associated with these outcomes from the perinatal period to 15 months after giving birth.

In a population-based prospective study, a systematically recruited cohort of women completed baseline assessments in either the last trimester of pregnancy or 4–6 weeks after giving birth and were followed up 15 months later. The common mental disorders of major depression, generalised anxiety and panic disorder were assessed by psychiatrist-administered Structured Clinical Interview for DSM-IV Disorders at both baseline and follow-up.

A total of 211 women provided complete data in this study. The incidence rate of CMD in the first postpartum year was 13% (95% CI 8–19), and 70% (95% CI 59–80) of women who had perinatal CMD recovered within the first postpartum year. Incidence was associated with having experienced childhood maltreatment, experiencing the intimate partner as providing little care, sensitivity, kindness or affection, and the chronic stress of household poverty. Recovery was associated with higher quality of a woman's relationships with her intimate partner and her own mother, longer period of mandated rest following birth, and sharing of domestic tasks and infant care.

Modifiable social factors, in particular the quality of a woman's closest relationships with her partner and her own mother, and participation by family members in domestic work and infant care, are closely related to women's mental health in the first year after giving birth in resource-constrained settings.

Recent evidence suggests that post-conflict stressors in addition to war trauma play an important role in the development of psychopathology.

To investigate whether daily stressors mediate the association between war exposure and symptoms of posttraumatic stress and depression among war-affected youth.

Standardised assessments were conducted with 363 Sierra Leonean youth (26.7% female, mean age 20.9, s.d. = 3.38) 6 years post-war.

The extent of war exposures was significantly associated with post-traumatic stress symptoms (P<0.05) and a significant proportion was explained by indirect pathways through daily stressors (0.089, 95% CI 0.04–0.138, P<0.001). In contrast, there was little evidence for an association from war exposure to depression scores (P = 0.127); rather any association was explained via indirect pathways through daily stressors (0.103, 95% CI 0.048–0.158, P<0.001).

Among war-affected youth, the association between war exposure and psychological distress was largely mediated by daily stressors, which have potential for modification with evidence-based intervention.

The PRODIGY trial (Prevention of long term social disability amongst young people with emerging psychological difficulties, ISRCTN47998710) is a pilot trial of social recovery cognitive–behavioural therapy (SRCBT).

The PRODIGY qualitative substudy aimed to (a) explore individual experiences of participating in the pilot randomised, controlled trial (recruitment, randomisation, assessment) and initial views of therapy, and (b) to explore perceived benefits of taking part in research v. ethical concerns and potential risks.

Qualitative investigation using semi-structured interviews with thematic analysis.

Analysis revealed participant experiences around the key themes of acceptability, disclosure, practicalities, altruism and engagement.

Participants in both trial arms perceived themselves as gaining benefits from being involved in the study, above and beyond the intervention. This has implications for the design of future research and services for this client group, highlighting the importance of being flexible and an individualised approach as key engagement tools.

Individual-based cognitive–behavioural therapy (CBT) is in short supply and expensive.

The aim of this randomised controlled trial (RCT) was to compare mindfulness-based group therapy with treatment as usual (primarily individual-based CBT) in primary care patients with depressive, anxiety or stress and adjustment disorders.

This 8-week RCT (ClinicalTrials.gov ID: NCT01476371) was conducted during spring 2012 at 16 general practices in Southern Sweden. Eligible patients (aged 20–64 years) scored $10 on the Patient Health Questionnaire-9, $7 on the Hospital Anxiety and Depression Scale or 13–34 on the Montgomery–åsberg Depression Rating Scale (self-rated version). The power calculations were based on non-inferiority. In total, 215 patients were randomised. Ordinal mixed models were used for the analysis.

For all scales and in both groups, the scores decreased significantly. There were no significant differences between the mindfulness and control groups.

Mindfulness-based group therapy was non-inferior to treatment as usual for patients with depressive, anxiety or stress and adjustment disorders.

Little is known about how functional imaging changes in bipolar disorder relate to different phases of the illness.

To compare cognitive task activation in participants with bipolar disorder examined in different phases of illness.

Participants with bipolar disorder in mania (n = 38), depression (n = 38) and euthymia (n = 38), as well as healthy controls (n = 38), underwent functional magnetic resonance imaging during performance of the n-back working memory task. Activations and de-activations were compared between the bipolar subgroups and the controls, and among the bipolar subgroups. All participants were also entered into a linear mixed-effects model.

Compared with the controls, the mania and depression subgroups, but not the euthymia subgroup, showed reduced activation in the dorsolateral prefrontal cortex, the parietal cortex and other areas. Compared with the euthymia subgroup, the mania and depression subgroups showed hypoactivation in the parietal cortex. All three bipolar subgroups showed failure of de-activation in the ventromedial frontal cortex. Linear mixed-effects modelling revealed a further cluster of reduced activation in the left dorsolateral prefrontal cortex in the patients; this was significantly more marked in the mania than in the euthymia subgroup.

Bipolar disorder is characterised by mood state-dependent hypoactivation in the parietal cortex. Reduced dorsolateral prefrontal activation is a further feature of mania and depression, which may improve partially in euthymia. Failure of de-activation in the medial frontal cortex shows trait-like characteristics.

Dementia with Lewy bodies (DLB) is underrecognised in clinical settings.

To investigate whether performing a 123I-ioflupane injection (123I-FP-CIT also called DaTSCANTM) single photon emission computed tomography (SPECT) scan in patients with possible DLB would lead to a more certain diagnosis (probable DLB or non-DLB dementia).

We randomised 187 patients with possible DLB 2:1 to have a scan or not (control group). The outcome measure was a change in diagnosis to probable DLB or non-DLB.

There were 56 controls and 114 scanned patients, of whom 43% had an abnormal scan. More patients in the imaging group had a change in diagnosis compared with controls at 8 and 24 weeks (61% (n = 70) v. 4% (n = 2) and 71% (n = 77) v. 16% (n = 9); both P<0.0001). Clinicians were more likely to change the diagnosis if the scan was abnormal (82%) than if it was normal (46%).

Imaging significantly contributed to a more certain diagnosis, proving to be a useful adjunct in the work-up of patients with possible DLB.

People with dementia are extremely vulnerable in hospital and unscheduled admissions should be avoided if possible.

To identify any predictors of general hospital admission in people with dementia in a well-characterised national prospective cohort study.

A cohort of 730 persons with dementia was drawn from the Scottish Dementia Research Interest Register (47.8% female; mean age 76.3 years, s.d. = 8.2, range 50–94), with a mean follow-up period of 1.2 years.

In the age- and gender-adjusted multivariable model (n = 681; 251 admitted), Neuropsychiatric Inventory score (hazard ratio per s.d. disadvantage 1.21, 95% CI 1.08–1.36) was identified as an independent predictor of admission to hospital.

Neuropsychiatric symptoms in dementia, measured using the Neuropsychiatric Inventory, predict non-psychiatric hospital admission of people with dementia. Further studies are merited to test whether interventions to reduce such symptoms might reduce unscheduled admissions to acute hospitals.

Nothing is known about the prevalence of delusional infestation in veterinary practice and the consequences for psychiatrists.

We attempted to examine the frequency of delusional infestation among pet owners presenting their animals to veterinary clinics.

We conducted a survey among 32 663 veterinary clinicians who were members of the Veterinary Information Network.

The respondents had seen 724 suspected cases of delusional infestation by proxy in a pet. The clients were mainly White, female and 30–60 years old. They presented mainly dogs and cats, and the alleged infestation was mainly with arthropods or worms. Also, 252 clients claimed to be affected themselves; we termed this ‘double delusional infestation’.

Delusional infestation is seen frequently in veterinary practice. Psychiatrists need to be aware that patients may have pets they believe are infested.