Supervised injectable heroin (SIH) treatment has emerged over the past 15 years as an intensive treatment for entrenched heroin users who have not responded to standard treatments such as oral methadone maintenance treatment (MMT) or residential rehabilitation.

To synthesise published findings for treatment with SIH for refractory heroin-dependence through systematic review and meta-analysis, and to examine the political and scientific response to these findings.

Randomised controlled trials (RCTs) of SIH treatment were identified through database searching, and random effects pooled efficacy was estimated for SIH treatment. Methodological quality was assessed according to criteria set out by the Cochrane Collaboration.

Six RCTs met the inclusion criteria for analysis. Across the trials, SIH treatment improved treatment outcome, i.e. greater reduction in the use of illicit ‘street’ heroin in patients receiving SIH treatment compared with control groups (most often receiving MMT).

SIH is found to be an effective way of treating heroin dependence refractory to standard treatment. SIH may be less safe than MMT and therefore requires more clinical attention to manage greater safety issues. This intensive intervention is for a patient population previously considered unresponsive to treatment. Inclusion of this low-volume, high-intensity treatment can now improve the impact of comprehensive healthcare provision.

Recently, a general psychopathology dimension reflecting common aspects among disorders has been identified in adults. This has not yet been considered in children and adolescents, where the focus has been on externalising and internalising dimensions.

To examine the existence, correlates and predictive value of a general psychopathology dimension in young people.

Alternative factor models were estimated using self-reports of symptoms in a large community-based sample aged 11–13.5 years (N= 23 477), and resulting dimensions were assessed in terms of associations with external correlates and future functioning.

Both a traditional two-factor model and a bi-factor model with a general psychopathology bi-factor fitted the data well. The general psychopathology bi-factor best predicted future psychopathology and academic attainment. Associations with correlates and factor loadings are discussed.

A general psychopathology factor, which is equal across genders, can be identified in young people. Its associations with correlates and future functioning indicate that investigating this factor can increase our understanding of the aetiology, risk and correlates of psychopathology.

Sleep disturbances are commonly reported in the psychosis prodrome, but rarely explored in relation to psychotic experiences.

To investigate the relationship between specific parasomnias (nightmares, night terrors and sleepwalking) in childhood and later adolescent psychotic experiences.

The sample comprised 4720 individuals from a UK birth cohort. Mothers reported on children's experience of regular nightmares at several time points between 2 and 9 years. Experience of nightmares, night terrors and sleepwalking was assessed using a semi-structured interview at age 12. Psychotic experiences were assessed at ages 12 and 18 using a semi-structured clinical interview.

There was a significant association between the presence of nightmares at 12 and psychotic experiences at 18 when adjusted for possible confounders and psychotic experiences at 12 (OR = 1.62, 95% CI 1.19–2.20). The odds ratios were larger for those who reported persistent psychotic experiences.

The presence of nightmares might be an early risk indicator for psychosis.

Psychotic experiences are common in the general population and are associated with adverse psychiatric and social outcomes, even in the absence of a psychotic disorder.

To examine the association between psychotic experiences and mortality over a 24–27 year period.

We used data on 15 049 adult participants from four sites of the Epidemiologic Catchment Area baseline survey in the USA in the early 1980s, linked to the National Death Index and other sources of vital status up until 2007. Psychotic experiences were assessed by the Diagnostic Interview Schedule.

Lifetime psychotic experiences at baseline (n = 855; weighted prevalence, 5.5%) were significantly associated with all-cause mortality at follow-up after adjustment for sociodemographic characteristics and psychiatric diagnoses, including schizophrenia spectrum disorders (P<0.05). Baseline psychotic experiences were associated with over 5 years' shorter median survival time. Among the underlying causes of death, suicide had a particularly high hazard ratio (9.16, 95% CI 3.19–26.29).

Future research needs to explore the association of psychotic experiences with physical health and lifestyle factors that may mediate the relationship of psychotic experiences with mortality.

There is little information on lung function and respiratory diseases in people with psychosis.

To compare the respiratory health of people with psychosis with that of the general population.

In a nationally representative sample of 8028 adult Finns, lung function was measured by spirometry. Information on respiratory diseases and symptoms was collected. Smoking was quantified with serum cotinine levels. Psychotic disorders were diagnosed utilising the Structured Clinical Interview for DSM-IV (SCID-I) and medical records.

Participants with schizophrenia and other non-affective psychoses had significantly lower lung function values compared with the general population, and the association remained significant for schizophrenia after adjustment for smoking and other potential confounders. Schizophrenia was associated with increased odds of pneumonia (odds ratio (OR) = 4.9), chronic obstructive pulmonary disease (COPD, OR = 4.2) and chronic bronchitis (OR = 3.8); and with high cotinine levels.

Schizophrenia is associated with impaired lung function and increased risk for pneumonia, COPD and chronic bronchitis.

Lithium inhibits glycogen synthase kinase-3, an enzyme implicated in the pathogenesis of dementia.

To examine the association of lithium and dementia risk in a large claims-based US cohort of publicly insured older adults with bipolar disorder.

The cohort included individuals ⩾50 years diagnosed with bipolar disorder who did not receive dementia-related services during the prior year. Each follow-up day was classified by past-year cumulative duration of lithium use (0, 1–60, 61–300 and 301–365 days). Dementia diagnosis was the study outcome. Anticonvulsants commonly used as mood stabilisers served as a negative control.

Compared with non-use, 301–365 days of lithium exposure was associated with significantly reduced dementia risk (hazard ratio (HR) = 0.77, 95% CI 0.60–0.99). No corresponding association was observed for shorter lithium exposures (HR = 1.04, 95% CI 0.83–1.31 for 61–300 days; HR = 1.07, 95% CI 0.67–1.71 for 1–60 days) or for any exposure to anticonvulsants.

Continuous lithium treatment may reduce dementia risk in older adults with bipolar disorder.

The mood stabilisers lithium and valproate might plausibly have differing associations with mortality because of differing effects on mental health and various physiological indicators.

To assess associations between lithium, valproate and non-suicide mortality.

Intention-to-treat, propensity score-matched cohort study.

Lithium was associated with significantly reduced non-suicide mortality in the intent-to-treat cohort over 0–90 days (hazard ratio (HR) = 0.67, 95% CI 0.51–0.87) but not longer. In secondary analyses, a sizeable reduction in mortality was observed during active treatment with lithium across all time periods studied (for example 365-day HR = 0.62, 95% CI 0.45–0.84), but significantly increased risks were observed among patients discontinuing lithium by 180 days (HR = 1.54, 95% CI 1.01–2.37).

Patients initiating lithium had lower non-suicide mortality over 0–90 days than patients initiating valproate and consistently lower non-suicide mortality among patients maintaining treatment, but elevated risk among patients discontinuing treatment by 180 days. Although residual confounding or selection effects cannot be excluded, this study suggests potential benefits to enhancing lithium treatment persistence and the monitoring of patients discontinuing lithium. There is a need for further research.

Little is known about the effects of lithium intake through drinking water on suicide. This intake originates either from natural rock and soil elution and/or accumulation of lithium-based pharmaceuticals in ground water.

To examine the interplay between natural lithium in drinking water, prescribed lithium-based pharmaceuticals and suicide in Austria.

Spatial Bayesian regressions for males, females and pooled suicide mortality rates were estimated.

Although the expected inverse association between lithium levels in drinking water and suicide mortality was confirmed for males and for total suicide rates, the relationship for females was not significant. The models do not indicate that lithium from prescriptions, assumed to accumulate in drinking water, is related to suicide risk patterns either as an individual effect or as a moderator of lithium levels in drinking water. Gender-specific differences in risk factors and local risk hot spots are confirmed.

The findings do not support the hypotheses that lithium prescriptions have measureable protective effects on suicide or that they interact with lithium in drinking water.

Media stories on suicide can increase suicidal ideation, but little is known about variations in media effects with regard to audience vulnerability and story contents.

We investigated the impact of three drama films with suicidal content that varied with regard to the final outcome (suicide completion, mastery of crisis and death by natural causes) and tested the moderating effect of baseline suicidality of the participants on the effects.

Within a laboratory setting, we randomly assigned 95 adults to three film groups. We used questionnaires to analyse the effects of the films on mood, depression, life satisfaction, self-worth, assumed benevolence of the world and suicidality, as well as identification with the protagonist. We stratified the sample into participants with suicidal tendencies above and below the sample median.

The film that ended with the protagonist's suicide led to a deterioration of mood particularly in individuals with baseline suicidality below the median, who also experienced an increase in self-worth. Participants with stronger suicidal tendencies experienced a rise in suicidality that depended on their level of identification with the protagonist. The film featuring the main character positively coping with his crisis increased life satisfaction particularly among participants with higher suicidal tendencies.

The effects of suicide-related media material seem to vary with individual vulnerability and with type of media portrayal. Individuals with lower vulnerability experience more emotional reactions when exposed to a film culminating in suicide, but individuals with higher vulnerability experience a rise in suicidal tendencies particularly if they identify with the protagonist who died by suicide. In contrast, portrayals of individual mastery of crisis may have beneficial effects in more vulnerable individuals.