Stalking is causing pervasive and intense personal suffering and is an area of psychiatry that is currently overlooked.

To review demographic and clinical characteristics of stalkers as well as the psychological consequences for victims of stalking.

A Medline and PsycLit search was conducted on stalking, forensic psychiatry, personality disorders, de Clérambault syndrome and erotomania, with respect to the relevance of the articles selected for stalking.

Stalkers are best thought of as a heterogeneous group whose behaviour can be motivated by different forms of psychopathology, including psychosis and severe personality disorders.

There is a clear need to arrive at a consensus on a typology of stalkers and associated diagnostic criteria. The effectiveness of psychological and pharmacological treatments have not yet been investigated. Treatment may need to be supplemented with external incentives provided by the legal system.

A new actuarial method for violence risk assessment – the Iterative Classification Tree (ICT) – has become available. It has a high degree of accuracy but can be time and resource intensive to administer.

To increase the clinical utility of the ICT method by restricting the risk factors used to generate the actuarial tool to those commonly available in hospital records or capable of being routinely assessed in clinical practice.

A total of 939 male and female civil psychiatric patients between 18 and 40 years old were assessed on 106 risk factors in the hospital and monitored for violence to others during the first 20 weeks after discharge.

The ICT classified 72.6% of the sample as either low risk (less than half of the sample's base rate of violence) or high risk (more than twice the sample's base rate of violence).

A clinically useful actuarial method exists to assist in violence risk assessment.

The extent to which forensic psychiatric rehabilitation alters an individual's level of risk is unclear.

To highlight some essential features of a forensic psychiatric rehabilitation system, and to discuss risk assessment in this context to create a conceptual framework for risk research and practice.

The applicability of risk assessment instruments to forensic psychiatric rehabilitation was examined. Core processes and elements considered essential in this type of rehabilitative work were reviewed.

Current risk research has limited application to rehabilitation. Future research aimed at analysing forensic psychiatric rehabilitation will be hampered by the complexity of the treatment systems and the number of methodological issues relevant to this type of research.

Novel research approaches are suggested to analyse further the risk factors and processes important in forensic psychiatric rehabilitation.

Mental health review tribunals are required to apply legal criteria within a clinical context. This can create tensions within both law and psychiatry.

To examine the role of the medical member of the tribunal as a possible mediator between the two disciplines.

Observation of tribunal hearings and panel deliberations and interviews with tribunal members were used to describe the role of the medical member.

The dual roles imposed on the medical member as witness and decisionmaker and as doctor and legal actor create formal demands and ethical conflicts that are hard, in practice, either to meet or to resolve.

The structure for providing tribunals with access to expert psychiatric input and advice requires reconsideration.

Changes in service provision, secular trends in substance misuse and changing social structures might affect outcome in psychosis.

To assess the three-year outcome of an inception cohort of first-episode psychoses treated in a modern, community-oriented service; to compare outcomes with an earlier cohort treated in hospital-based care; and to examine the predictive validity of ICD–10 diagnostic criteria.

Three-year follow-up (1995–1997) of an inception cohort of first-episode psychoses and comparison with two-year follow-up (1980–1982) of the Determinants of Outcome of Severe Mental Disorders (DOSMED) Nottingham cohort.

On most outcome measures, non-affective psychoses had a worse outcome than affective psychoses. Affective psychoses had better outcome than previously reported. Substance-related psychoses had very poor occupational outcome. Similar proportions of the current and DOSMED cohort were in remission but the former were rated as having greater disability.

In a modern community service, 30–60% of patients with first-episode psychoses experience a good three-year outcome. The ICD–10 criteria have good predictive validity.

Along with all other branches of medicine, child and adolescent psychiatry is faced with the need to consider its evidence base and justify its activities accordingly.

To consider critically the use of the term ‘evidence’, to suggest limits to the value of conventionally defined evidence and to point to possible ways forward to bridge the gap between research findings and clinical practice.

A review of the literature relating to the use of evidence-based methods.

The term ‘evidence’ needs to be used more widely than is conventionally the case. Substantial evidence exists from controlled trials, but there are barriers to its use.

A move away from non-validated methods of intervention is both desirable and feasible. The use of qualitative methods of enquiry, both in situations where controlled trials are unlikely to be feasible and as adjuncts to quantitative methods, should be considered more seriously.

Most previous case–control studies of obstetric complications in schizophrenia have been small scale and many have relied on retrospective information.

To determine which obstetric complications are more common in probands with schizophrenia than matched controls.

Two hundred and ninety-six probands with an in-patient diagnosis of schizophrenia who had been born in Scotland in 1971–74, and a further 156 born in 1975–78, were closely matched with controls and the incidence of obstetric complications in the two compared using obstetric data recorded in a set format shortly after birth.

Not a single complication of pregnancy or delivery was significantly more common in the probands with schizophrenia than the controls in the 1971–74 birth cohort and only emergency Caesarean section and labour lasting over 12 hours were significantly more common in the schizophrenia probands in the 1975–78 cohort.

The evidence that schizophrenia is associated with a raised incidence of obstetric complications is weaker than has recently been assumed.