A significant association between attention-deficit hyperactivity disorder (ADHD) and obesity has been reported. This study addresses unexplored aspects of this relationship.

To evaluate the association between adult obesity and: (a) persistent, remitted or lifetime ADHD; (b) number of childhood ADHD symptoms, controlling for socioeconomic status and mood, anxiety and substance use disorders.

Face-to-face psychiatric interviews in 34653 US adults from the National Epidemiologic Study on Alcohol and Related Conditions. Obesity was defined as a body mass index ⩾30.

Persistent, lifetime or remitted ADHD were not associated with obesity after controlling for confounders. The number of childhood ADHD symptoms was significantly associated with adult obesity, even after adjustment, in women.

Childhood ADHD symptoms are associated with obesity in women even after comorbid psychiatric disorders are accounted for. This provides a rationale for longitudinal studies assessing the impact of the treatment of childhood ADHD symptoms on obesity in women.

Attention-deficit hyperactivity disorder (ADHD) is linked to increased risk for substance use disorders and nicotine dependence.

To examine the effects of stimulant treatment on subsequent risk for substance use disorder and nicotine dependence in a prospective longitudinal ADHD case–control study.

At baseline we assessed ADHD, conduct disorder and oppositional defiant disorder. Substance use disorders, nicotine dependence and stimulant treatment were assessed retrospectively after a mean follow-up of 4.4 years, at a mean age of 16.4 years.

Stimulant treatment of ADHD was linked to a reduced risk for substance use disorders compared with no stimulant treatment, even after controlling for conduct disorder and oppositional defiant disorder (hazard ratio (HR) = 1.91, 95% Cl 1.10−3.36), but not to nicotine dependence (HR = 1.12, 95% Cl 0.45−2.96). Within the stimulant-treated group, a protective effect of age at first stimulant use on substance use disorder development was found, which diminished with age, and seemed to reverse around the age of 18.

Stimulant treatment appears to lower the risk of developing substance use disorders and does not have an impact on the development of nicotine dependence in adolescents with ADHD.

Little is currently known about how maternal depression symptoms and unhealthy nutrition during pregnancy may developmentally interrelate to negatively affect child cognitive function.

To test whether prenatal maternal depression symptoms predict poor prenatal nutrition, and whether this in turn prospectively associates with reduced postnatal child cognitive function.

In 6979 mother–offspring pairs participating in the Avon Longitudinal Study of Parents and Children (ALSPAC) in the UK, maternal depression symptoms were assessed five times between 18 weeks gestation and 33 months old. Maternal reports of the nutritional environment were assessed at 32 weeks gestation and 47 months old, and child cognitive function was assessed at age 8 years.

During gestation, higher depressive symptoms were related to lower levels of healthy nutrition and higher levels of unhealthy nutrition, each of which in turn was prospectively associated with reduced cognitive function. These results were robust to postnatal depression symptoms and nutrition, as well as a range of potential prenatal and postnatal confounds (i.e. poverty, teenage mother, low maternal education, parity, birth complications, substance use, criminal lifestyle, partner cruelty towards mother).

Prenatal interventions aimed at the well-being of children of parents with depression should consider targeting the nutritional environment.

High levels of attentional and hyperactivity problems in school-aged children, even if subthreshold for attention-deficit hyperactivity disorder (ADHD), are associated with academic under-achievement. Few large-scale, community-based studies have investigated the relationship between pre-school and adolescence.

To investigate whether pre-school hyperactivity/inattention and conduct problems are independently associated with academic outcomes at age 16.

Data from the prospective, population-based Avon Longitudinal Study of Parents and Children (ALSPAC) were used. After adjusting for a broad range of confounder variables, the associations between parent-rated hyperactivity/inattention and conduct problems measured at age 3 and academic outcomes at age 16 (national General Certificate of Secondary Education (GCSE) examination results) were investigated (n = 11640).

Both early hyperactivity/inattention and conduct problems had negative effects on academic outcomes. In adjusted analyses, abnormal hyperactivity/inattention scores were associated with reductions of ten GCSE points in boys. Borderline and abnormal conduct problem scores were associated with reductions of 9–10 and 12–15 points respectively.

Pre-school hyperactivity/inattention and conduct problems carry risk of worse academic outcomes at 16.

Although dietary patterns have been linked to depression, a frequently observed precondition for suicide, no study has yet examined the association between dietary patterns and suicide risk.

To prospectively investigate the association between dietary patterns and death from suicide.

Participants were 40 752 men and 48 285 women who took part in the second survey of the Japan Public Health Center-based Prospective Study (1995–1998). Dietary patterns were derived from principal component analysis of the consumption of 134 food and beverage items ascertained by a food frequency questionnaire. Hazard ratios of suicide from the fourth year of follow-up to December 2005 were calculated.

Among both men and women, a ‘prudent’ dietary pattern characterised by a high intake of vegetables, fruits, potatoes, soy products, mushrooms, seaweed and fish was associated with a decreased risk of suicide. The multivariable-adjusted hazard ratio of suicide for the highest v. lowest quartiles of the dietary pattern score was 0.46 (95% CI 0.28–0.75) (P for trend, 0.005). Other dietary patterns (Westernised and traditional Japanese) were not associated with suicide risk.

Our findings suggest that a prudent dietary pattern may be associated with a decreased risk of death from suicide.

Adolescent substance use is associated with both earlier childhood behavioural problems and serious lifetime addiction problems later in life.

To examine whether, and through which mechanisms, targeting risk factors in early childhood prevents substance use across adolescence.

Disruptive kindergarten boys (n = 172) living in Montreal were randomly allocated to a preventive intervention and a control condition. The intervention was delivered over 2 years (7–9 years of age) with two main components: (a) social and problem-solving skills training for the boys; and (b) training for parents on effective child-rearing skills.

Adolescent substance use, up to 8 years post-intervention, was reduced in those who received the intervention (d = 0.48−0.70). Of most interest, the intervention effects were explained partly by reductions in impulsivity, antisocial behaviour and affiliation with less deviant peers during pre-adolescence (11–13 years).

Adolescent substance use may be indirectly prevented by selectively targeting childhood risk factors that disrupt the developmental cascade of adolescent risk factors for substance use.

Major depressive disorder is associated with significant impairment in occupational functioning and reduced productivity, which represents a large part of the overall burden of depression.

To examine symptom-based and work functioning outcomes with combined pharmacotherapy and psychotherapy treatment of major depressive disorder.

Employed patients with a DSM-IV diagnosis of major depressive disorder were treated with escitalopram 10–20mg/day and randomised to: (a) telephone-administered cognitive-behavioural therapy (telephone CBT) (n = 48); or (b) adherence-reminder telephone calls (n = 51). Outcomes included the Montgomery-åsberg Depression Rating Scale (MADRS), administered by masked evaluators via telephone, and self-rated work functioning scales completed online. (Registered at clinicaltrials.gov: NCT00702598.)

After 12 weeks, there were no significant between-group differences in change in MADRS score or in response/remission rates. However, participants in the telephone-CBT group had significantly greater improvement on some measures of work functioning than the escitalopram-alone group.

Combined treatment with escitalopram and telephone- administered CBT significantly improved some self-reported work functioning outcomes, but not symptom-based outcomes, compared with escitalopram alone.

Relatives of people with psychosis experience high levels of distress and require support. Family interventions have been shown to be effective in improving outcomes but are difficult to access and not suitable for all relatives.

To assess the feasibility and effectiveness of a supported self-management package for relatives of people with recent-onset psychosis.

A randomised controlled trial (n = 103) comparing treatment as usual (TAU) in early intervention services with TAU plus the Relatives' Education And Coping Toolkit (REACT) intervention (trial identifier: ISRCTN69299093).

Compared with TAU only, those receiving the additional REACT intervention showed reduced distress and increased perceived support and perceived ability to cope at 6-month follow-up.

The toolkit is a feasible and potentially effective intervention to improve outcomes for relatives. A larger trial is needed to reliably assess the clinical and cost-effectiveness of REACT, and its impact on longer-term outcomes.

Identifying modifiable risk factors for cognitive decline may inform prevention of dementia.

To examine the combined impact of cigarette smoking and heavy alcohol consumption on cognitive decline from midlife.

Prospective cohort study (Whitehall II cohort) with three clinical examinations in 1997/99, 2002/04 and 2007/09. Participants were 6473 adults (72% men), mean age 55.76 years (s.d. = 6.02) in 1997/99. Four cognitive tests, assessed three times over 10 years, combined into a global z-score (mean 0, s.d. = 1).

Age-related decline in the global cognitive score was faster in individuals who were smoking heavy drinkers than in non-smoking moderate alcohol drinkers (reference group). The interaction term (P = 0.04) suggested that the combined effects of smoking and alcohol consumption were greater than their individual effects. Adjusting for age, gender, education and chronic diseases, 10-year decline in global cognition was −0.42 z-scores (95% Cl −0.45 to −0.39) for the reference group. In individuals who were heavy alcohol drinkers who also smoked the decline was −0.57 z-scores (95% Cl −0.67 to −0.48); 36% faster than the reference group.

Individuals who were smokers who drank alcohol heavily had a 36% faster cognitive decline, equivalent to an age-effect of 2 extra years over 10-year follow-up, compared with individuals who were non-smoking moderate drinkers.

Dependent cocaine users consistently display cognitive deficits but cognitive performance of recreational cocaine users has rarely been investigated.

To examine whether cognitive performance is impaired in relatively pure recreational and dependent cocaine users.

The cognitive performance of recreational (n = 68) and dependent cocaine users (n = 30) was compared with the performance of stimulant-naive controls (n = 68) employing an extensive neuropsychological test battery. Moreover, the impact of attention-deficit hyperactivity disorder (ADHD) symptoms, craving and early age at onset was analysed.

Dependent cocaine users display broad cognitive impairments in the domains of attention, working memory, declarative memory and executive functions. The performance of recreational cocaine users in all four domains was intermediate between that of controls and dependent users and they displayed significant deficits foremost in the domains of attention and working memory. In addition, ADHD symptoms, craving and age at onset were important modulators of cognitive function in cocaine users.

Cognitive deficits occur at a recreational and non-dependent level of cocaine use. Cocaine use and ADHD seem to have mutually aggravating effects on cognitive impairment.

Body image dissatisfaction during adolescence is common but not benign. School-based interventions have the potential for wide reach, but scalability of previous programmes is limited by a reliance on external facilitators.

To assess the acceptability, feasibility and efficacy of a teacher-delivered body image intervention.

A pilot clustered randomised controlled trial in which 16 classes of adolescent girls were allocated to a 6-session body image programme (n = 261), or usual curriculum control (n = 187) (registration: ISRCTN42594993).

Students in the intervention group had significantly improved body esteem and self-esteem and reduced thin-ideal internalisation. Effects for body esteem and thin-ideal internalisation were maintained for 3 months. There were no group differences for eating pathology, peer factors or depression. Acceptability, feasibility and efficacy varied between schools.

Teacher-delivered body image lessons have promise but further work is needed to increase efficacy and make interventions suitable across a range of schools.

Although outcomes among people with schizophrenia differ by social context, this has rarely been examined across rural v. urban settings. For individuals with schizophrenia, employment is widely recognised as a critical ingredient of social integration.

To compare employment for people with schizophrenia in rural v. urban settings in China.

In a large community-based study in four provinces representing 12% of China's population, we identified 393 people with schizophrenia (112 never treated). We used adjusted Poisson regression models to compare employment for those living in rural (n = 297) v. urban (n = 96) settings.

Although rural and urban residents had similar impairments due to symptoms, rural residents were three times more likely to be employed (adjusted relative risk 3.27, 95% Cl 2.11-5.07, P<0.001).

People with schizophrenia have greater opportunities to use their capacities for productive work in rural than urban settings in China. Contextual mechanisms that may explain this result offer a useful focus for future research.

There are no randomised clinical trials comparing the outcomes of short- with long-term psychodynamic group psychotherapy.

To compare differences in outcome during and after short-and long-term group psychotherapy.

In total, 167 out-patients with mood, anxiety and personality disorders were randomised to short- or long-term group therapy (20 or 80 weekly, 90 min sessions). Outcome measures were: symptoms (Symptom Checklist 90 – Revised), interpersonal problems (Inventory of Interpersonal Problems – Circumplex) and psychosocial functioning (Global Assessment of Functioning (GAF) split version: GAF-Symptom and GAF-Function). Change over the 3-year study period was assessed using linear mixed models. The study was registered in clinicalTrials.gov as NCT00521417.

Patients in both groups made significant gains. A significantly larger symptomatic change over time was found for long-term compared with short-term therapy, but no significant differences were detected for the three remaining outcome variables. There was a higher number of premature terminations in the long-term (33.3%) compared with the short-term group (8.6%).

Short- and long-term therapy seem equally effective for typical out-patients seeking group psychotherapy, except for symptomatic distress.

Former child soldiers are at risk of developing post-traumatic stress disorder (PTSD); however, the trajectory of symptoms has yet to be examined.

The risk and protective factors associated with PTSD symptom change among former child soldiers in Sierra Leone were investigated.

Data from 243 former child soldiers (mean age 16.6 years, 30% female) were analysed.

Self-reported rates of possible PTSD using standard cut-off points declined from 32% to 16% 4 years later (P<0.05). Symptoms of PTSD at baseline were significantly associated with war experiences (P<0.01) and post-conflict family abuse (P<0.001). Reliable improvement in symptoms was reported by 30%. In growth models examining symptom change, worsening of symptoms was associated with death of a parent (P<0.05) and post-conflict stigma (P<0.001). Protective effects were observed for increases in family acceptance (P<0.001).

The findings indicated improvement in PTSD symptoms among former child soldiers despite limited access to care. Family and community support played a vital part in promoting psychological adjustment.