A wide range of cognitive deficits have been demonstrated in schizophrenia, but their longitudinal course remains unclear.

To bring together all the available information from longitudinal studies of cognitive performance in people with schizophrenia.

We carried out a meta-analysis of 53 studies. Unlike previous reviewers, we included all studies (regardless of the type of medication), analysed each variable separately and compared results with data from controls.

Participants with schizophrenia showed a significant improvement in most cognitive tasks. The available data for controls showed, with one exception (the Stroop test), a similar or greater improvement. Performance in semantic verbal fluency remained stable in both individuals with schizophrenia and controls.

Participants with schizophrenia displayed improvement in most cognitive tasks, but practice was more likely than cognitive remediation to account for most of the improvements observed. Semantic verbal fluency may be the best candidate cognitive endophenotype.

Judging whether we can trust other people is central to social interaction, despite being error-prone. A fear of others can be instilled by the contemporary political and social climate. Unfounded mistrust is called paranoia, and in severe forms is a central symptom of schizophrenia.

To demonstrate that individuals without severe mental illness in the general population experience unfounded paranoid thoughts, and to determine factors predictive of paranoia using the first laboratory method of capturing the experience.

Two hundred members of the general public were comprehensively assessed, and then entered a virtual reality train ride populated by neutral characters. Ordinal logistic regressions (controlling for age, gender, ethnicity, education, intellectual functioning, socio-economic status, train use, playing of computer games) were used to determine predictors of paranoia.

The majority agreed that the characters were neutral, or even thought they were friendly. However, a substantial minority reported paranoid concerns. Paranoia was strongly predicted by anxiety, worry, perceptual anomalies and cognitive inflexibility.

This is the most unambiguous demonstration of paranoid ideation in the general public so far. Paranoia can be understood in terms of cognitive factors. The use of virtual reality should lead to rapid advances in the understanding of paranoia.

Adversities operating over intrauterine life have been associated with risk of schizophrenia, but the biology of resultant developmental perturbation is poorly understood.

To examine the relationship of congenital anomalies and related functional impairments in infancy to risk of schizophrenia.

Using the Congenital Anomalies data-set from the Prenatal Determinants of Schizophrenia birth cohort, congenital anomalies and related functional impairments were categorised and related to subsequent risk of schizophrenia-spectrum disorder.

The presence of any hypothesis-based congenital anomaly or related functional impairment was associated with a doubling of risk of schizophrenia-spectrum disorder. In contrast, having any other congenital anomaly or related functional impairment was not associated with risk of schizophrenia-spectrum disorder.

These findings constitute evidence for early events, which may result from both genetic predisposition and environmental insults, in the pathogenesis of schizophrenia.

The role of folate, vitamin B12 and homocysteine levels in depression is not clear.

To investigate cross-sectional and prospective associations between folate, B12 and homocysteine levels and late-life depression.

A total of 732 Korean people aged 65 years or over were evaluated at baseline. Of the 631 persons who were not depressed, 521 (83%) were followed over a period of 2–3 years and incident depression was ascertained with the Geriatric Mental State schedule. Serum folate, serum vitamin B12 and plasma homocysteine levels were assayed at both baseline and follow-up.

Lower levels of folate and vitamin B12 and higher homocysteine levels at baseline were associated with a higher risk of incident depression at follow-up. Incident depression was associated with a decline in vitamin B12 and an increase in homocysteine levels over the follow-up period.

Lower folate, lower vitamin B12 and raised homocysteine levels may be risk factors for late-life depression.

Few studies have examined whether attributional style (an individual's explanation of why events happen) is a genetically influenced vulnerability factor for depression.

To investigate whether attributional style is an enduring vulnerability trait for recurrent depression.

As part of the Cardiff Depression Study, we interviewed 108 people with depression and their siblings, and a control group of 105 healthy individuals and their siblings, using the Schedules for Clinical Assessment in Neuropsychiatry and the Life Events and Difficulties Schedule. Participants also completed the Attributional Style Questionnaire.

Regression analyses showed that attributional style results from mood state and is not a familial risk factor for depression. However, the tendency to internalise negative events was related to having had a prior episode of depression, suggesting a ‘scarring’ effect. Also, non-severe events were associated with one subset of optimistic attributions.

Attributional style mainly measures current mood and does not reflect a familial risk factor for depression.

Clinical samples have identified a number of psychosocial risk factors for suicidal acts but it is unclear if these findings relate to the general population.

To describe the prevalence of and psychosocial risk factors for suicidal acts in a general adult population.

Data were obtained from a Canadian epidemiological survey of 36 984 respondents aged 15 years and older (weighted sample n=23 662 430).

Of these respondents, 0.6% (weighted n=130 143) endorsed a 12-month suicidal act. Female gender (OR=4.27, 95% CI 4.05–4.50), being separated (OR=37.88, 95% CI 33.92–42.31) or divorced (OR=7.79, 95% CI 7.22–8.41), being unemployed (OR=1.70, 95% CI 1.50–1.80), experiencing a chronic physical health condition (OR=1.70, 95% CI 1.67–1.86) and experiencing a major depressive episode in the same 12-month period as the act (OR=9.10, 95% CI 8.65–9.59) were significantly associated with a suicidal act.

The psychosocial correlates of suicidal acts in this sample are consistent with those previously reported in clinical and general population samples. These findings reinforce the importance of the determination of suicide risk and its prevention not only of psychiatric illness but of physical and psychosocial factors as well.

The 5HTTLPR genetic variant of the serotonin transporter gene (SERT or 5-HTT), which is comprised of a short (SERT-s) and a long (SERT-l) allele, is associated with major depressive disorder and post-traumatic brain disorder.

The present study sought to determine whether the total thalamus and major subregions are altered in size in major depressive disorder and in relation to the 5HTTLPR genotype.

We investigated the influence of 5HTTLPR genotype, psychiatric diagnosis, suicide and other clinical factors on the volume of the entire post-mortem thalamus.

Major depressive disorder, SERT-ss genotype and suicide emerged as independent factors contributing to an enlargement of the total thalamus. The majority of the volume enlargement associated with the SERT-ss genotype occurred in the pulvinar, whereas enlargement associated with major depressive disorder occurred in the limbic nuclei and in other regions of the thalamus. A history of antidepressant treatment was associated with reduced thalamic volume.

The 5HTTLPR genetic variation may affect behaviour and psychiatric conditions, in part, by altering the anatomy of the thalamus.

It is not clear whether the severity of depressive episodes changes during the course of depressive disorder.

To investigate whether the severity of depressive episodes increases during the course of illness.

Using a Danish nationwide case register, all psychiatric inpatients and out-patients with a main ICD-10 diagnosis of a single mild, moderate or severe depressive episode at the end of first contact were identified. Patients included in the study were from the period 1994–2003.

A total of 19 392 patients received a diagnosis of a single depressive episode at first contact. The prevalence of severe depressive episodes increased from 25.5% at the first episode to 50.0% at the 15th episode and the prevalence of psychotic episodes increased from 8.7% at the first episode to 25.0% at the 15th episode. The same pattern was found regardless of gender, age at first contact and calendar year.

The increasing severity of depressive episodes emphasises the importance of early and sustained prophylactic treatment.

Partial syndromes of eating disorder are common in adolescents but the health significance of these syndromes remains uncertain.

To document the health and social adjustment in young adulthood of females assessed as having a partial syndrome of eating disorder in adolescence.

A community sample of 1943 participants was tracked over 10 years in an eight-wave cohort study. A partial syndrome was defined as the fulfilment of at least two DSM-IV criteria for either anorexia or bulimia nervosa at one assessment or more between the ages of 15 years and 17 years.

Partial syndromes were found in 9.4% of 15- to 17-year-old female participants and 1.4% of males. There were few instances of progression of partial syndromes to fully fledged anorexia and bulimia nervosa. However, among those with partial syndromes depressive and anxiety symptoms were two to three times higher in young adulthood, substance misuse was common, and a majority of those with a partial syndrome of anorexia nervosa were still underweight in their mid-20s.

Given the level of subsequent psychopathology and social role impairment, there may be justification for initiating trials of preventive and early clinical intervention strategies for adolescent partial syndromes.

An integrated multidisciplinary approach to dementia is often recommended but has rarely been evaluated.

To evaluate the clinical effects of an integrated multidisciplinary diagnostic facility for psychogeriatric patients.

Patients suspected of having complex psychogeriatric problems were randomly allocated to the intervention (n=137) or to treatment as usual (n=93). They were assessed at baseline, and at 6 months and 12 months follow-up by means of personal interviews with the patient's proxy. The primary outcome was health-related quality of life, assessed using the visual analogue scale (VAS) of the EuroQd measure, EQ-5D.

Health-related quality of life had improved at 6 months in the intervention group, whereas that of the control group had decreased. Furthermore, more patients in the intervention group experienced a clinically relevant improvement of 10 points or more on the VAS at both follow-up measurements.

An integrated multidisciplinary approach improves dementia care.