A national survey in 1997 found that Australia had a high prevalence of mental disorders with low rates of treatment. Since then, treatment availability has increased greatly and unmet need has reduced. However, there is little evidence that the nation's mental health has improved.

There is concern regarding the quality of information about mental health problems on the internet. A trial was carried out to see whether sending feedback to website administrators about the quality of information on their website would lead to an improvement (ACTRN12609000449235). Fifty-two suicide prevention websites were identified by means of an online search. The quality of information about how to help someone who is suicidal was scored against expert consensus guidelines. Websites were randomised to receive feedback or serve as controls. The information on the websites varied greatly in quality. However, feedback did not lead to an improvement.

Phonological recoding is commonly viewed as a back-up mechanism when word identification using the visual pathway fails. A second more important role for phonological recoding is as a self-teaching mechanism by which the child learns to identify words visually. Although phonological recoding may play a minor role in skilled adult reading, it plays a critical role in helping the child become a skilled reader. This article reviews the evidence relevant to these issues. The first section examines evidence on the role of phonological recoding in the development of word identification skills and reading comprehension. The next section reviews evidence showing that children with reading disabilities often have deficits in basic phonological processing skills. The third section deals with the nature of the reading problem in such children which, it is argued, is consistent with the proposed developmental analysis of the importance of phonological recoding in learning to read. The article concludes with a discussion of the teaching implications of these conclusions.

Background. There has been ethical concern that participants in psychiatric research will become distressed and their mental state might worsen.

Method. A systematic search was carried out for studies that examined distress following participation in research that involved the assessment of psychiatric state or associated risk factors. There were 46 relevant studies.

Results. A minority of participants become distressed immediately after participation, with distress more likely in studies of traumatic experiences. There is limited evidence on longer-term effects, but what there is suggests no adverse impact. Positive reactions to participation show little association with distress and these are more common than negative reactions. Very few studies of distress in research have used control groups to establish causal associations. However, what evidence there is suggests no causal role, including for research on suicidality. Researchers in this area have made a range of suggestions about ethical practice.

Conclusions. A minority of participants in psychiatric research become distressed, but there is no evidence of longer-term harm. Nevertheless, researchers need to take account of ethical concerns in designing studies. Future research in the area needs to be carried out with stronger designs involving control groups.

Objective: This cross-sectional study examined the prevalence and characteristics of depression in subjects with mild cognitive impairment (MCI). The data presented here are from the first wave of the longitudinal Personality and Total Health Through Life 60+ (PATH 60+) Project.

Method: A total of 2551 community-dwelling individuals in the age range 60–64 years were recruited randomly through the electoral roll. They were screened using a short cognitive battery and those who screened positive underwent detailed medical and neuropsychological assessments. There were 29 subjects who fulfilled the Mayo Clinic criteria for MCI and these were compared to 520 controls. Subjects were evaluated for depression symptoms and DSM-IV major and minor depression syndromes.

Results: Subjects with MCI had more minor depression and higher scores on a symptom scale. However, a multivariate examination of specific symptoms showed that the differences were confined to only two motivation-related symptoms (“felt slowed up” and “little interest or pleasure”).

Conclusion: Motivation-related depressive symptoms are more relevant in subjects with MCI than mood-related symptoms.

Background. While pre-trauma personality and mental health measures are risk factors for post-traumatic stress disorder (PTSD), such information is usually obtained following the trauma and can be influenced by post-trauma distress. We used data collected from a community-based survey of young adults before and after a major natural disaster to examine the extent to which participants' traumatic experiences, demographic and pre-trauma risk factors were associated with their screening positive for PTSD when re-interviewed.

Method. A representative selection of 2085 young adults from the Australian Capital Territory and environs, interviewed in 1999 as part of a longitudinal community-based survey, were re-interviewed 3–18 months after a major bushfire had occurred in the region. When re-interviewed, they were asked about their experiences of trauma threat, uncontrollable and controllable traumatic experiences and their reaction to the fire. They were also screened for symptoms of fire-related PTSD experienced in the week prior to interview.

Results. Four-fifths of participants were exposed to the trauma with around 50% reporting having experienced uncontrollable traumatic events. Reporting PTSD symptoms was associated with being female, having less education, poorer mental health and higher levels of neuroticism prior to the trauma. Particular fire experiences, including being evacuated and feeling very distressed during the disaster, were more strongly associated with PTSD symptoms compared with pre-trauma measures.

Conclusions. While demographic and pre-trauma mental health increased the likelihood of reporting PTSD symptoms, exposure to trauma threat and reaction to the trauma made greater contributions in explaining such symptoms as a result of this disaster.

Much of the burden of depression and anxiety in the population is attributable to subclinical symptoms. Broadening formal health-care systems to treat subclinical depression and anxiety is not the answer to reducing this burden, because health-care systems lack the resources even to provide optimal care to clinical cases. The solution proposed is the population-wide dissemination of informal self-help strategies that have evidence for effectiveness. These are highly acceptable to the public, easily applied, inexpensive and may avert the development of many clinical cases.

Background. Case control studies have supported a relationship between low folic acid and vitamin B12 and high homocysteine levels as possible predictors of depression. The results from epidemiological studies are mixed and largely from elderly populations.

Method. A random subsample of 412 persons aged 60–64 years from a larger community sample underwent psychiatric and physical assessments, and brain MRI scans. Subjects were assessed using the PRIME-MD Patient Health Questionnaire for syndromal depression and severity of depressive symptoms. Blood measures included serum folic acid, vitamin B12, homocysteine and creatinine levels, and total antioxidant capacity. MRI scans were quantified for brain atrophy, subcortical atrophy, and periventricular and deep white-matter hyperintensity on T2-weighted imaging.

Results. Being in the lowest quartile of homocysteine was associated with fewer depressive symptoms, after adjusting for sex, physical health, smoking, creatinine, folic acid and B12 levels. Being in the lowest quartile of folic acid was associated with increased depressive symptoms, after adjusting for confounding factors, but adjustment for homocysteine reduced the incidence rate ratio for folic acid to a marginal level. Vitamin B12 levels did not have a significant association with depressive symptoms. While white-matter hyperintensities had significant correlations with both homocysteine and depressive symptoms, the brain measures and total antioxidant capacity did not emerge as significant mediating variables.

Conclusions. Low folic acid and high homocysteine, but not low vitamin B12 levels, are correlates of depressive symptoms in community-dwelling middle-aged individuals. The effects of folic acid and homocysteine are overlapping but distinct.

Background and aims: The IQCODE is widely used as a screening test for dementia, particularly where the subject is unable to undergo direct cognitive testing or for screening in populations with low levels of education and literacy. This review draws together research on the psychometric properties and validity of the IQCODE.

Method: A systematic search of the literature was carried out using three databases.

Results: The review shows that the questionnaire has high reliability and measures a single general factor of cognitive decline. It validly reflects past cognitive decline, performs at least as well at screening as conventional cognitive screening tests, predicts incident dementia, and correlates with a wide range of cognitive tests. A particular strength is that the IQCODE is relatively unaffected by education and pre-morbid ability or by proficiency in the culture's dominant language. The disadvantage of the IQCODE is that it is affected by informant characteristics such as depression and anxiety in the informant and the quality of the relationship between the informant and the subject.

Conclusions: Because the IQCODE provides information complementary to brief cognitive tests, harnessing them together can improve screening accuracy.

Background: There are no existing epidemiological data on use of medications to enhance memory.

Method: A community survey was carried out in Canberra and Queanbeyan, Australia, of an electoral roll sample of 2551 adults aged 60–64 years. Data collected included self-reports of using medications to enhance memory, tests of memory and other cognitive functions, anxiety, depression, physical health and use of other medications.

Results: 2.8% of the sample reported using medications to enhance memory, the main ones being gingko biloba, vitamin E, bacopa (brahmi), and folic acid/B vitamins. Users were more likely to be female, to have subjective memory problems and to use other psychotropic medications. However, they did not differ in memory performance, anxiety, depression or physical health.

Discussion: Some older people are using complementary medications to improve their memory or prevent memory loss, despite the lack of strong evidence for their effectiveness. These people show no objective evidence of memory impairment