Globalisation is the process by which traditional boundaries of cultures are changing. Industrialisation, urbanisation and influence of the media are influencing idioms of distress across cultures.

To discuss the role of globalisation, using the epidemiology, diagnosis, clinical presentation and treatment of depression across various cultures as an example.

Recent studies focusing on transcultural aspects of depression were reviewed and summarised.

Cultural, social and religious mores account for variations in the presentation of depression across cultures. Somatic symptoms are common presenting features throughout the world and may serve as cultural idioms of distress, but psychological symptoms can usually be found when probed. Feelings of guilt and suicide rates vary across cultures and depression may be underdiagnosed.

Training packages could enhance clinicians' cultural competency in multicultural settings. However, globalisation is likely to influence idioms of distress and pathways to care in ways that are difficult to predict.

Violence against women is increasingly recognised as an important issue in both research and social policy.

To assess the lifetime experience of physical and sexual violence among lone and partnered mothers and the association with psychiatric disorders.

Analysis of the Australian National Survey of Mental Health and Wellbeing. The representative sample included 2232 women with children who completed the Composite International Diagnostic Interview, a scale of psychological distress and sociodemographic measures.

Lone mothers were more likely to have psychiatric disorders (odds ratios between 2.4 and 3.4) and have experienced physical and sexual violence (odds ratios between 31 and 41) than partnered mothers. The measures of physical and sexual violence were better predictors of psychiatric disorders than either lone parent status or the sociodemographic measures.

Experience of physical and sexual violence accounted for much of the greater prevalence of psychiatric disorders among lone compared with partnered mothers.

Low birth weight increases the risk of childhood behavioural problems, but it is not clear whether poor foetal growth has a long-term influence on susceptibility to depression.

To examine the relation between birth weight and risk of psychological distress and depression.

At age 16 years 5187 participants in the 1970 British Cohort Study completed the 12-item General Health Questionnaire to assess psychological distress. At age 26 years 8292 participants completed the Malaise Inventory to assess depression and provided information about a history of depression.

Women whose birth weight was 3 kg had an increased risk of depression at age 26 years (OR=1.3; 95% CI 1.0–1.5) compared with those who weighed > 3.5 kg. Birth weight was not associated with a reported history of depression or with risk of psychological distress at age 16 years. In men there were no associations between any measurement and the full range of birth weight but, compared with men of normal birth weight, those born weighing $2.5 kg were more likely to be psychologically distressed at age 16 years (OR=l.6, 95% CI 1.1–2.5) and to report a history of depression at age 26 years (OR=l.6, 95% CI 1.1–2.3).

Impaired neurodevelopment during foetal life may increase susceptibility to depression.

Although there have been many studies of the biological and psychosocial causations of postnatal depression, studies of sociocultural risk factors are rare.

To investigate the sociocultural risk factors of postnatal depression using ethnographically informed epidemiological methods.

Atotal of 959 women were assessed at their first ante-partum visit (baseline), in the third trimester, immediately after delivery, and 3 months post-partum. Six domains of risk factors were examined. The dependent variable was postnatal depression (as defined by the Edinburgh Postnatal Depression Scale) at 3 months post-partum.

Conflict with mother-in-law, marital dissatisfaction, past depression and antenatal depression independently predicted the occurrence of postnatal depression. The cultural practice of peiyue – a Chinese post-partum custom of mandated family support – was associated with better social support and a slightly lower risk of postnatal depression.

Sociocultural aspects of the immediate puerperium shape maternal emotional well-being. In-law conflict is an important source of household distress in many Asian societies. The findings have implications for clinical practice and future studies.

Deaths from antidepressants continue to account for a substantial proportion of drug-related deaths.

To investigate the relative toxicity of the major classes of antidepressant drugs, with the specific objective of assessing this in relation to the cause of death; and to analyse the deaths where there were multiple mentions of antidepressant drugs or other psychoactive drugs with antidepressants.

Mortality data were collected from the National Programme of Substance Abuse Deaths, and antidepressant prescription data were collected.

Most deaths from antidepressant drugs were suicides (80%). Tricyclic antidepressants (TCAs) accounted for more drug mentions than did other antidepressant drugs (12 per million prescriptions). Selective serotonin reuptake inhibitors (SSRIs) were associated with a significantly lower risk of toxicity, but 93% of deaths from SSRIs occurred in combination with other drugs, especially TCAs (24.5%). In ‘combination’ deaths patients were significantly more likely to have had a history of drug misuse.

The efficacy and safety of augmentation therapy with TCAs in SSRI-resistant patients should be monitored carefully, and patients prescribed antidepressants should be screened for drug use/misuse.

Care for people with schizophrenia should address a wide range of outcomes, including professional and consumer perspectives.

To measure changes in psychopathology functioning, needs for care and quality of life; to develop predictive models for each outcome domain; and to assess the frequency of ‘good'and ‘poor’ outcomes, as defined in a series of different definitions that use combinations of the four domains measured.

Three-year follow-up of a 1-year-treated prevalence cohort of 107 patients with an ICD–10 diagnosis of schizophrenia attending the South Verona community-based mental health service.

Mean symptom severity and some types of needs for care worsen, but quality of life shows no change. Functioning shows a non-significant trend to deteriorate. Between 32% and 42% of the variance in the four key outcomes was explained by our model. Different definitions of good'and ‘poor’ outcome included 0–31% of patients, depending on the definition used.

The 3-year outcome for schizophrenia depends on the domain of outcome used, whether staff or patient ratings are used and the stringency of the definitions used for good and poor outcome.

Weight gain is a common consequence of antipsychotic drug treatment and can lead to further morbidity.

To assess the effects of antipsychotic drug therapy on abdominal fat deposition, on insulin and leptin secretion, and on circulating glucose and lipids.

Abdominal body fat was determined by magnetic resonance imaging in a group of previously untreated patients with schizophrenia, before and after 10 weeks'antipsychotic drug treatment. Body mass and blood concentrations of glucose, insulin, leptin and lipids were also measured.

Significant increases in both subcutaneous and intra-abdominal fat were identified after antipsychotic drug treatment. A three-fold increase in leptin secretion as well as significant increases in levels of circulating lipids and non-fasting glucose were also identified.

Patients first receiving antipsychotic drugs experience substantial deposition of both subcutaneous and intra-abdominal fat, reflecting a loss of the normal inhibitory control of leptin on body mass. Along with fat deposition, the increase in levels of fasting lipids and in non-fasting glucose may provide early signs of drug-induced progression towards the metabolic syndrome.

Early single-session psychological interventions, including psychological debriefing following trauma, have not been shown to reduce psychological distress. Longer early psychological interventions have shown some promise.

To examine the efficacy of a four-session cognitive–behavioural intervention following physical injury.

A total of 152 patients attending an accident and emergency department displaying psychological distress following physical injury were randomised 1–3 weeks post-injury to a four-session cognitive–behavioural intervention that started 5–10 weeks after the injury or to no intervention and then followed up for 13 months.

At 13 months, the total Impact of Event Scale score was significantly more reduced in the intervention group (adjusted mean difference=8.4, 95% CI 2.4–14.36). Other differences were not statistically significant.

Abrief cognitive–behavioural intervention reduces symptoms of post-traumatic stress disorder in individuals with physical injury who display initial distress.

No national data on the prevalence of mental disorders are available in Iran. Such information may be a prerequisite for efficient national mental health intervention.

To determine the mental health status of a population sample aged 15 years and over.

Through random cluster sampling, 35 014 individuals were selected and evaluated using the 28-item version of the General Health Questionnaire. A complementary semi-structured clinical interview was also undertaken to detect learning disability (‘mental retardation’), epilepsy and psychosis.

About a fifth of the people in the study (25.9% of the women and 14.9% of the men) were detected as likely cases. The prevalence of mental disorders was 21.33% in rural areas and 20.9% in urban areas. Depression and anxiety symptoms were more prevalent than somatisation and social dysfunction. The interview of families by general practitioners revealed that the rates of learning disability epilepsy and psychosis were 1.4%, 1.2% and 0.6%, respectively Prevalence increased with age and was higher in the married, widowed, divorced, unemployed and retired people.

Prevalence rates are comparable with international studies. There is a wide regional difference in the country, and women are at greater risk.

The ICD – 10 and DSM – IV diagnostic criteria for hyperkinetic disorder and attention-deficit hyperactivity disorder (ADHD) require symptoms or impairment in two or more settings. Thus, information on children's symptoms in school is usually required. This paper presents the Child ADHD Teacher Telephone Interview (CHATTI), an instrument aimed at systematically obtaining this information.

To examine the stability, test–retest reliability and criterion validity of the CHATTI for children referred with a suspected diagnosis of ADHD.

Data were obtained from 79 teachers, of whom 36 were interviewed on two occasions.

Overall, the CHATTI shows good stability test–retest reliability and criterion validity for symptom scores. Test–retest reliability for some individual items was low. Reliability for the operationalised criteria of ‘pervasiveness' (i.e. symptoms at school and home) and ‘school impairment’ was excellent (κ=1).

The CHATTI appears to be a promising tool for assessing ADHD symptoms in a school setting and could be useful in clinical as well as research settings.

Patients and doctors often have divergent views on care needs.

To examine whether providing patients with an opportunity to identify and discuss their needs would improve communication and induce changes in care.

Patients with schizophrenia (n=134) were randomly allocated to either standard care or use of the Two-Way Communication Checklist (2-COM). Before seeing their clinician for a routine follow-up, participants in the active intervention group were given 2-COM, a list of 20 common needs, and told to indicate those areas they wanted to discuss with their doctor. Outcomes were assessed immediately and again after 6 weeks.

Using 2-COM induced a stable improvement of patient-reported quality of patient–doctor communication (B=0.33, P=0.031), and induced changes in management immediately after the intervention (OR=3.7, P=0.009; number needed to treat, 6). Treatment change was more likely in patients with more reported needs, and needs most likely to induce treatment change displayed stronger associations with non-medication than with medication changes.

A simple intervention to aid people in discussion of their needs results in improved communication and changes in management.