The World Health Organization (WHO) has indicated that 8–12% of couples worldwide experience infertility, and in recent years the number seeking treatment has dramatically increased. The diagnosis and therapy put a heavy psychological and physical burden on most patients, female and male. The incidence of depression in couples presenting for infertility treatment is significantly higher than in comparable fertile couples. Anxiety is significantly higher in infertile couples than in the general population. Professionals have become aware of the importance of providing educational interventions to address patients' fears and concerns, and to better prepare patients for the demands of treatment. Health professionals should follow a patient-centred approach to provide for the specific needs of the couple. Women in general have a positive attitude to seeking psychological help in the form of cognitive-behavioural therapy, couples counselling and infertility counselling.

The relationship between alcohol use and cognitive impairment has been notoriously difficult to disentangle. We present what is known about cognitive impairment associated with alcohol use/misuse, covering the spectrum from mild and subtle cognitive change through to severe alcohol-related brain damage, including Wernicke-Korsakoff syndrome. We highlight aids to the diagnosis and management of these conditions, and emphasise the benefits of prompt treatment on outcome. We also review progress in understanding their neurobiology. Suggestions for possible service configuration based on both our clinical practice and national guidelines are given.

Young adults and adolescents who experience a first episode of psychosis are faced with important issues and choices concerning their future mental health. Individual and family psychological treatments and psychosocial supportive measures are now well recognised interventions for this group of individuals. This article considers the complexity surrounding medication management after the initial recovery from psychosis. The discussion focuses particularly on the medical treatments, developmental considerations and roles of psychiatrists in improving outcomes for this group of patients.

We describe the work of a psychodynamic psychotherapy group for individuals affected by chronic schizophrenia in our community-based rehabilitation and recovery service. Despite presenting with negative symptoms, over time patients made good use of the psychodynamic setting: they attended, expressed emotions, made connections and reflected within the group on their personal experience of mental ill health. We discuss the rationale and indications for psychodynamic psychotherapy for individuals with severe and enduring mental illnesses. We also reflect on the challenges we faced working psychodynamically with psychosis and on the necessary adaptation of the approach to work with chronic psychosis. We present vignettes from group sessions to illustrate themes that we identified in the therapy, making links with the literature. We conclude that the unstructured setting of the psychodynamic group approach can help individuals affected by most severe forms of psychosis to make sense of their experiences and use the space.

This article reviews the recent changes to the DSM diagnostic classification of feeding and eating disorders with particular reference to children and adolescents. The common clinical presentations of the ‘atypical’ feeding and eating problems of middle childhood and early adolescence are reviewed using clinical case vignettes, and the limited evidence base regarding management is summarised. There are many gaps in the evidence base and this is likely to be an area of rapid development for the field subsequent on the new terminology outlined in DSM-5.

This article presents evidence for the efficacy of psychosocial interventions for people with dementia and their carers. The evidence base is not yet robust enough to clearly suggest which interventions are most suited for which environment. However, from our literature review there appears to be reason to use music therapy, aromatherapy, life story work, animal-assisted therapy and post-diagnosis/carer support work. We focus on both the traditional outcome measures of behavioural and psychological symptoms of dementia (BPSD) and the more difficult to measure, but equally important, person-centred outcomes of nonpharmacological interventions, as their properties are distinctly different from those of pharmacological agents.

Mental disorder and criminality are separate entities but some people with a mental disorder commit criminal offences and some criminals have a mental disorder. Before 1800 there was no separate category of mentally disordered offenders (referred to as criminal lunatics until 1948) in UK legislation. The provision of facilities for mentally disordered offenders in Britain and Ireland overlapped with, but was also separate from, provision for the mentally ill generally. The interface between general and forensic psychiatry is an area of tension and of collaboration. To understand how contemporary general and forensic psychiatry interact, it is useful to have an understanding of how factors have evolved overtime.

With the subspecialisation of psychiatry in the UK, clinicians encounter problems at the interfaces between specialties. These can lead to tension between clinicians, which can be unhelpful to the clinical care of the patient. This article focuses on the interface between general and forensic psychiatry in England and Wales. The pattern of mental health services in England and Wales differs to an extent from those in Scotland, Northern Ireland and in the Republic of Ireland. Consequently, the interface between general and forensic psychiatry is subject to varying influences. Important interface issues include: the definition of a ‘forensic patient’; the remit and organisation of services; resources; clinical responsibility; and care pathways. This article also discusses a general overview of how to improve collaboration between forensic and general adult psychiatric services.