I.M.A. has been a consultant for pharmaceutical companies developing and marketing antidepressants and has been an author on publications that have used the term treatment-resistant depression.

None.

M.M.L. has provided expert testimony in legal proceedings following in-patient suicide. N.K. sits on the Department of Health (England) National Suicide Prevention Strategy Advisory group.

In the past 3 years R.H.M.W. has received support for research, expenses to attend conferences and fees for lecturing and consultancy work (including attending advisory boards) from various pharmaceutical companies including Astra Zeneca, Cyberonics, Eli Lilly, Janssen, LivaNova, Lundbeck, MyTomorrows, Otsuka, Pfizer, Roche, Servier, SPIMACO and Sunovion. D.M.B.C. has received fees from LivaNova for attending an advisory board. In the past 3 years A.J.C. has received fees for lecturing from Astra Zeneca and Lundbeck; fees for consulting from LivaNova, Janssen and Allergan; and research grant support from Lundbeck.

In the past 3 years A.C. has received fees for lecturing from pharmaceutical companies namely Lundbeck and Sunovion. In the past 3 years A.L.M. has received support for attending seminars and fees for consultancy work (including advisory board) from Medtronic Inc and LivaNova. R.M. holds joint research grants with a number of digital companies that investigate devices for depression including Alpha-stim, Big White Wall, P1vital, Intel, Johnson and Johnson and Lundbeck through his mindTech and CLAHRC EM roles. M.S. is an associate at Blueriver Consulting providing intelligence to NHS organisations, pharmaceutical and devices companies. He has received honoraria for presentations and advisory boards with Lundbeck, Eli Lilly, URGO, AstraZeneca, Phillips and Sanofi and holds shares in Johnson and Johnson. In the past 3 years P.R.A.S. has received support for research, expenses to attend conferences and fees for lecturing and consultancy work (including attending an advisory board) from life sciences companies including Corcept Therapeutics, Indivior and LivaNova. In the past 3 years P.S.T. has received consultancy fees as an advisory board member from the following companies: Galen Limited, Sunovion Pharmaceuticals Europe Ltd, myTomorrows and LivaNova. A.H.Y. has undertaken paid lectures and advisory boards for all major pharmaceutical companies with drugs used in affective and related disorders and LivaNova. He has received funding for investigator initiated studies from AstraZeneca, Eli Lilly, Lundbeck and Wyeth.

Many studies have documented robust relationships between depression and hopelessness and subsequent suicidal thoughts and behaviours; however, much weaker and non-significant effects have also been reported. These inconsistencies raise questions about whether and to what degree these factors confer risk for suicidal thoughts and behaviours.

This study aimed to evaluate the magnitude and clinical utility of depression and hopelessness as risk factors for suicide ideation, attempts and death.

We conducted a meta-analysis of published studies from 1971 to 31 December 2014 that included at least one longitudinal analysis predicting suicide ideation, attempt or death using any depression or hopelessness variable.

Overall prediction was weaker than anticipated, with weighted mean odds ratios of 1.96 (1.81–2.13) for ideation, 1.63 (1.55–1.72) for attempt and 1.33 (1.18–1.49) for death. Adjusting for publication bias further reduced estimates. Effects generally persisted regardless of sample severity, sample age or follow-up length.

Several methodological constraints were prominent across studies; addressing these issues would likely be fruitful moving forward.

None.

Copy number variants (CNVs) are established risk factors for neurodevelopmental disorders. To date the study of CNVs in psychiatric illness has focused on single disorder populations. The role of CNVs in individuals with intellectual disabilities and psychiatric comorbidities are less well characterised.

To determine the type and frequency of CNVs in adults with intellectual disabilities and comorbid psychiatric disorders.

A chromosomal microarray analysis of 599 adults recruited from intellectual disabilities psychiatry services at three European sites.

The yield of pathogenic CNVs was high – 13%. Focusing on established neurodevelopmental disorder risk loci we find a significantly higher frequency in individuals with intellectual disabilities and comorbid psychiatric disorder (10%) compared with healthy controls (1.2%, P<0.0001), schizophrenia (3.1%, P<0.0001) and intellectual disability/autism spectrum disorder (6.5%, P < 0.00084) populations.

In the largest sample of adults with intellectual disabilities and comorbid psychiatric disorders to date, we find a high rate of pathogenic CNVs. This has clinical implications for the use of genetic investigations in intellectual disability psychiatry.

None.

Incidence and determinants of affective disorders among adults with intellectual disabilities are unknown.

To investigate affective disorder incidence, and determinants of unipolar depression, compared with general population reports.

Prospective cohort study measuring mental ill health of adults with mild to profound intellectual disabilities living within a defined community, over 2 years.

There was 70% cohort retention (n = 651). Despite high mood stabiliser use (22.4%), 2-year incident mania at 1.1% is higher than the general population; 0.3% for first episode (standardised incident ratio (SIR) = 41.5, or 52.7 excluding Down syndrome). For any bipolar episode the SIR was 2.0 (or 2.5 excluding Down syndrome). Depression incidence at 7.2% is similar to the general population (SIR = 1.2), suggesting more enduring/undertreatment given the higher prevalence. Problem behaviours (odds ratio (OR) = 2.3) and life events (OR = 1.3) predict incident unipolar depression.

Depression needs improved treatment. Mania has received remarkably little attention in this population, despite high prevalence and incidence (similar to schizophrenia), and given the importance of clinician awareness for accurate differential diagnosis from attention-deficit hyperactivity disorder and problem behaviours.

None.

Visual scales may be particularly useful in screening for depression in patients with low literacy. However, few have been validated and none are in common use.

Modification and validation of a visual scale to screen for depression in low literacy settings.

We assessed the validity, reliability and factor loading of a 28-item visual depression inventory using pictorial items depicting depression signs and symptoms. We validated a revised scale comprised of 18 items known as the Akena Visual Depression Inventory (AViDI-18) against a structured diagnostic interview (Mini-International Neuropsychiatric Inventory) in 343 patients in Kampala (Uganda) and Cape Town (South Africa).

The 18 pictorial items had acceptable validity and reliability. The area under the curve (AUC) score of the AViDI-18 was 0.9. AUC scores were not significantly associated with sociodemographic variables.

The AViDI-18 is a valid screen for depression in patients with low literacy.

None.

Connectedness is a central dimension of personal recovery from severe mental illness (SMI). Research reports that people with SMI have lower social capital and poorer-quality social networks compared to the general population.

To identify personal well-being network (PWN) types and explore additional insights from mapping connections to places and activities alongside social ties.

We carried out 150 interviews with individuals with SMI and mapped social ties, places and activities and their impact on well-being. PWN types were developed using social network analysis and hierarchical k-means clustering of this data.

Three PWN types were identified: formal and sparse; family and stable; and diverse and active. Well-being and social capital varied within and among types. Place and activity data indicated important contextual differences within social connections that were not found by mapping social networks alone.

Place locations and meaningful activities are important aspects of people's social worlds. Mapped alongside social networks, PWNs have important implications for person-centred recovery approaches through providing a broader understanding of individual's lives and resources.

None.

None.