In patients with bipolar disorder, admissions for manic and depressive episodes frequently display a seasonal pattern. We examined this variation and compared the patterns with the seasonal admission rates for schizophrenia.

Patients with bipolar disorder or schizophrenia were identified from the Finnish Hospital Discharge Register of in-patient admissions to all psychiatric hospitals during the years 1969–91. They were included in the analysis if the first admission had occurred before 30 years of age. A total of 295 bipolar patients were found and a sample of 295 schizophrenic patients was randomly selected for comparison.

There was no seasonal variation among all hospital admissions for bipolar disorder or schizophrenia However, the first admission for a depressive compared with a manic episode of bipolar disorder occurred significantly more often in the autumn (33% v. 21% respectively). The peak difference occurred during the week after the autumnal equinox in September.

Our findings suggest that there is no seasonal variation in bipolar disorder, although in some patients the clinical course might be influenced by the autumn, as far as the likelihood of a first admission for depression is concerned.

Contemporary cognitive psychological theories suggest that distress plays a mediating role in delusion formation.

To study the amplifying role of distress from early perceptual intrusions to delusion formation.

A general population sample of 7076 individuals was interviewed with the Composite International Diagnostic Interview (CIDI) in 1996 (baseline), 1997 (T1) and 1999 (T2). At T2, clinicians also scored the Brief Psychiatric Rating Scale (BPRS) item ‘unusual thought content’. Analyses compared hallucinatory experiences with and without subjective distress at baseline for risk of delusion formation at follow-up.

Individuals experiencing hallucinations with distress, compared with those without distress had a fourfold increased risk of subsequent delusion formation.

This finding corroborates the hypothesis that distress associated with early perceptual intrusions serves as a catalyst in the development of delusions.

Since their introduction as diagnostic criteria by Schneider in 1937, nuclear symptoms have played a key role in concepts of schizophrenia, but their relationship to each other and to genetic predisposition has been unclear.

To ascertain the factor structure and familiality of nuclear symptoms.

Nuclear (Schneiderian) symptoms were extracted from case notes and interviews in a study of 103 sibling pairs with DSM–III–R schizophrenia or schizoaffective disorder.

Principal components analysis demonstrated two major factors: one, accounting for about 50% of the variance, groups thought withdrawal, insertion and broadcasting, with delusions of control; and the second, accounting for <20% of the variance, groups together third-person voices, thought echo and running commentary. Factor I was significantly correlated within sibling pairs.

The correlation within sibling pairs suggests that, contrary to the conclusion of some previous studies, some nuclear symptoms do show a degree of familiality and therefore perhaps heritability.

The aim was to document the mortality of psychiatric patients within a service system characterised by a low beds-to-population ratio.

All patients admitted to one psychiatric hospital were followed from date of first admission after 31 July 1980 until 31 December 1992 with regard to death, by linkage to the Norwegian Central Register of Persons. Age-adjusted total mortality rates and standardised mortality ratios (SMRs) compared with the general population were computed.

Mortality rates were highest in men, and increased with age in both sexes. SMRs were highest in the younger age-groups, and the overall SMR was significantly higher for men than for women. Mortality was highest during the first year after admission for both sexes and was higher than in the general population in all diagnostic groups.

The mortality of psychiatric patients is still unsatisfactorily high, and men constitute a special high-risk group.

For many common medical and neuropsychiatric disorders, early age at onset reflects high familial liability to illness. However, for schizophrenia, most studies do not find such a relationship.

Using Cox proportional hazard models, we investigate this question in the epidemiologically-based Roscommon family study.

No relationship was found between age at onset in schizophrenic probands and the hazard rate for schizophrenia in their relatives. Similar results were obtained when the definition of illness was expanded to include schizoaffective disorder and other non-affective psychoses.

For schizophrenia, a ‘common-sense’ model for age of onset (i.e. those with highest familial liability to illness succumb first while those with lower liability survive longer before falling ill) does not seem to apply. Our results are more consistent with a model in which variation in age at onset of schizophrenia is due to random developmental effects or to environmental experiences unique to the individual.

In addition to the health burden caused by mental illnesses, these conditions contribute to economic disadvantage because of their impact on labour force participation.

To quantify the cost of lost savings and wealth to Australians aged 45–64 who retire from the labour force early because of depression or other mental illness.

Cross-sectional analysis of the base population of Health&WealthMOD, a microsimulation model built on data from the Australian Bureau of Statistics' Survey of Disability, Ageing and Carers and STINMOD, an income and savings microsimulation model.

People who are not part of the labour force because of depression or other mental illness have 78% (95% CI 92.2–37.1) and 93% (95% CI 98.4–70.5) less wealth accumulated respectively, compared with people of the same age, gender and education who are in the labour force with no chronic health condition. People who are out of the labour force as a result of depression or other mental illness are also more likely to have the wealth that they do have in cash assets, rather than higher-growth assets such as superannuation, home equity and other financial investments.

This lower accumulated wealth is likely to result in lower living standards for these individuals in the future. This will compound the impact of their condition on their health and quality of life, and put a large financial burden on the state as a result of the need to provide financial assistance for these individuals.

Lower cognitive ability in childhood is associated with increased risk of future schizophrenia, but its relationship with adult psychotic-like experiences and other psychopathology is less understood.

To investigate whether this childhood risk factor is shared with adult subclinical psychiatric phenotypes including psychotic-like experiences and general psychiatric morbidity.

A population-based sample of participants born in Great Britain during 1 week in March 1946 was contacted up to 20 times between ages 6 weeks and 53 years. Cognition was assessed at ages 8, 11 and 15 years using a composite of age-appropriate verbal and non-verbal cognitive tests. At age 53 years, psychotic-like experiences were self-reported by 2918 participants using four items from the Psychosis Screening Questionnaire and general psychiatric morbidity was assessed using the scaled version of the General Health Questionnaire (GHQ-28).

Psychotic-like experiences were reported by 22% of participants, and were highly comorbid with other psychopathology. Their presence in adults was significantly associated with poorer childhood cognitive test scores at ages 8 and 15 years, and marginally so at age 11 years. In contrast, high GHQ scores were not associated with poorer childhood cognition after adjustment for the presence of psychotic-like experiences.

Psychotic and non-psychotic psychopathologic symptoms are highly comorbid in the general population. Lower childhood cognitive ability is a risk factor for psychotic-like experiences in mid-life; these phenomena may be one end of a continuum of phenotypic expression driven by variation in early neurodevelopment.

Few studies have attempted to analyse the organisational aspects of the workplace that may affect the well-being of psychiatrists and even fewer have offered insights into what a positive workplace might look like. This study provides an outline of such a workplace, with reference to individual and organisational factors. In addition, a comparison is made between two European cities to check for cultural differences.

Three hundred and eighty psychiatrists from Stockholm and Birmingham responded to a previously tested questionnaire on their work environment.

Predictors of a positive workplace for psychiatrists were: high self-esteem, satisfactory support with work-related problems, lower perceived workload, positive view of leadership, low work-related exhaustion and having a sense of participation in the organisation. There were few cultural differences.

Measures should be taken to improve leadership skills for managers, to offer more support for work-related problems, and to allow psychiatrists to participate more in the organisation.