A major short coming of current research into personality is its failure to explore the relationship between theories of general personality and mental disorder.

To provide preliminary data to address this deficit.

In the first of two studies, we examined the relationship between the Neuroticism, Extraversion and Other – Five-Factor Inventory (NEO–FFI) and DSM personality disorders in a consecutive series of mentally disordered offenders. In the second, we sought to separate the personality dimension neuroticism from symptoms of depressive disorder in a sample of subjects with current depression.

Factors from the NEO–FFI were associated with different personality disorders in a predictable manner (first study). It was possible to identify a component of neuroticism (i.e. ‘worry’) that could be separated from depressive symptoms (second study).

Theories of general personality theory can enlighten and refine descriptions of abnormal mental states by informing both their aetiology and their prognosis.

A complementary approach to defining symptomatic subtypes of schizophrenia is to identify characteristic patterns of ‘problem behaviours’ associated with the capacity of patients to function in the community.

In a large epidemiological survey, patients fulfilling Feighner criteria for schizophrenia were identified by key informants and assessed using the MRC Social Behaviour Schedule (SBS) and the Manchester Scale. An exploratory factor analysis was used to extract behavioural syndromes from the SBS data in order to compare the syndrome profiles in community, acute and long-stay subgroups and to examine their associations with symptoms and social functioning.

Four behavioural syndromes were identified: Thought disturbance, ‘Social withdrawal’, ‘Depressed behaviour’ and ‘Anti-social behaviour’, which distinguished between the patient subgroups and had significant differential relationships to symptoms and social functioning variables.

The evaluation of disability in schizophrenia and effectiveness of treatment interventions is incomplete without an assessment of problem behaviours.

Neighbourhood greenness or vegetative presence has been associated with indicators of health and well-being, but its relationship to depression in older adults has been less studied. Understanding the role of environmental factors in depression may inform and complement traditional depression interventions, including both prevention and treatment.

This study examines the relationship between neighbourhood greenness and depression diagnoses among older adults in Miami-Dade County, Florida, USA.

Analyses examined 249 405 beneficiaries enrolled in Medicare, a USA federal health insurance programme for older adults. Participants were 65 years and older, living in the same Miami location across 2 years (2010–2011). Multilevel analyses assessed the relationship between neighbourhood greenness, assessed by average block-level normalised difference vegetative index via satellite imagery, and depression diagnosis using USA Medicare claims data. Covariates were individual age, gender, race/ethnicity, number of comorbid health conditions and neighbourhood median household income.

Over 9% of beneficiaries had a depression diagnosis. Higher levels of greenness were associated with lower odds of depression, even after adjusting for demographics and health comorbidities. When compared with individuals residing in the lowest tertile of greenness, individuals from the middle tertile (medium greenness) had 8% lower odds of depression (odds ratio 0.92; 95% CI 0.88, 0.96; P = 0.0004) and those from the high tertile (high greenness) had 16% lower odds of depression (odds ratio 0.84; 95% CI 0.79, 0.88; P < 0.0001).

Higher levels of greenness may reduce depression odds among older adults. Increasing greenery – even to moderate levels – may enhance individual-level approaches to promoting wellness.

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The increasing use of the methods of evidence-based medicine to keep up-to-date with the research literature highlights the absence of high-quality evidence in many areas in psychiatry.

To outline current uncertainties in the maintenance treatment of bipolar disorder and to describe some of the decisions involved in designing a large simple trial.

We describe some of the strategies of evidence-based medicine, and how they can be applied in practice, focusing specifically on the area of bipolar disorder.

One of the key clinical uncertainties in the treatment of bipolar disorder is the place of maintenance drug treatments and their relative efficacy. A large-scale study, the Bipolar Affective Disorder: Lithium Anticonvulsant Evaluation (BALANCE) trial, is proposed to compare the effectiveness of lithium, valproate and the combination of lithium and valproate.

Providing reliable answers to key clinical questions in psychiatry will require new approaches to clinical trials. These will need to be far larger than previously appreciated and will therefore need to be collaborative ventures involving front-line clinicians.

Previous studies have suggested that cognitive therapy is effective in modifying delusions.

To assess the effectiveness of cognitive therapy on patients seen in routine clinical work.

Eighteen patients with chronic delusions were treated using cognitive therapy, after the method of Chadwick and Lowe. A single-case multiple-baseline experimental design was used, including a control treatment. Each subject was used as their own control.

Six patients reduced conviction in their delusions during cognitive therapy and not during the control treatment. Seven patients' conviction ratings did not change. Five patients showed a variable response. Degree of conviction did not fall to zero in any patient. All patients reported that the therapy had been helpful; six spontaneously mentioned changes in psychotic thinking.

One-third of patients with chronic delusions whom we treated responded to delusion modification with a reduction in degree of belief. Change within therapy sessions predicted outcome, as did variation in the conviction during baseline. Cognitive therapy with delusions should aim at reducing distress as well as conviction.

The greater frequency of mental illness in deprived and inner-city populations is well recognised; allocation of funds in the UK health service makes some allowance for this. However, it is not clear whether the differences are similar for all levels of mental health care need.

To study the range in prevalence of mental health problems and care at primary care, general secondary care and forensic care levels.

We used mainly descriptive statistics to study evidence available from existing sources – some based on indicators of likely need, some on observed prevalance of treatment.

Among English health authority areas, the most morbid have about twice the prevalence of primary care level mental illness of the least morbid. For secondary care the ratio is between 2.5 and 4 to 1, while for services for mentally disordered offenders it is in excess of 20:1.

Where needs indices are used for resource allocation, responsible authorities should ensure that they produce ranges reflecting the full compass of services funded. For forensic services the range of morbidity levels may be so great that funding needs to rest at a larger population level than that of health authorities.