Young children with autism spectrum disorders (ASD) have impairments in the areas of communication and social interaction and often display repetitive or non-compliant behaviour. This early pattern of difficulties is a challenge for parents. Therefore, approaches that help parents develop strategies for interaction and management of behaviour are an obvious route for early intervention in ASD. This review updates a Cochrane review first published in 2002 but is based on a new protocol.

Rates of detected autism spectrum disorder (ASD) are currently rising, and there is a need for effective treatments to manage the symptoms. In this commentary I outline the challenges that autism presents to service delivery and consider a Cochrane review that evaluates one of the best-known classes of treatment for ASD, parent-mediated early intervention. I discuss effect size and bias in the interpretation of the review's results, and consider also the rationale for low- and high-intensity intervention at both the individual level and, from a public health perspective, at population level.

Autism spectrum disorder (ASD) is a complex, multifactorial disorder, the prevalence of which is rising. Specific biomarkers are yet to be identified for the classic ASD phenotypes, so despite treatment advances, most interventions focus on the comorbid disorders of ASD and have little impact on the underlying pathogenesis of the disorder. This article describes drug treatments that target the core symptoms of ASD and its comorbid conditions in children and adolescents. Difficulties and challenges encountered when treating the most frequent comorbidities are discussed, with emphasis on the safety, tolerability and efficacy of medications. In view of its widespread use, complementary and alternative medicine is also described.

Autism spectrum disorder (ASD) is a heterogeneous disorder with clearly recognisable core features, but without reliable biomarkers as yet. It has a high rate of comorbid psychiatric disorders which need to be identified and appropriately treated. Emerging concepts in genetics, pathobiology and outcome measurement have potential to significantly advance the treatment of both ASD and its comorbidities over the following decades.

Tourette syndrome is a complex neuropsychiatric disorder of juvenile onset, characterised by motor and phonic tics. It is associated with a number of comorbid psychiatric conditions and a reduced quality of life in the young person and with parenting stress, caregiver burden and psychopathology in the parents. The global prevalence (about 1%) is higher than previously thought, with a strong male preponderance. Evidence is emerging that Tourette syndrome is not a unified disorder; rather, it encompasses a number of subtypes, characterised by complexity of tics and the simultaneous presence of other behaviours or disorders. This article discusses the aetiology of the syndrome, and examines its clinical features and comorbid psychiatric conditions and psychopathologies. Assessment and diagnosis are also discussed. Psychoeducation is a cornerstone of management, augmented with behavioural and/or pharmacological treatments. Newer therapies, such as deep brain stimulation, offer tantalising possibilities, but further research is still needed.

We offer a contemporary review of studies of the offspring of parents with bipolar disorder and explore the clinical characteristics of these populations. We discuss how different methodological approaches may influence study findings and may explain some of the heterogeneity in the results reported. We also highlight some of the environmental risk factors that may increase the likelihood of transition from an ‘at-risk’ or high-risk state to bipolar disorder. Last, we briefly discuss the implications of study findings for early intervention strategies and comment on such issues as genetic counselling and primary and early secondary prevention programmes.

The concept of an ‘at-risk mental state’ for psychosis arose from previous work attempting to identify a putative psychosis prodrome. In this article we summarise the current criteria used to identify ‘at-risk’ individuals, such as the ultra-high-risk (UHR) criteria, and the further identification of important clinical risk factors or biomarkers to improve prediction of who might develop a psychotic disorder. We also discuss important ethical issues in classifying and treating at-risk individuals, current treatment trials in this area and what treatment current services can offer.

This article is aimed primarily at psychiatry trainees, MRCPsych course organisers, College tutors, educational supervisors and clinical supervisors. It describes recent changes to the MRCPsych curriculum and examinations and discusses the different approaches that educators can utilise to best help their trainees. We describe how the content of MRCPsych courses can help prepare trainees for both the written papers and the clinical assessment of skills and competencies (CASC). We discuss ways of incorporating patients and carers into course development, innovative approaches using technology to enhance learning, the role of workplace-based assessments and how international graduates may maximise their pass rate.

College tutors for psychiatry trainees are National Health Service (NHS) consultants who have responsibility for organisation and delivery of postgraduate education and learning opportunities for the core trainees in NHS trusts. College tutors are responsible for monitoring the progress of trainees through the core training schemes. Tutors have various roles and responsibilities in teaching and training. Being a tutor can be a rewarding experience and any consultant interested in postgraduate teaching should consider becoming one.

Journal clubs are a mandatory aspect of psychiatric training in the UK, yet are not always seen as a stimulating experience. Clarifying the aim of the club and tailoring it to the needs and wishes of the audience is an essential step. Teaching skills in critical appraisal is often seen as the main purpose of journal clubs. Depending on the audience, being able to formulate questions from clinical dilemmas, search the literature, and integrate research evidence, clinical expertise and the patient's needs and wishes may be as important. Linking these tasks in the journal club with routine clinical practice increases the chances of changing attitudes and behaviour and thus influencing care. New approaches to using social media and online formats mean that journal clubs are no longer restricted to a particular place or time, although the social aspect of meeting colleagues continues to be important for many.

We outline benefits and problems of introducing internet-based approaches (e.g. e-learning, social networking) into journal clubs. We also look at potential risks to the continuing existence of clubs posed by the changing health economy and the move in psychiatry from clinical medicine to community care. Overall, we are optimistic for the journal club's survival.