Findings from neuroimaging studies complement our understanding of the wide-ranging neurobiological changes in trauma survivors who develop post-traumatic stress disorder (PTSD).

To determine whether neuroimaging studies had identified structural and functional changes specific to PTSD.

A review of all functional and structural neuroimaging studies of subjects with PTSD was carried out. Studies were identified using general medical and specific traumatic stress databases and paper searches of current contents and other secondary sources.

The most replicated structural finding is hippocampal volume reduction, which may limitthe proper evaluation and categorisation of experience. Replicated localised functional changes include increased activation ofthe amygdala after symptom provocation (which may reflect its role in emotional memory) and decreased activity of Broca's area at the same time (which may explain the difficulty patients have in labelling their experiences).

Evidence from neuroimaging studies has suggested areas ofthe brain that may be damaged by psychological trauma. The clinical implications ofthese neuroimaging findings need to be investigated further because they challenge traditional therapeutic approaches.

An association between stressful job conditions and depressive symptoms has been reported. This association could be explained by personality traits.

To examine the relationship between psychosocial factors at work and changes in depressive symptoms, taking into account personality traits.

The role of occupational characteristics, psychosocial stress and personality traits in predicting an increase of depressive symptoms was evaluated in 7729 men and 2790 women working at the French National Electricity and Gas Company, with a 3-year follow-up.

In men, high decision latitude was predictive of a decrease in the Centre for Epidemiologic Studies — Depression scale (CES-D) scores. In both genders, high job demands and low social support at work were predictive of increased scores, irrespective of personality traits and covariates.

Adverse psychosocial work conditions are predictors of depressive symptom worsening, independent of personality traits.

Certain personality traits may mediate the relationship between familiality and adversity in causing depression.

It is not clear whether the increased mortality associated with depression can be explained by the effects of potential confounding variables.

To measure the effect of depression on mortality after controlling for cognitive decline, cardiovascular risk factors and antidepressant use.

A prospective cohort study derived from data from a multi-centre randomised controlled trial of moderate hypertension. Atotal of2584 participants, aged 65–75 years at study entry, were followed up for 11 years.

Depression on the SelfCARE-D scale was associated with mortality after controlling for gender. After controling for cardiovascular risk factors, cognitive decline and anti-depressant use, depression continued to have a modest effect (hazard ratio⩵l.43; 95% CI 1.03–1.98). Depression in males and in people aged under 70 years significantly increased the risk of death.

Depression was associated with mortality only after controlling for gender. There was a modest but robust association between depression and mortality that was not explained by confounding by cardiovascular risk factors, cognitive decline or history of antidepressant use.

Neuroimaging studies have demonstrated changes in the dorsolateral prefrontal cortex (DLPFC) and anterior cingulate cortex (ACC) in major depression.

We investigated the expression of cell adhesion molecules (CAMs) in the prefrontal cortex in depression.

Immunohistochemistry to localise CAMs in post-mortem tissue from 20 subjects with major depression and 20 controls, and image analysis to quantify their expression.

We found significant increases in CAMs in the grey matter ofthe DLPFC in the depression group but no comparable differences in the ACC or occipital cortex. In the white matter there was a non-significant increase in intercellular adhesion molecule-1 in the DLPFC in the depression group but no increase in the other areas or for vascular cell adhesion molecule-1 in any area. Paired tests showed specificity for the DLPFC in the depression group only.

Theincreasein CAM expression in the DLPFC suggests an inflammatory reaction and is consistent with ischaemia.

Spontaneous dyskinesia and parkinsonism have been reported in never-medicated patients with schizophrenia but there has been no previous study of the natural history of these conditions.

To determine the prevalence of spontaneous dyskinesia and parkinsonism in a group of never-medicated, chronically ill patients with schizophrenia on two occasions separated by an 18-month interval.

Dyskinesia was assessed by the Abnormal Involuntary Movements Scale using Schooler and Kane criteria for its presence; parkinsonism by the Simpson and Angus scale; and mental state by the Positive and Negative Syndrome Scale for schizophrenia.

Thirty-seven patients were examined on two occasions. Nine (24%) had dyskinesia on both occasions, 12 (33%) on one occasion and 16 (43%) on neither occasion. Twenty-one (57%) had dyskinesia on at least one occasion. Thirteen patients (35%) had parkinsonism on at least one occasion.

Spontaneous dyskinesia and parkinsonism fluctuate over time. The former was found on at least one occasion in the majority of patients. It is an integral part ofthe schizophrenic disease process.

Magnetic resonance imaging (MRI) has demonstrated abnormalities of brain structure, particularly of the temporal lobes, in schizophrenia. These are thought to be neurodevelopmental in origin, but when they become evident is unknown.

To determine iftemporal lobe volumes reduce during the development of symptoms of schizophrenia in initially well people at high riskofthis disorder.

A group of 66 people who had at least two first— or second-degree relatives with schizophrenia and a control group of 20 healthy people had a structural MRI scan ofthe whole brain which was repeated after approximately 2 years. Regions of interest, specifically the amygdala-hippocampus complex and the temporal lobes, were traced semi-automatically by three masked raters with good inter— and intrarater reliability

Regional brain volume changes over 2 years did notdiffer between high-risk and healthy participants. Within the high-risk group, the 19 people with psychotic symptoms (12 at first assessment) had a mean reduction of 2163 mm3 intherighttemporal lobe compared with 97 mm3 in the 47 without symptoms (P⩵0.02).

Our findings suggest that people at high risk of schizophrenia with psychotic symptoms show reductions in temporal lobe volumes.

The results of one randomised control trial testing a psychological rehabilitation programme aimed at information processing strategies showed improvements in cognition post-treatment.

To determine whether there are concomitant brain activation changes as a result of engaging in cognitive remediation therapy (CRT).

Three groups (patients receiving control therapyor CRT and a healthy control group) were investigated in a repeated measures design using the two-back test. Functional magnetic resonance imaging (fMRI) data and a broad assessment of executive functioning were completed at baseline and post-treatment. Brain activation changes were identified after accounting for possible task-correlated motion artefact.

fMRI analyses indicate that the control group showed decreased activation butthetwo patient groups showed an increase in activation over time. The patient group that received successful CRT had significantly increased brain activation in regions associated with working memory particularly the frontocortical areas.

This isthefirsttimethat brain activation changes in a seriously disabled group of patients with schizophrenia can be associated clearly with psychological rather than pharmacological therapy.

There are no epidemiological data in Europe on associations between sexual molestation in males and psychological disturbance.

To investigate whether sexual molestation in males is a significant predictor of psychological disturbance.

We recruited men attending general practice and genitourinary medicine services. Participants took part in a computerised interview about sexual molestation as children or adults. We ranked reported sexual experiences into three categories of decreasing severity. Each category was treated as an independent predictor in a multivariate analysis predicting different types of psychological disturbance.

Men who reported child sexual abuse were more likely to report any type of psychological disturbance. Men who reported sexual molestation in adulthood were 1.7 (1.0–2.8) times more likely to have experienced a psychological disorder, but self-harm was the single most likely problem to occur (odds ratio⩵2.6, range⩵l.3–5.2). Men reporting ‘consenting’ sexual experiences when aged under 16 years also were more likely to report acts of self-harm (odds ratio⩵l.7, range⩵0–2.8).

Sexual abuse as a child or adult is associated with later psychological problems. All forms of sexual molestation were predictive of deliberate self-harming behaviour in men.

Brief screening instruments appear to be a viable way of detecting post-traumatic stress disorder (PTSD) but none has yet been adequately validated.

To test and cross-validate a brief instrumentthat is simple to administer and score.

Forty-one survivors of a rai l crash were administered a questionnaire, followed by a structured clinical interview 1 week later.

Excellent prediction of a PTSD diagnosis was provided by respondents endorsing at least six re-experiencing or arousal symptoms, in any combination. The findings were replicated on data from a previous study of 157 crime victims.

Performance of the new measure was equivalent to agreement achieved between two full clinical interviews.