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In South Africa the prevalence of household food insufficiency is very high compared with studies conducted in the developed world, and is independently associated with having a 12-month and lifetime DSM-IV diagnosis. The relationship between food insufficiency and mental health has implications for reducing the burden of common mental disorders in South Africa since, unlike a number of major risk factors for mental illness, food insufficiency may be relatively amenable to intervention.

www.isrctn.org identifier: ISRCTN38094599.

The results suggest that brief problem solving in a booklet/workshop format may be an effective, feasible and acceptable short-term treatment for people with CMD's in deprived communities. In this setting, group delivery of PST had lower drop-out rates than individual delivery, and was more feasible and acceptable. Randomized controlled trials are needed to evaluate the effect of brief self-help PST more rigorously.

Preterm birth is a strong predictor of cerebral palsy (CP), with risk of CP increasing with earlier delivery. There is a lower individual risk of CP among infants born at term, but even so, most infants with CP are born after 36 weeks of gestation. Little data are available within this range of term births on the association between risk of CP and gestational age in infants born at term. This population-based study investigated whether risk of CP is associated with timing of birth in the term and post-term period. Information obtained from the national health and insurance registries in Norway was used to identify 1,682,441 singleton live births between 1967 and 2001 with a gestational age of 37 to 44 weeks. Linkage to other national registries provided follow-up data for this cohort through 2005. The primary study outcome measure was the absolute and relative risk (RR) of CP among children who survived to at least 4 years of age. The gestational age was estimated using information based on the last menstrual period. Data from the Norwegian compulsory health insurance system identified 1938 term and post-term children with CP (1.15/1000 births). The lowest risk of CP was found among infants delivered at 40 weeks; the prevalence was 0.99/1000, with a 95% confidence interval (CI) of 0.90–1.08. Compared with term delivery, CP risk was higher with both earlier or later delivery: prevalence at 37 weeks was 1.91/1000 (95% CI, 1.58–2.25) with a RR of 1.9 (95% CI, 1.6–2.4); at 38 weeks, 1.25/1000 (95% CI, 1.07–1.42) with a RR of 1.3 (95% CI, 1.1–1.6); at 42 weeks, 1.36/1000 (95% CI, 1.19–1.53) with a RR of 1.4 (95% CI, 1.2–1.6); and after 42 weeks, 1.44 (95% CI, 1.15–1.72) with a RR of 1.4 (95% CI, 1.1–1.8). The association of CP risk with gestational age was even stronger with ultrasound-based gestational age than with last menstrual period for infant subgroups born at 37 weeks (prevalence, 1.17/1000 [95% CI, 0.30–2.04] with a RR of 3.7 [95% CI, 1.5–9.1]) and at 42 weeks (prevalence, 0.85/1000 [95% CI, 0.33–1.38] with a RR of 2.4 [95% CI, 1.1–5.3]). The RRs for gestational age were unaffected by adjustment for infant gender, maternal age, and several socioeconomic measures. These findings show that risk of CP is lowest at 40 weeks of gestation and is higher before and after this.

Purpose: Over the past 2 decades there has been a dramatic increase in prevalence of obesity in the United States. Adipocytes are recently recognized as endocrine cells that secrete a variety of bioactive substances including tumor necrosis factor a, IL-6, and IL-8. This would suggest an increase in the inflammation burden in patients with inflammatory bowel disease and potentially result in a negative impact on health related quality of life (HRQoL). We sought to evaluate disease activity and quality of life in our Crohn's disease (CD) patient population based on body mass index. Methods: This was a retrospective study evaluating all CD pts being followed in a single referral center. Demographic information and disease characteristics were obtained from our database. Disease activity and quality of life were measured using the Harvey Bradshaw index (HBI) and Short Inflammatory Bowel Disease Questionnaire (SIBDQ) respectively. Mean body mass index (BMI) was obtained from patients who had at least 3 measurements of BMI, HBI and SIBDQ and was stratified into three categories - Normal (< 25kg/m2), Overweight (25-29.9kg/m2), and obese (> 30kg/m2). Results: There were 576 CD pts (226 men, 350 women) included with a mean age of 43 years. Approximately 33% of patients had inflammatory disease, 40% stricturing and 27% with fistulizing disease. Half the patients (50%) had involvement of both the small and large bowel. Ninety-one patients (15%) were current smokers. Fifty-six patients were non-white (10%). A majority of the patients were on combined immunomodulator and biologic therapy (57%) (27% on biologics alone and 10% on immunomodulators alone). The mean SIBDQ was 51 points with a mean HBI in our cohort of 3. Mean BMI was 26.8kg/m2 with 40%, 33%, and 27% in the normal, overweight and obese categories respectively. On multivariate analysis, the obese (-2.8, 95% CI -4.4 to -1.2) and the overweight cohorts (-1.7, 95% CI -3.2 to -0.24) had modestly reduced SIBDQ compared to those with normal weight. There was no difference in mean HBI by BMI. Obese patients had slightly lower number of surgeries on adjusted analysis (-0.4, 95% CI -7 to -0.1) but were no different in number of hospitalizations. Conclusion: Elevated BMI is associated with slight decrease in HRQoL in patients with Crohn's disease but has no impact on Crohn's disease activity represented by HBI.

In DSM-IV-TR, trichotillomania (TTM) is classified as an impulse control disorder (not classified elsewhere), skin picking lacks its own diagnostic category (but might be diagnosed as an impulse control disorder not otherwise specified), and stereotypic movement disorder is classified as a disorder usually first diagnosed in infancy, childhood, or adolescence. ICD-10 classifies TTM as a habit and impulse disorder, and includes stereotyped movement disorders in a section on other behavioral and emotional disorders with onset usually occurring in childhood and adolescence. This article provides a focused review of nosological issues relevant to DSM-V, given recent empirical findings. This review presents a number of options and preliminary recommendations to be considered for DSM-V: (1) Although TTM fits optimally into a category of body-focused repetitive behavioral disorders, in a nosology comprised of relatively few major categories it fits best within a category of motoric obsessive-compulsive spectrum disorders, (2) available evidence does not support continuing to include (current) diagnostic criteria B and C for TTM in DSM-V, (3) the text for TTM should be updated to describe subtypes and forms of hair pulling, (4) there are persuasive reasons for referring to TTM as "hair pulling disorder (trichotillomania)," (5) diagnostic criteria for skin picking disorder should be included in DSM-V or in DSM-Vs Appendix of Criteria Sets Provided for Further Study, and (6) the diagnostic criteria for stereotypic movement disorder should be clarified and simplified, bringing them in line with those for hair pulling and skin picking disorder.

We identified a set of genes with methylation changes present at birth in children whose mothers smoked during pregnancy. This is the first study of differential methylation across the genome in relation to maternal smoking during pregnancy using the 450K platform. Our findings implicate epigenetic mechanisms in the pathogenesis of the adverse health outcomes associated with this important in utero exposure.