Most people with suicide ideation, plans and attempts receive no treatment. This is a consistent and pervasive finding, especially in low-income countries. Improving the receipt of treatment worldwide will have to take into account culture-specific factors that may influence the process of help-seeking.

Emerging research has provided support for the use of the Kessler Psychological Distress Scales in developing countries; however, this research has yet to be extended to southern Africa. This study sought to evaluate the performance of the Kessler scales in screening for depression and anxiety disorders in the South African population. The scales along with the Composite International Diagnostic Interview (CIDI) were included in the South African Stress and Health study, a nationally representative household survey. The K10/K6 demonstrated moderate discriminating ability in detecting depression and anxiety disorders in the general population; evidenced by area under the receiver operating curves of 0.73 and 0.72 respectively. However, both scales failed to meet our acceptability criteria of high sensitivity and high positive predictive value. Examinations of differences in responding by race/ethnicity revealed that the K10/K6 [Kessler Psychological Distress Scale 10-item (K10) and the abbreviated six-item (K6)] had significantly lower discriminating ability with respect to depression and anxiety disorders among the Black group (0.71) than among the combined minority race/ethnic groups of White, Colored, and Indian/Asian (0.78; p = 0.016). The difference in time period assessed on the K10/K6 (past 30 days) versus the CIDI (past 12 months) was a notable limitation of this study. Additional validation studies using clinician diagnostic instruments are recommended.

In this study, we compared the relationships of body mass index (BMI) and body adiposity index (BAI) with body fat percentage (BF%) in a Caucasian, European population. BF% was measured by dual-energy x-ray absorptiometry in a population-based cross-sectional study of 5,193 middle-aged (47-49 years) and elderly (71-74 years) men and women from the Hordaland Health Study in western Norway from 1997 to 1999. In the total population, the correlation between BAI and BF% was stronger (r = 0.78) than the correlation between BMI and BF% (r = 0.56) with similar results in the middle-aged and elderly groups. However, in men and women separately, BMI was a better correlate of BF% (for men, r = 0.76; for women, r = 0.81) than was BAI (for men, r = 0.57; for women, r = 0.72). BMI was also a better correlate of BF% than was BAI assessed by partial correlations adjusted for sex (for BMI-BF%, r = 0.79; for BAI-BF%, r = 0.67). Bland-Altman plots and BF%-stratified analyses showed that BAI tended to overestimate BF% in lean subjects and to underestimate it in those with higher proportions of body fat, but that it predicted BF% well for those whose BMI was in a normal range. At the individual level and in population studies adjusted for sex, BMI outperforms BAI as a predictor of BF%.

Our findings do not support a protective effect of dietary folate intake or folic acid supplementation on spontaneous PTD. Pre-conceptional folic acid supplementation starting more than 8 weeks before conception was associated with an increased risk of PTD. These results require further investigation before discussing an expansion of folic acid supplementation guidelines.

No particular medication class definitively demonstrates efficacy in the treatment of trichotillomania. Preliminary evidence suggests treatment effects of clomipramine, NAC and olanzapine based on three individual trials, albeit with very small sample sizes.

These data provide a picture of diagnosis and practice patterns across a range of psychiatric settings and suggest that anxiety disorders, despite being among the most prevalent of psychiatric disorders remain underdiagnosed and undertreated particularly in respect of the use of psychotherapeutic interventions.

AMI incidence rates declined during 2001-2009. The decline was due to reductions in rates of out-of-hospital deaths and hospitalizations in individuals 45 years or older. A worrying increase in hospitalization rates was observed in those younger than 45 years.

Previous neuroimaging studies link both alcohol use disorder (AUD) and early adversity to neurobiological differences in the adult brain. However, the association between AUD and childhood adversity and effects on the developing adolescent brain are less clear, due in part to the confound of psychiatric comorbidity. Here we examine early life adversity and its association with brain volume in a unique sample of 116 South African adolescents (aged 12-16) with AUD but without psychiatric comorbidity. Participants were 58 adolescents with DSM-IV alcohol dependence and with no other psychiatric comorbidities, and 58 age-, gender- and protocol-matched light/non-drinking controls (HC). Assessments included the Childhood Trauma Questionnaire (CTQ). MR images were acquired on a 3T Siemens Magnetom Allegra scanner. Volumes of global and regional structures were estimated using SPM8 Voxel Based Morphometry (VBM), with analysis of covariance (ANCOVA) and regression analyses. In whole brain ANCOVA analyses, a main effect of group when examining the AUD effect after covarying out CTQ was observed on brain volume in bilateral superior temporal gyrus. Subsequent regression analyses to examine how childhood trauma scores are linked to brain volumes in the total cohort revealed a negative correlation in the left hippocampus and right precentral gyrus. Furthermore, bilateral (but most significantly left) hippocampal volume was negatively associated with sub-scores on the CTQ in the total cohort. These findings support our view that some alterations found in brain volumes in studies of adolescent AUD may reflect the impact of confounding factors such as psychiatric comorbidity rather than the effects of alcohol per se. In particular, early life adversity may influence the developing adolescent brain in specific brain regions, such as the hippocampus.

Abstract Newell and Shanks provide a useful critique on unconscious decision making. However, they do not consider an important set of functional brain imaging studies of unconscious processes. Here we review briefly the relevant brain imaging and psychobiological literature and its implications for understanding unconscious decision making.

Sexual health is a major area of relevance to global public health. The World Health Organization (WHO) has stipulated that every person has the right to sexual health. The United Nations Educational, Scientific and Cultural Organization (UNESCO) has identified sexual rights and sexual health education and training as a global priority. There is also growing interest in human rights and lesbian, gay, bisexual, transgender and intersex (LGBTI) issues internationally. However, there are few centres of excellence for sexual health in low- and middle-income countries, where the vast majority of the world’s population live, and there is a real need to establish such resources.

Comorbidity is common in both mental and physical disorders, and both are associated with substantial days out of role in South Africa. These data indicate substantial social and economic loss associated with these conditions, and emphasize the need to integrate health services to include common mental disorders in all basic packages of care and to assess for and manage comorbid conditions.