To prevent and treat physical health problems in patients with severe mental illness, support in daily structure and lifestyle changes is needed. Management support is needed to change daily practice and implement routines regarding physical health.

Urbanization is a global and growing phenomenon that pose significant challenges to mental health and mental health services. Fast and unstructured urbanization, such as that seen in many developing countries, further exacerbates these challenges. There are promising initiatives emerging including initiatives to end homelessness, to improve access to green areas in urban environments, to provide emergency psychiatric services, and to develop new forms of mental health services adjusted to urban settings. Regrettably there are no universally accepted guidelines that would help governments in structuring health services for people with mental illness in towns and help to prevent mental health problems related to rapid urbanization.

Highlights Widowhood is associated with a high prevalence of common mental disorders  About 40% meet the cut-off for depression using screening scales  About 20% meet full diagnostic criteria for depression  There was no difference in the prevalence of depression between the two sexes  The pooled prevalence estimate of anxiety disorders was about 27%

This programme shows promise in addressing health promotion for these patients and can easily be integrated into contemporary treatments.

Purpose To conduct a systematic review and meta-analysis examining the association of the prevalence of depression and time since spousal loss in widowed people. Methods The databases MEDLINE, Embase and PsycInfo were searched (May 2017) for papers reporting on time since spousal loss in widowed people and the prevalence of common mental disorders. A systematic review was conducted according to MOOSE guidelines. Random effects meta-analyses of the prevalence of depression were conducted by intervals of time since spousal loss. Results The literature search identified 12,982 studies of which 22 were eligible for inclusion in the systematic review. Of these, 14 were furthermore eligible for inclusion in the meta-analysis. The summary estimates found in the meta-analysis for the prevalence of depression in the intervals of time since spousal loss were: ≤ 1 month: 38.2% (21.9-55.8%); > 1 month to 3 months: 25.0% (17.3-33.5%); > 3 months to 6 months: 23.1% (18.0-28.7%); > 6 months to 12 months: 19.4% (15.2-24.0%); > 12 months to 18 months: 11.1% (5.3-18.7%); > 18 months to 24 months: 15.2% (12.3-18.2%); > 24 months to 60 months: 10.5% (4.3-18.5%). Conclusion Widowhood is associated with a high prevalence of depression and the study identifies a population group needing special attention in daily clinical practice. The prevalence is highest in the first month of widowhood, however, continues to be high at least 5 years into widowhood.

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Academia needs to be re-implemented into clinical psychiatry. Staff with research experience is needed in all professions to increase evidence-based practice. Leaders must take responsibility for implementing new knowledge into the routines of the department and must support staff in these activities on a daily basis.

mind (7) that leads many of our colleagues to consider that our field of knowledge is more related to philosophy and social sciences than medicine. It is our impression that this scenario is changing rapidly.Psychiatry is a leading field in many countries, and its prestige is closely related to the scientific achievements in the area. The translational neurosciences as the basis for 21st century psychiatry may help to address many of the challenges raised by our colleagues in their work (6). We cannot call ourselves specialists in neuroscience and, at the same time, call to ourselves the duty of explaining complex human behavior in strictly theoretical terms-as philosophers might.We do not have to convince our colleagues that psychiatry is 'good' and that they must think highly of us. What we can do is to focus on our work within medicine and refrain from using psychiatry as a means to provide large explanatory models for human behavior. If we concentrate in our target to help people who suffer from mental disorders using available scientific evidence, our diagnostic and therapeutic achievements shall determine how our colleagues and the community think about us and our work.