Most diagnoses adequately tested had good to very good reliability with these representative clinical populations assessed with usual clinical interview methods. Some diagnoses that were revised to encompass a broader spectrum of symptom expression or had a more dimensional approach tested in the good to very good range.

General hospital emergency departments (EDs) are obvious places for individuals in psychiatric distress or a mental health crisis to seek assistance. However, the typical mental health presentation does not fit with the treatment norm of most EDs creating a tension around the care of individuals with mental illnesses. Eight focus groups were held with mental health patients and their families to determine their satisfaction with care received in regional EDs with particular emphasis on their evaluation of the role of the psychiatric emergency nurse. Themes identified were: waiting in the ED, attitudes of treatment staff, diagnostic overshadowing, 'no where else to go', family needs, and a wish list for ideal services. These issues are described in this paper along with clinical and systemic implications.

These results show promising test-retest reliability results for this group of assessments, many of which are newly developed or have not been previously tested in psychiatric populations

In the last decade, there has been an increase in interest in the burden of chronic and disabling health conditions that are not necessarily fatal, such as the mental disorders. This review systematically summarizes data on the burden associated with 11 major mental disorders of adults. The measures of burden include estimates of prevalence, mortality associated with the disorders, disabilities and impairments related to the disorders, and costs. This review expands the range of mental disorders considered in a report on the global burden of disease, updates the literature, presents information on the range and depth of sources of information on burden, and adds estimates of costs. The purpose is to provide an accessible guide to the burden of mental disorders, especially for researchers and policy makers who may not be familiar with this subfield of epidemiology.

Objective Apathy is highly prevalent among neuropsychiatric populations and is associated with greater morbidity and worse functional outcomes. Despite this, it remains understudied and poorly understood, primarily due to lack of consensus definition and clear diagnostic criteria for apathy. Without a gold standard for defining and measuring apathy, the availability of empirically sound measures is imperative. This paper provides a psychometric review of the most commonly used apathy measures and provides recommendations for use and further research. Methods Pertinent literature databases were searched to identify all available assessment tools for apathy in adults aged 18 and older. Evidence of the reliability and validity of the scales were examined. Alternate variations of scales (e.g., non-English versions) were also evaluated if the validating articles were written in English. Results Fifteen apathy scales or subscales were examined. The most psychometrically robust measures for assessing apathy across any disease population appear to be the Apathy Evaluation Scale and the apathy subscale of the Neuropsychiatric Inventory based on the criteria set in this review. For assessment in specific populations, the Dementia Apathy Interview and Rating for patients with Alzheimer’s dementia, the Positive and Negative Symptom Scale for schizophrenia populations, and the Frontal System Behavior Scale for patients with fronto-temporal deficits are reliable and valid measures. Conclusion Clinicians and researchers have numerous apathy scales for use in broad and disease-specific neuropsychiatric populations. Our understanding of apathy would be advanced by research that helps build a consensus as to the definition and diagnosis of apathy, and further refine the psychometric properties of all apathy assessment tools.

Multisite field trials and training comparable to what would be available to any clinician after publication of DSM-5 provided “real-world” testing of DSM-5 proposed diagnoses.

C o m m e n t a r y A m J Psych ia try 1 6 9 :1 , Ja nu a ry 2 0 1 2 a jp.p sych ia tryo n lin e.o rg

The quality of a woman's life can be seriously impaired by illness or its treatment. Health care providers can help improve the lives of women with severe mental illness by focusing on how options and alternatives are presented, by exploring the impact of illness and treatment on a woman's day-to-day life, and by determining the appropriate structure of the therapeutic relationship.