This small, open label naturalistic study shows that up to six low dose ketamine infusions can safely be given within an existing NHS clinical structure to patients who continue their antidepressants. The response rate was comparable to that found in RCTs of single doses of ketamine in antidepressant-free patients but took slightly longer to develop.

Reliable conclusions from this review are severely limited by the small amount of data usable for analysis. The body of evidence about glutamate receptor modulators in bipolar disorder is even smaller than that which is available for unipolar depression. Overall, we found limited evidence in favour of a single intravenous dose of ketamine (as add-on therapy to mood stabilisers) over placebo in terms of response rate up to 24 hours; ketamine did not show any better efficacy in terms of remission in bipolar depression. Even though ketamine has the potential to have a rapid and transient antidepressant effect, the efficacy of a single intravenous dose may be limited. Ketamine's psychotomimetic effects could compromise study blinding; this is a particular issue for this review as no included study used an active comparator, and so we cannot rule out the potential bias introduced by inadequate blinding procedures.We did not find conclusive evidence on adverse events with ketamine. To draw more robust conclusions, further RCTs (with adequate blinding) are needed to explore different modes of administration of ketamine and to study different methods of sustaining antidepressant response, such as repeated administrations. There was not enough evidence to draw meaningful conclusions for the remaining two glutamate receptor modulators (memantine and cytidine). This review is limited not only by completeness of evidence, but also by the low to very low quality of the available evidence.

A 2004 meta‐analysis reported good validity for the observer attachment Q‐sort (AQS), but poor validity for the parental self‐report version. Despite this, the self‐report AQS is still widely used, with researchers arguing that providing additional training can improve its validity. The aim of this study was to update the 2004 meta‐analysis. Two hundred forty‐five studies from 1987 to 2016 were included (n = 32,426). Separate meta‐analyses were conducted to examine validity and reliability. The observer AQS showed moderate convergent validity with the Strange Situation Procedure (r = .25; r = .39 for long observation periods) and good predictive validity in terms of associations with sensitivity (r = .32). It showed a relatively weak association with infant temperament (r = .21), suggesting some discriminant validity. The self‐report version showed comparable convergent validity with Strange Situation Procedure (r = .18), but significantly weaker correlations with sensitivity (r = .25) and stronger correlations with temperament (r = .33). There was no evidence that providing additional training improved the validity of the self‐report version. This study corroborates the previous finding that the observer AQS is a valid measure of infant attachment, especially after long periods of observation. The self‐report version showed significantly weaker discriminant and predictive validity. Highlights The aim of the study was to update the 2004 meta‐analysis assessing the validity of the attachment Q‐Sort (AQS). This study broadly replicated the findings of the previous meta-analysis, showing that the observer AQS is a valid measure of attachment. Caution should be shown in using the self-report AQS due to its comparatively weaker predictive and discriminate validity.

Background: Understanding the course of post-traumatic stress disorder (PTSD) and the factors that impact this is essential to inform decisions about when and for whom screening and intervention are likely to be beneficial. Objective: To provide meta-analytic evidence of the course of recovery from PTSD in the first year following trauma, and the factors that influence that recovery. Method: We conducted a meta-analysis of observational studies of adult PTSD prevalence which included at least two assessments within the first 12 months following trauma exposure, examining prevalence statistics through to 2 years post-trauma. We examined trauma intentionality (intentional or non-intentional), PTSD assessment method (clinician or self-report), sample sex distribution, and age as moderators of PTSD prevalence over time. Results: We identified 78 eligible studies including 16,484 participants. Pooled prevalence statistics indicated that over a quarter of individuals presented with PTSD at 1 month post-trauma, with this proportion reducing by a third between 1 and 3 months. Beyond 3 months, any prevalence changes were detected over longer intervals and were small in magnitude. Intentional trauma, younger age, and female sex were associated with higher PTSD prevalence at 1 month. In addition, higher proportions of females, intentional trauma exposure, and higher baseline PTSD prevalence were each associated with larger reductions in prevalence over time. Conclusions: Recovery from PTSD following acute trauma exposure primarily occurs in the first 3 months post-trauma. Screening measures and intervention approaches offered at 3 months may better target persistent symptoms than those conducted prior to this point. HIGHLIGHTS PTSD rates in the immediate aftermath of trauma exposure decline from 27% at 1 month to 18% at 3 months post-trauma, showing significant spontaneous recovery. Problems appear to stabilize after 3 months. Screening/intervention for PTSD at 3 months post-trauma is indicated.

Purpose There is a growing evidence base for cognitive behavioural therapy (CBT) as a treatment for psychogenic non-epileptic seizures (PNES) in the general population. Despite the relatively high proportion of individuals with PNES who have an intellectual disability (ID) there is a paucity of literature on the use of CBT for PNES in this population. The purpose of this paper is to describe the use of an adapted CBT approach to treat PNES in a woman with mild ID. Design/methodology/approach The intervention used a CBT approach that included both the client and her mother, her primary care giver, throughout the therapy sessions. It involved 13 1-hour sessions over 20 weeks. Findings Over the course of the intervention the client experienced a reduction in seizure activity. Both the client and her mother reported increases in her perceived ability to cope with the seizures. Originality/value This report describes an adapted CBT-based intervention for individuals with PNES in the context of ID. It is the first report to include the involvement of a care-giver in adapting this approach for individuals with ID.

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There is emerging evidence that glutamatergic system dysfunction might play an important role in the pathophysiology of bipolar depression. This review focuses on the use of glutamate receptor modulators for depression in bipolar disorder.

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