Why do some people see their glass as half-empty rather than half-full or even imagine that the glass will be filled in the future? Experimental methods can illuminate how individual differences in information processing style can profoundly impact mood or even result in disorders such as depression. A computerized cognitive bias modification intervention targeting interpretation bias in depression via positive mental imagery (CBM-I) was evaluated by investigating its impact on mental health and cognitive bias compared with a control condition. Twenty-six depressed individuals completed either positive imagery-focussed CBM-I or a control condition daily at home over one week. Outcome measures were collected pre-treatment and post-treatment and at two-week follow-up. Individuals in the positive condition demonstrated significant improvements from pre-treatment to post-treatment in depressive symptoms, cognitive bias and intrusive symptoms compared with the control condition. Improvements in depressive symptoms at two-week follow-up were at trend level. The results of this first controlled comparison of positive imagery-focussed CBM-I for depression further support the clinical potential of CBM-I and the development of a novel computerized treatment that could help patients imagine a more positive future. Broader implications concern the modification of individual differences in personality variables via their interaction with key information processing targets. Copyright © 2011 John Wiley & Sons, Ltd.

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SynopsisFacial behaviour may be an important determinant in clinical ratings of psychopathology. A standardized objective technique was used to quantify measures of facial behaviour in 21 chronic schizophrenic subjects, in comparison with control groups of depressed, demented and Parkinsonian subjects. Facial behaviours were counted and timed from video-recordings of each subjects' face during a clinical interview. Separate measurement of behaviours were obtained while subjects were speaking and silent. For most variables, the amount of facial behaviour was significantly less in schizophrenic subjects than in control groups. The groups differed significantly on a number of measures, but schizophrenics could not be reliably identified by a single facial behaviour variable. However, using a discriminant function analysis with measures for eye contact while speaking and silent, broad smiles and small smiles, discrimination between groups was good, with over 80% correctly classified as either schizophrenic, or not schizophrenic. These techniques may increase our understanding of psychopathological signs and the mechanisms that underly them.

The 2013 report from the Intergovernmental Panel on Climate Change has caused renewed concern among both clinicians and health policy makers. Climate change is continuing at an increasing rate. This guest editorial describes how climate change might affect global mental health and proposes three things that psychiatrists from every country could implement to respond appropriately to this urgent and severe global threat. These responses are mitigation and adaptation strategies for mental health services, and the integration of sustainability into training.

SummaryWith the subspecialisation of psychiatry in the UK, clinicians encounter problems at the interfaces between specialties. These can lead to tension between clinicians, which can be unhelpful to the clinical care of the patient. This article focuses on the interface between general and forensic psychiatry in England and Wales. The pattern of mental health services in England and Wales differs to an extent from those in Scotland, Northern Ireland and in the Republic of Ireland. Consequently, the interface between general and forensic psychiatry is subject to varying influences. Important interface issues include: the definition of a ‘forensic patient’; the remit and organisation of services; resources; clinical responsibility; and care pathways. This article also discusses a general overview of how to improve collaboration between forensic and general adult psychiatric services.Learning Objectives•Develop an understanding of important issues at the forensic/general adult psychiatry interface.•Be aware of areas of conflict that may arise at the forensic/general adult psychiatry interface.•Be aware of options for optimum cooperation at the interface.

Demands on our mental health services are growing as financial pressures increase. In addition, there are regular changes to service design and commissioning. The current political mantra is ‘more and more, of better quality, for less and less, please’. We suggest that mental health services need to actively respond to these constraints and that clinical transformation is needed to move towards a more sustainable system of healthcare. Emphasis on prevention, patient empowerment and leaner, greener services is required alongside more extensive use of technologies. Focusing on these areas will make mental health services more responsive to the challenges we face and serve to future-proof psychiatry in the UK. Services need to be delivered to provide maximum benefit to the health of our patients, but also to our society and the environment.

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Little advice is offered in the literature for the novice report writer, despite the gravity of the situation, for example, a patient appealing against detention. Section 20, which renews the authority for detention after periods of 6 months or a year, is a useful reminder for clinicians, as it outlines the components that must be present in order for detention to continue.