Many clinicians use group support to reduce the psychosocial difficulties of persons with cancer. This study compared the long-term benefits of a thematic counseling model used both as a structure for group support and for counseling patients individually. The thematic model included eight counseling sessions focused on information about cancer and positive health strategies such as progressive relaxation, diet, and exercise. The psychosocial status of women newly diagnosed with gynecologic cancer was assessed before the counseling, immediately after counseling, and again 6 months later. The women who participated in thematic counseling were significantly less depressed and less anxious and had more knowledge of their illness, better relationships with care givers, fewer sexual difficulties, and more participation in leisure activities. Data confirmed the model to be equally helpful whether it was used as a structure for individual counseling or more cost-effective group counseling. This model is easily adaptable to the needs of persons with other forms of cancer.

Disruptive behaviour disorders (DBDs), including attention-deficit/hyperactivity disorder (ADHD), oppositional defiant disorder (ODD) and conduct disorder (CD) are chronic disorders with significant overlap in aetiology and presentation. An integrative examination of environmental risk factors is lacking. Six literature searches of web-based bibliographic databases were completed to identify literature on DBDs in general and five disorders in particular: CD, ODD, ADHD, deficits of attention, motor control and perception, and reactive attachment disorder. Searches were filtered to focus on studies including diagnostic assessment, focussing on environmental risk and protective factors in the first 4 years of life. The database searches generated 9806 papers of which 47 were reviewed after filters had been applied. The evidence suggests links between a number of early life risk factors and DBDs, including prenatal cigarette smoking and alcohol use, prenatal viral illness, maternal stress and anxiety, low birthweight, peri-partum and early neonatal complications, parental stress and parenting styles in infancy, early deprivation, adoption and separation. Despite the understanding that there is sharing of risk factors between the DBDs, there has been a disproportionate focus on the role of certain risk factors at the expense of others and the field is weakened by difficulties in controlling for all potential confounding variables.

This article examines the recommendations in the Mental Health (Care and Treatment) (Scotland) Act 2003 that are related to child and adolescent psychiatric services. Statistics relating to the first 6 months of the Act are included to indicate how it is being implemented and enable conclusions to be reached on how the Act is working in practice at this early stage.