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ed due to lack of space. We will highlight the most interesting of these here and list the rest. The war over weed continues: as I noted in the last Et al, the UK government has reclassified cannabis from class C to B, making possession a more serious offence. This prompted a rejoinder from the chair of the government’s own advisory council on drugs, David Nutt, stating that alcohol is certainly more harmful to the population and possibly more harmful to the individual. He in turn received a dressing down from the Home Secretary for comparing the dangers of riding a horse with the risks of taking ecstasy (MDMA), but that’s another story. Continuing the search for long term harms due to cannabis, this typically well conducted cohort study (Acta Psychiatr Scand 2008;118:395–403) from Norway asks whether heavy use leads to depression or suicide attempts in adolescents. Buried amidst a heap of non-significant outcomes, they did manage to find a threefold rise in suicide attempts but not until you reach your late twenties. Try making EBMH Notebook EBMH May 2009 Vol 12 No 2 39 a public health warning out of that. Whatever message you come up with, you will have a hard time selling it, as this randomised controlled trial (Addiction 2008;103:241–8) shows. Motivational interviewing was compared with providing drug information in reducing cannabis use in a sample of students. There was no difference between the two interventions although the authors suspect this may be due to a lack of motivational skills in those doing the interviewing. They certainly do things differently in Norway. Are there many other places in the world that offer 10 weeks of inpatient treatment for social phobia.free of charge? Perhaps it’s a reward for compulsory enrolment in all of those cohort studies. In a previous issue of Evid Based Ment Health (2008;11:68–9), John Markowitz vehemently made a case for inpatient psychotherapies and he is a contributor to this randomised controlled trial (J Anxiety Disord 2008;22:991–1010) comparing residential cognitive therapy with residential interpersonal therapy for social phobia. The participants had failed to respond to outpatient treatment but in this trial both groups improved with no difference between the two. However, with the absence of a control group, we’re left none thewiseras to whether the psychotherapies themselves were effective or if it was simply the 10 week respite. Talk of ethnicity and racism in mental health divides opinion and makes people uncomfortable, which is why there is a tendency to tiptoe around this particular elephant. There is broad agreement that there are both inequalities of experience and outcome for black and ethnic minorities in mental health but what gets the ‘‘rapid responses’’ firing is the question of cause. That minority ethnic groups are less likely to receive services for mood and anxiety disorders is a fairly consistent research finding. This large cross sectional survey (J Clin Psychiatry 2008;69:1112–21) uses data from the US National Epidemiologic Survey on Alcohol and Related Conditions to examine health service use in people with comorbid mood and substance use disorders. Compared with black respondents, white respondents were three times more likely to receive outpatient treatment or medication for mood disorders. In contrast, black people were more likely than white people to use services for drug misuse. Illness behaviour or stereotyping? Social pressures or stigma? All of these mechanisms have been suggested in an area of research that still tends to generate rather more heat than light. The UN tells us that with the exception of just 18 states, the global population is aging. With pension funds in a state of collapse, this is not good news but another consequence is that dementia will become much more common—4.6 million cases per year at the least count. Several earlier studies suggested a differential in prevalence with rates in low income and middle income countries between a quarter and a fifth of those typically recorded in the USA and Europe. Arguing that the DSM-IV diagnosis is too restrictive, the 10/66 Research Group (named for the 10% of research that focuses on the 66% of people with dementia living in low and middle income countries) contradicts these findings with a new survey showing a higher prevalence of dementia in developing countries that is also more consistent across sites (Lancet 2008;372: 464–74). Hoping to catch the ear of the DSM-V Task Force, they suggest that the DSM-IV criteria may hinder rather than help diagnosis with a requirement for memory impairment that may not be an early feature of dementia. They also point out that in settings where there is a greater degree of support for older people, looking for evidence of social and occupational impairment may prove difficult. It is all too easy to criticise drug trials for their narrow inclusion criteria and lack of generalisability. Once you exclude anybody with a history of drug or alcohol misuse, suicide attempts, psychotic symptoms or comorbid physical illness from a treatment trial for depression, only 15% of a typical outpatient population will qualify. So this randomised controlled trial (J Clin Psychiatry 2008;69:701–5.) of add-on quetiapine in people with both bipolar disorder and alcohol dependence should be worth a look. The trouble is it’s too small for randomisation to take account of a mixed bunch sample taking a variety of additional psychotropic medicines. Some statistical sophistry purporting to show a reduction in depressive symptoms for those taking quetiapine cannot mask the fact that this is really a negative study. THERAPEUTICS Borge FM, Hoffart A, Sexton H, et al. Residential cognitive therapy versus residential interpersonal therapy for social phobia: A randomized clinical trial. J Anxiety Disord 2008;22:991–1010. Brown ES, Garza M, Carmody TJ. A randomized, double-blind, placebo-controlled addon trial of quetiapine in outpatients with bipolar disorder and alcohol use disorders. J Clin Psychiatry 2008;69:701–5. Imel ZE, Malterer MB, Mckay KM, et al. A meta-analysis of psychotherapy and medication in unipolar depression and dysthymia. J Affect Disord 2008;110:197–206. KrakowskiMI,CzoborP,NolanKA.Atypical antipsychotics, neurocognitive deficits, and aggression in schizophrenic patients. J Clin Psychopharmacol 2008;28:485–93. McCambridge J, Slym RL, Strang J. Randomized controlled trial of motivational interviewing compared with drug information and advice for early intervention among young cannabis users. Addiction 2008;103: