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Body dysmorphic disorder is a distressing and often disabling condition characterised by a preoccupation with imagined or slight physical defects in appearance. It has been recognised as a mental disorder for many years (and named body dysmorphic disorder since 1980), but epidemiological studies and clinical trials have been few. To a large extent, the disorder has been ignored by the mental health community, who often fail to elicit the diagnosis. This article reviews the diagnostic criteria for the disorder, its validity and its relationship to other disorders such as obsessive–compulsive disorder, anorexia nervosa, social phobia and somatisation disorders. The course of the illness, its aetiology and treatment approaches are discussed. As research is growing alongside an increase in patient presentations, body dysmorphic disorder requires a coherent response from healthcare services.

Inpatient services constitute the most highly specialized child and adolescent mental health provision and cater for the most severe disorders in this age group. In view of a number of mapping and audit initiatives in the UK in recent years and changing influences on admission policies worldwide, it is timely to review their function and effectiveness.

Specialist eating disorders services may improve outcomes and reduce hospitalisations for children and adolescents with anorexia nervosa. Reductions in hospitalisation could save money for the NHS and are better for young people because hospitalisation disrupts their home life, social life and education. This study evaluated outcomes and costs of specialist eating disorders services compared to general child and adolescent mental health services (CAMHS) for children and adolescents with anorexia nervosa.

Despite a number of reviews outlining methodological difficulties in the area of outcome assessment in child and adolescent mental health services, the past year has seen a proliferation of public policy initiatives drawing attention to the merits of outcome measurement in these services. In the UK, these initiatives focused the attention of many nonacademic services on outcome measurement for the first time.

The self-report questionnaire method was employed to determine the prevalence and pattern of drinking, smoking and illicit substance use among 2888 11-16-year-olds in Blackburn secondary schools. Substances reported most commonly used were alcohol, cigarettes, hallucinogenic substances, glue/solvents and cannabis. Use increased steadily with advancing school year. Boys were significantly greater users of cannabis and hallucinogenic substances. The baseline data provided could form the basis of a well-targeted preventative programme. The need for more comprehensive surveys, preferably longitudinal in design, is stressed.