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Although widely used, pharmacotherapeutic approaches to the treatment of post-traumatic stress disorder (PTSD) have been undermined by uncertainty about efficacy. Hoskins et al (pp. 93–100) systematically reviewed the relevant literature and found that selective serotonin reuptake inhibitors (SSRIs) appear to be superior to placebo in reducing PTSD symptoms but with a small associated effect size. Fluoxetine, paroxetine and venlafaxine were individually identified as potential treatments. The authors highlight the lack of evidence to support the use of other pharmacological agents and also the absence of adequately controlled head-to-head trials of pharmacological and psychological interventions for PTSD. Set in primary care, Sundquist et al (pp. 128–135) undertook a randomised controlled trial of mindfulness group therapy for patients with depression, anxiety or stress and adjustment disorders, with a treatment-as-usual control arm (treatment as usual was individual cognitive–behavioural therapy (CBT) primarily). Improvement was seen in both treatment groups with no difference found between the groups. The authors comment on the potential resourceand cost-saving implications for mindfulness group therapy delivered by certified instructors in primary care compared with individual CBT delivered by psychologists or counsellors. Two different approaches to evaluating mental health treatment are presented in the BJPsych this month – one a qualitative substudy linked to a pilot trial and the other an analysis of international survey data. Notley et al (pp. 122–127) qualitatively examined participant views and experiences in relation to involvement in the PRODIGY trial, a pilot trial of social recovery CBT for young people with emerging psychological difficulties. They found that participants in both arms reported perceived benefits of involvement in the trial beyond the intervention itself. The authors discuss the implications of their findings for addressing ethical concerns associated with trial recruitment in this group, including the issue of disclosure during assessments, which was found by many of the participants to be beneficial. Concerns about the extent to which mental health treatments and services are wasted on the ‘worried well’ prompted Bruffaerts et al (pp. 101–109) to analyse data from the World Health Organization’s World Mental Health Surveys of community samples recruited from 23 countries. Around half of those reporting mental health treatment in the previous 12 months were found to meet criteria for a past-year DSM-IV disorder, an additional 18% for a lifetime disorder and a further 13% for another indicator of need (multiple subthreshold disorders, recent stressors or suicidal behaviours). General hospital admission and SPECT imaging in dementia