Background: Epidemiological data on personality disorders, comorbidity and associated use of services are essential for health service policy.Aims: To measure the prevalence and correlates of personality disorder in a representative community sample.Method: The Structured Clinical Interview for DSM-IV Axis II disorders was used to measure personality disorder in 626 persons aged 16-74 years in households in England, Scotland and Wales, in atwo-phase survey.Results: The weighted prevalence of personality disorder was 4.4% (95% CI 2.9-6.7). Rates were highest among men, separated and unemployed participants in urban locations. High use of healthcare services was confounded by comorbid mental disorder and substance misuse. Cluster B disorders were associated with early institutional care and criminality.Conclusions: Personality disorder is common in the community especially in urban areas. Services are normally restricted to symptomatic, help-seeking individuals, but a vulnerable group with cluster B disorders can be identified early are in care during childhood and enter the criminal justice system when young. This suggests the need for preventive interventions at the public mental health level.

Aims: To characterize e‐cigarette use, users and effects in a sample of Electronic Cigarette Company (TECC) and Totally Wicked E‐Liquid (TWEL) users.Design and setting: Online survey hosted at the University of East London with links from TECC/TWEL websites from September 2011 to May 2012.Measurements: Online questionnaire.Participants: One thousand three hundred and forty‐seven respondents from 33 countries (72% European), mean age 43 years, 70% male, 96% Causacian, 44% educated to degree level or above.Findings: Seventy‐four percent of participants reported not smoking for at least a few weeks since using the e‐cigarette and 70% reported reduced urge to smoke. Seventy‐two percent of participants used a ‘tank’ system, most commonly, the eGo‐C (23%). Mean duration of use was 10 months. Only 1% reported exclusive use of non‐nicotine (0 mg) containing liquid. E‐cigarettes were generally considered to be satisfying to use; elicit few side effects; be healthier than smoking; improve cough/breathing; and be associated with low levels of craving. Among ex‐smokers, ‘time to first vape’ was significantly longer than ‘time to first cigarette’ (t₁₁₀₄ = 11.16, P < 0.001) suggesting a lower level of dependence to e‐cigarettes. Ex‐smokers reported significantly greater reduction in craving than current smokers (χ²₁ = 133.66, P < 0.0007) although few other differences emerged between these groups. Compared with males, females opted more for chocolate/sweet flavours (χ²₁ = 16.16, P < 0.001) and liked the e‐cigarette because it resembles a cigarette (χ²₃ = 42.65, P < 0.001).Conclusions: E‐cigarettes are used primarily for smoking cessation, but for a longer duration than nicotine replacement therapy, and users believe them to be safer than smoking.

There are no previous surveys of psychopathy and psychopathic traits in representative general population samples using standardized instruments. This study aimed to measure prevalence and correlates of psychopathic traits, based on a two-phase survey using the Psychopathy Checklist: Screening Version (PCL: SV) in 638 individuals, 16-74 years, in households in England, Wales and Scotland. The weighted prevalence of psychopathy was 0.6% (95% CI: 0.2-1.6) at a cut score of 13, similar to the noncriminal/nonpsychiatric sample described in the manual of the PCL: SV. Psychopathy scores correlated with: younger age, male gender; suicide attempts, violent behavior, imprisonment and homelessness; drug dependence; histrionic, borderline and adult antisocial personality disorders; panic and obsessive-compulsive disorders. This survey demonstrated that, as measured by the PCL: SV, psychopathy is rare, affecting less than 1% of the household population, although it is prevalent among prisoners, homeless persons, and psychiatric admissions. There is a half-normal distribution of psychopathic traits in the general population, with the majority having no traits, a significant proportion with non-zero values, and a severe subgroup of persons with multiple associated social and behavioral problems. This distribution has implications for research into the etiology of psychopathy and its implications for society.

Background: There is accumulating evidence of hypothalamic–pituitary–adrenal (HPA) axis disturbances in chronic fatigue syndrome (CFS). The salivary cortisol response to awakening has been described recently as a non-invasive test of the capacity of the HPA axis to respond to stress. The results of this test correlate closely with those of more invasive dynamic tests reported in the literature; furthermore, it can be undertaken in a naturalistic setting.Aims: To assess the HPA axis using the salivary cortisol response to awakening in CFS.Method: We measured salivary cortisol upon awakening and 10, 20, 30 and 60 min afterwards in 56 patients with CFS and 35 healthy volunteers.Results: Patients had a lower cortisol response to awakening, measured by the area under the curve.Conclusions: This naturalistic test of the HPA axis response to stress showed impaired HPA axis function in CFS.