Weight gain is a common, distressing side-effect of antipsychotic medication prescribed for people with severe mental illness. National guidance for antipsychotic-induced weight gain (AIWG) encourages early intervention and physical health monitoring; healthcare professionals (HCPs) often struggle to implement these recommendations in routine care.

To explore how HCPs understand and respond to AIWG for patients.

This realist evaluation, part of the RESOLVE project, builds on a realist synthesis. Thirty HCPs participated in realist interviews. A programme theory with nine context–mechanism–outcome configurations (CMOCs) was generated, explaining how HCPs perceive non-pharmacological care provision for patients with AIWG. Clinical and lived experience stakeholders reviewed and refined the theory and CMOCs.

The nine CMOCs spanned three areas: (a) systemic and professional challenges; (b) strategies to enhance individualised and meaningful support; and (c) the role and limitations of non-professional support. HCPs described how lack of training, siloed services and system-level constraints limited their ability to offer integrated care. They highlighted the importance of relational continuity, early and tailored conversations, and alignment with patients’ values and motivations. Peer and family support were valued, but structural barriers undermined their consistent implementation.

AIWG was experienced as compromising professional values for HCPs working in mental health settings. Person-centred care was often undermined by fragmented systems, role ambiguity and insufficient training. These issues require investment in professional development, structural integration, and relationship-based approaches that support timely, collaborative action.

Youth in low- and middle-income countries (LMICs) bear a disproportionate burden of mental health conditions, alongside low health-seeking behaviours and limited access to services. These gaps underscore the need for accessible strategies such as youth peer-based mental health programmes and supports (Y-PBMHPS).

To examine whether Y-PBMHPS can help address the mental health needs of LMIC youth.

We conducted a rapid review of peer-reviewed literature, searching Medline, PsycINFO, CINAHL, CAB Global Health, Science Citation Index and Social Sciences Citation Index for studies of Y-PBMHPS in LMICs published in English between 1 January 2002 and 19 September 2025. Two review authors performed title/abstract screening and full-text review. Study quality was assessed by one review author using Joanna Briggs Institute critical appraisal tools. The primary outcome was change in mental health status, expressed in standardised difference units.

Of 6105 unique records identified, 329 studies were reviewed in full and 34 were included. All studies were conducted in Asia or Africa; 17 were quantitative studies (including randomised controlled trials), 9 were qualitative studies and 8 used quantitative designs with qualitative findings. Y-PBMHPS included counselling, psychotherapy, psychoeducation and self-help groups, with peers acting as leaders, facilitators, educators or service providers. Quantitative studies most frequently assessed anxiety and depression, reporting negligible to moderate effects. Qualitative findings indicated good fidelity, adherence and acceptability, alongside some feasibility challenges.

Y-PBMHPS can broaden youth mental health support and services in LMICs. Clearer guidelines on peer selection, training and supervision and further research in other LMICs, including cost-effectiveness evaluations, would strengthen the evidence base.

People with severe mental illness (SMI) face significant challenges when reintegrating from correctional facilities back to the community. These include increased recidivism risk, homelessness and mental health deterioration. Although specialised reintegration programmes were developed to address the needs of this vulnerable population, their effectiveness remains unclear owing to mixed findings reported in the literature.

We performed a systematic review to synthesise and evaluate available evidence on reintegration programmes designed specifically for people with SMI.

Studies were included if they focused on adults with SMI transitioning from correctional facilities to community settings. The search was conducted through 10 January 2026. Two reviewers independently screened eligible studies and scored the appropriate risk of bias tools under supervision. A narrative analysis was adopted given the heterogeneity of methodologies and outcomes.

We identified 26 eligible studies, of which 11 were longitudinal, seven were randomised controlled trials, 3 had an AB design, 2 quasi-experimental, 2 retrospective and 1 brief report. The median number of participants involved in these studies was 207 (range: 22–3086). Studies employed various interventions, including peer mentoring, critical time intervention models, case management and therapeutic community. Results showed mixed effectiveness: some programmes demonstrated reduced recidivism and improved mental health service engagement, whereas others had minimal impact or even counterintuitive increases in re-imprisonment. Programmes generally showed better outcomes with a longer duration and comprehensive aftercare components.

Reintegration programmes show promise, but current approaches demonstrate variable efficacy. Successful interventions appear to require comprehensive, sustained support addressing multiple domains including mental health treatment, housing, employment and social support.

Serious incidents, such as patient suicide, profoundly impact clinicians. In mental health settings, these events are uniquely distressing. Despite policy shifts towards learning from serious incidents, many doctors report inadequate support and significant emotional distress. Resident doctors, already vulnerable to burnout and emotional exhaustion, are particularly at risk.

This study aimed to understand resident psychiatry doctors’ experiences of serious incidents. It sought to gather in-depth insights about how resident psychiatrists navigate the serious incident process, and the effect the process has on their professional and personal lives.

A qualitative study recruited 10 participants via email in 1 National Health Service (NHS) trust. Semi-structured online interviews were audio-recorded, transcribed and analysed using Braun and Clarke’s six-phase thematic analysis, employing an iterative, constant comparative approach.

Descriptive characteristics of the participants are reported. Three overarching themes were identified: (a) when the process becomes the experience, with subthemes focusing on how open and transparent the investigation process was, about communication during the process and how doctors felt the process impacted their clinical role; (b) from theory to practice: when training meets reality. Subthemes here reflected on whether resident doctors felt prepared and knowledgeable about the process. There was also focus on the experience itself being a learning opportunity; (c) the emotional undercurrents: trauma, grief and support. Here the subthemes focused on the emotional toll of an incident and investigation, the grief and wider impact of a patient death and lastly, the need for support to resident doctors including supervisor and peer-to-peer support. Themes are reported accompanied by verbatim quotes from participants.

Findings confirm prior studies investigating the negative impact of serious incidents on resident doctors’ well-being and career confidence, highlighting the need for robust support. The study adds to the literature through emphasising the inadequacy of current support and highlights rectifiable issues such as the need for structured peer support and improved supervisor/resident training for emotional and professional complexities. Future research should compare these findings with experiences under the new Patient Safety Incident Framework (PSIRF) system to assess improvements.

Dementia affects approximately 6–13% of adults aged 65 years and older, with Alzheimer’s disease accounting for most cases. Established symptomatic therapies, including acetylcholinesterase inhibitors and memantine, provide limited benefit and do not modify disease progression. Multiple monoclonal antibodies (mABs) targeting different amyloid-β species have been developed as potential disease-modifying therapies; because some agents have entered clinical use whereas others remain investigational, a continuously updated synthesis of their efficacy and safety is needed.

To evaluate the efficacy and safety of all anti-amyloid mABs for adults with Alzheimer’s disease, using a living systematic review and meta-analysis.

We will conduct a living systematic review and meta-analysis in accordance with the Cochrane Handbook, Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) 2020 and the PRISMA extension for living systematic reviews. Randomised controlled trials comparing any approved or investigational anti-amyloid mAB with placebo, standard care or active comparators will be included. Searches of Ovid MEDLINE, Embase, Cochrane Central Register of Controlled Trials, ClinicalTrials.gov and WHO International Clinical Trials Registry Platform will be updated every 6 months. Meta-analyses will be conducted separately for each antibody molecule using random-effects models. Critical outcomes include global clinical change and disease severity, cognitive abilities, functional ability and dependency, and safety (serious adverse events, treatment discontinuation and amyloid-related imaging abnormalities). Important outcomes include neuropsychiatric symptoms, quality of life and health system outcomes. Certainty of evidence will be assessed using the methodology Grading of Recommendations, Assessment, Development and Evaluation.

This article describes a protocol; therefore, no review findings are available at this stage.

This living systematic review will provide an up-to-date synthesis of the benefits and harms of anti-amyloid monoclonal antibodies to inform clinical decision-making and health-system planning in Alzheimer’s disease.

This study explores the historical roots of phobic disorders through an analysis of Abu Zayd al-Balkhi’s ninth-century written venture into mental health and wellbeing, “Sustenance of the Soul”. It compares al-Balkhi’s descriptions, differentiation, and management of phobia with the current ICD-11 framework. Previous comparative research has demonstrated consistencies in his writings when compared to contemporary framework. As such, we hypothesised that al-Balkhi’s account would show substantial conceptual overlap with modern nosology while offering a more integrated phenomenological perspective that remains relevant to current psychiatric practice.

A multi-stage content analysis was undertaken using the manifest analysis method. First, relevant thematic premises were identified through examination of al Bakhli’s text. Second, focussing on aetiology, symptomatology, and therapeutic approaches, psychological terminology and their implied meanings were extracted. Finally, these findings were compared directly with the ICD-11 phobia-related classification and associated diagnostic constructs. The analytical process and mappings were independently cross-checked by a secondary researcher.

Al-Balkhi described phobia as an excessive, maladaptive fear response–referred in his work as “terror”–that exceeds the individual’s control and impairs functioning. He distinguished normative fear states from the pathological using description of threat appraisal and temporal proximity, paralleling modern distinctions between general anxiety and phobia. He also described symptoms of physiological arousal and cognitive interferences during fear states, including restricted clarity of thought. Management strategies included education regarding feared stimuli and desensitisation-like techniques, anticipating the core principles of contemporary psychological treatments.

Al-Balkhi’s account of phobia correlates to a significant degree with ICD-11 categorisations of anxiety and phobic disorders. Although some of the ideology lacks modern political correctness which reflects its era, the underlying clinical observations are notably consistent with modern phenomenology and psychologically informed care. These findings support the value of historical psychiatric scholarship in refining contemporary understanding and suggests that pre-modern consolidative models may still enrich current diagnostic and therapeutic approaches.

Problematic teacher–pupil relationships (TPR) affect children’s educational outcomes and mental health, particularly for children with psychiatric disorders and neurodevelopmental conditions, yet few population-based studies have explored this association.

To estimate the association between problematic TPRs and psychiatric disorder classifications including neurodevelopmental conditions and poor mental health, and whether this varied by informant.

A cross-sectional analysis of the Mental Health in Children and Young People 2017 survey (n = 6634) was performed. Mental health was assessed using the Strengths and Difficulties Questionnaire, whereas classification of psychiatric disorders, including neurodevelopmental conditions, was assessed using the Development and Well-Being Assessment. TPR quality was evaluated through reports from parents and children (aged >11 years). Bivariable and multivariable regression analyses were stratified by age (5–10 years, n = 3509; 11–16 years, n = 3010), controlling for covariates. Multiple imputation was used to address missing data.

Data-set information: NatCen Social Research (2024), Mental Health in Children and Young People 2017, UK Data Service, SN 8467.

Problematic TPRs were associated with increased odds of any psychiatric disorder in children aged 5–10 years (adjusted odds ratio = 4.80, 95% CI: 2.74–8.40) and 11–16 years (adjusted odds ratio = 4.07, 95% CI: 2.76–6.01). Strengths and Difficulties Questionnaire total difficulties scores were higher by 4.26 points (95% CI: 3.09–5.42) and 3.93 points (95% CI: 3.04–4.83) for children aged 5–10 and 11–16 years, respectively. Problematic TPRs were also associated with attention-deficit hyperactivity disorder, with no significant differences between informant types. Teacher recognition of poor mental health did not moderate these associations.

These findings support the importance of TPRs in school policy and of supporting teachers to foster positive relationships in schools.

Mental health literacy (MHL) is the ability to recognise mental disorders; have knowledge of professional help available, effective self-help and prevention strategies; and have the skills to support others. MHL is linked to better help-seeking behaviours and better management of mental illness. Mental illness prevalence is increasing in Malawi. Assessing MHL in communities crucially helps identify knowledge gaps, informing the development of evidence-based interventions.

This study assessed the MHL levels of young adults (16–30 years old) in rural and urban communities in Malawi.

A cross-sectional national survey was administered to 682 people across 13 districts in Malawi, using a self-reporting Mental Health Literacy questionnaire (MHLq) that assessed knowledge of mental health problems, erroneous beliefs/stereotypes, first aid skills, help-seeking behaviour and self-help strategies.

Most respondents were either unemployed (36%) or enrolled in school (43%). A total of 73% completed primary or secondary education, and 48% knew someone with a mental illness, but only 14% of this group could specify the illness. The mean MHL score was 111.8 (s.d. 13.9). Individuals with primary and secondary school qualifications had significantly lower scores in factor 2 (erroneous beliefs/stereotypes) and factor 3 (first aid skills and assistance-seeking behaviour) of the MHLq than those with higher education.

This research highlights persisting mental health misconceptions, limited knowledge about specific mental illnesses and low help-seeking behaviour among young adult Malawians. Higher education is linked to a better understanding of mental health. Prioritising community education on causes, signs, treatments and prognosis of mental illness is crucial for increased MHL.

Non-suicidal self-injury (NSSI) is a major clinical and public health issue in adolescence. Although psychological factors such as depression, anxiety and emotion dysregulation have been widely examined, less is known about how pain perception and autonomic reactivity interact with these variables in NSSI.

This study aimed to compare pressure pain threshold (PPT), autonomic responses and psychological characteristics between adolescents with NSSI and healthy controls, and to explore associations between pain perception, psychopathology, emotion regulation and NSSI functions.

Sixty-eight adolescents (34 with NSSI, 34 controls) participated. PPT was assessed using a pressure algometer. Depressive symptoms, anxiety symptoms and emotion regulation difficulties were measured, and NSSI functions were evaluated using a standardised tool. Systolic (SBP)/diastolic blood pressure and heart rate were recorded before and after pain stimulation. Correlational analyses and mixed (repeated measures) analyses of variance were performed.

The NSSI group showed a significantly higher PPT than controls (mean difference 1.43 kg/cm2; 95% CI: 0.64–2.00; p < 0.001). A significant group × time interaction emerged for SBP (η2 = 0.09), indicating a blunted post-pain response in the NSSI group. Emotion regulation difficulties were positively associated with PPT (r = 0.28). PPT was also positively correlated with sensation seeking (r = 0.36), autonomy (r = 0.34) and peer bonding (r = 0.36) functions of NSSI.

Adolescents with NSSI demonstrate elevated pain thresholds and altered autonomic reactivity. These findings highlight the importance of considering pain processing alongside psychological characteristics and NSSI functions in clinical assessment and intervention planning.

Cognitive complaints are common in multiple sclerosis, but their relationship to non-cognitive symptoms such as fatigue, sleep dysfunction and psychopathology has not been systematically examined in patients referred for specialist cognitive evaluation. These potentially modifiable symptoms may warrant attention in a clinical context.

This study aimed to characterise common patterns of cognitive and non-cognitive symptoms in a referred patient cohort and determine whether cognitive complaints are associated with clinically significant fatigue, sleep dysfunction and psychopathology.

Cognitive complaints were captured using (a) a binary classification derived from clinical impression and (b) a severity rating from a self-report instrument. Objective cognitive performance was measured across five cognitive domains. Patients also completed self-report measures of fatigue, sleep dysfunction and psychopathology.

Fifty-one patients were included. Although 98% had cognitive complaints, only 29% had objective cognitive impairment. Most (90%) had significant non-cognitive symptoms, primarily fatigue (86%), sleep dysfunction (28%) and depression (26%). Pattern analysis revealed that the most common symptom phenotype was cognitive complaints with significant non-cognitive symptoms, occurring in the absence of objective cognitive impairment. More severe cognitive complaints were associated with greater psychopathology (r = 0.57, BF10 = 2188.48), fatigue (r = 0.53, BF10 = 366.44) and sleep dysfunction (r = 0.47, BF10 = 69.27).

Cognitive complaints in multiple sclerosis may reflect broader non-cognitive symptom burden rather than objective cognitive impairment, even among patients referred for specialist evaluation. Their presence should prompt consideration of fatigue, sleep disturbance and psychopathology as potential targets for intervention.

This systematic review investigates the psychological phenomenon of Cancel Culture Induced Anxiety (CCIA) among Generation Z individuals aged 16–25. The primary aims are to synthesise empirical evidence from existing literature and develop an integrated conceptual model mapping the causes, pathways, and psychological effects of this condition.

A systematic review was conducted in accordance with PRISMA guidelines and the Cochrane Method. Comprehensive literature searches were performed across PsychINFO,PubMed, and Scopus to identify peer-reviewed, primary empirical studies. Ten studies were selected for inclusion based on a predefined Population, Exposure, Outcome (PEO) framework. Quality Assessment was then performed using Critical Appraisal Skills Programme (CASP) checklists. Finally, evidence was synthesised using the Temporal Need Threat Model, context collapse, and networked publics as theoretical foundations.

Findings indicate that CCIA manifests primarily as acute social anxiety, which frequently escalates to clinical depression, diminished self-esteem, and in severe cases, suicidal ideation. Key behavioural outcomes include avoidance, self-censorship, and both internal and external conformity. These effects are sustained through psychological mechanisms such as rejection sensitivity and rumination. The review establishes that CCIA is driven by simultaneous threats to four fundamental human needs: belonging, self-esteem, control and meaningful existence. Social media, shaped by the dynamics of context collapse, emerges as the dominant environment for CCIA, though its severity is mediated by cultural, socio-economic, and individual predisposing and protective factors. The identified coping strategies are predominantly reactive and individualised, highlighting a significant gap for systemic and preventative interventions.

The proposed conceptual model establishes a vital foundation for understanding CCIA across diverse cultural and social contexts. It offers practical guidance for psychiatrists and mental health professionals in designing targeted clinical interventions and institutional policies. Future research should employ longitudinal and mixed-method approaches to validate the model and inform preventative strategies, addressing CCIA as a systemic feature of the digital age.

Functional neurological disorder (FND) is a common condition, but there remain substantial gaps in our understanding of its effects, particularly on severity of disability and health status.

To characterise disability, quality of life and psychological and somatic symptom comorbidity in individuals with FND attending a specialist multidisciplinary clinic in Australia.

We conducted a cross-sectional analysis of patients assessed at an FND clinic in Sydney, Australia, between August 2022 and February 2025. We assessed disability (World Health Organization Disability Assessment Schedule (WHODAS 2.0)), health-related quality of life (EQ-5D five-level version (EQ-5D-5L), 36-Item Short Form Health Survey), psychological distress (Depression Anxiety and Stress Scale-21, Kessler Psychological Distress Scale (K10)) and somatic symptom severity (Patient Health Questionnaire-15 (PHQ-15)).

The cohort (N = 105) was predominantly female (74.3%), with a mean age of 35.4 (s.d. = 13.3) years. Functional seizures (46.7%) and functional weakness (45.7%) were the most common presentations. Only 33.7% were employed; 42.9% were unable to work because of FND. The average delay from diagnosis to clinic assessment was 356 days (s.d. = 463). WHODAS 2.0 scores indicated high levels of disability, exceeding international norms for both physical and mental illness. EQ-5D-5L scores were low, with 15.8% reporting a health state rated as ‘worse than death’. Psychological distress and somatic symptom severity were high: 49.5% scored in the K10 ‘very high’ range and 54.5% had high PHQ-15 scores.

FND is associated with significant functional disability, poor quality of life and high levels of psychological and somatic symptom comorbidity. Delays in accessing appropriate care and high rates of vocational disruption highlight the need for earlier diagnosis and better access to integrated, multidisciplinary FND services in Australia.

Test anxiety affects up to 40% of university students and is associated with academic failure, depression and suicidal ideation, yet clinical screening and high-frequency research designs remain hampered by the burden of 20-item instruments such as the Test Anxiety Inventory (TAI). Although brief measures exist (e.g. the ten-item Westside Test Anxiety Scale and the five-item TAI), a validated, gender-invariant hierarchy of ultra-short forms tailored to contemporary undergraduates is lacking.

To develop and validate a hierarchy of brief TAI versions (ten-item Short Form, five-item Ultra-Short Form and three-item Micro Form) suitable for systematic screening and ecological monitoring in student mental health contexts.

A large sample of Israeli undergraduates (N = 1803) completed the Hebrew TAI. Items were selected based on exploratory factor analysis loadings. Structural validity and gender measurement invariance were confirmed via confirmatory factor analysis.

The five-item Ultra-Short Form showed excellent fit (comparative fit index (CFI) = 0.995, root mean square error of approximation (RMSEA) = 0.05) and the three-item Micro Form exhibited strong standardised factor loadings (≥0.79). Strict scalar invariance was established across genders for all versions. All versions maintained high internal consistency (α ≥ 0.85) and strong correlations with the full scale (r ≥ 0.88). Selected items prioritised somatic over cognitive distress, suggesting contemporary students experience test anxiety as a visceral, physiological ‘survival threat’ rather than cognitive rumination.

These validated brief measures offer a promising toolkit for ‘agile assessment’ in student mental health settings, enabling early identification of at-risk students, pending external criterion validation and independent replication.

Accurate trauma recollections are essential in legal and research contexts; however, studies frequently reveal significant inconsistencies in trauma reporting over time.

To investigate the trauma-reporting patterns among healthcare workers (HCWs) following their exposure to the Beirut port blast.

This longitudinal study examined trauma memory alteration among 296 HCWs at 6 months (wave 3) and 2–2.5 years (wave 4) post-blast. Participants reported trauma exposure prior to the event, and probable post-traumatic stress disorder (PTSD) secondary to the Beirut port blast. Depression and psychological distress were analysed as potential predictors of memory alteration using multinomial models.

The majority of participants (72.4%) exhibited inconsistent trauma reporting, with 36.43% exaggerating and 35.71% diminishing their trauma accounts over time. Developing probable depression and screening positive for PTSD at wave 4 were predictors of memory exaggeration (respectively odds ratio 5.71, 95% CI: 1.19–27.32; odds ratio 8.04, 95% CI: 0.98–65.73), while remitted psychological distress was protective (odds ratio 0.08, 95% CI: 0.01–0.99). No significant predictors were found for memory diminishment.

A substantial portion of HCWs exposed to the Beirut port blast demonstrated inconsistent trauma reporting, with mental health conditions such as depression and PTSD influencing memory exaggeration. These findings underscore the importance of considering memory reliability in trauma research, particularly in populations with mental health disorders and exposed to major disasters.

Limited data exist on factors influencing the length of hospital stay (HLoS) in patients with schizophrenia.

This study aimed to identify and quantify patient characteristics associated with HLoS.

A retrospective study was conducted on patients diagnosed with schizophrenia (F20, ICD-10) admitted to the County Emergency Hospital of Cluj-Napoca, Romania, from 2018 to 2022. Demographics, comorbidities, symptom severity (Positive and Negative Syndrome Scale/Brief Psychiatric Rating Scale), antipsychotic treatment and adverse effects data were collected from medical charts. Predictors of HLoS for patients with one hospitalisation were assessed using negative binomial regression.

The sample comprised 288 patients aged 18–65 years, with 75% over 30 years and a balanced gender distribution. Most patients had no comorbidities (64.24%) whereas 49.46% reported addictions. Men had higher rates of tobacco use (62.00 v. 53.49%) and self-reported use of substances/drugs (15.49 v. 3.91%). Independent predictors of HLoS (P < 0.05) in the multivariable model included gender, being retired, experiencing fear or violence in the context of psychotic decompensation, percentage score reduction in symptom severity score, first-generation antipsychotics treatment and the presence of reasons for late discharge. Men had an expected HLoS 39% longer than women. Experiencing fear (adjusted incidence rate ratio (aIRR) 1.13, 95% CI [1.01; 1.27]) and violence in the context of psychotic decompensation (aIRR 1.19, 95% CI [1.06; 1.34]), and first-generation antipsychotics treatment (aIRR 1.17, 95% CI [1.02; 1.35]) were associated with longer stay, whereas being retired predicted shorter HLoS (aIRR 0.83, 95% CI [0.70; 0.98]).

The length of hospital stay in patients with schizophrenia is influenced by demographic, clinical and treatment factors. Targeted interventions addressing these predictors may optimise the duration of hospitalisation.