Growing research has underscored the elevated prevalence and burden of psychiatric morbidity among adults living with long COVID. The severity of acute SARS-CoV-2 infection may predict the prevalence and severity of psychiatric symptoms in long COVID. Although Global South countries have faced among the highest incidence rates and burden of COVID-19, little is known about the psychiatric symptoms of long COVID in these regions, especially in Sub-Saharan Africa.

This study aimed to (a) compare the prevalence of long-term psychiatric symptoms between acute COVID-19 infection groups, (b) estimate the associations between COVID-19 severity and long-term psychiatric symptoms, (c) determine the association between long COVID symptoms and psychiatric symptoms, and (d) test the potential mediating effect of long COVID symptoms in the association between acute COVID-19 infection and psychiatric symptoms.

This case–control study took place in Johannesburg, South Africa, between August 2022 and July 2023. A total of 360 adults were categorised into one of four case groups based on initial COVID-19 symptoms: asymptomatic, symptomatic, admitted to hospital and vaccinated controls.

Prevalence rates of post-traumatic stress disorder (21.1%) and somatic symptoms (22.9%) were elevated. Individuals with symptomatic COVID-19 exhibited the greatest psychiatric morbidity out of all groups, exhibiting the highest levels of depression, suicidality, anxiety, post-traumatic stress disorder, bipolar disorder and somatisation. Acute COVID-19 severity was associated with worse symptoms of depression, somatisation and physical fatigue. Severity of long COVID symptoms was directly associated with psychiatric sequelae.

These results call attention to the long-term psychiatric sequelae of SARS-CoV-2 infection and early identification and management of emerging psychiatric symptoms in high-risk COVID-19 survivors.

Improving access to community-based crisis care and reducing in-patient admissions are key policy objectives in England, yet evidence on who uses crisis-related services remains limited.

To examine sociodemographic patterns in the use of six crisis-related services in England: crisis phonelines; crisis cafés; Crisis Resolution and Home Treatment teams (CRHTs); voluntary in-patient admissions; compulsory in-patient admissions under the Mental Health Act 1983 (MHA); and conveyance to a Place of Safety (PoS) by police under section 136 of the MHA.

This retrospective observational study used the Mental Health Services Data Set (2021/2022−2023/2024). Adults (18+ years) using any of the six services were included. A multinomial logit regression model estimated average marginal effects for age, gender, ethnicity and area-level deprivation, with robust patient-level standard errors and year fixed effects.

Among crisis-related patients, adjusted analysis showed that several ethnic minority groups were more likely than White individuals to be compulsorily detained or brought to a PoS, and less likely to use CRHTs, with the largest disparities in compulsory admissions for Black (+15.0 percentage points) and Asian (+7.3 percentage points) groups. Compulsory admissions were more common among older adults and men (+1.5 percentage points). Crisis phonelines were used less by older adults, men (−4.8 percentage points), Black (−15.6 percentage points) and Asian (−4.7 percentage points) groups. Although adjusted differences by deprivation were small (<1.0 percentage points), over half of users lived in the 2 most deprived quintiles.

Groups at greater risk of coercive care were less likely to access community crisis services. Addressing these disparities could reduce inequalities.

Despite growing recognition of disparities in the diagnosis and treatment of adult attention deficit hyperactive disorder (ADHD), few studies have examined how gender intersects with rural healthcare contexts to shape diagnostic pathways. This gap is particularly concerning given that rural healthcare settings face structural constraints such as limited access to specialized mental health services that may further exacerbate diagnostic inequities, especially for gender-diverse populations. The aims of this study were to explore ADHD subtype distribution among adults attending a rural outpatient clinic, examine demographic and psychosocial correlates of subtype, and assess gender-based variation in these associations using the Gender-Based Analysis Plus (GBA+) framework.

This is a retrospective cross-sectional study of adults diagnosed with ADHD in an outpatient mental health clinic in rural Northern British Columbia, Canada. ADHD subtypes were classified using two standardized diagnostic assessments: the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM–5), and the Diagnostic Interview for ADHD in Adults, version 5 (DIVA–5). Sociodemographic characteristics, psychosocial factors, comorbidities, and medication use were extracted from clinical records. Associations between ADHD subtype and key variables were examined using both descriptive and inferential statistics. Gender-stratified analyses were performed to explore the relationships between ADHD subtype and psychosocial factors, with a focus on treatment patterns and functional indicators relevant to rural health service delivery.

The sample consisted of 660 adults age range between 20 and 75 years (mean age=38 years). The combined presentation was the most prevalent ADHD subtype (67%),followed by the predominantly inattentive presentation (30%); the hyperactive/impulsive presentation was uncommon (3%). ADHD subtype distribution did not differ significantly by gender. The association between ADHD diagnosis subtype and gender was not statistically significant, χ²(4, N=660)=1.10, p=0.894. Employment status also did not differ significantly by ADHD subtype (χ² (2)=4.48, p=0.107), indicating similar employment distributions across combined, inattentive, and hyperactive/impulsive ADHD presentations. In contrast, medication use differed significantly by ADHD subtype (χ² (2)=12.75, p=0.002), with higher rates of pharmacological treatment among individuals with combined presentations.

These findings support adult ADHD guidelines that prioritize comprehensive assessment and individualized care rather than gender-based assumptions. In rural mental health systems, aligning practice with standardized diagnosis, subtype-informed treatment planning, and structured follow-up may strengthen equity, consistency, and continuity in adult ADHD care delivery.

Many studies have observed a link between mortality and mental illness, although the contribution of violence exposure to mortality in people with mental illness remains under-researched.

To examine the association of violence exposure, such as being physically assaulted, with general and cause-specific mortality in a population using mental health services.

We assembled a cohort study using electronic health records from a mental health and substance use treatment provider in south-east London. Records were linked to acute medical admission and emergency department presentation data, as well as to a national mortality register with death certificates for deaths registered in England and Wales. Cox regressions estimated the associations of binary and cumulative violence exposure, as indicated by assault admission and presentation to emergency departments for violence-related reasons. Mortality was adjusted for sociodemographic and clinical potential confounders.

The hazard ratio for assault admission with all-cause mortality was 2.14 (95% CI: 1.93–2.36) following covariate adjustment. Adjusted associations were also found with mortality from the following causes: internal (natural) (hazard ratio 1.72, 95% CI: 1.50–1.98), external (hazard ratio 1.94, 95% CI: 1.51–2.48), suicide (hazard ratio 2.20, 95% CI: 1.38–3.52), respiratory (hazard ratio 2.01, 95% CI: 1.41–2.85), circulatory (hazard ratio 1.71, 95% CI: 1.27–2.28), diabetes-related (hazard ratio 2.86, 95% CI: 1.20–6.86) and alcohol-related (hazard ratio 1.56, 95% CI: 1.10–2.22). Results for cumulative assault were consistent with these in both direction and magnitude. There was evidence for an association of weapon-related assault admission with all-cause mortality (hazard ratio 1.58, 95% CI: 1.14–2.18).

People with mental illness, who are exposed to assault, experience greater mortality than those who are not exposed. Excess mortality attributable to violence exposure in people with mental illness was related to deaths from natural and external causes.

The psychological consequences of hospital admission for COVID-19, such as post-traumatic stress disorder (PTSD), are under-researched.

To describe the prevalence of, and risk factors for, psychological trauma symptoms in COVID-19 patients discharged from hospital.

We used data from the Post-Hospitalisation COVID-19 (PHOSP-COVID) study of adults discharged from UK hospitals after COVID-19. Psychological trauma was assessed using the Posttraumatic Stress Disorder Checklist for DSM-5 (PCL-5) 5 and 12 months after discharge. We used log binomial regression to identify risk factors for probable PTSD.

We describe 1565 study participants discharged from hospital between February 2020 and March 2021 following an admission for COVID-19. Most were male (61.3%), White (77.4%) and from more deprived areas (62%). Of these, 15% had probable PTSD (PCL-5 ≥34) at 5 months which was associated with being 18 to 50 years old (risk ratio: 3.0 (2.1– 4.3), p < 0.001), lower income (e.g. <£19,001, risk ratio 2.1, 95% CI: 1.5 – 2.8, p < 0.001), longer admission and a history of depression or anxiety. Out of 236, 136 (57.6%) with probable PTSD at 5 months still had probable PTSD at 12 months. Persistence was associated with intensive care unit (ICU) admission (risk ratio 1.3, 95% CI 1.1–1.6, p < 0.001) and higher anxiety and PCL-5 scores at 5 months.

Probable PTSD was common 5 months after admission for COVID-19 and was associated with lower socioeconomic status, longer admission and previous depression or anxiety. Over half remained symptomatic at 12 months, associated with ICU admission and higher 5-month PCL-5 scores.

Despite young British Bangladeshis experiencing a higher prevalence of mental health problems than the White British population, they are comparatively underrepresented in mental health research and fewer access services.

This study aimed to identify priorities and preferences for mental health support among young British Bangladeshis, as well as strategies to enhance the cultural appropriateness and accessibility of services.

A qualitative study was conducted in London and Leicester, with participants recruited through voluntary and community organisations. In-depth interviews were held with young people with lived experience of mental health problems (n = 12), their family members (n = 7) and Bangladeshi community workers from voluntary sector organisations (n = 7). Data were analysed using thematic framework analysis.

Participants’ priorities for mental health support included reducing stigma, raising awareness, and addressing intergenerational and identity-related stressors. Preferences centred on culturally and linguistically appropriate care delivered by therapists familiar with Bangladeshi values in trusted community settings. Suggested strategies for improving existing services included enhancing access by providing support in trusted community spaces, building trust through the involvement of culturally aware professionals, and involving families and community leaders to reduce stigma and promote open discussion around youth mental health.

This study identifies a need for culturally tailored, linguistically accessible and community-rooted mental health support for British Bangladeshi youth. Representatives from these communities should be actively involved in the development of future programmes and policies, ensuring that support is both relevant and sustainable.

Mental health remains a low health priority globally. Despite the high burden of mental health in Ghana, little is known about the extent of financing and prioritisation by policymakers and other relevant stakeholders.

This study aims to understand the determinants of low domestic public financing and the prioritisation of mental health in Ghana, and to identify opportunities and strategies to increase policy attention.

Kingdon’s multiple streams framework was used to map barriers to domestic financing for mental health. We conducted a document analysis of relevant policies, strategies and articles, and carried out semi-structured interviews with relevant national stakeholders. We analysed interview transcripts deductively following the key domains for the multiple streams framework.

We found that low public financing for mental health stems from several issues at the level of the ‘problem stream’: low awareness and misunderstandings in general society, stigma and discrimination, insufficient public funding of the health sector in general, catastrophic healthcare expenditure insufficiently documented, limited political attention to mental health and limited donor interest. There is clear evidence of dynamism on the ‘policy solution stream’, including development of national laws, policies, strategies and institutions; adoption of international strategies and recommendations; and existence of policy entrepreneurs and windows. The democratic system of Ghana creates opportunities in the ‘politics stream’, but also raises the issue of continuity across governments.

In Ghana, mental health is not yet sufficiently recognised as a societal issue, which affects demand for services and contributes to the low policy priority and resource allocation by the government. Greater investment is therefore needed to raise public awareness through coalition building, research, campaigns and education activities.

In Central Asia, investment in youth mental health research and practice remains limited despite widespread exposure of children and young people to social adversity, including poverty, marginalisation and violence. Evidence is needed to direct resources towards youth mental health and inform interventions.

This scoping review aimed to map existing research on the mental health needs and experiences of children and young people in Central Asia, to inform opportunities for further research, policy and practice.

Following Joanna Briggs Institute (2015) guidance, we searched five databases (Ovid Medline, PsychINFO, Embase, Scopus and Web of Science) and Google Scholar to retrieve peer-reviewed studies in English, with inclusion criteria applied.

Forty eligible studies published between 2013 and 2025 were identified, mostly based in Kazakhstan. Study populations included children and adolescents (aged 3–19 years), university students, participants across life stages and adults involved in young people’s care. Samples included general populations and groups with specific conditions or lived experiences. Research topics included the following: (a) anxiety and affective disorders; (b) suicide; (c) well-being and quality of life; (d) promoting mental health and resilience; (e) substance use; and (f) other mental health difficulties. Most studies employed quantitative cross-sectional designs, focusing on prevalence and risk and protective factors.

Studies included a range of populations, including children, adolescents, university students and caregivers, and topics including common mental health disorders, suicide and well-being. Nevertheless, more rigorous and contextually relevant research is needed to inform policies and interventions for children and young people in Central Asia.

Understanding the neuroanatomical correlates of treatment response in schizophrenia is crucial for improving clinical stratification and clarifying underlying pathophysiological mechanisms.

To examine subcortical volumetric differences across clinically defined schizophrenia treatment-response subgroups.

T1-weighted structural magnetic resonance imaging data were analysed from 109 participants, including 79 individuals with schizophrenia and 30 healthy controls. Patients were categorised into three distinct treatment response groups: ultra-treatment-resistant (UTR; n = 22), clozapine-responsive (n = 28) and first-line antipsychotic responsive (FLR; n = 29). Group differences were examined across 33 regions of interest, including subcortical, ventricular and hippocampal subfield regions.

The UTR group had higher antipsychotic dosages and exhibited greater symptom severity than other patient groups. Across all schizophrenia subgroups, hippocampal and amygdala volumes were smaller relative to controls. Treatment-resistant patients (UTR and clozapine-responsive) also showed reduced nucleus accumbens volumes, whereas FLR patients demonstrated larger pallidal volumes. In addition, the UTR subgroup exhibited enlarged lateral ventricles. Hippocampal subfield analyses revealed widespread reductions in treatment-resistant patients, most prominently in the CA4/dentate gyrus, subiculum and stratum, whereas FLR patients showed more focal reductions in the CA4/dentate gyrus and left subiculum.

These results suggest that smaller hippocampal and amygdala volumes represent a shared neuroanatomical signature of schizophrenia, whereas reduced accumbens and enlarged pallidal volumes may differentiate treatment-resistant and treatment-responsive profiles, respectively. The findings underscore the heterogeneity of schizophrenia and highlight the need for longitudinal research to disentangle illness-related pathology from medication effects.

GAP is the largest psychiatric specialty, but most treatment evidence is generated in other populations, or excludes participants with severe conditions, comorbidities and treatment-resistance–essentially omitting most GAP inpatients. Consequently, the published evidence may have limited relevance.

Aimswere to characteriseGAP inpatients–diagnoses, severity, treatment-resistance, comorbidities, and legal status–to benchmark and inform the development of a framework to meta-analyse publications to test how accurately they reflect real-world practice.

We characterised consecutive admissions to a GAP ward using the measures usually employed in psychiatric publications. Data included demographics, Brief Psychiatric Rating Scale (BPRS), Inventory of Depressive Symptomatology (IDS-SR), Personality Disorder Severity (PDS-ICD-11), Generalised Anxiety Disorder scale (GAD-7), Substance Use scale (TAPS), and medical abnormalities and comorbidities.

N=65 (‘GAP-65’, 11 declined/could not be consented). Psychosis Group N=32: 60% treatment-resistant (clozapine protocol), severe psychosis (BPRS mean 58.2), very severe depression (IDS-SR mean 39.4), smoking, alcohol, and cardiometabolic disease frequent. Bipolar Mania Group N=5: Severe mania (YMRS mean 39.6), 60% obese, 50% hypertensive, and frequent metabolic abnormalities (DM II, prolactin elevation). Bipolar Depression Group N=2: All treatment-resistant (Massachusetts General Hospital Staging), 50% DM II and hypertensive. Unipolar Depression Group N=9: Very severe depression (IDS-SR mean 50.6), 57.1% treatment-resistant, 38% obese, 71% hypertensive, and high rates of cardiometabolic and respiratory illness. Axis II Group N=15: 80% PD, 93.3% suicidal ideation, physical comorbidities less common but mean BMI 30.2.

When these features are operationalised, an extremely low proportion of GAP inpatients would meet criteria for recruitment into even exemplars of contemporary academic psychiatry e.g. 1) translational neuroscience; Rupprechter et al., Brain (2020) (£4.7M, N=475)–92% participants were in the healthy or mild depression range and treatment-resistant patients were excluded c.f. GAP-65 who were all severely ill and mostly treatment-resistant. 2) treatment trials; Jog et al., JAMA Netw Open (2025) (highlighted by evidencealerts.com, including for clinical relevance)–participants were in the moderate depression range, treatment-resistant patients were excluded, and the reduction in depression scores following transcranial direct current stimulation would not move pertinent GAP-65 patients out of the severe range of illness.

Our results highlight a critical gap in psychiatric research: Studies that are highly cited and influential do not adequately represent the severity and complexity of typical GAP inpatients. Correspondingly, we propose a systematic review and meta-analysis of clinically important features of GAP inpatients to evaluate the extent to which psychiatric research represents real-world practice.

Clozapine is the gold-standard treatment for treatment-resistant schizophrenia but carries serious cardiac risks, including sudden cardiac death (SCD). Specific risk factors for SCD in clozapine-treated patients remain poorly defined.

To systematically identify and synthesise evidence on risk factors for SCD and sudden unexplained death (SUD) in clozapine-treated patients, to guide clinical monitoring.

We conducted a systematic review following Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines (PROSPERO, no. CRD420250646384). Five databases were searched from inception to 13 October 2025. Studies reporting SCD or SUD in clozapine-treated patients were included without restrictions on study design, demographics or diagnosis. Two reviewers independently screened studies and extracted data. Quality was assessed using Joanna Briggs Institute checklists and Risk Of Bias In Non-randomised Studies of Exposures tools. Given study heterogeneity, we performed structured narrative synthesis.

Twenty-one studies (1989–2023) were included, comprising 498 cases of SCD/SUD in clozapine-treated patients. Risk factors were grouped into four categories: treatment intensity (high doses (≥525 mg/day), rapid titration), drug interactions (valproate, benzodiazepines, polypharmacy), lifestyle factors (smoking, obesity, diabetes, substance use) and monitoring. Two patterns emerged: early inflammatory myocarditis (weeks 2–6) and late-onset cardiomyopathy (months–years).

Clozapine-associated SCD appears multifactorial. These findings suggest a role for gradual titration, avoidance of high-risk co-medications, baseline biomarker monitoring and ongoing management of metabolic and cardiovascular risk factors. Increased multidisciplinary surveillance may help identify patients at higher risk and inform clinical decision-making in clozapine-treated patients.

Behavioural and psychological symptoms of dementia (BPSD), particularly agitation, are common among people living with dementia, negatively affecting their psychological well-being and quality of life. Non-pharmacological interventions such as therapeutic gardens may offer a holistic approach to managing these symptoms.

This study aimed to investigate whether participation in a multimodal, dementia-specific therapeutic garden intervention could reduce BPSD, with a particular focus on agitation, and improve psychological well-being among people with dementia.

A naturalistic observational study was conducted with 24 residents of a dementia-friendly garden. Participants engaged in tailored, nature-based therapy over 6 months. The intervention was adapted to individual cognitive and physical abilities and included motor, sensory and social activities within the participants’ familiar living environment. Standardised assessments of BPSD and psychological well-being were administered, including evaluations reported by relatives.

The intervention was associated with a significant reduction in agitation, as measured by the non-cognitive subscales of the Alzheimer’s Disease Assessment Scale (p < 0.05). Furthermore, reduced agitation was linked to improved psychological well-being among participants.

The findings suggest that multimodal therapeutic gardens can serve as an effective non-pharmacological intervention in reducing agitation and supporting psychological well-being in people with dementia. This study adds to the growing evidence that therapeutic gardens could contribute to the functional and emotional health of individuals living with dementia.

Attention-deficit hyperactivity disorder (ADHD) is a prevalent neurodevelopmental disorder characterised by inattention, hyperactivity and impulsivity, resulting in impaired functioning in multiple settings, including home, school and in social settings. Disparities exist in ADHD care among children, with White male children experiencing increased access to diagnosis and treatment. Other children remain underdiagnosed, undertreated and subject to poorer functional outcomes. Factors that impact equitable ADHD treatment include gender, race, ethnicity and social determinants of health (SDOH), including household income, parental education, insurance status, neighbourhood deprivation and discrimination. Medication is effective, yet little is known regarding the impact of medication type and trajectories of use on functional outcomes.

Data from the first 6 time points of the Adolescent Brain and Cognitive Development℠ Study® (N = 11 868) will be used to address the following aims. Aim 1: identify typologies of children with distinct trajectories of medication use using multivariate latent class growth analysis. Aim 2: identify typologies of children with distinct trajectories of child-reported functional outcomes using latent class growth analysis. Aim 3: examine relationships of gender, race, ethnicity, SDOH and medication use with trajectories of functional outcomes using multinomial logistic regression.

This study protocol describes the background and methods for an observational study seeking to better understand the impact of gender, race, ethnicity, SDOH and trajectories of medication use on child-reported functional outcome trajectories in a diverse group of US children with ADHD.

Findings will advance the understanding of effective ADHD treatment and highlight the importance of equitable treatment access.

Access to depression care can be improved by overcoming a combination of supply-side barriers and demand-side factors.

To describe the systematic development of a community-based intervention to improve uptake of, and adherence to, a psychosocial treatment for depression delivered by trained primary healthcare staff in Goa, India.

This mixed-methods study included five steps: Step 1, Synthesis of existing evidence by conducting relevant systematic reviews and a review of public health programmes in India; Step 2, In-depth interviews with community stakeholders (n = 35); Step 3, Consultation workshops with community stakeholders (n = 19) and primary healthcare staff (n = 34); Step 4, Triangulation of findings from the preceding steps; and Step 5, Content development for the intervention (e-course for training and the community intervention toolkit for delivery).

Overall, 20 strategies to enhance help-seeking and 5 strategies to improve adherence were identified to constitute the intervention. The community-based intervention is organised into four domains (Learn, Inform, Engage and Follow-up), with self-care integrated throughout the intervention. This intervention is designed to be delivered by a community volunteer who is motivated to cater to the communities’ needs. The community volunteer is trained to deliver the intervention via a blended approach, an e-course and in-person one-on-one learning support by a coach, who later acts as a facilitator during the intervention delivery phase.

The systematic method enabled the development of a comprehensive intervention with contextually appropriate delivery strategies. The effectiveness of the intervention is presently being tested as part of a Hybrid Type II Implementation-Effectiveness randomised controlled trial. If found effective, the intervention has the potential to be a low-cost and sustainable opportunity to improve demand and adherence to depression treatment while also providing essential social, emotional and logistical support during the recovery process.

Global initiatives to reduce restrictive practices in mental health settings have gained increasing attention. However, discrepancies in restrictive practice rates create uncertainties about whether these variations reflect true differences in clinical practices or arise from inconsistent classification and reporting methods.

This study investigated how healthcare professionals classify and report potential restrictive practice scenarios, and examined variations in classification and documentation across diverse facilities.

This was an international survey conducted using an online questionnaire via the Qualtrics platform. Healthcare professionals working in adult mental health in-patient settings were recruited through multiple media platforms and snowball sampling. The questionnaire included 44 potential restrictive practice case scenarios. Participants rated each scenario as follows: (a) whether it should be classified as a restrictive practice; (b) whether it should be recorded as such; (c) whether it would be classified as a restrictive practice within their facility; and (d) whether it would be reported as a restrictive practice in their facility. Survey development was guided by systematic reviews and co-design work with stakeholders. Data were analysed using ordered regression models, with clustering by participant identity and country. Robust standard errors were applied to ensure accurate estimation of variability.

A total of 491 healthcare professionals from 41 countries participated. Results indicated substantial inconsistencies in clinicians’ perspectives regarding what constitutes restrictive practices and whether a given action should be reported as a restrictive practice. Although participants frequently identified scenarios as restrictive practices, their intention to report them was considerably lower. Additional discrepancies were observed between clinicians’ individual perspectives and their expectations of how these practices were actually being classified and reported as restrictive practices within the in-patient facilities where they work.

Discrepancies between healthcare professionals’ classification of restrictive practices and their reporting intentions, as well as between their perspectives and actual institutional practices, highlight potential errors in current reporting systems. These findings underscore the need for standardised definitions, enhanced reporting frameworks and structured training programmes and monitoring mechanisms to improve consistency in the management of restrictive practices across mental health settings.

Neuroimaging research in autism often excludes individuals with co-occurring intellectual impairment or minimally verbal status, limiting the generalisability of findings. Understanding magnetic resonance imaging (MRI) scan success predictors in a representative autistic sample is crucial for equitable research.

This study identified factors predicting successful brain MRI acquisition and data quality in diverse autistic individuals, focusing on including those with intellectual impairment or minimally verbal status.

A total of 122 participants (83 autistic individuals (27 with intellectual impairment, 19 with minimally verbal status) and 39 typically developing controls) received multi-modal brain MRI scans (including structural, resting-state functional and diffusion MRI). Scan success, assessed using both binary criteria and quantitative data-quality metrics, was related to participant characteristics.

Although overall scan success was high, specific factors differentiated success within subgroups. Key factors contributing to scan success included age, non-verbal intelligence and attention-deficit hyperactivity disorder (ADHD) symptoms. Older participants, those with fewer ADHD symptoms and those with higher non-verbal intelligence were more likely to achieve successful scans, regardless of autism diagnosis. Higher data quality, particularly in structural and functional MRI, was associated with higher intelligence, better adaptive functioning, fewer autistic and ADHD symptoms, and fewer behavioural problems.

Identifying these factors is key to designing more inclusive and effective neuroimaging protocols. This work paves the way for more comprehensive research into the neurobiology of the full autism spectrum, and offers insights for improving the clinical MRI experience for autistic individuals with diverse support needs. Individualised strategies may also be useful in clinical settings, helping to improve the experience of MRI scanning for autistic individuals.

Paternal postpartum depression (PPD) is an emerging concern globally but remains under recognized in low-resource and patriarchal societies. In Pakistan, sociocultural stigma and lack of mental health infrastructure may exacerbate this burden. This study aimed to assess the prevalence of paternal PPD, identify associated risk factors, and evaluate awareness among Pakistani fathers.

A cross-sectional, multicentre study was conducted across three provinces of Pakistan, enrolling 475 fathers of infants under one year of age. Participants completed the Beck Depression Inventory (BDI) and a structured questionnaire covering demographics, reproductive history, awareness of PPD, and psychosocial stressors. Statistical analyses included t-tests, chi-square tests, ANOVA, and Pearson correlation.

A BDI score ≥10, indicating mild or greater depressive symptoms, was observed in 70.1% of participants, while 10.1% had severe symptoms suggestive of clinical depression. Only 19.4% of fathers were aware that men could experience PPD. Significant associations were found between paternal depression and maternal PPD (p=0.002), adverse life events (p=0.003), and lack of family support (p=0.045). Age showed a weak positive correlation with depression severity (r=0.19, p<0.001). No significant associations were observed for occupation, number of children, awareness, or access to leave policies. A majority (94.7%) reported no access to paternal mental health services.

This is the largest study to date on paternal PPD in Pakistan, highlighting a substantial burden of depressive symptoms among new fathers. Cultural stigma, poor awareness, and lack of support structures contribute to under-recognition and under-treatment. Multi-level interventions to address paternal PPD, including but not limited to screening strategies, paternal-inclusive care, and public education are urgently needed

Electroconvulsive therapy (ECT) is highly effective for major depressive disorder (MDD), but about 50% of patients relapse within 1 year. A comprehensive review of all potential relapse-prevention strategies is lacking.

This systematic review aimed to identify, summarise and critically evaluate the available evidence on pharmacological, neuromodulatory, psychological and combination strategies to prevent relapse following successful ECT for MDD.

A systematic review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines (PROSPERO: no. CRD42023392575). We searched PubMed, Embase, PsychInfo and Cochrane Library up to March 2025. Eligible studies included adults (>18 years) with unipolar MDD who responded to acute ECT and were followed for ≥3 months. We included randomised controlled trials (RCTs), cohort studies and case series (over ten cases). Risk of bias and quality were assessed and a narrative synthesis conducted.

A total of 28 studies (N = 11 119) were included. Lithium (alone or with antidepressants) was most consistently associated with reduced relapse in 10 studies. Continuation ECT (C-ECT), particularly when combined with pharmacotherapy, also reduced relapse in several RCTs. Evidence for psychotherapy (e.g. cognitive–behavioural therapy) is limited (two studies), warranting further studies. No studies on repetitive transcranial magnetic stimulation or ketamine were found. Study quality varied, with some being underpowered or having used inconsistent definitions of relapse.

Pharmacotherapy with lithium and, separately, C-ECT combined with medication, showed the strongest evidence for relapse prevention following ECT. The evidence base is limited by heterogeneity, small sample sizes and few studies on novel or psychological strategies. More robust clinical studies are needed to identify optimal long-term strategies.

The QualityRights initiative has shown benefits in decreasing coercive practices and enhancing the recognition of human rights in healthcare.

To translate the World Health Organization’s (WHO) QualityRights Practices Questionnaire into Spanish and assess the relationships between coercive practices in healthcare settings, perceptions of mental disorders, and attitudes and commitment to human rights among primary healthcare professionals from multiple disciplines. Also, we sought to compare these variables between trained and untrained professionals, and evaluate longitudinal outcomes of integrating QualityRights training into undergraduate medical education.

A quasi-experimental study with a non-equivalent control group was conducted. Instruments included the Community Attitudes Toward the Mentally III, Human Rights Exposure in Social Work and Human Rights Engagement in Social Work scales, and the WHO QualityRights Practices Questionnaire. A total of 260 professionals from 12 Colombian regions participated in the study. Multiple linear regression analyses were conducted to examine the effects of the QualityRights initiative on various dimensions related to human rights.

Translation and validation of the WHO QualityRights Practices Questionnaire yielded excellent psychometric properties (Kaiser–Meyer–Olkin value: 0.945; Cronbach’s α = 0.891–0.923; single component explaining 73.4% of variance). The QualityRights initiative was significantly associated with greater human rights knowledge and lower endorsement of coercive practices and authoritarian beliefs. In relation to coercive practices, the initiative was significantly associated with lower scores on the QualityRights Practices Questionnaire (B = −3.118, p < 0.001).

In Colombia, incorporating the QualityRights initiative into medical education appears to be a promising strategy for reducing stigma, enhancing knowledge and commitment to human rights, and minimising coercive practices in primary mental healthcare.