Care for bipolar spectrum disorders is often delayed, and these delays are associated with a poorer prognosis. However, little is known about the specific factors that contribute to these delays. Bipolar disorder onset peaks in adolescents and young adults, where barriers to care may be distinct from younger or older populations.

To identify the available evidence on factors contributing to delays in care for adolescents and young adults with bipolar disorder.

We performed a pre-registered systematic search of the literature on delays in the care of 13- to 24-year olds diagnosed with bipolar disorder. Our search yielded n = 5991 unique articles published between 2000 and 2025. Two independent reviewers screened abstracts and full texts for eligibility according to a priori inclusion criteria. Findings from included studies (n = 27) were summarised in a narrative synthesis, organised according to patient, disease and systemic factors within the Model of Pathways to Treatment.

Findings were limited to observational levels of evidence. There was a relative paucity of research in the appraisal and help-seeking intervals. Some factors in delays to care were consistently identified across multiple studies. However, there were also contradictions or a lack of replication around identified factors.

Research in this area has been declining in the past decade despite contradictory findings and ongoing significant delays in bipolar disorder care. Factors contributing to delays in bipolar disorder care can be effectively organised according to appraisal, help-seeking, diagnostic and pre-treatment intervals. This enables a systematic approach to identifying areas in need of quality improvement and further research.

To estimate lifetime, 12-month, and 30-day prevalence of OCD in Qatar; characterise symptom profiles and comorbidity patterns; identify sociodemographic correlates; and examine sex differences in functional impairment.

To estimate lifetime, 12-month, and 30-day prevalence of OCD in Qatar; characterise symptom profiles and comorbidity patterns; identify sociodemographic correlates; and examine sex differences in functional impairment.

Weighted lifetime prevalence of OCD was 2.9% (95% confidence interval 2.4–3.5) and was higher among females (3.8%) than males (2.3%; p=0.007). The most commonly reported symptom types were checking (68.2%), religious scrupulosity (65.7%), and cleaning (60.0%). Nearly all individuals with lifetime OCD had at least one psychiatric comorbidity (91.0%), most frequently mood disorders (68.5%), post-traumatic stress disorder (71.3%), and other anxiety disorders (45.9%). Female sex was associated with OCD in an unadjusted model (odds ratio 2.05; p=0.002) but not after controlling for comorbidities (odds ratio 1.24; p=0.397). Compared with ages 18–29 years, ages 30–39 years had the highest odds of OCD (odds ratio 3.1; p=0.006). Qatari nationality was also associated with OCD (odds ratio 1.71; p=0.049). High functional impairment was observed in 76.9% of affected individuals, with significantly greater impairment in home and social domains among females than males.

As the first national epidemiological study of OCD in Qatar, these findings provide a critical baseline for service planning, early detection strategies, and resource allocation. OCD is prevalent, highly impairing, and characterised by extensive psychiatric comorbidity, supporting the need for integrated and culturally responsive care pathways.

Secure psychiatric services (SPS) are vital for people with severe mental disorders who pose significant risks, yet national evidence on referral pathways, acceptance and timeliness of admission is limited. Delays and variability in access are especially concerning in prisons, where mental health crises are frequent and alternatives limited.

This study presents the first national analysis of SPS referral and admission patterns in England following the introduction of provider collaboratives. It identifies predictors of referral acceptance and delays across the referral-to-admission pathway to inform equity and performance improvement.

Data were drawn from 149 low-secure and 98 medium-secure services across 15 provider collaboratives, encompassing 1356 referrals. Multivariable models examined predictors of acceptance and delay, benchmarked against national policy standards.

Almost half of referrals originated from prisons (46%, n = 529), with 55% accepted. Acceptance was associated with gender, legal status, Mental Health Act status, prior secure admission, diagnosis, referral origin and reason for referral, but not with ethnicity or urgency. Substantial site-level variation reflected local practice and resources. Delays were widespread: fewer than a third of urgent referrals were assessed within 2 days, and only 19–25% of accepted prison referrals met recommended assessment and admission targets. Although prison referrals were processed more quickly than community or SPS referrals, national standards were seldom achieved.

Access to SPS remains inconsistent, with substantial variation in acceptance and widespread delays across referral pathways. Despite faster processing of prison referrals, national assessment and admission standards were rarely met, particularly for this group. These findings highlight gaps between policy expectations and practice, indicating a need for improved adherence to national timeframes, greater standardisation of decision-making and enhanced system oversight, to reduce inequities in access.

In low- and middle-income countries, four out of five people with mental illness do not receive specialised treatment. Utilising non-specialist frontline workers to deliver basic mental health services at the community level therefore warrants exploration.

This study assessed improvement in the knowledge and skills of frontline community workers in identifying symptoms of anxiety and depression, making appropriate referrals and providing psychosocial counselling, in a rural district of Pakistan.

Project mPareshan developed a training manual to enhance the mental health literacy of government-employed lady health workers (LHWs) and lady health supervisors (LHSs). Content was adapted from the World Health Organization’s Mental Health Gap Action Programme 2.0 intervention guide to suit the local context. A total of 72 participants (36 LHSs and 36 LHWs) from the Badin District, Sindh, Pakistan, received the training. Pre- and post-tests were conducted to assess changes in knowledge and skills, using the Wilcoxon signed-rank test.

There was a statistically significant improvement in both knowledge (p < 0.01, r = 0.85) and competency (p < 0.01, r = 0.81) median scores following the mPareshan training. LHSs demonstrated higher percentage increase in knowledge and competencies in domains requiring practical application, such as coping mechanisms, psychosocial support and referral pathways, compared with LHWs, highlighting the importance of their supervisory role and support in mental health service delivery.

The mPareshan mental health training has the potential to improve the knowledge and competencies of community health workers. Such initiatives can be scaled up to enable frontline workers to function as an effective workforce in the absence of specialist mental health services.

Healthcare providers working in conflict zones face unique occupational and psychological challenges that significantly impair sleep quality. In the Gaza Strip, prolonged exposure to violence and humanitarian crises exacerbates these challenges, yet data on the sleep health of this critical workforce remain scarce. This cross-sectional study aimed to assess the prevalence and patterns of sleep disturbances among healthcare providers at Nasser Medical Complex during the 2023–2025 Israel–Gaza conflict, and to examine associations between sleep quality and sociodemographic and occupational factors.

A cross-sectional study was conducted among 400 healthcare providers (70% nurses, 20% physicians, 10% non-medical staff) at Nasser Medical Complex from May to July 2025. Of 1000 eligible, 993 were approached; 400 participated (participation rate 40.3%). Participants completed the validated Arabic version of the Pittsburgh Sleep Quality Index (PSQI) and a sociodemographic questionnaire. Descriptive statistics, bivariate analyses, and multivariate regression were used to evaluate sleep quality and its predictors. Ethical approval: Palestinian Ministry of Health (Ref 2563158). No funding.

The PSQI demonstrated acceptable internal consistency (Cronbach’s alpha [value pending]). Thirty-five per cent of participants reported poor sleep quality (PSQI >5). Additionally, 40% reported sleeping less than 6–7 hours nightly. Sleep disturbances were frequent, including difficulty initiating sleep (50% reporting problems weekly or more), nighttime awakenings (60%), loud snoring (37.5%), and breathing pauses (20%). Physical discomfort during sleep–such as back pain and breathing difficulties–was prevalent.

Sleep disturbances are alarmingly common among Gaza’s healthcare providers in conflict settings. These findings underscore the urgent need for integrated mental health and sleep interventions, occupational health screenings, and infrastructural support to safeguard provider wellbeing and healthcare delivery sustainability in protracted crises.

The mental healthcare workforce supporting people with dementia and comorbid mental disorders requires specific skills and knowledge.

We co-designed and conducted a survey to understand key issues facing community mental healthcare services accessed by older adults.

We invited all English National Health Service (NHS) older people’s community mental health teams (OPCMHTs) in England to complete the survey. We compared service structures, resourcing and waiting times between regions, and considered how responses might inform current policy priorities.

A total of 182 out of 242 (75.2%) English NHS OPCMHTs participated. We estimated there were 120 233 referrals to OPCMHT services per year, with 77.5% of services reporting increasing referral rates. In a quarter of services (n = 46, 25.3%), clients waited over a month from referral to initial assessment. Most services (107/181, 59.1%) experienced difficulties accessing in-patient beds for people with dementia, with rural regions more likely to report these difficulties. Half of the services (n = 100, 55.2%) reported providing higher-quality care for people with dementia than 5 years ago, despite increasing caseload complexity. Resource limitations challenged opportunities for prevention, care quality and collaborative working, and respondents rated team relationships with social services (n = 86, 47.8%), general hospital in-patient (n = 74, 41.4%) and out-patient (n = 54, 30.2%) services, and primary care (n = 54, 30.2%) as poor or requiring improvement.

OPCMHT service leads are committed to integrated working, but services are insufficiently resourced to realise their potential. Addressing challenges related to workforce retention, training and ways of working could optimise OPCMHT contributions to integrated care for people with dementia.

Aggression has been closely linked to suicidal ideation in schizophrenia (SCZ). However, whether its correlates differ by suicidal ideation status remains unclear.

This study aimed to assess the prevalence of aggression and compare the clinical correlates and predictive models of aggression in chronic SCZ patients with and without suicidal ideation.

A total of 659 chronic SCZ patients were recruited from 10 psychiatric hospitals in China. A brief interview assessed the presence of suicidal ideation in patients. Participants were assessed using the Insomnia Severity Index, Hamilton Depression Rating Scale, Modified Overt Aggression Scale and Positive and Negative Syndrome Scale.

SCZ patients with suicidal ideation exhibited a higher prevalence of aggression than those without (39.46 v. 22.15%, p < 0.001). Regardless of suicidal ideation status, patients with aggression were younger and presented with more severe clinical symptoms across multiple domains, except for negative symptoms which showed differential associations between groups. Among patients with suicidal ideation, those exhibiting aggression had a higher proportion of females and lower body mass index. Logistic regression analysis indicated that, in patients without suicidal ideation, male gender was an independent risk factor for aggression (odds ratio 1.856) whereas milder negative symptoms acted as a protective factor. In patients with suicidal ideation, positive and general psychopathology symptoms were positively associated with aggression whereas negative symptoms retained a protective effect.

Our findings suggest that aggression is more prevalent in patients with suicidal ideation, and its clinical correlates differ significantly based on suicidal ideation status. Stratified assessment of aggression risk considering suicidal ideation is warranted.

Obesity and eating disorders (EDs) are associated with high morbidity, mortality, and limited long-term treatment efficacy. Virtual reality (VR) interventions are increasingly used in these conditions, yet their effects on objective biomarker outcomes have not been systematically evaluated. This review aimed to synthesize and critically appraise evidence on the effects of immersive VR interventions on clinical and biomarker outcomes in obesity and EDs.

A systematic review was conducted following PRISMA 2020 guidelines. PubMed, Web of Science, and PsycINFO were searched from inception to April 2025. Eligible studies evaluated immersive VR interventions targeting obesity or EDs and reported at least one biomarker outcome, including anthropometric, physiological/autonomic, endocrine/metabolic, or neurocognitive measures. Randomized controlled trials (RCTs), non-randomized trials, and observational studies were included. Risk of bias was assessed using Joanna Briggs Institute tools. Random-effects meta-analyses were conducted when three or more RCTs reported comparable outcomes; otherwise, a structured narrative synthesis was conducted.

Twenty-three studies (N=1,413; obesity=11, EDs=12) were included. ED populations comprised individuals with anorexia nervosa, bulimia nervosa, and binge-eating disorder.

Obesity: VR-enhanced cognitive–behavioural therapy (VR-CBT) promoted sustained weight loss, whereas VR-based exercise interventions produced short-term reductions in BMI and body weight. Meta-analysis of four RCTs revealed a significant pooled effect of VR versus control on anthropometric outcomes (Hedges’ g=−0.35, 95% CI [−0.61,−0.09], p=0.009; I²=0%), with stronger effects for VR-CBT. Long-term follow-up (6–12 months) confirmed sustained benefits (g=−0.39, 95% CI [−0.73,−0.05]). Within-group pre–post analyses consistently showed reductions in BMI and weight (g=−0.56).

Eating Disorders: VR-CBT consistently reduced body image disturbance and fear of weight gain, while VR cue-exposure therapy decreased binge-eating and purging behaviours. Eye-tracking measures revealed attentional biases toward disorder-relevant cues. Autonomic markers (heart rate, heart rate variability, skin conductance), endocrine biomarkers (cortisol, α-amylase, leptin), and enzymatic measures confirmed that VR reliably elicited measurable psychophysiological responses.

Immersive VR interventions show promise for improving clinical outcomes and eliciting measurable biomarker changes in obesity and EDs. Evidence supports VR-CBT for sustained anthropometric improvements and highlights VR’s potential for investigating autonomic and neurocognitive mechanisms. Larger, biomarker-integrated RCTs are needed to confirm efficacy and inform personalized, mechanism-driven treatment approaches.

Peer-supported self-management at discharge from early intervention in psychosis services (EIPS) has received limited attention. The MyPREPED (My Personal Recovery Plan for Early Discharge) trial will evaluate a co-designed, digital and paper-based, peer-delivered recovery and self-management focused intervention, tailored for young people exiting EIPS.

This protocol describes a hybrid type 2 effectiveness–implementation trial designed to assess MyPREPED’s impact, feasibility, real-world implementation and cost–utility.

This multi-site, mixed-method, two-arm (1:1), parallel-group, randomised controlled trial (MyPREPED versus treatment as usual) trial will be delivered across eight Australian EIPS that deliver ultra-high risk and/or first-episode psychosis streams, using a hybrid type 2 implementation–effectiveness design. Eligible participants are young people aged 16 years and over within 6 months of planned discharge from EIPS. Peer coaches will deliver up to ten sessions of using a self-management plan (modules: discharge, recovery, well-being, relapse prevention, goal-setting, service navigation). Co-primary outcomes include (a) mental health recovery (Recovery Assessment Scale – Domains and Stages; effectiveness outcome) and (b) feasibility (Feasibility of Implementation Measure; implementation outcome). Secondary outcomes assess broader effectiveness domains (mental health quality of life, clinical and functional outcomes) and other implementation outcomes. A cost–utility analysis will estimate incremental costs and quality-adjusted life-years associated with MyPREPED, alongside a secondary cost-effectiveness analysis. Analyses will follow intention-to-treat principles, using mixed-effects models.

This study will provide the first rigorous test of a co-designed, peer-delivered recovery and self-management focused intervention specifically targeting EIPS discharge.

Working memory deficits are common in mood disorders and severely affect everyday functioning. Serotonin (5-HT) signalling has been implicated in depression and is also involved in cognitive functioning. However, its relevance for working memory remains largely unexplored.

Using positron emission tomography (PET) brain imaging, we investigated the link between working memory and multiple 5-HT brain features in both healthy individuals and patients with mood disorders in a cross-sectional analysis of pooled data-sets.

We used multiple linear regression to test the associations between working memory performance and 5-HT 1B receptor (5-HT1BR) (healthy controls: 28), 5-HT 2A receptor (5-HT2AR) (healthy controls: 116), 5-HT 4 receptor (5-HT4R) (healthy controls: 97, patients: 98) and 5-HT transporter (5-HTT) (healthy controls: 137, patients: 12) PET binding in the frontal cortex. The frontal cortex was chosen as region of interest as it is critical for working memory functions.

There was no association between working memory and 5-HT1BR (p = 0.14), 5-HT2AR (p = 0.99) or 5-HTT (p = 0.80) frontal cortex binding in healthy controls. For the 5-HT4R, we observed a significant interaction effect of group status (p = 0.01), with patients showing a positive association (β = 6.51, p = 0.02) and healthy individuals showing no significant association (p = 0.16).

We found no evidence that key 5-HT receptor systems are associated with working memory performance in healthy individuals, but did observe a positive association for 5-HT4R in patients with mood disorder. We speculate that although 5-HT neurotransmission markers may map onto working memory performance in the healthy state, pathologically altered 5-HT signalling may contribute to working memory deficits in mood disorders, possibly through downstream signalling and/or interactions with other neurotransmitter systems.

The COVID-19 pandemic disrupted healthcare delivery and coincided with increased psychological distress worldwide. In the UK, restrictions on healthcare access, rapid adoption of remote consultations and pressures on mental health services may have influenced prescribing of psychotropic medications. However, evidence comparing prescribing trends across the four UK nations during the pandemic remains limited.

To examine trends in community prescribing of psychotropic medicines across England, Scotland, Wales and Northern Ireland before and during the COVID-19 pandemic.

We conducted a repeated cross-sectional study of national Prescription Cost Analysis data-sets covering March 2019 to March 2023. Monthly utilisation of antidepressants, anxiolytics/hypnotics, antipsychotics and antidementia medicines was measured, using two indicators: number of items dispensed per 1000 inhabitants and defined daily doses per 1000 inhabitants per day. Interrupted time-series regression was applied to assess changes in prescribing levels and trends associated with the first (March 2020) and second (November 2020) UK national lockdowns.

Psychotropic prescribing increased across most medicine classes during the study period. Antidepressant utilisation increased by 24.6% across the UK, representing the largest rise among psychotropic medicines. Antipsychotic prescribing increased by 2.7%; anxiolytic/hypnotic prescribing showed modest overall change (2.7%), but this varied between nations, increasing in Scotland (7.3%) and Northern Ireland (7.4%), and declining in Wales (−9.5%). Antidementia medicines increased modestly overall (9.3%), with variation between countries. Interrupted time-series analyses indicated that most changes occurred gradually rather than abrupt shifts following lockdowns.

Psychotropic prescribing increased during the COVID-19 period, but largely reflected continuation of pre-existing trends rather than immediate effects of lockdown restrictions.

Anorexia nervosa (AN) is associated with high morbidity and mortality and significant barriers to recovery, including food-related anxiety and avoidance behaviours. Virtual reality (VR) interventions offer immersive, safe exposure to feared stimuli and may enhance engagement with treatment. The OASIS feasibility study aimed to evaluate the acceptability, feasibility, and preliminary effectiveness of a VR-based, AI-personalized adjunct to treatment as usual (TAU) in adults with AN.

This is a single-site feasibility study conducted at South London and Maudsley NHS Foundation Trust (SLaM). Up to 45 adults with AN from inpatient, day-care, and outpatient services will participate in a one-week VR intervention alongside TAU. The OASIS app, delivered via Pico 4 headset, will provide personalized sessions including psychoeducation, graded food exposure, motivational support from a virtual companion, and relaxation exercises. Primary outcomes will include recruitment, adherence, retention, and acceptability. Secondary outcomes will include anxiety, relaxation, BMI, and qualitative feedback from focus groups with patients, carers, and clinicians. Data will be analysed descriptively, and thematic analysis will be applied to qualitative data.

The OASIS study will provide evidence on the feasibility and acceptability of a VR-based intervention for adults with AN and will inform the design of a future randomized controlled trial. Insights from patient, carer, and clinician feedback will guide refinement of the intervention and identify barriers and facilitators to implementation in routine clinical care.

People with schizophrenia spectrum disorders (SSDs) experience high rates of obesity and metabolic dysfunction, contributing substantially to excess morbidity and mortality. Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) such as semaglutide and tirzepatide have demonstrated substantial efficacy for weight and glycaemic outcomes in the general population, but evidence in people with SSDs remains limited.

To synthesise all placebo-controlled, randomised controlled trials (RCTs) examining semaglutide and/or tirzepatide in people with SSDs.

A preregistered systematic review and meta-analysis of RCTs examining the efficacy and safety of semaglutide and/or tirzepatide in adults with SSDs was conducted. Outcomes and adverse events were pooled using random-effects meta-analysis. Certainty of evidence was assessed using the GRADE criteria.

Three trials (n = 258) met inclusion criteria, examining semaglutide dosages of 1.0–2.0 mg over 26–36 weeks. No trials examining tirzepatide were found. Semaglutide significantly reduced body weight (−11.32 kg; 95% CI −15.35 to −7.29), body mass index (−3.58 kg/m2; 95% CI −4.86 to −2.30), haemoglobin A1c (−0.37%; 95% CI −0.51 to −0.22) and fasting glucose (−0.54 mmol/L; 95% CI −0.94 to −0.13). In adverse event analyses, semaglutide was associated with increased risks of abdominal pain (risk ratio 2.93; 95% CI 1.13–7.60), vomiting (risk ratio 2.57; 95% CI 1.39–4.77) and constipation (risk ratio 3.23; 95% CI 1.14–9.18). There was no evidence of increased risk of serious adverse events.

Semaglutide produces clinically meaningful improvements in weight and glycaemic outcomes in people with SSDs, with an adverse event profile consistent with known gastrointestinal effects of GLP-1 RAs in the general population. These findings support semaglutide as a promising adjunctive metabolic intervention in this population, although larger and longer trials, specifically those testing tirzepatide, are needed to better characterise heterogeneity of effects and long-term safety of these promising pharmacological treatments.

Gambling-related harm is under-recognised in patients receiving opioid substitution treatment (OST). This study aimed to determine the prevalence and severity of gambling harm in an OST outpatient population, explore associations with concurrent substance use (cocaine, cannabis, illicit benzodiazepines), and assess the feasibility of routine screening in clinical practice.

A cross-sectional service evaluation was conducted in an NHS addictions psychiatry outpatient service. Adults aged ≥18 years receiving methadone or buprenorphine were opportunistically screened during routine appointments, excluding those unable to engage due to acute intoxication, severe withdrawal, cognitive impairment, or acute psychiatric instability. Gambling-related harm was assessed using the Problem Gambling Severity Index (PGSI). Demographic data, opioid substitution treatment type, concurrent substance use, and psychiatric comorbidities were extracted from clinical records and patient self-report. Data were anonymised and analysed descriptively, with exploratory comparisons between patients with and without gambling-related harm.

A total of 62 patients were screened. Eighteen patients (29%) scored ≥3 on the Problem Gambling Severity Index (PGSI), indicating moderate-risk or problem gambling, while nine patients (14%) met criteria for problem gambling (PGSI ≥8). Gambling-related harm was more frequently observed among patients reporting concurrent cocaine use and illicit benzodiazepine use. The majority (82%) of patients with moderate or severe gambling harm had no prior documentation of gambling difficulties in their clinical records, suggesting significant under-recognition. Screening was feasible, added minimal time to routine assessments, and prompted clinically relevant discussions around financial stress and relapse risk.

Gambling-related harm appears common yet under-identified among patients receiving OST in addiction psychiatry outpatient services. Routine screening using brief validated tools such as the PGSI is feasible and may enhance holistic assessment and care planning. Integrating gambling harm assessment into standard addiction reviews may help address unmet clinical need and improve outcomes in this complex patient group.

Family harmony, emotion-management skills, problematic social media use and individual social responsibility are relevant to young adults’ psychosocial functioning, but evidence on their interrelations remains limited, particularly in Turkish samples.

This study examined whether emotion-management skills and problematic or dysregulated social media use statistically mediated the association between family harmony and individual social responsibility among Turkish young adults.

A cross-sectional online survey was completed by 854 participants (64.1% female) using the Individual Social Responsibility Scale, Family Harmony Scale, Emotion-Management Skills Scale and the Bergen Social Media Addiction Scale, interpreted here as an indicator of problematic or dysregulated social media use symptoms.

Family harmony showed a significant total association with individual social responsibility (B = 0.77, 95% CI 0.64 to 0.89) and remained directly associated after the mediators were included (B = 0.60, 95% CI 0.47 to 0.72). The total indirect effect was significant (B = 0.17, 95% CI 0.13 to 0.22), including specific indirect associations through emotion-management skills (B = 0.11, 95% CI 0.07 to 0.15), problematic social media use (B = 0.04, 95% CI 0.02 to 0.06) and their serial pathway (B = 0.03, 95% CI 0.01 to 0.04).

Family harmony was associated with individual social responsibility directly and through emotion-related and digital-behavioural correlates. Because the data are cross-sectional, findings should be interpreted as associative rather than causal.

Ethnic minority groups are disproportionately represented in in-patient mental health services, yet research has largely overlooked their carers’ experiences. Because carers play a crucial role in managing their family member’s mental well-being, gaining insight into their potentially unique challenges and support needs is essential for service development.

To investigate the experiences of ethnic minority carers of patients receiving in-patient psychiatric care in the UK, identify challenges they face and understand the role of culture and ethnicity in an in-patient setting.

In the UK, ‘ethnic minority’ refers to all individuals from a non-White British background. Twelve carers from ethnic minority groups were recruited from third-sector organisations across the UK to participate in semi-structured interviews online. Audio-recordings of the interviews were transcribed, and data were analysed with reflexive thematic analysis.

Three core themes were identified: ‘The Challenges of Navigating Hospital Admission’, ‘Cultural and Carer Exclusion in in-patient Care’ and ‘Improving the Ethnic Minority Carer Experience’. Findings elucidated the nuanced ways in which culture and ethnicity influence carers’ experiences. Participants highlighted systemic barriers to timely support, experiences of disempowerment and exclusion, and culturally insensitive care. Participants offered recommendations to improve support for carers.

Ethnic minority carers of in-patients experience difficulties arising from a lack of cultural safety within in-patient psychiatric services. Embracing a holistic approach to care and providing comprehensive, culturally responsive guidance and support for carers are essential for promoting equitable mental healthcare.

To investigate the personality profiles of heroin addicts in Pakistan using the Eysenck Personality Questionnaire (EPQ) and to explore how personality traits such as extraversion, neuroticism, and psychoticism relate to substance abuse within the sociocultural and economic context of the region.

A cross-sectional study in Islamabad (May 2023–May 2024) assessed 300 heroin-dependent individuals (sample size calculated using the WHO calculator), aged 18–60, in rehabilitation centres. Participants were selected using purposive sampling to meet study criteria. The Eysenck Personality Questionnaire measured extraversion, neuroticism, and psychoticism. Data were collected via self-administered questionnaires andanalysed in SPSS v29; Chi-squared tests determined significance (p < 0.05). Ethical approval was obtained from the institutional review board of Islamabad Medical and Dental College, and all participants provided informed consent.

Data was collected from 300 participants aged 18–60. Overall, heroin addicts had a mean extraversion score of 12.4 (SD = 4.8; range 5–20), neuroticism 17.6 (SD = 5.2; range 7–25), and psychoticism 8.3 (SD = 3.9; range 2–15), indicating average sociability, high emotional instability, and moderate aggression.

Age group differences were significant: the 18–30 group had the highest scores for extraversion (13.2), neuroticism (18.4), and psychoticism (9.1), followed by 31–45 (11.5, 17.0, 8.0) and ≥46 (11.0, 16.8, 7.5) (p = 0.02–0.04). Addiction duration was inversely related to scores: participants with <1 year of addiction scored highest (extraversion 13.5,neuroticism 19.0, psychoticism 9.5), 1–5 years scored moderately (12.0, 17.8, 8.3), and >5 years scored lowest (11.2, 16.5, 7.8) (p = 0.01–0.03).

Gender differences were not statistically significant: males had mean scores of 12.5, 17.5, and 8.4; females had 12.0, 18.0, and 8.0 for extraversion, neuroticism, and psychoticism, respectively (p > 0.05).

Heroin addicts in Pakistan exhibit high neuroticism and moderate extraversion and psychoticism, with younger individuals and those with shorter addiction duration showing higher trait levels. These findings underscore the need for personalized interventions, such as CBT, DBT, peer support, and medication-assisted treatment, to address emotional instability and improve recovery outcomes. Policymakers should prioritize individualized treatment strategies and support further research to enhance rehabilitation effectiveness.

Burnout among healthcare workers is an increasing mental health concern, particularly in low- and middle-income countries such as Pakistan, where public-sector hospitals operate under substantial workforce and resource constraints. Burnout is conceptualized as a multidimensional psychological response to chronic occupational stress, encompassing emotional exhaustion, depersonalization, and reduced personal accomplishment. This study hypothesized that shorter sleep duration would be associated with higher levels of burnout across these dimensions.

A cross-sectional correlational study was conducted among healthcare workers employed at a public-sector hospital in Pakistan. Participants included doctors, nurses, and allied healthcare professionals across medical and surgical specialties (N=92–93). Average daily sleep duration was self-reported. Burnout was assessed using the Maslach Burnout Inventory (MBI), measuring emotional exhaustion, depersonalization, and personal accomplishment. Pearson product–moment correlation analyses were performed to examine associations between sleep duration and burnout dimensions, as well as interrelationships among burnout subscales.

Sleep duration was not significantly associated with emotional exhaustion (r=−0.12, p=0.26), depersonalisation (r=−0.08, p=0.46), or personal accomplishment (r=0.10, p=0.35). A moderate positive correlation was observed between emotional exhaustion and depersonalisation (r=0.39, p < 0.01), indicating that higher exhaustion levels were associated with greater emotional distancing. No statistically significant associations were found between personal accomplishment and the other burnout dimensions.

Although sleep duration alone did not demonstrate a significant relationship with burnout, these findings contribute to an understanding of burnout as a multi factorial psychological phenomenon. The strong association between exhaustion and depersonalization reflects a core burnout pathway involving emotional depletion and disengagement. From a mental health standpoint, the results highlight the importance of addressing systemic and workplace-related stressors through mental health-informed interventions in Pakistani public hospitals, rather than focusing solely on individual lifestyle factors.