Women with infertility and those diagnosed with gynaecological malignancies experience significant psychological distress. While infertility-related suicidality has been increasingly studied, suicidal risk among women with gynaecological oncology remains underexplored, particularly in low- and middle-income settings. This study aimed to compare depression, anxiety, quality of life, and suicidal ideation between women with gynaecological oncology and women with general infertility.

Women with infertility and those diagnosed with gynaecological malignancies experience significant psychological distress. While infertility-related suicidality has been increasingly studied, suicidal risk among women with gynaecological oncology remainsunderexplored, particularly in low- and middle-income settings. This study aimed to compare depression, anxiety, quality of life, and suicidal ideation between women with gynaecological oncology and women with general infertility.

Women with gynaecological oncology demonstrated significantly higher levels of depressive symptoms and anxiety compared to women with infertility, as measured by BDI and BAI scores (p <0.001). The oncology group also showed significantly greater global psychopathology on the SCL-90 Global Severity Index. Quality of life scores across physical functioning, emotional wellbeing, social functioning, and role limitations were markedly lower in the oncology group on the SF-36. Suicidal ideation was significantly more prevalent among women with gynaecological oncology compared to infertile women (p <0.01), indicating a higher level of suicidal risk in the oncology population.

Women with gynaecological oncology demonstrated significantly higher levels of depressive symptoms and anxiety compared to women with infertility, as measured by BDI and BAI scores (p <0.001). The oncology group also showed significantly greater global psychopathology on the SCL-90 Global Severity Index. Quality of life scores across physical functioning, emotional wellbeing, social functioning, and role limitations were markedly lower in the oncology group on the SF-36. Suicidal ideation was significantly more prevalent among women with gynaecological oncology compared to infertile women (p <0.01), indicating a higher level of suicidal risk in the oncology population.

Catatonia is a treatable syndrome that can occur due to psychiatric and neurological pathology, such as hypoxic-ischaemic brain injury. Many neuroanatomical pathways may contribute to catatonia but no single pathway has been found to be the sole cause.

A systematic review assessing evidence of adult-only cases of catatonia after hypoxic-ischaemic brain injury and summarisation of the presentation, lesion location, treatment and outcome.

A PRISMA-2020 compliant PubMed/MEDLINE search of terms related to catatonia and hypoxia/ischaemia was carried out. Catatonia had to be explicitly diagnosed and must have been secondary to a hypoxic-ischaemic insult. Data were extracted based on lesion characteristics, timeline, treatment, and outcome.

Seven studies met the criteria and they were all case reports. Lesions were heterogeneous and included bilateral parietal watershed infarcts, basal ganglia, thalamus,corona radiata, extensive white matter disease, pontine and cerebellar infarcts, and fronto-insular atrophy with inferred hypoxia. Presentations ranged from stuporous catatonia to delirium and affective disorders with catatonic features. Outcomes were generally good and catatonia resolved; however, post-neurological consequences of hypoxic-ischaemic insult remained in a few.

The evidence was limited to case reports and no single lesion causing catatonia was found.The findings supported the disrupted cortico-striato-thalamo-cortical motor pathway and the disconnection pathway as a possible cause for catatonia. There was also evidence for the involvement of neurochemical pathways such as GABA, dopamine and NMDA as a potential cause or treatment focus. Further studies with standardised catatonia measures and imaging are required.

Mental Health Tribunal reports are documents written by psychiatrists to reflect the patient’s mental state and justifications for detention. They can be time-consuming and labour-intensive. Reports should include chronology, diagnosis, risk, statutory criteria and an actionable plan. Microsoft 365 Copilot may reduce drafting burden. Copilot-generated reports from clinical notes were assessed and scored to determine their performance.

Twenty-three questions were identified on a tribunal report which could be answered with an AI-generated response, such as forensic history, circumstances of admission and current progress. A scoring sheet was designed covering each question, scoring 0–5, with higher weights for critical domains. Prompts were refined after multiple runs until a prompt generating a comprehensive, accurate and human-like report was selected. Patient notes were supplied as uploaded Word files. Narrative quality was also scored separately to question performance across 8 domains (scoring 0–4 each) such as coherence, tribunal-appropriate tone and minimal redundancy. A combined final score weighted question performance (80%) and narrative quality (20%). A single clinician reviewer scored all reports.

Five patients were evaluated; 1 patient was generated 3 times to assess repeatability. Seven drafts were scored. All 23 questions were answered in every draft. The mean score per question was 4.9/5. The mean weighted question score was 98%. The average narrative quality was 28/32 (88%). Mean combined final score was 96% and all drafts met the “minor edits” threshold. For the repeated patient, weighted question scores varied minimally. The average time taken to generate a report was 30 seconds. One of the repeated reports contained a single hallucination concerning date of admission.

Copilot consistently produced quick and comprehensive tribunal reports under a structured prompt, but hallucination was found and is a risk. Clinician verification is required. As the prompt was being refined, it became clear that the reports altered significantly based on the prompt used. The quality of the reports signified potential use in generating community treatment orders (CTO) and medical recommendations. Limitations are that narrative scoring has a high subjectivity burden and this pilot only contained 5 patients. Further trials with a larger cohort and multiple assessors are required for more reliable results.

Antipsychotics are the mainstay of treatment for severe mental illness (SMI) but cause metabolic side effects, such as rapid and clinically significant weight gain, hyperglycaemia, and hypercholesterolaemia, increasing the risk of type 2 diabetes and cardiovascular disease. Metabolic side effects develop through physiological mechanisms (e.g. plasma glucose dysregulation), but also through behaviour changes (e.g. increased calorie intake, sedentary lifestyle). This study aimed to characterise the behavioural determinants associated with developing metabolic side effects by exploring people’s experiences of taking antipsychotics for an SMI.

Participants (n=22) were recruited, as members of the public via Mental Health charities and an existing database of people who had been previously prescribed antipsychotic treatment for an SMI (n=20), and via National Health Service Trusts who were recently initiated on antipsychotic treatment for an SMI (n=2). Sociodemographic characteristics (age group, biological sex, ethnic group, index of multiple deprivation) were collected from participants to ensure a diverse sample. Individual, reflective interviews with a semi-structured style were undertaken to explore determinants associated with changes in behaviour when antipsychotics were initiated. Template analysis was undertaken, comprising an inductive approach and a priorithemes.

The following main themes were created which were associated with changes in behaviour influencing the development of metabolic side effects: environmental determinants (e.g. Covid-19 pandemic, weather, finances); social determinants (e.g. social exclusion, social support, provision of food from family/friends); emotional determinants (e.g. experience of trauma, low mood, shame); and motivation around healthy eating and physical activity (e.g.convenience, cravings, self-medication). Integrative themes included: impact of weight gain (e.g. on identity, quality of life, comorbidities); experience of being a mental health patient (e.g. clinical support, monitoring of side effects); and impact of medication/side effects on eating and physical activity behaviours (e.g. sedation, decreased energy, prior knowledge of side effects).

There are a variety of determinants influencing behaviours associated with developing antipsychotic-induced metabolic side effects. Current clinical practice is to treat side effects with pharmacological and/or non-pharmacological interventions once they have developed as per National Institute for Health and Care Excellence Guidelines and the Lester Tool. Interventions targeting specific behaviours and determinants should be implemented at the start of antipsychotic treatment to prevent metabolic side effects from developing. Further research should explore interventions and ongoing support appropriate to, and developed in partnership with, this population.

This study was sponsored by a University of Leicester PhD scholarship and Pharmacy Research UK.

Attention-Deficit Hyperactivity Disorder (ADHD) is a neurological developmental disorder that involves a criterion which requires an onset of symptoms before 12 years of age for clinical diagnosis (American Psychiatric Association, 2013).

Be that as it may, longitudinal studies have identified cohorts of adults with symptoms of ADHD but also lack a clear childhood history of symptoms. This phenomenon challenges the core diagnostic criteria described in the DSM–5 and creates notable uncertainty clinically (Moffitt et al., 2015).

This systematic review aims to critically analyse and evaluate the published evidence that both supports and contradicts the validity of adult-onset ADHD being a diagnostic construct, as well as to investigate other possible causalities for this type of clinical presentation.

Following PRISMA guidelines (Page et al., 2021), a comprehensive search of PubMed, PsycINFO, and Embase was conducted for peer-reviewed studies that have been published from 2000 onwards, exploring late-onset ADHD. Studies were screened by one reviewer. Due to the heterogeneity of the studies, a narrative synthesis was performed usingthe extracted data to arrange findings into arguments based on the various topics that materialised, pertaining to methodology, aetiology, and differential diagnosis.

The synthesis identified a notable conflict in the evaluated literature. Multiple longitudinal studies provided evidence supporting a late-onset ADHD presenting subtype. Nevertheless, this evidence is countered by literature arguing that findings in support of adult-onset ADHD are attributable to limitations in methodology, including both recall bias when patients self-report retrospectively as well as the failure to detect “masked“ childhood symptoms (Faraone et al., 2016). Moreover, a significant amount of literature explores the idea that there may be an overlap of symptoms with conditions that present similarly to ADHD such as complex trauma, emotional dysregulation and misuse of substances.

The evidence analysed and evaluated for a distinct late-onset neurological developmental subtype of ADHD remains inconclusive. These adult presentations outline a complex reality facing the clinicians of which require further meticulous and thorough assessment. This systematic review shows a need for this late-onset ADHD subtype to be further explored and studied with more subjects, as well as investigating possible strategies that could be implemented to mitigate undiagnosed or misdiagnosed patients. Healthcare professionals should make conducting a comprehensive differential diagnosis and recording collateral history a priority, in order to avoid a patient remaining undiagnosed and to distinguish ADHD from similar presenting and/or mimicking conditions.

Attention Deficit Hyperactivity Disorder (ADHD) is one of the most common neurodevelopmental disorders in children and adolescents with an estimated prevalence of up to 5% in children. Since 2019 there has been an average annual increase of 18% nationally, in ADHD medication prescriptions. Therefore with the uncertainty around the long-term effects of medication use and the side effects as we currently understand them, there is the need for other interventions to be available for children with ADHD.

This research evaluated the feasibility of a yoga and mindfulness-based family programme developed specifically for children with an ADHD diagnosis; designed to reduce ADHD behaviours, improveparent-child relationships, and emotional regulation.

17 families with children aged 6–11 completed a 6-week yoga and mindfulness programme. Families completed the E SWAN assessment forms which include questionnaires for ADHD, Disruptive Mood Dysregulation Disorder, Depression, Anxiety and Panic Disorder. Families were also interviewed post intervention.

The quantitative findings were positive with significant outcomes: 94.1% of participants were reported to show an improvement in ADHD symptoms post intervention, with an overall 38.6% reduction in symptoms. The qualitative findings evidenced that post intervention the children were able to independently implement emotional regulation techniques, parents/carers were also able to implement strategies to regulate their own emotions, improving their ability to co-regulate their child.

This is the first study using this particular family intervention that has been developed specifically for children with ADHD diagnosis. The results highlighted the programme was effective in reducing ADHD symptoms, improving the parent-child relationship and emotional regulation.

There is a high prevalence of concentration and cognitive functioning problems in people with depression. Research evidence indicates that transcranial direct current stimulation (tDCS) can improve cognitive functioning, and an aspect of cognitive functioning is the ability to concentrate. Flow FL-100 is a tDCS device self-administered at home.

The aim was to investigate the impact of 1, 2, 3, 6 and 10 weeks of Flow Neuroscience AB FL-100 tDCS use on self-reported concentration problems in people with depression, using the Montgomery–Åsberg Depression Rating Scale Self (MADRS-S) concentration problem question.

A retrospective analysis of Montgomery–Åsberg Depression Rating Scale (MADRS-S) self-report data collected between 2020 and 2024.

Out of 20,197 tDCS users with self-reported depression at baseline, 10,888 had concentration problems (53.9%). Among those who adhered to the tDCS protocol, theproportion who moved from having concentration problems to not having them was 29.3% at one week, 37% at two weeks, 45.2% at three weeks, 54.7% at six weeks, and 57.4% at ten weeks. Concentration problems strongly correlate with depression.

The results show that tDCS can reduce concentration problems in those with self-reported depression. Some people experience concentration problems despite addressing lifestyle and environmental factors that can negatively affect concentration. There are negative side effects of some methods of improving concentration, for example, the use of stimulants. tDCS could be a valuable alternative approach to reducing concentration problems in people experiencing depression. Concentration problems are symptoms of other mental illness diagnosis, for example, schizophrenia and tDCS could be used. Appropriately designed and powered randomised controlled trials (RCTs) are warranted to investigate the impact of tDCS on cognitive functioning and concentration.

Transcranial direct current stimulation (tDCS) is a non-invasive brain stimulation technique used at home and delivers mild electric currents, applied through two pads on the forehead. It does not have the side effects associated with antidepressant medication, is highly acceptable and easily offered through primary care. Research studies show that tDCS can significantly improve sleep quality and provide insomnia remission. Rates of insomnia remission of between 22–50% have been seen. The aim of the project was to assess effect of ‘Flow’ tDCS on insomnia in primary care patients.

Intervention: tDCS for 30 minutes, for five sessions per week for four weeks. Baseline and follow-up scores collected. Interviews with GPs and 14 participants about their experience.

Significant improvements on 1. Sleep: Insomnia Severity Index (ISI); 2. Depression: Patient Health Questionaire-9 (PHQ-9); 3. cognitive functioning: Perceived Deficits Questionnaire (PDQ-5); Quality of Life (EQ-5D-5L); and real-world functioning: Work and social adjustment (WASA). Patients have described improved quality of life, reduction in insomnia symptoms, improved sleep, improved mood, better meaningfulness/engagement in life, and better educational, social and work functioning. The project showed that offering tDCS was feasible and effective.

Evidence about the improvement with tDCS could expand NHS treatment for millions of people who experience insomnia. Having a new effective treatment in the NHS that can be used at home could be life-changing for people with insomnia. Providing a non-pharmacological choice in primary care is essential.

Large language models (LLMs) are increasingly evaluated and deployed in healthcare, yet unrecognised bias risks reinforcing inequities. This risk is particularly salient in psychiatry, where biased outputs could influence risk formulation, diagnostic reasoning, triage, and therapeutic communication. We examined whether and how bias is evaluated in studies of medical applications of LLMs, and summarised methodologies, reporting practices,and limitations of current bias detection and mitigation approaches to support safe and trustworthy implementation.

We searched databases (EMBASE, MEDLINE, PsycINFO, PubMed, ACL Anthology, ACM Digital Library, arXiv, medRxiv, and bioRxiv; 2017–June 2025), following PRISMA guidance. After de-duplication, >1,800 records were retrieved for title/abstract screening. We assessed 3,664 full-text articles against pre-specified eligibility criteria. Studies were included if they evaluated a medical application of an LLM and reported any explicit bias assessment. Studies that otherwise met eligibility for medical LLM evaluation but did not assess bias were recorded separately to quantify the evidence gap. Screening and data extraction were conducted by multiple reviewers with disagreements resolved by discussion. We extracted specialty (including psychiatry), use case (e.g. decision support, documentation, patient communication), evaluation setting (benchmark/vignette vs clinical data), protected attributes and bias targets assessed, bias methods/metrics, and mitigation strategies proposed or tested. Findings were synthesised narratively with descriptive counts across specialties and use cases.

Of 3,664 full texts screened, 278 studies met inclusion by explicitly assessing bias. A further 757 studies evaluated medical applications of LLMs and otherwise met eligibility criteria but did not report any bias assessment, indicating that most medical LLM evaluations omit bias evaluation. Included studies spanned clinical decision support, medical documentation, patient communication, education, and biomedical research across multiple specialties. Bias assessment rates varied by specialty: psychiatry 21/180 (11.7%), radiology 7/107 (6.5%), and oncology 5/51 (9.8%). Bias assessments most commonly examined demographic bias (gender, race/ethnicity, age) and variation in symptom or diseasepresentation. Methodologies included prompt-based probing (e.g. clinical vignettes), counterfactual testing, and red teaming to elicit biased responses; statistical comparisons of performance across groups (including fairness-adjusted performance metrics such as the FAP score); and clinician-led safety evaluation frameworks assessing output suitability. Proposed mitigation strategies included more diverse training data, reinforcement learning with human feedback (RLHF), direct preference optimisation, and ongoing human oversight.

Despite rapid growth in medical LLM research, explicit bias assessment remains inconsistent and frequently absent. Standardised, transparent bias evaluation across patient populations, tasks, and clinical contexts is needed to support safe implementation and ensure equitable provision.

Acceptance and Commitment Therapy (ACT) is a third-wave cognitive-behavioural therapeutic modality that promotes psychological flexibility through six core principles: acceptance, cognitive defusion, contact with the present moment, self-as-context, values, and committed action. This pilot study aimed to evaluate the effectiveness of an immersive ACT intervention delivered in a fully interactive environment for reducing symptoms of depression, anxiety, and obsessive-compulsive disorder (OCD) among medical students. The immersive ACT experience was created by uploading and adapting ACT therapeutic content into the Immersive Studio software, which projected the material onto the walls of the suite. Participants could interact with the content presented visually and auditorily by touching the walls. The use of immersive technology was intended to enhance engagement and experiential learning of ACT principles, thereby reducing symptoms of depression, anxiety, and/or OCD.

A pre-post intervention design was implemented at Cardiff University’s School of Medicine HIVE immersive learning suite: a 5×5 metre room equipped with fully immersiveand interactive capabilities. This environment enabled participants to engage with ACT content across three immersive modules, each designed to teach and apply ACT’s six core principles in a dynamic and experiential manner. Pre-and post-intervention scores were collated using the Patient Health Questionnaire-9 (PHQ-9) for depression, Generalised Anxiety Disorder-7 (GAD-7) for anxiety, and Obsessive-Compulsive Inventory-Revised (OCI-R) for OCD as standardised, validated measures.

Ten medical students completed all elements of the three immersive ACT modules, as well as the pre and post measures. Scores from the three validated measures were analysed using the Wilcoxon Signed Rank test to assess changes in symptom severity. Depressive symptoms significantly decreased following the intervention, with mean PHQ-9 scores reducing from 7.13 to 4.00 (z=−2.207, p <0.05). No statistically significant changes were observed in anxiety (GAD-7) or OCD (OCI-R) scores.

Delivering ACT as an immersive and interactive therapeutic modality appears to be an effective approach for reducing depressive symptoms among medical students. This pilot study highlights the potential of immersive environments to enhance psychological interventions and enhance psychological flexibility. Further research with larger samples (currently underway) is required to examine its impact on anxiety, depression and OCD symptoms and to optimise immersive delivery for broader mental health benefits.

To establish whether past psychiatric conditions or pre-existing vulnerabilities influence the neuropsychiatric presentation in people with neurological conditions, and to identify common reasons for referral and diagnoses to help direct service delivery and enhance patient care.

A retrospective study of consecutive inpatient Neuropsychiatry referrals from the Neurosciences wards at the Atkinson Morley Regional Neurosciences Centre at St George’s Hospital, London, was conducted. All referrals from 1 January 2022 to 1 January 2024 were reviewed. The exclusion criteria were duplicate referrals and patients who were not seen by Neuropsychiatry following referral. Reasons for this included being transferred or discharged before being seen or clinically inappropriate referrals.

A data collection proforma was designed and trialled on a small sample of records to identify any issues before being implemented for wider use. Data was extracted from the clinical notes systems, RiO and iClip, and collected using RedCAP, an online secure data collection system, with pseudo-anonymisation.

362 records were reviewed and 307 included. The main reasons for exclusion were duplicate records (19), other (18), transferred before being seen (10), inappropriate referral (7), and died before being seen (1). The age range of patients was from 18–100 years with a mean age of 53 years with 58.0% biologically male and 42.0% biologically female.

Referrals were predominantly from the regional neurology ward (41.4%), followed by neurosurgery (23.8%) and the hyperacute and acute stroke units (21.4%). Reasons for referral were varied with the most common being mood (45.0%), agitation/aggression (30.0%) and suicidality (24.1%).

Following assessment, low mood was the most reported symptom occurring in 65.1% of referrals followed by sleep (58.6%), anxiety (45.6%) and agitation (31.6%). Differences were seen in the most common symptom depending on the primary neurological diagnosis. Traumatic Brain Injury (TBI) had the strongest association with agitation, Cerebrovascular Accident (CVA) with depression and Functional Neurological Disorder (FND) with motor disturbance and anxiety.

Those with a psychiatric history (56.4%) were more likely to present with low mood (70.0%) whereas those without were more likely to present with sleep problems (64.1%). This pattern was not seen in those with a history of trauma (26.7%). A high mortality rate was observed with 14.7% of patients deceased within 2 years of referral.

This research provides valuable insights into the complex, bidirectional associations between neurological and psychiatric conditions. These insights will help to identify areas for improving service delivery and therefore enhancepatient care.

Globally, up to 15% of adolescents (ages 10–19) experience loneliness, reportedly harming health. This scoping review systematically explores interventions combating adolescent loneliness worldwide, a topic with limited existing literature.

The aim is to map and characterise existing interventions for adolescent loneliness and evaluate the quality of available evidence.

Preliminary research uncovered systematic reviews and meta-analyses reviewing interventions combating adolescent loneliness worldwide. As multiple interventions were analysed by said systematic reviews and meta-analyses, this led to the hypothesis that a growing body of research on interventions combating adolescent loneliness worldwide exists.

The research protocol followed Joanna Briggs Institute JBI scoping review guidelines and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). From April to June 2024, literature searches were conducted on PubMed and five EBSCO host databases, using a search string. Time frame for study inclusion was January 2000 to 23 April 2024. Data extraction and analysis were conducted manually. Quality of systematic reviews and meta-analyses were assessed using A Measurement Tool to Assess Systematic Reviews (AMSTAR).

The literature search uncovered 16 papers. The 9 selected for review included 7 countries (Portugal, the USA, Canada, Israel, China, Australia, and the UK), and encompassed 2 systematic reviews and one meta-analysis rated critically low, low, and moderate quality, respectively. Several studies had small sample sizes, the median being 43.5, and range being 4 to 2966. Intervention types were categorized into group-based (n=37), individual (n=19), or mixed group and individual (n=3). Data were excluded from one systematic review that did not specify intervention type. Thematic analysis revealed 11 out of 16 interventions from a systematic review were classed as high-intensity. 3 studies suggested benefits of high-intensity interventions.

Consistent with the hypothesis, there is a growing body of research oninterventions combating adolescent loneliness worldwide. However, closer analysis of existing research indicates further studies are needed, with larger sample sizes, more diverse demographics and standardised research methods and outcome measures. More high-quality primary studies are needed to produce quality systematic reviews. Considering resources required for high-intensity interventions, future research may focus on health economics and cost-benefit analyses.

This study received no external funding.

Language deficits present early in Alzheimer’s disease, with symptoms ranging from word-finding difficulties to non-coherent speech. These can be assessed in high-income countries using picture description tasks (PDT). However, they are culturally specific, so have a reduced utility in Sub-Saharan Africa (SSA). The dementia incidence in SSA is increasing but there is a substantial diagnostic gap. Therefore, there is a need for accessible and culturally acceptable cognitive measures. Also allowing for detection of impairments at an earlier stage and for use in prevention studies. This study aims to determine the diagnostic accuracy of a culturally adapted PDT in Tanzania.

This was a cross-sectional validation in socio economically different communities in Kilimanjaro, Tanzania. Eleven PDT scoring methods were adapted from existing literature. Participants were asked: “tell me everything you can see happening in this picture”. Responses were audio-recorded, transcribed and translated. General cognition was assessed using the Identification and Intervention for Dementia in Elderly Africans (IDEA) screen. Participants with a low IDEA score (≤9) underwent a blinded gold-standard clinical dementia assessment alongside 10% of controls (IDEA >9). Visual acuity was also assessed using a Landolt C near vision chart.

A total of 465 individuals ≥60 years were recruited. 378 individuals were included in the analysis due to 37 refusals and 50 methodological/technical exclusions. All PDT scoring methods, apart from implausible details and words per content unit, correlated with the IDEA screen, age, education and frailty. The scoring method of content units (CUs) showed the greatest correlation. Males, those with greater educational attainment, and a previously skilled occupation performed better. The scoring methods with the highest area under the receiver operating characteristic (AUROC) curve for identification of IDEA score ≤9 were CUs 0.740, CUs and additional details 0.742 and total objects 0.764. The prevalence of dementia was 3.79% (n=8/211). The scoring methods with the highest AUROC curve for identification of dementia were global length of text 0.743 and additional details 0.767.

The diagnostic accuracy was acceptable for three scoring methods to identify cognitive impairment as measured by the IDEA and for two methods in identifying clinical dementia diagnosis. A culturally adapted PDT could be used to support assessment of language in those with cognitive impairment, as part of a wider cognitive testing battery. However, dementia prevalence was very low in this community, potentially biasing findings.

The value and utility of psychiatric diagnoses have been heavily debated within the literature, with proponents advocating that they offer evidence-based treatment and ease of professional communication. The role of social determinants of mental health has been gaining traction, and one alternative to psychiatric diagnoses has been proposed to use phenomenological codes within the current medical system to record both symptoms and the social determinants that service users report. The literature suggests that this approach has been minimally used, however, to date, no research has explored mental health professionals’ views on using this within clinical practice. This research had two broad aims: to elicit the views of psychiatrists working within general adult mental health services on the use of psychiatric diagnoses and alternatives to these, with a focus on using phenomenological codes and to explore how these alternatives may be utilised within clinical practice, specifically focusing on the positives and challenges.

14 Consultant Psychiatrists were recruited from three NHS sites across the North West of England from a range of adult mental health services. Semi-structured interviews were completed either virtually or face-to-face which included a video explaining the idea of using phenomenological codes. The interviews were recorded with consent, transcribed, and analysed using reflexive thematic analysis.

Six overarching themes and 18 subthemes were generated from the interviews. These included: psychiatric diagnoses are imperfect but practical, coding may be helpful but impractical, we are all just stuck in the system, psychological input is helpful but a luxury and moving forwards towards best practice. The results demonstrated the multitude of factors that both impacted on views of psychiatric diagnoses and the ability to implement potential alternatives within NHS mental health services.

Overall, participants demonstrated enthusiasm towards non-diagnostic approaches and exploring the role of social determinants, however felt that coding would be logistically challenging. Participants discussed the complexity of this area, exploring both the impact of personal and professional views shaped by experience alongside wider systemic factors such as professional identity and the constraints within NHS services. Future research could explore further how to integrate medical and non-diagnostic approaches to highlight the role of social determinants in the development of mental health difficulties and how this can be effectively applied within clinical services.

This study aimed to estimate the prevalence of Childhood trauma (CT) subtypes and problematic internet use (PIU) among Sudanese medical students and the association between them. It examined which subtypes of the CT are most significantly associated with PIU, it also assessed the demographic predictors for PIU.

A descriptive cross-sectional study was conducted using an online questionnaire, it was distributed among 430 medical students from six universities located in Khartoum and Al Jazeera states, Sudan. Childhood maltreatment was measured using the Childhood Trauma Questionnaire-Short Form (CTQ-SF), and problematic internet use levels were assessed using the Chinese Internet Addiction Scale-Revised (CIAS-R). Both instruments are internationally validated. Descriptive statistics were reported as frequencies and percentages for categorical variables, and as medians with interquartile ranges for non-normally distributed continuous variables; Spearman correlation and multiple linear regression were used to assess associations and identify predictors of PIU while controlling for trauma-related anddemographic variables. A significance level of p <0.05 was applied.

Emotional abuse appeared as the most common form of childhood trauma, 48.8% (n=210), followed by physical neglect, 40.5% (n=174), and sexual abuse, 34.0% (n=146).The prevalence of problematic internet use among the participants was 46.0% (n=198). Also, a significant positive association was observed between PIU and overall CT scores (ρ=0.189, p<0.001). Among childhood trauma subtypes, emotional abuse had the strongest association with problematic internet use (ρ=0.219, p<0.001), while physical neglect, emotional neglect, and physical abuse also contributed. Furthermore, fifth-year students had remarkably lower CIAS-R scores compared to first-year students.

Emotional abuse emerged as the strongest indicator of problematic internet use severity among medical students. These findings emphasize the necessity for trauma-informed interventions, including counselling services and awareness programmes, to indicate the influences of childhood trauma and minimize problematic internet use among Sudanese medical student populations. Future studies should assess the internal psychological factors through which emotional abuse influences problematic internet use; understanding these details will contribute to building more targeted interventions.

Long-acting injectable antipsychotics (LAIs) are commonly used alternatives to oral antipsychotics (OAPs) in treating schizophrenia spectrum disorders. Multiple systematic reviews and meta-analyses have evaluated their effectiveness, but findings vary. This umbrella review of systematic reviews and meta-analyses aims to synthesise the highest-level evidence by conducting an umbrella review of systematic reviews and meta-analyses comparing LAIs with OAPs in patients with early psychosis.

A literature search was conducted to identify systematic reviews and meta-analyses of LAIs versus OAPs. Eligible studies included reviews published up to December 2025 and reported clinical outcomes including symptom change, relapse, hospitalisation, treatment discontinuation, and adverse effects. Findings were synthesised narratively with focus on consistency across reviews and strength of evidence.

Eleven eligible reviews (seven systematic reviews and four meta-analyses) wereidentified, together covering 58 unique primary studies with sample sizes ranging from 220 to 14,313 participants. Across reviews, LAIs generally demonstrated a positive impact on symptomatic outcomes in early psychosis. Most reviews noted greater reduction in discontinuation due to non-adherence or inefficacy with LAIs versus OAPs; however, meta-analytic results did not consistently show significant differences in overall discontinuation or relapse prevention. Evidence regarding relapse was heterogeneous, with some reviews suggesting benefit and others showing inconclusive results. Reports of metabolic side effects were similar between formulations, with some indication of lower extrapyramidal symptoms with LAIs.

Umbrella-level evidence suggests that LAIs may offer advantages over oral antipsychotics in certain outcomes, particularly related to adherence, but there is no clear consensus that LAIs uniformly outperform OAPs across all clinical endpoints in early psychosis. These findings highlight the need for further high-quality pragmatic research to refine clinical guidance on LAI use.

Young carers (YCs), estimated to comprise 2–8% of the child and young person (CYP) population in England, face numerous sociodemographic challenges that put them at increased risk of poor mental health (MH). The Covid-19 pandemic exacerbated challenges by increasing caregiving responsibilities. However, research on YCs in the pandemic era remains limited. This study is a secondary analysis of the NHS England 2020 Mental Health of Children and Young People (MHCYP) survey, investigating the characteristics, pandemic experiences, and MH outcomes of YCs aged 11–22 in England.

The NHS England MHCYP 2020 survey was a follow-up to the 2017 survey, taking place July/August 2020. The original 2017 cohort, selected through random probability sampling from the NHS Patient Register, included 9,117 CYP aged 2–19 and/or their parents. Of these, 3,570 (46%) completed the follow-up 2020 survey, now aged 5–22. The main measure of mental health in 2020 was the Strengths and Difficulties Questionnaire (SDQ), a broad measure of mental health difficulties. The 2020 survey included a range of questions about pandemic experiences, which were compared for YCs and non-YCs. Longitudinal regression analyses assessed whether YC status in 2017 predicted change in SDQ score between 2017 and 2020. Weighted analyses adjusted sequentially for baseline SDQ, demographics, and a comprehensive theoretically informed covariate set.

The analysis revealed some differences in demographic and pandemic-related variables between YCs and non-YCs. Parents of young carers were more likely to report that they could not afford food or had to use a food bank compared to parents of other young people (5.7% compared to 1.8%). Young carers were more likely than non young carers toreport that their household could not pay bills (5.5% compared to 1.8%). There was no evidence of difference in MH outcomes in 2020 as measured by the SDQ between YCs and non-YCs, nor did the longitudinal analysis indicate a greater deterioration in SDQ scores among YCs from 2017 to 2020.

These findings suggest that YCs as a group were more likely to face socioeconomic challenges during the pandemic, although we found no differences in mental health outcomes. This may reflect protective factors at play or reflect study limitations. There was considerable attrition between the 2017 and 2020 surveys, requiring weighted analysis and reducing power. Further research is warranted to explore the complex interactions between caregiving, socioeconomic factors, and MH, and to develop risk-mitigation and mental health promotion strategies.

Depression and anxiety in geriatric inpatients are linked to functional decline and prolonged hospital stays. While antidepressants are the standard of care, polypharmacy and poor tolerability often limit their effectiveness. This study examined whether a six-week structured mind-body programme achieved greater symptom reduction than treatment as usual (TAU) in an older adult psychiatric inpatient setting.

This longitudinal, parallel, controlled study involved 26 in patients (aged 60 years or older) with a diagnosis of depression and comorbid anxiety. All participants were receiving standard antidepressant pharmacotherapy. Thirteen patients elected to participate in a structured mind-body programme, while 13 continued with TAU alone. The intervention consisted of weekly supervised sessions (3–5 sessions total based on clinical availability), integrating physical movement with mental engagement through yoga, tai chi, strength training, walking, and gardening. Symptoms were assessed via the Patient Health Questionnaire-9 (PHQ-9) and Generalised Anxiety Disorder-7 (GAD-7) at baseline and six weeks.

Data analysis involved paired-sample t-tests and Wilcoxon signed-rank tests for within-group changes, with between-group comparisons conducted using independent-sample t-tests or Mann–Whitney U tests as appropriate for the data distribution.

Baseline scores were statistically comparable between groups (p >0.05). Both cohorts demonstrated significant within-group reductions in symptoms over the six-week period (p <0.001). In the activity group, mean PHQ-9 scores decreased from 17.15 to 8.46(reduction 8.69, SD 3.54). In the TAU group, scores fell from 14.69 to 10.38 (reduction 4.31, SD 2.10).

Between-group analysis demonstrated a significantly greater reduction in depressive symptoms for the mind-body group (mean difference 4.38; 95% CI 1.99 to 6.77; p=0.001), with a large effect size (Hedges’ g=1.46). While anxiety symptoms improved in both groups (mean GAD-7 reduction 3.62 vs. 3.23), no significant between-group difference was observed (p=0.875; Hedges’ g=0.16).

Participation in structured mind-body activities was associated with greater reductions in depressive symptoms among older adult psychiatric inpatients compared with treatment as usual alone. While anxiety symptoms improved in both groups, no additional benefit was observed for anxiety reduction. Although self-selection should be considered, these findings suggest mind-body programmes may represent a feasible and potentially effective non-pharmacological adjunct for late-life depression in inpatient psychiatric settings.

Academic performance in medical school is shaped by socio-demographic and psychological determinants, yet evidence from Emirati cohorts remains scarce. This study examined associations between socio-demographic characteristics, psychological resilience and academic performance among Emirati undergraduate medical students, with a focus on family structure.

We conducted a cross-sectional, questionnaire-based study among Emirati Medical students enrolled at the United Arab Emirates University. Undergraduate medical students were invited via institutional channels. The online survey captured self-reported cumulative Grade Point Average (GPA), socio-demographic data (age, gender, academic year, school type, high-school tutoring, family structure, curriculum type) and psychological resilience using the Brief Resilience Scale (BRS). Descriptive statistics summarised the sample. Group differences in GPA were tested using independent-samples t-tests and one-way ANOVA, and the association between GPA and resilience was examined with Spearman correlation, withsignificance set at p<0.05. A total of 115 complete responses were analysed.

Respondents had a mean age of 20.3 years (SD 1.23); 75.7% were female. Slightly more attended public than private UAE schools (52.2% vs 47.8%); 71.3% had not received private tutoring. Most were in years 3–4 (64.4%). The majority lived in nuclear families (82.6%), with 12.2% in extended families and 5.2% in single-parent/own-household arrangements; 48.7% followed a UAE high-school curriculum and 51.3% non-UAE curricula. Mean cumulative GPA was 3.45 (SD 0.37). Resilience scores indicated moderate resilience (mean total 19.1, SD 3.66; mean item score 3.18, SD 0.61) and were not associated with GPA (Spearman r=0.022, p=0.814). There were no significant GPA differences by gender, tutoring, school type or curriculum (all p>0.05). Family structure showed a significant effect (F(2,112)=3.14, p=0.047), with students in single-parent/own-household arrangements having a lower GPA (M=3.09, SD 0.45) than those in nuclear families (M=3.46, SD 0.37), while those in extended families had a similarly high GPA.

In this cohort of Emirati medical students, academic performance was generally high and similar across gender, resilience, school type, tutoring, or curriculum. However, lower GPA among students living in single-parent or independent households suggests that reduced or disrupted family support may affect outcomes. Routine screening for social and family stressors, along with targeted support for students with less stable family arrangements, may help mitigate emerging inequalities.

No financial sponsorship has been received for this study.

Stigma involves the devaluation of individuals based on personal attributes and can lead to discrimination, social exclusion, and poorer mental health outcomes, strongly shaped by cultural and social norms. The United Arab Emirates (UAE) provides a unique context to examine mental illness stigma, particularly among university students and healthcare-related groups, where stigma may hinder help-seeking and care delivery. This study aimed to quantify levels of mental illness-related stigma and examine socio-demographic and occupational correlates among university students, medical professionals and allied health workers in the UAE.

We conducted a cross-sectional, questionnaire-based study using the nine-item Stigma-9 Questionnaire (STIG-9) to assess perceived public stigma towards people with mental illness (total score 0–27; higher scores indicate greater stigma). Participants were recruited via non-probability sampling at a federal university and multiple tertiary hospitals in the UAE, using email invitations to participate in an anonymous online survey. Demographic variables included gender, age group, nationality, continent of origin, marital status, religion, family income, caregiver experience, occupation/status, type of activity and place of study/work. Descriptive statistics summarised sample characteristics and STIG-9 scores. Independent-samples t-tests and one-way ANOVA with Tukey post hoc tests compared mean stigma scores across groups; significance was set at p<0.05.

A total of 510 participants completed the questionnaire; 70.4% were female, and 48.0% were Emirati. Most were aged 16–25 (43.5%) or 31–40 (24.9%). 42.2% were healthcare providers or administrators, 40.0% were undergraduate students, and 17.8% were postgraduate students. The mean STIG-9 score was 17.5 (SD 5.64), indicating substantial perceived stigma in this educated cohort. Age was significantly related to stigma (F(4,505)=2.52, p=0.04): 16–25-year-olds reported higher stigma than 31–40-year-olds (mean difference 1.81, p=0.031). Emirati participants scored higher than non-Emiratis (t(508)=2.33, p=0.02, Cohen’s d=0.21). No significant differences in stigma were found based on gender, nationality, marital status, religion, income, caregiver experience, occupation, study/work location, or when comparing medical vs. non-medical students, undergraduate vs. postgraduate students, or healthcare groups.

Mental illness stigma is common among university students and healthcareprofessionals in the UAE, despite high education levels. Higher stigma among younger adults and Emirati nationals indicates cultural and generational influences. Culturally informed anti-stigma education in universities and healthcare training, especially for younger Emiratis, could reduce stigma, enhance help-seeking, and promote equitable mental healthcare.

No financial sponsorship has been received for this study.