The 7 October 2023, terrorist attack at the Nova Festival in southern Israel caused deaths, injuries, hostage-taking and prolonged life-threatening exposure, creating an urgent need for early interventions to reduce post-traumatic morbidity. Although prolonged exposure is an established post-traumatic stress disorder (PTSD) treatment, its feasibility and benefit during ongoing threat remain unclear.

This preliminary study evaluated a war-adapted brief prolonged exposure protocol (WBPE) delivered shortly after trauma in Nova Festival survivors with acute stress disorder.

Forty survivors completed the WBPE and were assessed at baseline and immediately post treatment. A subsample of 27 WBPE completers and 18 untreated wait-list controls was reassessed after 5 months. Outcomes were PTSD (PDS-5), depression (PHQ-9) and anxiety (GAD-7) symptom severity.

WBPE was associated with significant reductions in PTSD, depression and anxiety immediately after treatment. At 5 months, WBPE participants showed greater reductions in PTSD and depressive symptom severity and lower PTSD and depression symptom scores than controls, with large effect sizes. Anxiety symptoms improved in both groups, consistent with possible natural recovery. Clinically significant depressive symptoms (48.15 v. 77.78%) and anxiety symptoms (37.04 v. 72.22%) were less frequent in WBPE participants than controls, whereas probable PTSD rates did not differ significantly. Substance use during the study period was associated with poorer outcomes and smaller symptom reductions.

WBPE appears feasible and potentially beneficial under wartime conditions, with meaningful improvements in PTSD and depression despite persistent threat. Substance use was linked to poorer recovery and should be systematically assessed in post-trauma care.

Social isolation and loneliness represent significant psychiatric determinants of cardiovascular disease, with emerging neurobiological evidence suggesting shared pathways for stress response and inflammation.

Social isolation reflects an objective lack of social contact while loneliness refers to the subjective perception of social disconnection. In practice, both frequently co-occur.

Current research inadequately examines the nuanced relationship between social disconnection and atrial fibrillation (AF) incidence. This paper aimed to systematically assess this relationship through a psychiatric lens.

A PRISMA-compliant systematic review was conducted across five databases. Five studies were selected, including large population-based cohorts from the UK Biobank, the Framingham Heart study and a nationwide heart failure cohort. Data on social isolation, loneliness, social network metrics and AF incidence were extracted. Narrative synthesis was performed due to the heterogeneity of populations and analytical methods.

Large observational cohort studies suggest that loneliness is associated with an increased risk of AF. In the UK Biobank, loneliness assessed via a composite score was associated with higher AF incidence (HR: 1.11, 95% CI 1.07–1.16). Subscale analyses demonstrated that this association was primarily driven by subjective feelings of loneliness, which showed a stronger association with AF (HR 1.20, 95% CI 1.14–1.26). This is supported by multistate modelling in a separate Biobank study. Social deprivation was also correlated with new-onset AF in a nationwide heart failure cohort.

In contrast, the Framingham Heart Study reported no association between overall social network index and AF incidence. When accounting for the competing risk of mortality, medium-low social connectedness appeared to have a lower AF incidence. This finding is likely attributable to survivorship and competing risk biases rather than a true protective effect. Furthermore, social group participation was associated with higher AF incidence, which may reflect increased healthcare access and consequent AF detection.

Most importantly, Mendelian Randomisation analysis in one study provided genetic evidence supporting a potential causal relationship between social isolation and AF risk, with no evidence of pleiotropy.

Overall, these findings indicate that survivorship bias, varying analytical methods and failure to consider competing mortality risks may obscure true associations between social disconnection and AF incidence.

Observational and genetic evidence support an association between social isolation and increased AF incidence. These findings highlight the need for novel AF prevention strategies such as psychosocial assessments and interventions to target loneliness and social disconnection, thereby emphasising the importance of a collaborative psychiatric-cardiology approach in clinical practice.

Earthquakes present significant threats to community mental health, yet post-disaster resource limitations and high demand restrict access to care. The 2023 Türkiye–Syria earthquakes affected millions, increasing psychological problems and highlighting the urgent need for scalable interventions.

This study assessed (a) the feasibility of procedures prior to a fully powered randomised controlled trial (RCT) and (b) the potential effectiveness of Problem Management Plus (PM+), a scalable psychological intervention, in reducing common mental health problems among Turkish earthquake survivors.

A two-arm, single-blind pilot RCT was conducted with survivors residing in temporary housing in Türkiye. Participants were randomly allocated (1:1) to PM+ (n = 38) or enhanced care-as-usual (E-CAU; n = 38) and assessed at baseline, 1 week post intervention and at the 1-month follow-up. The primary outcome was depression (Patient Health Questionnaire, PHQ-9); secondary outcomes were self-identified problems (Psychological Outcome Profiles, PSYCHLOPS), functional impairment (World Health Organization Disability Assessment Schedule, WHODAS 2.0), psychological distress (Kessler-10 Psychological Distress Scale, K-10), anxiety (Generalised Anxiety Disorder Scale, GAD-7) and post-traumatic stress (Post-traumatic Stress Disorder Checklist, PCL-5). The trial was prospectively registered (NCT06026306).

Recruitment, retention (74%) and treatment adherence (79%) supported feasibility. At post-assessment, PM+ showed greater reductions than E-CAU across all outcomes: PHQ-9 (adjusted mean difference −5.91, 95% CI –8.23 to –3.58), PSYCHLOPS (−6.94, –8.88 to –5.01), WHODAS 2.0 (−8.77, –12.50 to –5.03), K-10 (−9.66, –13.35 to –5.97), GAD-7 (−4.31, –6.39 to –2.24) and PCL-5 (−18.72, –25.97 to –11.47). At follow-up, improvements remained significant for psychological distress and self-identified problems.

Findings provide preliminary evidence that PM+ is a feasible and potentially effective intervention for alleviating common mental health problems among Turkish earthquake survivors.

The negative symptoms of psychosis are heterogeneous, which complicates efforts to understand their pathophysiology and develop effective treatments. Factor analytic studies of the Positive and Negative Syndrome Scale (PANSS) have reported two factorial negative symptom models, expressive deficit and social amotivation, albeit with different compositions. Although models derived from other assessment scales have been directly compared, no study has previously applied this approach to PANSS.

Our objectives were to (a) to establish which negative PANSS-derived factorial model provided the best fit to our data, (b) test its stability and (c) determine its clinical and demographic correlates.

A cohort of medication naive or minimally treated patients with first-episode schizophrenia (n = 446) were assessed using the PANSS scale before and 4 weeks after amisulpride treatment. Confirmatory factor analysis was performed to test five PANSS models. Hierarchical multiple regression was conducted to examine the associations between identified dimensions and clinical and demographic variables.

A nine-item PANSS model comprising social amotivation and expressive deficit dimensions outperformed the other models: comparative fit index = 0.98, goodness of fit index = 0.97, Tucker–Lewis index = 0.97, root mean square error of approximation = 0.06 (CI 90%: 0.04–0.08), Bayesian information criterion = 191.9, Akaike information criterion = 101.7. At baseline, the social amotivation dimension was associated with more severe depression whereas the expressive deficit dimension was associated with younger age. Both dimensions at baseline were associated with poor functioning, but expressive deficit to a lesser extent.

A nine-item PANSS model incorporating social amotivation and expressive deficit dimensions appeared to best reflect the underlying structure of negative symptoms in our sample.

Various biomarkers have been identified as being associated with the pathophysiology of major depression, with the potential to be utilised within an objective laboratory test for the diagnosis of depression, based on machine learning techniques.

This study aims to build on previous results by modelling, in a larger and more heterogeneous cohort, the joint diagnostic accuracy of urine and serum-based biomarkers that showed predictive value for depression in our previous work.

A novel, multivariable, machine learning-based diagnostic tool for depression was tested on a combination of 34 urine- and serum-based biomarkers among 160 people diagnosed with major depressive disorder (MDD) and 120 controls, split into 3 different cohorts. Quantile-based prediction was applied to construct a biomarker-based diagnostic model (BDM) yielding a score for each biomarker. The sum score for each participant was used to calculate an area under the receiver operating characteristic curve (AUC) as a measure of discriminatory power.

We demonstrated that the BDM after internal validation had good discriminatory power, with an AUC of 0.81. Further internal–external validation by calculating individual depression probability scores for each separate cohort resulted in an AUC of between 0.62 and 0.72.

In terms of clinical applicability, the present study shows that the combination of biomarkers and a machine learning model can discriminate between MDD and healthy controls with a modest level of diagnostic accuracy. A biomarker test could have potential added value for the future diagnostic toolkit, but this does require further research.

The relationship between media portrayal of psychedelic drugs, scientific research and drug policy is an area of debate.

To apply artificial intelligence technology to measure trends in media sentiment towards the therapeutic potential of psychedelic drugs.

Up to 300 of the most relevant articles from Google News searches for the term ‘psychedelics’ were sampled for each year from 2000 to 2025. A large language model, ChatGPT, evaluated subject matter and sentiment.

In total, 88.3% of screened URLs (3308 of 3747) were included in the analysis. The proportion of articles focusing on the therapeutic potential of psychedelics increased from 13.3% (26 of 198) from 2000 to 2009 to 85.3% (1254 of 1470) from 2020 to 2025. The average sentiment score from 2000 to 2025 for articles from all publications (N = 2168) was 78.5 ± 9.3 (mean ± s.d.) (possible range: 1–100). 1.3% (29 of 2168) of articles carried negative sentiment (<50) whereas 4.8% (103 of 2168) had extremely positive sentiment (≥90). Average sentiment reached a peak in 2020 (80.8 ± 7.0), and a statistically significant trough in sentiment was observed in 2024 relative to 2020–2023 (2020–2023, 79.2; 2024, 74.3, P < 0.00001, Mann–Whitney U-test). The proportion of negative-neutral articles (≤65) increased annually from a trough of 3.6% (8 of 267) in 2020 to a peak of 20.9% (43 of 253) in 2024. Artificial intelligence sentiment scores were correlated and concordant with average human rater scores (r = 0.88, concordance correlation coefficient 0.84).

Although most 21st-century media coverage of psychedelic drugs has been positively framed, negative and neutral coverage has increased in frequency since 2020. Researchers, clinicians, regulators and policy-makers should be mindful of the complex relationship between media portrayals of psychedelics and the results of scientific research.

Social isolation and loneliness are recognised as important risk factors for various health outcomes. However, their impact on functional bowel disorders (FBDs) remains underexplored.

To explore the associations of social isolation and loneliness with the risk of FBDs in a large prospective cohort.

We included 396 009 participants from UK Biobank who were free of cancer and FBDs at baseline. Social isolation and loneliness were assessed using validated self-reported questionnaires. Incident FBDs were ascertained during follow-up. Cox proportional hazards models were used to estimate hazard ratios and 95% CIs. Mediation, subgroup and sensitivity analyses were conducted.

Over a mean follow-up of 15.2 years, 31 877 incident FBDs cases were recorded. Compared with the least isolated, the most isolated had a higher risk of FBDs (hazard ratio 1.15, 95% CI 1.11–1.20). Loneliness was also associated with higher risk (hazard ratio 1.28, 95% CI 1.21–1.35). The highest risk was observed among participants who were most isolated and lonely (hazard ratio 1.46, 95% CI 1.33–1.60). Depression, anxiety and low physical activity partially mediated the associations between social isolation/loneliness and FBDs. The association between social isolation and FBDs risk appeared stronger among male, overweight and unemployed individuals, whereas middle-aged adults were more susceptible to loneliness-related risk.

Social isolation and loneliness were associated with a higher risk of FBDs, particularly when co-occurring. These findings underscore the potential relevance of social disconnection to FBDs and suggest that it may represent a target for future preventive strategies.

AVATAR therapy, a digitally supported intervention, utilises avatars to promote recovery in people who experience distressing auditory hallucinations. This approach was recently evaluated in a multicentre randomised controlled trial comparing brief (AV-BRF) and extended (AV-EXT) forms of therapy with treatment as usual (TAU). There was evidence for the effectiveness of therapy, particularly for AV-EXT. However, value for money needs to be assessed.

To compare separately the cost utility of the brief and extended forms of AVATAR therapy with TAU.

In a three-arm randomised controlled trial the use of health services was measured, and costs (2021/2022; pounds sterling) calculated from a health and social care perspective over a 28-week follow-up period. Quality-adjusted life years (QALYs; derived from the 5-level version of the EuroQol 5-Dimension questionnaire) were combined with costs.

AV-BRF resulted in extra costs of £319 (95% CI, −£1558 to £2496), and AV-EXT in lower costs of £1965 (95% CI, −£1912 to £1519), compared with TAU. Over the follow-up, AV-BRF resulted in 0.0159 (95% CI, −0.0103 to 0.0422) and AV-EXT in 0.0173 (95% CI, −0.0049 to 0.0395) more QALYs than TAU. The cost per QALY for AV-BRF compared with TAU was £20 016, while AV-EXT dominated TAU (lower costs and more QALYs).

Neither version of AVATAR had a substantial impact on QALYs. However, AV-EXT did result in reduced care costs − albeit not statistically significant − and was potentially cost-effective compared with TAU. AV-BRF had an incremental cost-effectiveness ratio that indicated lower potential cost-effectiveness. These findings are uncertain, but could still inform decision-making regarding interventions in this field.

The PReDicT study showed that predictive algorithm-guided antidepressant treatment reduces anxiety and improves functioning in patients with depression.

To estimate the costs, outcomes and cost-effectiveness of the PReDicT test compared with treatment as usual (TAU) for primary depression care in five European countries.

Within-trial economic analysis was conducted over 24 weeks from the health/social care and societal perspectives alongside the PReDicT trial (NCT02790970) in France, Germany, The Netherlands, Spain, and the UK, according to Consolidated Health Economic Evaluation Reporting Standards guidelines. We calculated quality-adjusted life-years (QALYs) based on the EQ-5D-5L, capability-weighted life-years based on the Oxford Capabilities Questionnaire – Mental Health (OxCAP-MH) (Germany and UK only), and costs for 2018 (€). Multiple imputation for missing data, multivariable regression for cost and outcome differences, and bootstrapping and sensitivity analyses for uncertainty were conducted.

There were significant outcome improvements (EQ-5D-5L PRedicT: +0.139; TAU: +0.140) and societal cost reductions (PRedicT: −€2589; TAU: −€2602) in both groups (N = 913) between the before and during trial periods. In the UK and Germany (n = 619), the PReDicT group showed significant additional capability well-being gains (OxCAP-MH: +2.127, p = 0.021). Cost-effectiveness probabilities ranged from 46 to 59% at trial level, but exceeded 80% in the UK. Results remained stable across different sensitivity analyses, with societal cost-effectiveness improved for those (self-)employed.

We observed potentially meaningful health and economic benefits of closely monitored antidepressant treatment, as implemented in both treatment and control arms of the PReDicT trial. The PReDicT test itself had some added benefits in improved capabilities and productivity, however, with great uncertainty and country-level variations in cost-effectiveness.

Clozapine-induced gastrointestinal hypomotility is a common and potentially fatal adverse effect, yet bowel monitoring and timely escalation remain inconsistently implemented despite national guidance. Following the removal of an electronic prescribing bowel-monitoring prompt in a medium secure women’s forensic service, concerns arose regarding reduced detection of constipation and increased patient safety risk.

This project aimed to evaluate baseline bowel monitoring and escalation practices for patients prescribed clozapine, explore staff and patient perspectives on existing monitoring systems, and assess the impact of introducing a structured paper-based bowel monitoring intervention on documentation quality and clinical escalation.

A mixed-methods quality improvement project was conducted between April and August 2025 in the Women’s Pathway at Newton Lodge. Baseline practice was assessed via retrospective review of ward documentation and Clinical Team Meeting (CTM) notes for all patients prescribed clozapine. Staff questionnaires explored perceptions of monitoring systems, safety, and usability. Semi-structured patient interviews examined acceptability and communication preferences. An iterative paper-based bowel monitoring chart was introduced, refined following staff feedback, and re-audited against national standards.

Seventeen patients prescribed clozapine were included in the documentation audit. Baseline recording of bowel status in the CTM notes occurred on approximately 10% of inpatient days. Seventeen staff responses were obtained across nursing and medical disciplines. Fifteen staff members (88%) reported that the previous electronic prescribing prompt improved patient safety, and the majority perceived increased risk following its removal. Initial uptake of a detailed paper bowel monitoring chart was low, with completion rates of approximately 25% over four weeks. Following simplification of the chart, completion increased to nearly 100% and was sustained on re-evaluation. Documentation of bowel status in the CTM notes improved from approximately 10% pre-intervention to almost 100% post-intervention. Escalation and documented clinical review for patients with more than 48 hours without bowel movement increased from approximately 60% at baseline to 100% following intervention. Five patient interviews demonstrated general acceptability of bowel monitoring, with preference for simple, discreet questioning methods.

A simplified bowel monitoring intervention significantly improved documentation and escalation of clozapine-related constipation. Integration into electronic prescribing systems, alongside staff training and standardised escalation thresholds, is recommended to ensure sustainable patient safety improvements.

Entry to higher education coincides with a period of accelerated psychosocial and brain development. Student need for acceptable and accessible well-being and mental health support is straining university resources.

To evaluate the acceptability and impact of a digital mental health literacy course tailored for undergraduates and delivered as an accredited interdisciplinary elective.

Analyses included pre–post course survey data from enrolled students and longitudinal U-Flourish Well-Being Survey data from a comparison sample of non-course takers over the same period (2021–2024). Linear mixed-effects models examined associations between course participation and 12-week changes in mental health literacy, psychosocial risk factors, well-being and common mental health concerns.

Pre–post course survey data (N = 2884) supported high acceptability, improvements in resilience (+0.06; 95% CI 0.03–0.08, p < 0.001) and self-compassion (+0.65; 95% CI 0.46–0.84, p < 0.001), and a reduction in brooding (−0.31; 95% CI −0.44 to−0.18, p < 0.001). Taking the course was associated with a reduction in anxiety (β = −0.41; 95% CI −0.55 to −0.27, p < 0.001) and cannabis use (proportional odds ratio 0.82; 95% CI 0.75–0.90, p < 0.001), improvement in sleep quality (β = 0.79; 95% CI 0.61–0.97, p < 0.001) and evidence of a protective effect on well-being (β = 0.24; 95% CI 0.11–0.36, p < 0.001) and depressive symptoms (β = −0.37; 95% CI −0.52 to −0.21, p < 0.001), compared with non-course takers. Effects differed by gender, with women benefitting most, but were comparable across minoritised student subgroups.

Mental health literacy delivered as an accredited undergraduate interdisciplinary course is highly acceptable and associated with improvement in psychological coping and positive effects on student mental health and well-being. Future research should focus on more diverse student samples, underlying mechanisms and sustained effects.

Obsessive–compulsive disorder (OCD) is a debilitating mental disorder commonly treated with selective serotonin reuptake inhibitors, atypical antipsychotic augmentation and cognitive–behavioural therapy. However, up to 60% of people with OCD do not respond to these treatments. Therefore, a novel intervention, psilocybin-assisted psychotherapy (PAP), is an option of interest. Moreover, there is a need to better understand the mechanisms underpinning PAP’s effect on OCD symptoms.

We aimed to (a) establish the feasibility, tolerability and safety of administering PAP to adults with treatment-resistant OCD; (b) provide preliminary data on the clinical effects of PAP for treatment-resistant OCD, to inform the design of larger clinical trials; and (c) compare neuroimaging and neurophysiological markers pre- and post-PAP in treatment-resistant OCD.

In this 12-week open-label trial, ten adults with treatment-resistant OCD will receive one 25 mg dose of psilocybin combined with psychological support. Feasibility, tolerability and safety will be assessed throughout. Clinical outcomes will be measured with the Yale–Brown Obsessive–Compulsive Scale. Exploratory measures will include brain imaging examining changes in dynamic connectivity from pre to post treatment, electroencephalogram to investigate changes in brain dynamics associated with psilocybin under acute conditions, and transcranial magnetic stimulation-electroencephalogram measures between baseline, provocation of OCD symptoms and up to 1-week post-dose.

The study will provide important preliminary data on the feasibility and efficacy of PAP in adults with treatment-resistant OCD, as well as inform our understanding of neurobiological mechanisms.

The findings of the study will inform the design of larger randomised controlled trials and advance the field of psychedelic-assisted therapies.

Healthcare personnel exhibit higher levels of anxiety and depression, with differences in the use of coping strategies to manage stressful situations.

To assess which coping strategies, sociodemographic factors and job-related variables predict anxiety and/or depression among healthcare professionals.

A total of 744 participants, including physicians, nurses and nursing assistants were involved in a cross-sectional study.

The ordinary least squares estimator was used to estimate the parameters. The results identified negative self-focus (β = 0.42, β = 0.45, p < 0.001), positive reappraisal (β = −0.20, β = −0.30, p < 0.001) and open emotional expression (β = 0.12, p < 0.001; β = 0.08, p < 0.01), as coping strategies significantly associated with anxiety and depression. Additionally, seeking social support was related to depressive symptoms (β = −0.02, p < 0.01), but not of anxiety. Interestingly, avoidant coping was associated with lower levels of both anxiety and depression (β = −0.14, p < 0.001). The absence of family responsibilities was associated with lower levels of anxiety and depression (β = −0.11, β = −0.10, p < 0.001). Being male was linked to lower anxiety levels (β = −0.11, p < 0.001), while being female was associated with greater depressive symptoms (β = 0.09, p < 0.01). Holding the position of nursing assistant was identified as a variable associated with anxiety and depression (β = 0.08, p < 0.05; β = 0.06, p < 0.05).

These results are essential for tailoring interventions aimed at occupational health.

Early intervention increases the likelihood of eating disorder recovery but many young people delay help-seeking. We developed a smartphone-friendly, online decision-making tool to address this gap (FREED-Mobile (FREED-M)).

To conduct a randomised controlled feasibility trial of the FREED-M decision-making tool with 16- to 25-year-olds with a suspected eating disorder and no previous treatment for this.

Participants were randomly allocated to FREED-M or an active control in a parallel group, two-arm trial. Outcomes were measured at weeks 0 (baseline), 4 (post-intervention) and 12 (follow-up). The primary feasibility outcome was attrition at follow-up. Other outcomes included motivational, clinical and economic measures.

We over-recruited with 204 randomised participants (including 20 fraudulent participants). Main analyses were conducted with 184 genuine responders (FREED-M: n = 91, control: n = 93). At baseline, participants’ mean age was 21.0 (s.d. 2.0) years, 89% identified as female and 64% as White. Mean body mass index was 23.1 kg/m2 (6.3). N = 83 participants had an anorexia nervosa-like disorder, 101 had another eating disorder or high eating disorder risk. Attrition at week 12 was n = 112 (61%). Of the n = 42 FREED-M participants who provided acceptability ratings, 79% liked the intervention and 66% found it useful. Between-group effect sizes for motivation and readiness to change were small to medium at 4 weeks (d = 0.27 and d = 0.15, respectively) favouring FREED-M, but differences were not sustained at follow-up (d = −0.02 and d = −0.12, respectively).

Although the attrition rate was high, recruitment exceeded expectations. Acceptability of FREED-M was high among participants who provided acceptability ratings. Motivation/readiness to change and help-seeking are candidates for primary outcomes in a future randomised controlled trial.

People experiencing homelessness (PEH) attend emergency departments, often presenting with complex needs. The relationship between housing status and access to mental healthcare is not well established.

To compare characteristics, clinical severity and admission rates by housing status, and to examine whether homelessness is associated with admission after adjusting for severity.

We conducted a retrospective cohort study of patients referred to psychiatry at an inner-city emergency department between 1 January and 31 December 2020. Housing status was recorded at presentation. Severity was rated using the Threshold Assessment Grid (TAG, range 0–24). The primary outcome was hospital admission. Group differences were examined using t-tests and χ2 tests. Multivariable logistic regression models assessed variables associated with admission, adjusting for TAG total, age and gender, and then for individual TAG domains.

Of 771 referrals, 282 (36.6%) were PEH. PEH had higher severity (mean TAG 12.3 v. 8.1, p < 0.001) but lower admission rates (10.6 v. 18.0%, p = 0.006). All TAG domains were elevated among PEH, with the largest differences in survival, risk from others and social functioning. Each one-point TAG increase was associated with higher odds of admission (adjusted odds ratio (aOR) 1.34, p < 0.001), as was older age (aOR 1.04 per year, p < 0.001). PEH had lower odds of admission (aOR 0.16, p < 0.001), which persisted following domain-level adjustment (aOR 0.45, p = 0.039).

Despite greater severity, admission rates among PEH were lower following emergency psychiatric assessment. These findings highlight the need for better understanding of how emergency mental health services respond to the complex needs of this population.

The Membership examination of the Royal College of Psychiatrists (MRCPsych) is a postgraduate professional exam that doctors must pass to progress from core to specialist training in psychiatry in the UK. The MRCPsych courses refer collectively to a range of educational programmes, in England usually organised by different NHS Trusts, funded via postgraduate education through deaneries. There was a move to virtual teaching for the MRCPsych theory papers since the Covid-19 pandemic, providing greater accessibility. This came with challenges as trainers and learners struggled with engagement. This study examined an MRCPsych teaching programme delivered across three trusts, enrolling 121 resident doctors in 2023–2024 and 148 in 2024–2025, and aimed to systematically evaluate the programme, identify areas for enhancement through feedback and coproduction with residents, and assess the impact on curriculum delivery.

A mixed methods evaluation was undertaken for delivery of the theory paper teaching. Residents attending Paper A and Paper B MRCPsych teaching programmes in 2023–2024 (n=201) were asked to fill in post-session questionnaires comprising Likertscale items and some questions allowing free text answers. Quantitative data were pooled into descriptive categories, while qualitative responses underwent inductive content and thematic analysis. Themes were further explored and validated through resident focus groups and verified with a large language model for research triangulation. Insights informed a structured review of the 2024–2025 MRCPsych curriculum delivery involving a senior resident. The revised programme was reevaluated using the same methodology (n=237), enabling comparison.

In 2023–2024, residents rated content clarity, presentation quality and clinical relevance highly (≥83% “excellent” or “very good”). Suggestions included increased exam focus, more interactivity, improved time management, and provision of presession materials. Following curriculum revision, 2024–2025 ratings demonstrated further improvement, with ≥85% selecting “excellent” or “very good” across domains and reduction in “poor” responses. Candidates particularly valued enhanced exam-focused content, greater session interaction, and improved structuring and expansion of complex topics. At both time periods there was a request for increasing interaction in teaching and strengthening alignment with the MRCPsych syllabus.

Co-produced evaluation enabled systematic identification of ‘areas of improvement’ within the MRCPsych teaching programme, allowing targeted changes that yielded measurable improvements in satisfaction. This approach demonstrates circular evaluation of curriculum delivery through a continuous feedback loop within a quality assurance model that integrates curriculum design, teaching delivery, assessment, and outcomes. We recommend continued collaborative, resident-centred refinement of MRCPsych courses with mapping to the syllabus.

Alcohol use disorder (AUD) is one of the most common mental health disorders globally. The diagnosis of AUD typically relies on self-reporting measures for identification, and requires that patients disclose their alcohol use to a provider.

To explore the factors associated with the disclosure of alcohol use to a healthcare practitioner among injury patients, considering stigma and alcohol-related consequences of disclosure as major factors.

In this cross-sectional study conducted in Moshi, Tanzania, we investigated factors influencing alcohol use disclosure among injury patients. Path analysis modelling explored the relationships among Alcohol Use Disorders Identification Test (AUDIT) scores, perceived alcohol stigma, Drinker Inventory of Consequences results and disclosure.

Among 341 injury patients, 246 reported current or past-year alcohol use, with only 10.6% having previously disclosed alcohol use to a healthcare provider. Participants who disclosed had higher median drinks per day, elevated AUDIT scores and had experienced more alcohol-related consequences. Other factors associated with disclosure included a positive alcohol test on arrival, higher drinks per day, self-report of alcohol interfering with one’s life, problems with peers, and engagement in risk behaviours. Alcohol stigma was not associated with disclosure. The relationship between disclosure and alcohol use was mediated by alcohol-related consequences.

People who drank more and had more alcohol-related consequences were more likely to disclose their drinking to a provider. Further research is needed to understand the factors limiting disclosure.