Depression and post-traumatic stress disorder (PTSD) are highly prevalent and frequently co-occur in conflict-affected populations, yet the complex relationships among their symptoms remain poorly understood. This study applied psychological network analysis and Bayesian network modelling to examine symptom associations and exploratory directional dependencies among participants living in Cox’s Bazar and neighbouring Bandarban, Bangladesh.

Baseline data were obtained from 9,397 participants, including forcibly displaced Rohingya refugees and host-community members. Depression symptoms (Patient Health Questionnaire-9) and PTSD symptoms (Harvard Trauma Questionnaire-16) were analysed using regularized partial correlation networks and directed acyclic graphs. Symptom centrality, bridge centrality, predictability and network stability were assessed, alongside sensitivity analyses by settlement status and sex.

Distinct yet interconnected clusters of depression and PTSD symptoms emerged. Guilt, anhedonia, recurrent traumatic thoughts, emotional detachment, hopelessness about the future and rumination emerged as the most central symptoms. Bridge-strength analyses identified guilt and physical health problems as the most prominent bridge symptoms linking depression and PTSD symptom communities. Bayesian network analysis identified several highly stable exploratory directional dependencies involving anhedonia, guilt, rumination, recurrent traumatic thoughts and emotional detachment. The network demonstrated excellent stability (correlation stability = 0.75), while symptom-level classification accuracy ranged from 0.542 to 0.791. Sensitivity analyses indicated that network structure differed across settlement settings, whereas no significant difference in overall network structure was detected between sexes.

These findings provide a nuanced understanding of symptom interrelationships between depression and PTSD in a major humanitarian setting. Symptoms such as guilt, rumination, recurrent traumatic thoughts and physical health problems warrant further interventions as potential intervention targets, potentially informing more focused and culturally sensitive mental health strategies for conflict-affected populations.

Prolonged war-related adversity places Ukrainian university students at heightened risk of psychological distress. Scalable, low-intensity interventions such as WHO Self-Help Plus (SH+) show promise, yet evidence of their implementation and short-term effectiveness during active conflict is limited.

A multicenter longitudinal study was conducted across five universities. Students with mild-to-moderate distress (PSS-10) joined a 5-week offline Acceptance and Commitment Therapy-based SH+ course led by trained non-specialist facilitators. Outcomes included psychological distress (PHQ-9, GAD-7, PCL-5), well-being (WHO-5), daily functioning (WHODAS 2.0), and resilience (CD-RISC-10), assessed at baseline (T1), post-intervention (T2), and 3-month follow-up (T3). Analyses used non-parametric longitudinal tests on 297 completers.

SH+ participation significantly reduced perceived stress, depression, anxiety, and post-traumatic stress from T1 to T2. Well-being and daily functioning improved, with all gains sustained at T3. Resilience remained stable. Implementation barriers included security threats, power outages, and exam overlaps, contributing to attrition.

WHO SH+ is an effective, scalable first-line psychosocial intervention for university students in wartime. It alleviates distress, enhances functioning, and maintains benefits over 3 months. SH+ can be rapidly deployed by non-specialists within stepped-care university frameworks during humanitarian crises. Flexible delivery and alignment with academic schedules are essential to overcome conflict-driven barriers.

Autistic adults experience high rates of co-occurring mental health difficulties, yet little is known about their representation within secondary adult mental health services. This study aimed to examine the actual prevalence and clinical presentation of autistic adults attending a community general adult mental health service in Ireland.

A cross-sectional retrospective chart review was conducted in July 2023 within a community-based secondary mental health service serving a population of 92,610. Demographic characteristics, autism-related factors, diagnoses, self-harm/suicidality, and multidisciplinary service utilisation were extracted and analysed using descriptive and inferential statistics.

Forty autistic service users were identified among a total caseload of 1,270 (3.1%). The median age was 23 years, and 67.5% were male. Most autism diagnoses (65%) were made through Child and Adolescent Mental Health Services. Psychotic disorders were the most common psychiatric diagnosis (30%), followed by mood and anxiety disorders. Over half (52.5%) had a history of self-harm and/or suicidality, and 17.5% had required psychiatric inpatient admission. Although 95% were referred to at least one multidisciplinary team (MDT) service, 30% did not attend these appointments.

Autistic adults represented a small proportion of service users despite their high burden of mental health difficulties, suggesting possible underrecognition of autism and barriers to accessing secondary mental health services. Those receiving care demonstrated complex clinical needs, including high rates of psychosis and suicidality. Improving autism recognition, developing integrated care pathways, and adapting multidisciplinary services to better meet autistic adults’ needs are essential to delivering equitable mental healthcare.

This study examined how subjective disaster recovery and cancer-care satisfaction jointly shape family well-being in Japan, and when better cancer care accompanies higher well-being.

A quota-stratified web survey of 2,179 adults aged 20-69 was conducted across Japan (September 2019), with quotas by Fukushima residency and family cancer experience. Subjective recovery from any major disaster within 10 years (unexposed; recovered or in prospect; no prospect), household cancer experience, and Short FAMCARE satisfaction were modeled against latent well-being by structural equation modeling.

Among non-cancer households (n = 1,324), unrecovered damage was associated with lower well-being (β = −0.08, 95% CI −0.13 to −0.03, P = 0.001), with no association in cancer-affected households (β = 0.00, P = 0.98). Among cancer-affected families (n = 855), high satisfaction was associated with higher well-being (β = 0.17, P < 0.001), more so in recovered than unrecovered households (contrast 0.149, 95% CI 0.031 to 0.268, P = 0.014). Resting on small subgroups, this interaction is exploratory.

Better cancer care did not offset incomplete disaster recovery; its association with higher well-being was confined to households with recovery achieved or in prospect. These cross-sectional findings are consistent with delivering reconstruction and cancer care together.

Disasters, large-scale crises, and prolonged adversities such as pandemics can place sustained psychosocial pressure on families and disrupt everyday family functioning. Although family resilience is increasingly used to explain why some families adapt better than others, the evidence base is dispersed across conceptual, empirical, and intervention-focused work.

We searched PubMed, Scopus, and Web of Science and included peer-reviewed studies that examined family resilience or family coping in disaster, pandemic, or sustained adversity contexts. Study selection followed PRISMA 2020 principles. Data were extracted using a standardized form and synthesized using narrative and thematic approaches.

Forty-two studies were included in the qualitative synthesis. Across contexts, family resilience was most often described as a dynamic, system-level process that involves shared meaning-making, organizational flexibility, and effective communication. Parenting practices repeatedly emerged as a key pathway linking family resilience to child adjustment. Resilience-oriented family interventions reported overall beneficial effects across disaster, pandemic, and serious illness contexts, with no evidence of harm.

Family resilience is a critical contributor to psychosocial adaptation during disasters and large-scale crises. Interventions that strengthen family-level processes—especially communication, coping skills, and supportive parenting—may offer a scalable approach to improve preparedness, response, and longer-term recovery.

The European Psychiatric Association (EPA) undertook a study to investigate treatment preferences of European psychiatrists towards Bipolar Disorder (BD), as part of the Ambassador programme series of surveys.

We conducted a cross-sectional online survey among psychiatrists and psychiatry trainees from 40 European countries. The questionnaire contained clinical vignettes of different phases of BD including manic, rapid cycling, mixed, hypomanic, and depressive episodes, for both initial and subsequent treatment strategies.

The final sample consisted of 654 participants, from Central and Eastern Europe (CEE), Southern Europe (SE), Northern Europe (NE), and Western Europe (WE). The majority preferred pharmacotherapy, most commonly as a combination of two or three drugs to treat all phases of the BD, with lithium being the most preferred option in all phases.

Among antipsychotics, olanzapine and quetiapine were the most commonly chosen. Antidepressants were applied in almost 20% of responses for the depressive phase. Psychosocial interventions were not systematically implemented, particularly during manic and mixed episodes, but when recommended, the most common approaches included psychoeducation, cognitive behavioural therapy (CBT) in up to 40% in depressive phase, and lifestyle recommendations. However, latent class analysis identified four different classes of prescribers.

Psychiatrists showed broadly similar pharmacological treatment preferences for BD, with frequent use of lithium-based combination therapies and limited implementation of psychosocial interventions, although latent class analysis revealed distinct prescribing profiles. These findings support the need for enhanced dissemination of evidence-based guidelines and greater integration of psychosocial approaches in BD care.

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.