Advance care planning (ACP) is widely implemented in older adults with dementia, yet reports focusing on young-onset dementia remain scarce. Valuable insights may be drawn from studies on younger adults with serious chronic illnesses, as they share similar life stages and challenges. To examine ACP in young and middle-aged adults with serious and chronic illnesses and assess their relevance for young-onset dementia.

A systematic scoping review. Open Science Framework (https://osf.io/cjwy4). A search was conducted in PubMed, EMBASE, and CINAHL until 19 December 2023. Title/abstract screening was conducted using ASReview. Two authors independently performed the full-text screening and quality assessment. Studies were categorized into 2 groups: (1) process (clinical practice and preferences) and (2) interventions.

Fifty-six studies were included, including 26 interventions. Participants preferred initiating ACP either shortly after diagnosis or later, with physicians or general practitioners. In practice, physicians and nurses discussed ACP shortly after diagnosis or later. Preferred topics include end-of-life care and physical, social, psychological, and spiritual/cultural domains. However, in practice, discussions primarily focused on legal representation, end-of-life care, and the physical domain.

ACP should adopt a holistic approach at an appropriate stage of the disease trajectory and is a multidisciplinary process. A multidisciplinary team effort could facilitate the integration of the different aspects of ACP. The findings of this review are applicable to young-onset dementia. However, due to the progressive cognitive decline, it should be initiated earlier and revisited throughout the disease trajectory, with increasing family involvement.

Recent studies have focused on characterising the brain‘s intrinsic connectivity networks during fear learning, going beyond traditional brain activation analyses, to study the acquisition of fearful associations as a model for clinical anxiety onset.

Given the sharp increase in prevalence of affective disorders during puberty, a period marked by heightened affective sensitivity and fronto-amygdala circuitry development, the current study compares the connectivity within and between the salience network, executive control network and default mode network throughout fear learning, between young adults with and without mild mixed affective complaints. We hereby aim to identify potential neural targets for promising novel treatment options, such as functional magnetic resonance imaging (fMRI)-guided neurofeedback or transcranial magnetic stimulation.

Generalised psychophysiological interaction analysis was used to assess connectivity changes within and between the salience network, executive control network and default mode network during an fMRI fear-conditioning paradigm (habituation, early, mid and late acquisition phase). Results were compared between healthy controls (n = 44), spider phobics (n = 44) and a group with subclinical mixed psychopathology (n = 52; 21 males), all aged 16–25 years.

Task-induced changes in functional connectivity were specifically found in the default mode network (F(6, 792) = 4.170, p < 0.001). Overall, the default mode network showed less functional connectivity during conditioned threat stimulus than neutral ‘safe’ stimulus trials. Notably, a subset of connections within the default mode network of the subclinical mixed psychopathology group failed to differentiate between the stimuli (F(27, 377.39) = 2.01, false discovery rate-adjusted p-value = 0.014), which is in line with fear-conditioning research showing impaired (behavioural) stimuli differentiation in affective disorders.

Stimulus-specific temporal dynamics of the default mode network during fear learning differentiated young adults with and without mild psychopathology. These results add up to a growing body of research identifying deficient default mode network functionality in affective disorders.

Diagnostic criteria for attention deficit hyperactivity disorder (ADHD) and autism have broadened and are common at estimated adult prevalences of 3%. This paper explores the incidence of autism and overlap of features in ADHD young adults transitioning from Child and Adolescents Mental Health Services (CAMHS) into a specialist adult ADHD service, and the utility of the Ritvo Autism Asperger Diagnostic Scale 14 (RAADS-14) assisting assessment and support planning.

This comparative cohort study included all young adult ADHD patients referred from CAMHS. A comprehensive assessment and diagnostic formulation, including RAADS-14 was completed. Those without a current autism diagnosis but clinical assessment suggested autism, underwent further assessment. Percentage of autistic and ADHD young adults was calculated. RAADS-14 total and subscale scores were compared between groups. Gender differences were assessed.

Co-occurrence of autism in a group of young adults diagnosed with ADHD was high (53%). High levels of autism features were evident in the ADHD only group. Significant differences in the RAADS-14 sub-scores (social anxiety, mentalizing and sensory sensitivities) were found between the autistic ADHD and non autistic ADHD groups. Autistic females scored higher on all domains of the RAADS-14 compared to males. Sensory sensitivities were significantly higher in females in both groups.

The level of co-occurrence of autism, and overlap of features, suggests employment of neurodevelopmental rather than single condition approaches to avoid mis-diagnosis/missed diagnoses. Sensory sensitivities are suggestive of neurodevelopmental differences particularly in females regardless of diagnostic category. The RAADS-14 may be helpful as part of screening and support planning.

The prevalence and burden of depression are increasing among young people. Despite this, relatively few treatments specifically target this critical developmental period, and under-addressed mental health difficulties in youth often have lifelong consequences. Social isolation is commonly reported by young adults and is both a risk and maintenance factor for depression. There is a need for accessible, engaging interventions that can reduce depressive symptoms and improve social connectedness.

Building on evidence of the therapeutic potential of social dance-based activities for depression, this randomized controlled trial evaluated the efficacy of an 8-week salsa dance intervention for young adults (aged 18–24 years) with mild to moderately severe depressive symptoms. 121 participants were randomly assigned to either a salsa intervention or a waitlist control. Participants completed the Patient Health Questionnaire (PHQ-9), a validated measure of depressive symptoms, and additional mental health measures at baseline, during, and after the intervention.

Participants in the salsa dance condition showed a significantly greater reduction in depressive symptoms than the waitlist control, with a −2.45 PHQ-9 point between-group difference, exceeding the criterion for clinical significance. Both groups reported improvements in social anxiety, generalized anxiety, loneliness, and daily happiness, but salsa participants had significantly greater reductions in social anxiety and greater improvements in daily happiness.

These findings support the value of social dance as a novel, accessible intervention for reducing depressive symptoms. Implementing such programs within a suite of wellbeing-oriented interventions for young people could provide cost-effective mental health benefits.

Cognitive Behavioural Therapy-Ten (CBT-T) offers a briefer manualised approach to treatment of non-underweight eating disorders (EDs) compared with traditional therapy models, and has the potential to help services deliver timely access to care. This study evaluated CBT-T outcomes in a naturalistic setting, with a focus on session-by-session change patterns.

A total of 151 young adults received CBT-T in a no-threshold-to-access community ED service. Symptom trajectories were assessed using the ED-15 global scale and subscales (eating concern, weight/shape concern). Using intent-to-treat principle, linear mixed-effect models evaluated treatment effectiveness, and chi-squared and receiver operating characteristic (ROC) analyses explored associations between early symptom change and end-of-treatment remission.

Treatment led to significant reductions in ED symptoms and psychosocial impairment, with large effect sizes. Reliable improvement in Weight/Shape Concern – but not Eating Concern – on ED-15 at session 4 significantly predicted ED symptom scores below the clinical cut-off at the last session.

CBT-T is effective in reducing ED symptoms in young adults with non-underweight EDs. While engagement and progress prior to session 4 have been used to guide treatment planning, as stated in the treatment manual, only the change in weight/shape concern at session 4 appeared to be strongly predictive of outcome in this sample, whereas change in eating concern did not. Early changes in weight and shape concerns at initial sessions may be informative in predicting treatment outcome. The findings can support the future development of CBT-T and other brief ED interventions.

Young adults (19–24 years) commonly experience elevated rates of sleep disturbance, anxiety, and cognitive stress yet often underutilise formal mental-health services. Music therapy, binaural beats, and related auditory entrainment techniques offer accessible, non-pharmacological approaches that may enhance emotional regulation, cognition, and physiological stability.

To systematically review interventional clinical trials published over the past decade evaluating music- and rhythm-based auditory interventions for mental-health and cognitive outcomes in young adults.

A systematic search of PubMed/MEDLINE and PsycINFO (01 January 2015 – 01 January 2025) was conducted using the terms (music therapy OR binaural beats OR auditory entrainment) AND (mental health OR neurorehabilitation OR cognition OR anxiety OR depression). After screening 122 abstracts, 10 trials met inclusion criteria. Effect sizes (Cohen’s d) and 95% confidence intervals were extracted or estimated. Risk of bias was assessed using the Cochrane RoB-2 tool. The review protocol was registered in PROSPERO (CRD420251178490).

Interventions included bedtime music therapy, audiovisual stimulation, and binaural-beat exposure across laboratory, clinical, and rehabilitation settings. Most studies demonstrated significant or moderate improvements in at least one domain: anxiety reduction, stress physiology, mood regulation, sleep quality, or cognitive performance (standardised mean differences 0.3–0.6).

Evidence suggests that music-based and binaural-beat interventions can beneficially modulate sleep, anxiety, and cognitive processes in young adults. However, heterogeneity in design and small sample sizes limit the certainty of findings. Future adequately powered randomised controlled trials should address transdiagnostic mechanisms and long-term efficacy.

Mental health literacy (MHL) is the ability to recognise mental disorders; have knowledge of professional help available, effective self-help and prevention strategies; and have the skills to support others. MHL is linked to better help-seeking behaviours and better management of mental illness. Mental illness prevalence is increasing in Malawi. Assessing MHL in communities crucially helps identify knowledge gaps, informing the development of evidence-based interventions.

This study assessed the MHL levels of young adults (16–30 years old) in rural and urban communities in Malawi.

A cross-sectional national survey was administered to 682 people across 13 districts in Malawi, using a self-reporting Mental Health Literacy questionnaire (MHLq) that assessed knowledge of mental health problems, erroneous beliefs/stereotypes, first aid skills, help-seeking behaviour and self-help strategies.

Most respondents were either unemployed (36%) or enrolled in school (43%). A total of 73% completed primary or secondary education, and 48% knew someone with a mental illness, but only 14% of this group could specify the illness. The mean MHL score was 111.8 (s.d. 13.9). Individuals with primary and secondary school qualifications had significantly lower scores in factor 2 (erroneous beliefs/stereotypes) and factor 3 (first aid skills and assistance-seeking behaviour) of the MHLq than those with higher education.

This research highlights persisting mental health misconceptions, limited knowledge about specific mental illnesses and low help-seeking behaviour among young adult Malawians. Higher education is linked to a better understanding of mental health. Prioritising community education on causes, signs, treatments and prognosis of mental illness is crucial for increased MHL.

Although often associated with ageing, disability is becoming increasingly prevalent among young adults. While disability can pose a substantial psychological burden for young adults on critical pathways to establish the foundations for their future, the mental health risks faced by this population remain underexplored.

This study aimed to (1) assess the association between disability – including its presence, severity and type – and the risk of depressive and anxiety disorders, and (2) examine whether this association varies across sociodemographic factors, health behaviours and comorbidities in a young adult population.

We conducted a population-based cohort study using linked data from the National Disability Registry and the National Health Insurance Database of South Korea. A total of 6,058,290 individuals aged 20–39 years who underwent health check-ups between 2009 and 2012 were followed through 2022. Cox proportional hazards models were used to estimate adjusted hazard ratios (aHRs) for depressive and anxiety disorders.

Individuals with disabilities had significantly higher risks of depressive (aHR: 1.58, 95% CI: 1.55–1.60) and anxiety disorders (aHR: 1.50, 95% CI: 1.42–1.59). Increased risks were consistently observed across various disability types with the highest risk observed for mental health-related disabilities in depression (aHR: 4.98, 95% CI 4.62–5.37) and epilepsy-related disabilities in anxiety disorders (aHR: 12.05, 95% CI 8.73–16.63). Subgroup analyses revealed stronger associations among individuals in their 20s, low-income groups, non-smokers and those abstaining from alcohol, compared to their respective counterparts.

Young adults with disabilities, a population that has been relatively overlooked in policy discussions, warrant greater policy attention in relation to their mental health.