It is well-established that mental illness is associated with excess and premature mortality. Consequently, the assessment of physical health should be routine in the evaluation of persons living with mental disorders. Herein, we introduce the development of a global instrument to assess physical health status in persons with mental disorders.

Following the development of the Transdiagnostic Global Impression–Psychopathology (TGI-P) scale, a novel scale of physical health status, the Transdiagnostic Global Impression–Somatic Symptoms and Signs (TGI-3S), was created using similar principles. Scale development followed a multistage process involving (1) item generation using deductive methods, (2) two content validations by an expert panel, and (3) two iterative usability-testing rounds with patients and caregivers. These rounds therefore assessed understandability and ease of use for wording, visual format, and emotional/cognitive load of the instrument. The psychometric validation is underway.

The TGI-3S was developed as a front-end screening tool resulting in a broad somatic burden map, rather than a diagnostic instrument. Throughout the development process, experts, patients, and caregivers evaluated the TGI-3S positively. In the final usability round, 96% found the aim of the scale clear, and 87% considered the instructions easy to follow. The scale demonstrated high-level usability, with 72% completing the TGI-3S in <5 minutes. Emotional and cognitive burden of completing the TGI-3S was rated as low, and item wording was well-understood.

With psychometric validation underway, the TGI-3S offers an anamnesis-embedded, brief, yet comprehensive tool for facilitating the assessment of somatic health in patients with mental disorders.

Children in families navigating significant adversity often face co-occurring physical and mental health problems, which together can contribute to substantial marginalization across the life course. These children and their families may greatly benefit from targeted interventions to disrupt accumulating vulnerability, which requires empirical evidence on the underlying dynamics of adversity and health problems throughout childhood.

We investigated associations between childhood adversities (material deprivation, experiences of loss or threat of loss, and family dynamics) and hospitalizations for mental and physical health problems across four developmental periods among 11,978 children who experienced high rates of family adversity. We used data from the Danish Life Course (DANLIFE) register-based cohort study and applied cross-lagged networks models. Hospitalizations were identified through inpatient, outpatient, and emergency hospital contacts.

We found clear evidence of reciprocal associations between childhood adversities and physical and mental health problems across childhood, alongside strong autoregressive effects within adversity and health domains, indicating vicious circles of reinforcing vulnerability. Conditional on high health problems in infancy, childhood adversity was not found to be associated with additional health problems throughout the rest of childhood. Child health problems were, however, positively associated with subsequent adversity across childhood.

Dynamics of childhood adversity and poor health give rise to complex reinforcing patterns of vulnerability over time. Our findings contribute to a better understanding of the emergence of vulnerability resulting from childhood adversity and poor health in children, highlighting the importance of embracing the complex nature of these emergent phenomena, both in research and intervention.

There is currently no national approach to physical health and activity management for individuals under forensic mental healthcare.

This study aims to document the physical health and activity management of in-patients under forensic mental healthcare across Australia, physical activity opportunities and how data are recorded. It also explores staff perspectives on physical health and activity needs of forensic in-patients.

Forensic hospital staff with expertise in managing the physical health and activity of in-patients were invited to participate in a mixed-methods study.

Twenty-two surveys were completed and 64 staff members participated in 17 focus groups. Eight themes were identified: (a) lack of a standardised approach to physical health and activity; (b) inconsistent monitoring and documentation; (c) importance of general practitioners and multidisciplinary teams; (d) need for structured, adaptable programmes and engaged staff; (e) challenges related to patients, staff, ethics and infrastructure; (f) gaps in education, engagement and awareness; (g) need to balance nutrition and eating autonomy; and (h) importance of developing and implementing interventions.

Forensic hospitals in Australia lack a standardised approach to physical health and activity management, with inconsistent monitoring. Physical activity interventions require engaged staff, resources and flexibility, yet ethical and logistical barriers complicate implementation. Solutions include investing in specialised staff, scheduling physical activity into patients’ routines and integrating information technology systems. Comprehensive policies for assessment, monitoring, nutrition, physical activity and interventions are important for improving in-patient forensic mental healthcare, and key performance indicators should be developed.

This brief report examines physical and mental health symptom profiles among older adults approximately 5 months after Hurricane Helene–related flooding in Southern Appalachia.

Survey data were collected from 233 older adults and assessed physical health symptoms, posttraumatic stress disorder, depressive symptoms, flood event exposure, environmental contaminant exposure, and post-flood stressors. Cluster analysis was conducted to identify post-disaster physical and mental health symptom profiles, and analysis of variance and chi-square tests were conducted to examine differences in disaster exposure, post-flood stressors, and sociodemographic characteristics across profiles.

Three distinct post-disaster health symptom profiles were identified: a lower symptom profile, an elevated mental health symptom profile, and a combined elevated physical and mental health symptom profile. Disaster exposure, contaminant exposure, and post-flood stressors increased in a graded manner across profiles, indicating a dose–response framework of disaster-related health impacts. Higher symptom burden profiles were disproportionately represented among older adults with disabilities/chronic illness and among older age groups.

Findings highlight heterogeneity in post-disaster health experiences among older adults and underscore the value of identifying high-risk subgroups and implementing recovery strategies that address co-occurring physical and mental health needs among older adults following flood events.

Rapid weight gain commonly occurs following the onset of first-episode psychosis (FEP), leading to cardiometabolic disease. Most weight gain in FEP occurs in the first 3 months of treatment, offering a critical window for prevention. Despite this, most studies aiming to prevent antipsychotic-induced weight gain include people with chronic illness or people who have had lengthy exposure to antipsychotic medication. We aimed to synthesize and analyze the literature on interventions aimed at preventing antipsychotic-induced weight gain.

We conducted a systematic review in PsycInfo, MEDLINE, CINAHL, and EMBASE of studies that examined the effectiveness of interventions in preventing antipsychotic-induced weight gain in FEP. We examined their effect on weight gain and a range of cardiometabolic markers.

We screened 2,092 articles, 13 of which were eligible. Behavioral interventions, all three of which consisted of a multidisciplinary team approach, resulted in a mean of 3.05 kg less weight gain than treatment-as-usual (95% CI 1.36 kg to 4.73 kg). Pharmacological interventions displayed marked clinical and statistical heterogeneity, with each of the seven trials in adults using a different pharmacological intervention. Few studies collected comprehensive data on metabolic health. Only two pharmacological studies, and five studies in total, have been published since 2010.

Despite the importance of preventing weight gain in FEP, there have been few recent studies investigating this topic. Our results indicate that multidisciplinary team interventions are effective in preventing weight gain in FEP and should be offered to all patients.

People living with severe mental illness (SMI) experience a shorter life expectancy and poorer physical health than those without SMI. Cardiometabolic illness accounts for a significant proportion of this health inequality. Pharmacological management could reduce the noted inequalities.

This umbrella review aimed to synthesise evidence from systematic reviews for pharmacological interventions to manage cardiometabolic outcomes in adults with SMI.

Databases (Embase, MEDLINE, Cochrane Database of Systematic Reviews) were searched from inception to 11 June 2024 for systematic reviews of pharmacological interventions for all cardiometabolic outcomes in adults. Titles, abstracts and full texts were independently screened by two reviewers. Corrected cover area was calculated, and quality was assessed using AMSTAR 2. Results were analysed and a narrative synthesis conducted.

Thirty-three systematic reviews were included following screening of 1723 titles. Metformin, the most commonly studied intervention (n = 18), was effective in preventing and treating weight gain, dyslipidaemia (total cholesterol and triglycerides) and dysglycaemia.

Topiramate and glucagon-like peptide-1 agonists demonstrated efficacy in treating weight gain, but the effect across other parameters was less consistent. Licensed treatments, such as statins for dyslipidaemia, were reviewed in low numbers (n = 2). Nicotine replacement, bupropion and varenicline were effective for smoking cessation, an outcome that can significantly lower cardiometabolic risk.

The corrected cover area was 6.3%, indicating moderate overlap. Most reviews (n = 16, 48%) were rated critically low quality using AMSTAR 2, and the remainder rated either low (n = 7, 21%), moderate (n = 2, 7%) or high quality (n = 7, 24%).

Pharmacological interventions can improve cardiometabolic outcomes in adults with SMI when non-pharmacological interventions are either insufficient alone, impractical or unacceptable. However, licensed treatments have been reviewed in relatively low numbers. Improving cardiometabolic outcomes is a key area in psychiatry, and the results of this review will be important in shaping future guidance.

Intellectual disability is defined as an IQ of 70 or below. Women with intellectual disability frequently experience menstrual distress leading to the use of hormonal medications such as depot medroxyprogesterone acetate (DMPA). Despite risks such as reduced bone mineral density (BMD) and weight gain, DMPA is widely used in this cohort, prompting investigation into its suitability and risks.

A narrative review and local service evaluation were conducted to determine whether clinical management reflected recommendations in the literature.

PsycINFO and Medline were searched for articles post-1995 on contraception in menstruating women with intellectual disability. Contraceptive use in 100 randomly selected women was evaluated. Data were collected on physical health issues, general practitioner records were reviewed for contraceptive administration and risk discussions, and surveys assessed risk understanding and satisfaction.

The review identified 27 papers with higher DMPA use in the intellectual disability population compared to the general population, and specific BMD risks. The case series found 23 women with intellectual disability using DMPA, and revealed knowledge gaps in risk and monitoring, inappropriate use given individual risk, and poor proactive risk management.

Findings indicate disproportionate DMPA use in women with intellectual disability, with inadequate clinical justification and risk awareness. Many women and carers were unaware of BMD risks, and DMPA alternatives were rarely considered. Individualised contraceptive management and closer review of DMPA use in this cohort is needed. Monitoring could include dual X-ray absorptiometry (DEXA) scans, vitamin D and calcium supplementation, and weight management. Further research is needed into higher DMPA use and risks within this population.

Work stress levels rose among health and educational workforces during the COVID-19 pandemic, and can affect employee well-being and organisational efficiency.

To explore the association of work stress with mental health, including suicidal ideation and physical health, as well as presenteeism, as aspects of organisational efficiency in UK healthcare and university workers.

A total of 328 UK participants completed self-report questionnaires between April 2022 and September 2023 in the context of the European Platform to Promote Wellbeing and Health in the Workplace (EMPOWER) study. Cross-sectional analyses were conducted.

Two hundred and ninety-two (90%) employees reported work-related stress (Mini-Psychosocial Stressors at Work Scale). Depressive, anxiety and somatic symptoms were reported (61, 55 and 75%, respectively); 11% of the participants reported suicidal ideation (Patient Health Questionnaire 9) and 56% reported presenteeism (iMTA Productivity Cost Questionnaire). Psychological and somatic symptoms were worse when suicidal ideation or presenteeism was reported. Stressful work factors included having too much work to do (63%), a bad working atmosphere (28%), poor work–home balance (32%) and working hours hindering private life (35%). Spearman correlations showed significant associations between work stress and suicidal ideation (0.225), depressive (0.290), anxiety (0.299) and somatic symptoms (0.245) and presenteeism (0.311), but not with having a chronic medical condition.

Given the association between work stress, suicidal ideation and presenteeism, research should explore how psychosocial risk factors linked to work stress could be reduced for healthcare and higher education employees. The findings warrant the development of policies to address work stress, and to provide employee support for suicidal ideation and presenteeism in the work setting.

Unhealthy lifestyle behaviors are prevalent among people with mental illness (MI), affecting their physical and mental health. Most research has focused on the isolated effects of lifestyle behaviors, leaving the interconnectedness between these behaviors and health outcomes unexplored. This study aimed to examine these relationships and identify the most strongly connected lifestyle behavior or health outcome within a network.

We conducted a cross-sectional study with 423 inpatients with MI, receiving care as usual. Lifestyle behaviors, physical and mental health outcomes were assessed through questionnaires and routine data. A Gaussian Graphical Model was estimated, and strength centrality was calculated to identify the most influential nodes.

Mean age was 55.5 years, 42% were female, and 41% were diagnosed with schizophrenia. Psychological and physical quality of life (QoL), nighttime sleep problems, and overall sleep quality were the most strongly connected nodes. Sleep was strongly associated with physical QoL. Furthermore, there were negative associations between healthy food intake and cholesterol ratio, and positive associations between daily doses of antipsychotics and length of hospital stay. Node strength was stable (CS(cor = 0.7) = 0.75). No clear pattern emerged among other lifestyle behaviors and health outcomes.

This study offers insights into the interrelatedness of lifestyle behaviors and health outcomes. Addressing sleep problems could enhance QoL and potentially influence other health outcomes. Psychological and physical QoL were also strongly associated, emphasizing the importance of perceived well-being in health outcomes. Future research could explore causal pathways to identify treatment targets to improve care.

Digital peer support interventions have the potential to promote healthy lifestyles and better mental health. This systematic review and meta-analysis synthesizes evidence on the effectiveness of digital peer support interventions for enhancing physical and mental health in healthy individuals rather than those diagnosed with a clinical condition.

First, we evaluated the impact of digital peer support interventions on physical and mental health outcomes by attending to sources of peer support (informal, naturally occurring peer support; formal support from trained peers), effectiveness demonstrated through different study designs (pre–post comparison vs. well-controlled experimental conditions) and long-term effects of interventions. Second, we examined whether features of digital peer support interventions – specifically, dosage, uptake and platform affordances – moderated intervention effectiveness. Third, we considered moderating effects of individual differences (age and existing health conditions) and country.

Using random-effects modelling, which included 47 studies with 76 effect sizes on physical health, and 73 studies with 118 effect sizes on mental health, we found a moderate effect of digital peer support in improving physical health (standardized mean difference (SMD) = 0.35, p < 0.001; 95% CI: 0.30–0.41) and a large effect in enhancing mental health (standardized mean difference(SMD) = 0.53, p < 0.001; 95% CI: 0.46–0.61), which were similar across ages and individuals with varying degree of existing health conditions. Different sources of peer support demonstrated similar effects on physical health, but informal, naturally occurring peer support was more effective in bolstering mental health than formal support from trained peers, producing large effects that were comparable to online professional support. Positive effects on physical health were sustained over follow-up assessments, but weakened for mental health over time. Greater dosages of intervention had decreased effectiveness, but uptake of intervention did not moderate the effects on health. Interventions delivered on platforms that afford greater interactivity (apps, social networking sites and video conferencing) were more effective than those with lower interactivity (forums, websites and emails). Digital peer support interventions had stronger effects on improving physical health in Western countries than Eastern countries, but stronger effects on improving mental health in Eastern than Western countries.

Our findings contribute to the nascent conceptual models of digital peer support, lend credence to digital peer support as a scalable preventive intervention with real-world benefits in bolstering individuals’ physical and mental health and provide important insights into best practices.