Recent reports and inquiries indicate that the potential, identified from the early days of the asylum era, for residents of psychiatric institutions to be subject to abuse has not been eradicated. The findings and recommendations of individual inquiries are often so specific to their unique context that it can be difficult to draw general principles that have wider operationalizability. The aims of this study are to thematically analyse available inquiry reports into health care institutions from the mid-20th century to the present using a ‘generalisable’ framework in order (i) to identify the key themes underpinning the concerns raised, and (ii) to analyse how themes change (or persist) over time.

Inquiries relating to concerns about the institutional care of patients over the past 70 years were identified. In this pilot study, a selection of available reports were subject to thematic analysis to address the first phase of the study (identifying themes underpinning concerns).

Four overarching themes were identified. The first three themes reflect the different levels of system analysis. Thus, the first theme, ‘the proximal dynamic,’ describes the nature of the interaction between staff and patients which is influenced by staff experience, attitude, and actions. The second theme, ‘the organisational dynamic’, comprises processes, policy and culture particularly, but exclusively, within the provider organisation. The third level of analysis, ‘the system dynamic’ theme, includes the influence on the concerns raised of the way the health system is configured (e.g. commissioning arrangements, and use of 'out-of-area' placements). The fourth theme, which cuts across the first three, is ‘the response to concerns’ which ranges from identifying early warning signs to responding to overt expressions of concerns (including whistleblowing).

Using thematic analysis to examine past inquiries into poor institutional care of patients, this study has identified a thematic structure which (i) emphasises that problems arise in a ‘dynamic’ that can be located at three levels of analysis (proximal, organisational and system) and (ii) includes a cross-cutting theme of the way concerns are responded to. This structure can be used as a learning framework for the current provision of inpatient services that has the potential to improve care in institutions, but this will require empirical testing.

Too assess the incidence of PTSD among the survivors of natural disaster Yash cyclone.

Data were collected from adolescent population between the ages of 10 and 15 years who resided in the sunderban region of South 24 Parganas district of West Bengal

Research design adopted for the present study was descriptive, explorative of non experimental study.

Setting of the study was the relief camp operated for victims of climate change and natural disasters ie cyclone yash 2021.

Sampling technique adopted for the present study was simple random sampling.

Instruments used -

PCL 5 questionnaires

socio demographic pro forma.

The data were collected and analysed by means of descriptive and inferential statistics.

Analysis shows that there is statistical correlation between post traumatic stress disorder and subjects exposed to climate change events such as cyclone Yash.

Initial research suggests that a PCL-5 cut-off score between 31 and 33 is indicative of probable PTSD across samples.

In our study the mean pcl 5 value from the data assessment is 70.67 with standard deviation of 4.61. The mean age of the group was 13 years and the family income was Rs 50,804 .

The mean education level of the subjects is class 7.

Further assessment by linear regression analyses shows that female subjects are more prone to post traumatic stress disorder and higher income groups are more susceptible to ptsd.

As shown by higher values as per the pcl 5 scale.

It is evident that events linked to climate change and natural disasters such as cyclone Yash contribute to the development of PTSD as the values are above the cut of score of 33 and are increased across all 20 parameters of the PTSD Scale PCL-5.

Our study clearly demonstrates the impact of climate change and natural disasters on the mental health status of people living in disaster prone areas especially the child and adolescent population.

Our study group was child and adolescent population between 10 and 15 years.

The study was done in very difficult settings as our relief team with volunteers and psychologists had to travel to gosaba and sunderban region of West Bengal which had been devastated by cyclone Yash .

The psychologist and volunteers had to collect data in disasters affected zone , yet they collected data which gave a clear cut findings and a very clear statement on climate change and mental health.

The Royal College of Psychiatry was an observer in the recent international Congress on Climate change and had expressed concern over the impact of climate change on mental health.

Our study shows the profound impact natural disasters have on mental health similar to post-traumatic stress disorder.

Our study vindicates the position of the Royal College of Psychiatry on climate change and natural disasters.

The values are very high and consistent in most subjects across all twenty domains.

Our study group was child and adolescent, the most vulnerable group amongst the affected population.

It is our opinion that Mental health support should be provided for all victims of climate change and natural disasters and government should invest in resources for protection of vulnerable communities from the ravages of natural disasters.

Under-detection of frailty syndrome or sarcopenia can result in significant mortality and morbidity among elderly patients, especially in old-age mental health settings. Therefore, it is crucial to ensure doctors are equipped with the competency of early identification and management of frailty syndrome. To date, there is limited information about any systematic approaches to assess and improve the knowledge, attitude, and practice of doctors about frailty syndrome. This literature review is aimed to identify the tools used to assess the knowledge of doctors about frailty syndrome and the available educational intervention to improve doctors’ knowledge.

A literature search was performed in Google Scholar, PubMed, SCOPUS, Ovid, and EMBASE using the keywords of “frailty syndrome” AND “knowledge” AND “doctors”. Data collected included the assessment tool used to understand the knowledge level and the intervention used to improve the knowledge. The inclusion criteria were: studies published in English in the last 10 years which assessed the knowledge of doctors about frailty syndrome.

There were five studies fulfilling the inclusion criteria after the title and abstract screening, two from the Americas, two from Europe, and one from Australia.

The target group of studies involved general practitioners and doctors working in the primary healthcare setting (three), orthopaedic surgeons (one), and doctors working in the trauma setting (one). Two of the studies included non-medical healthcare practitioners as their participants.

One study used qualitative semi-structured individual interviews, two used a self-report questionnaire, one combined knowledge testing and self-report questionnaire, and one study compared the clinical assessment with a validated tool.

Only one study provided an educational intervention, i.e., a single-day training course conducted by three geriatricians.

Despite a comprehensive search, there were limited studies identified on this topic. The methods used to assess doctors’ knowledge about frailty syndrome are heterogeneous and no standardised tool has been identified in the process. There is only one study using educational intervention to improve knowledge, which was found to be effective and sustainable based on the change in self-perception, i.e. Kirkpatrick Level 1 of evaluation. There is a need to develop systematic assessment approaches or tools and training modules to improve the knowledge of doctors about frailty syndrome. Nevertheless, this review is limited only to studies published in English.

Physical activity, sleep, mental health, physical health, well-being, quality of life, cognition, and functioning are interconnected factors. Compared to general population average, people experiencing psychosis have lower levels of physical activity, high levels of sedation, and more sleep problems (Soundy et al. 2013; Vancampfort et al. 2015). This is linked to symptoms of depression, lower well-being, hopelessness, lower quality of life and physical health conditions, such as: cardiovascular disease (CVD), stroke, hypertension, osteoarthritis, diabetes, and chronic obstructive pulmonary disease (COPD) (Rhodes et al. 2017; Schuch et al. 2017). Engaging in physical activity is associated with improved quality of life, psychotic symptomatology, cognition, functioning and physical health for people with psychosis experience (Mittal et al. 2017). To be effective, interventions need to be individualised (Griffiths et al. 2021). An early intervention in psychosis (EIP) service intervention was delivered: the provision of a Fitbit and its software apps, sleep hygiene and physical activity guidance, motivational interviewing, workbook goal setting through three sessions with a clinician. EIP service staff used Fitbits themselves, sharing experiences with patients. Aim was to improve sleep, physical activity, well-being, and prevent weight gain.

Outcome measure data collection from baseline to 6 week follow-up. Change in physical activity, sleep, mental health, well-being and physical weight were assessed in 50 participants, and fifteen participants were interviewed. People with lived experience of psychosis were part of the research team and contributed to design, analysis and reporting.

Improvements were found in physical activity, sleep, mental health, and well-being, and there was no weight gain. Most patients actively used the Fitbit and its software apps, guidance and workbook to set goals and to make positive changes to their lifestyle and daily routines to improve motivation, quality of sleep, and level of physical activity.

Healthy effective sleep and physical activity/exercise is important to EIP service patients’ well-being and mental and physical health. EIP staff successfully and fully integrated the Well-Track intervention into routine service provision. The project has better allowed staff to effectively engage with and discuss issues around sleep, physical activity, well-being and mental health and reducing weight gain. The intervention was beneficial, relatively easy and low cost to implement, and well-liked by patients and staff; and therefore could be offered by all EIP services. EIP services should consider and assess sleep and physical activity/exercise issues and promote healthy effective sleep and physical activity/exercise within recovery focused practice.

‘Mental Health Answers’ [Salud Mental Responde] is a Crisis Telephone Line that was developed during the first months of the COVID-19 pandemic in the Autonomous City of Buenos Aires, Argentina. It is also a Point of Entry to Mental Health services, providing assisted referrals to the appropriate level of care. The aim of this paper is to evaluate the profile of the callers to the line during the first three waves of COVID-19.

Retrospective case analysis of calls made to the telephone line throughout the different COVID-19 waves under study. For this analysis, the time frame for the first three waves was as follows. First wave: from 1 August to 30 of November 2020; second wave: 15 of March to 30 of July 2021; third wave: from 20 of December 2021 to 25 January 2022.

The first wave lasted 122 days. 4,601 calls were recorded, 27 calls were discarded for missing data. Women's mean age 51.79, SD 17.3, n = 3355. Men's mean age 43.29, SD 15.52, n = 1219. Significant differences were found in age, being men younger (T=−15.764, p < 0.000). Women made the majority of calls (72.9%). Fear and anxiety represented 45.1% of calls, depression 27.3% and psychosis 9%.

The second wave lasted 138 days and there were 4051 calls. Again, most of calls were made by women (71.5%). There were significant differences in age, being men younger (T = 14.450, p < 0.000). Women's mean age 46.68, SD = 18.72, n = 2872; men's mean age 38.05, SD = 16.34, n = 1138. The three most common detected problems were fear and anxiety 53.3%, depression 14.9% and psychosis 18.3%.

The third wave lasted 36 days; it had 1117 calls. Most calls made by women, 70.5%. Men were younger and this difference was significant (women's mean age 46.09, men's mean age 42.54; T = 3.233, p = 0.001). Problems detected, fear and anxiety 37.6%, depression 4.5% and psychosis 32.7%.

There was a change in the caller profile throughout the studied period, the callers from the first wave were older than the ones from the second and third waves. There was a change in the motivation to call, the most noticeable changes the drop in the number of calls related to depression (from 27.3% to 4.5%) and the increase in calls related to psychotic problems (from 9% to 32.7%). This last change might be related to the shift in the use of the Phoneline, from a Crisis Line to a Point of Entry to Mental Health Services.

Background: In recent years, fathers have become increasingly involved in pregnancy and childcare and the concept of paternal perinatal mental illness (PMI) has gained research interest. There has been increased recognition of the impact of parenthood on the mental health of males, particularly in first time fathers where feelings of helplessness and marginalisation are common. Prevalence of paternal PMI is thought to be 10–16%, with higher risk demonstrated when their partner too experiences PMI. The importance of this topic was highlighted in the NHS long term plan, which recognised the disparity in service provision between males and females and the need to address this. Aim: To conduct a systematic review to establish the knowledge, beliefs, and experiences of males with PMI and whose partners had PMI, and to understand the barriers associated with help-seeking for paternal PMI.

Five databases including EMBASE, Web of Science, Ovid MEDLINE, Scopus and PsycINFO were searched for qualitative studies investigating the experiences of males affected by PMI personally or through their partner's illness. The research question and inclusion criteria were determined using the PICOSS (population, intervention, comparison, outcome, setting, study design) method. 11 studies met criteria for inclusion and were appraised for quality using the Critical Appraisal Skills Programme and Joanna Briggs Institute Qualitative checklists. Evidence was synthesised using thematic analysis and study quality and risk of bias were assessed using the Assessing the Methodological Quality of Systematic Reviews (AMSTAR 2) checklist and Risk of Bias in Systematic Reviews (ROBIS) too.

5 main themes and 17 sub-themes were identified, and demonstrated lack of knowledge and preparation for fatherhood, and distress and isolation experienced by males with PMI. Males were reluctant to seek help, and factors including stigma and lack of awareness regarding PMI and available support services were identified as barriers. The option to remain anonymous, flexibility of appointments and an emphasis on peer support were considered facilitators to engagement.

Unhelpful and potentially damaging stereotypes regarding masculinity and PMI still exist, prohibit help-seeking for PMI and promote the marginalisation of males in perinatal settings. Support for males with PMI is warranted but lacking, and effective communication and education regarding paternal PMI for both professionals and the public is needed to allow successful expansion of services to include males.

In light of growing evidence suggesting that medical students are particularly susceptible to stress and ill health, the need to enhance their psychological well-being has been highlighted as a priority concern in medical education and policy. However, only a few studies have comprehensively addressed both positive and negative contributors to medical students' psychological well-being. Therefore, this study aims to provide a more holistic understanding of medical students' psychological well-being, the coping strategies they use and any barriers they face in seeking support, as well as outline potential areas of improvement within provisional well-being support.

This qualitative study involves semi-structured interviews with 25 medical students to gain in-depth insight into their experiences and perspectives on the factors influencing their psychological well-being during their medical training. The interviews were transcribed and analysed using thematic analysis.

The study's results revealed that positive and negative factors influence medical students' psychological well-being. Positive factors such as study-life balance, academic achievement, meaningful relationships with staff and peers and time spent with close friends or family positively influenced students’ psychological well-being; while adverse educational, organisational and cultural factors negatively impacted students' well-being. Additionally, COVID-19 had negatively affected students’ academic, personal and social lives. Medical students mainly used active coping strategies, including planning, acceptance, positive reframing, and seeking support. However, some students reported facing barriers in seeking support, such as fear of stigma, lack of time/support, confidentiality concerns, and difficulty in accessing support. At the same time, there was an expressed need to improve well-being services or resource provision. Students have recommended various solutions to improve mental health support in schools, including addressing cultural and organisational changes within schools, increasing access to resources, reducing the stigma surrounding mental health, and promoting positive factors that support psychological well-being.

The findings highlight the importance of adopting a holistic approach that considers a variety of contributing factors affecting positively as well as negatively medical students’ well-being. It also highlights the need to provide a supportive and nurturing environment in medical schools and offer appropriate support and resources to help students cope with the stress and challenges of medical training.

Weight gain in the months/years after diagnosis/treatment severe enduring mental illness (SMI) is a major predictor of future diabetes, dysmetabolic profile and increased cardiometabolic risk in people treated with antipsychotic agents. There is limited data on the longer term profile of weight change in people with a history of SMI and how this may differ between individuals. We here report a 25-year perspective on weight change post-SMI diagnosis in Greater Manchester UK, an ethnically and culturally diverse community, with particular focus on a history of psychosis vs bipolar affective disorder.

We undertook an anonymised search in the Greater Manchester Care Record (GMCR). We reviewed the health records of anyone who had been diagnosed for the first time with first episode psychosis, schizophrenia, schizoaffective disorder, delusional disorder (non-affective psychosis = NAP) also bipolar disorder = BPD). We analysed body mass index (BMI) change in the period before and after first prescription of anti-psychotic medication.

We identified 9125 people with the diagnoses above. NAP (n = 5618; 37.5% female) mean age 49.3 years; BPD (n = 4131; 63.3% female) mean age 48.1 years. Follow-up period was up to 25 years. 27.0% of NAP were of non-white ethnicity vs 17.8% of BAP individuals.

A higher proportion of people diagnosed with NAP were in the highest quintile of social disadvantage 52.4% vs 39.5% for BPD. There were no significant differences in baseline BMI profile but mean HbA1c in those 2103 people where available was higher in NAP at baseline at 40.4mmol/mol vs 36.7mmol/mol for BPD.

At 5-year follow-up 53.6% of those NAP with a normal healthy BMI transitioned to obese / overweight BMI vs 55.6% with BPD. 43.7% of those NAP with normal BMI remained at a healthy BMI vs 42.7 % with BPD. At 5-year FU for NAP, 83.1% of those with BMI ≥30kg/m2 stayed in this category vs 81.5% of BPD.

At 5-year follow-up there was similarity in the overall % NAP in the obese ≥30kg/m2 category (42.4%) vs BPD (44.1%).

The results of this 25-year real world longitudinal cohort study suggest that the changes in BMI with treatment of non-affective psychosis vs bipolar disorder are not significantly different, highlighting the importance of regular physical health monitoring in all people with SMI.

Using longitudinal population data in this way has the potential to open up new avenues of research in psychiatry in terms of physical and mental health outcomes.

To adapt a digital micro intervention, the Pause: Smart Parent Timer app, to support evidence-based parenting skills programs, which are first line for disruptive behavioural disorders. 77% of parents use time out but 85% use it in ways contrary to evidence. This project aimed to optimise the app to support time out and related approaches across a diverse range of parenting programs.

Working with parenting program providers across the Midlands, the app was updated through an iterative process of agile sprints. The process drew on the EAST behavioural insights framework with a focus on consistency between parenting programs and the app.

The app was improved over several stages to meet the needs and preferences of parenting program providers. Key gains included: a) improved graphics, b) improved UX, c) more options for parents to change timings, d) a wider range of timing protocols for different parenting programs, e) removing references to time out, f) added elements of mindfulness.

This process resulted in a single app which can be used to support any major parenting skills program. Future plans include extending parent feedback and evaluating usability in practice.

Clinical teams oversee the care of patients within secure psychiatric inpatient settings. They are made up of a number of professions, including psychiatrists, psychologists, occupational therapists, social workers and nurses. The effective collaboration of the different members of the clinical team is vital for its functioning. However, so is the team's interface with other key stakeholder groups, namely nursing teams, service users and carers. Understanding the needs and priorities of these groups regarding their relationships with the clinical team is also important to recognise and in the provision of good quality care. To understand the experiences, priorities and needs of stakeholder groups in their relationship with the clinical team. Gaining feedback from multiple sources (service users, carers, nurses) will help facilitate functioning of the clinical team in the delivery of excellent care to service users.

Ethical approval was granted by the host NHS trust. Between October 2019 and October 2021, three focus groups were conducted using a semi-structured interview to gather responses from carers, nurses and service users (6 participants in each group) respectively. The interviews were recorded and transcribed. Thematic analysis was used to code each transcript and themes were drawn from the coded data.

Dominant themes emerged from the three data sets. Consistent themes between groups included communication, hierarchy/power and representation. There were also differences in themes identified, with the carer group bringing the theme of education/ knowledge, and nursing group raising the value of human relationships, including compassion. The theme of transparency emerged strongly for the service user group.

This study offers an interesting perspective on what distinct stakeholder groups want and value in their relationship with the clinical team. Gaining feedback from multiple sources (service users, carers, nurses and members of the MDT) can better inform a team about its functioning and help improve performance. Developing a tool to aid the systematic collection of multi-source feedback is the next step of this project, facilitating the voices of key stakeholder groups to be heard.

The study aimed to determine the level of Emotional intelligence and resilience in relation to the mental health of adolescents in Khartoum locality, Khartoum state, Sudan 2022.

This study is a descriptive cross-sectional study. A total of 392 high school students participated from four different high schools chosen using the multistage cluster sampling. An anonymous self-administered questionnaire was filled by the students including both Arabic and English versions consisted of the 30-item trait Emotional Intelligence Questionnaire- short form (TEQ-SF) for emotional intelligence measurement, Brief Resilience Scale-6 (BRS-6) as a brief measure for resilience, and Patient Health Questionnaire-4 (PHQ-4) for anxiety and depression screening as a measure for mental health. Data were analysed using SPSS 25, Pearson correlation test, and linear regression analysis were used to measure the associations between the variables.

In a sample of 392 Sudanese high school students, the emotional intelligence score was high (mean 131.53 ± 22.16). While Psychological resilience was normal (mean 3.20 ± 0.51). Students had mild to moderate degrees of anxiety, and depression at 89%, and 78% respectively. There was a strong positive association between emotional intelligence and psychological resilience (r = .272, p < .0005). Emotional intelligence had no direct significant relationship with anxiety and depression. Resilience was positively correlated with anxiety scores to a small extent (r= .105) i.e., the more resilient an adolescent is, the more anxious he/she is. There was no association between resilience and depression. Anxiety had a strong positive correlation with depression (r = .540) and a significant negative association with academic performance (r = -.102) indicating students’ suffering from anxiety had poorer academic scoring.

A significant unique contributor to the prediction of the resilience levels was the parents’ status, p value = 0.011 with an unstandardized beta coefficient of .368 i.e., if the parents were separated, a student has higher resilience and vice versa.

It is crucial to investigate the causes of the reported levels of anxiety and depression in secondary school students. Rapid detection will potentiate the possibility to provide suitable care, prevention from psychiatric morbidities and improvement of students’ academic performance by means of comprehensive psychological programs for screening, educating and training students including emotional intelligence training boosting their happiness, mental stamina and success.

To examine the prevalence of Generalized anxiety disorder (GAD), levels of anxiety and perceived stress in Sudanese medical students. Also measuring students’ academic performance, the satisfaction with the former, and lifestyle characteristics. Then investigating the different correlations between all these factors.

We conducted a cross-sectional study at University of Khartoum, among Sudanese medical students. A self-administered anonymous online questionnaire was filled by 340 medical students,which includes Generalized anxiety disorder-2 (GAD-2), and Perceived Stress Scale (PSS-10), beside academic performance and lifestyle characteristics questions.

The data obtained from 340 medical students revealed 3.8% (n = 13) had a previous GAD diagnosis and 29.1% scored ≥ 3 in GAD-2, indicating the possibility of having GAD, 7 of them have a previous GAD diagnosis. Among participants 9.7% use addictive substance, with 42% of them having a high GAD-2 score. Higher anxiety levels were associated with high stress scores (p = 0.000). High GAD-2 scores were significantly associated with those spending less than 10,000 SDG (18$)/week, increased hours of smart devices usage for entertainment (p-value = 0.004), and unhealthy diet (p-value = 0.004). Low anxiety scores were associated with improved quality of sleep (p-value = 0.00), satisfaction with religious practices (p-value = 0.00) and increased leisure /hobbies time (p-value = 0.018). Elevated stress levels were higher in females (p-value 0.035), students with lower academic performance satisfaction levels, and increased hours of smart devices usage for entertainment (p-value = 0.001). Reduced stress levels were associated with age > 23, increased time spent on leisure/hobbies (p-value = 0.002) and eating a healthier diet (p-value = 0.006). Mean academic score was positively associated with academic performance satisfaction (p-value = 0.00), making the mean academic score an indirect modulator for anxiety and perceived stress.

The study elaborates that GAD diagnosis is quite low; with almost third of participants having the probability of developing GAD, asserting the significance of implementing periodic mental health screening programs for medical students, early diagnosis of high-risk individuals, and early interventions through confidential access to mental health services to prevent further harm to the students' health. The impact of financial burden on medical students’ elevated the GAD-2 score; as well as poor lifestyle, i.e. habits such as unhealthy diet, increased hours of using smart devices, low sleep quality and low satisfaction with religious practices, which are all modifiable risk factors of GAD.

Perinatal Depression is a global issue, with several studies showing that it has detrimental effects on the development of children. The aim of this paper was to review these effects according to five domains of development: Cognitive, Motor, Behavioural and Social, Emotional, and Physical. These domains were then explored at four sub-categories of age: Neonate (0–30 days), Infant (1 month – 2 years), Young Child (2–6 years), and Child (6–12 years). This paper also aimed to examine how public health programs have been used to mitigate perinatal depression as a means of reducing child developmental issues.

We conducted a narrative review and searched PubMed and ScienceDirect for peer-reviewed articles, which explored perinatal depression and child development, as well as public health programs that attempted to challenge this problem. Articles were not limited by language or date.

A total of 352 titles and abstracts were screened for eligibility, with a resultant 25 articles meeting the criteria to be included in this review. The studies examined were conducted in 14 countries across different continents, with sample sizes ranging from 13 dyads (mother-child pairs) to 6550 children. At the neonatal and infant levels, there were distinct effects in most domains, including low motor scores, increased risk of neuromuscular developmental delays, and issues with emotional regulation. However, at the older stages, there was a decrease in physical deficits, as social and emotional developmental issues became more prominent. These were displayed as anxiety, depression, attention deficit hyperactivity disorder, and increased likelihood of aggression and rule-breaking behaviour.

Perinatal depression has damaging effects on child development in all five domains and during all four stages of development. Public health programs that use alternative forms of treatment as opposed to interpersonal therapy should be emphasized. There is a need to conduct more research on children in the later stages of development in order to identify the potentially long-lasting effects of perinatal depression. There are also significant challenges in investigating perinatal depression, as the effects of antenatal depression and postnatal depression on child development are often explored separately.

Autism spectrum disorders have recently encountered a change in how they are perceived, since what used to be a narrowly defined rare disorder of childhood is now recognized as a fairly common heterogeneous disorder, which may receive a first-diagnosis during adolescence and adulthood, yet, a common scenario within this age group is that either the diagnosis is missed or misdiagnosed with other psychiatric disorders. Nevertheless, relatively little has been published about the prevalence of autistic traits in adolescent and young adults, and specifically in those investigated for psychiatric conditions.In the present study, we explore the prevalence of autistic traits among 170 adolescents and young adults who were referred to the outpatient psychiatry clinic “Centro Giovani Ponti” in Milan, Italy between September 2021 and March 2022.

Socio-demographic information was collected and all participants completed the following questionnaires; (1) The Autism Quotient (AQ), (2) The Ritvo Autism Asperger Diagnostic Scale-Revised (RAADS-R), (3) The Sensory Perception Quotient (SPQ) and (4) The Empathy Quotient (EQ).

Out of 170 participants, a striking 103 (60.6%) of the subjects scored above the cut-off in RAADS-R, and 31 (18.2%) of the subjects scored above the cut-off in AQ. Furthermore, 99 (58.2%) participants were in the medium range and 47 (27.6%) were in the low empathy category according to EQ results. A significant sensory sensitivity was measured with an SPQ total score of 55.25 (SD = 17.76). Finally, gender difference was of significance in the RAADS-R, EQ and SPQ, but not in the AQ. In the RAADS-R, non-binary subjects (128.60) scored higher than females (78.68). Whereas, in the SPQ female (57.39) participants scored higher than non-binary subjects (40.30). Furthermore, females scored significantly higher compared to males in the EQ total score with values of 42.56 and 35.89, respectively.

To conclude, we report that a significant proportion of adolescents and young adults seeking psychiatric care have unrecognized autistic traits and that an impact of gender is observed. This so called ‘lost generation’ is attributed to be created by the complex phenotypic presentations, changes in diagnostic criteria and associated diagnostic difficulties. It is of utmost importance to clarify the prevalence of autistic traits within this age range and to increase awareness among clinicians, since establishing the true diagnosis, which is commonly complicated by the high rates of psychiatric comorbidity or overlapping mental health symptoms, will reduce the burden on patients, their families, clinicians, and the society.

We aimed to interview people who had received inpatient treatment for anorexia nervosa, to explore their perspectives on the impact their interactions with other patients during their admission had on their recovery, including short term and longer term effects.

We recruited people who had experienced inpatient admission for treatment of anorexia nervosa, and who had been recovered from anorexia nervosa for at least 12 months. We conducted semi-structured, one-to-one interviews, with nine individuals specifically exploring the helpful and unhelpful aspects of peer relationships during inpatient treatment for anorexia nervosa. Interviews were transcribed and analysed using thematic analysis.

We interviewed nine individuals. Five themes were indentified: comparison and justification, learnt unhelpful behaviours, dealing with distress, new-found compassion, and role-modelling. All participants expressed conflicting feelings about their relationships with peers, but generally described more resilience in resisting negative effects as they got closer to recovery. Positive effects, such a new-found compassion, appeared to hold significance long term in participants’ ‘recovered’ lives.

The detailed exploration of themes in this study provides a deeper understanding of the complex nature of peer relationships amongst people experiencing inpatient treatment for anorexia nervosa. This could aid clinical decision making when choosing appropriate treatment settings for individual patients as well as informing clinical practice in inpatient units.

Personality traits such as extraversion and neuroticism are associated with mental health and well-being with trait extraversion positively associated with resilience, and negatively associated with a plethora of mental disorders including depression. Resilience was likely a useful trait during the COVID-19 pandemic which studies have shown negatively impacted the mental health of several different population groups, particularly university students. Mental health may also have been impacted differentially based on trait extraversion, with some evidence finding the mental health of extraverts was negatively impacted by lockdown. This review aimed to investigate whether trait extraversion was protective to university student mental health and well-being, operationalised by different symptom domains including stress and anxiety, during lockdown. We hypothesised that due to an extravert's proclivity to seek out and enjoy social interaction and the restriction of these very activities during lockdown, trait extraversion would no longer have a protective effect on mental health and well-being.

Six databases (EMBASE, MEDLINE, PSYCHINFO, SCOPUS, Web of Science and Cardiff University Full Text Journals) were consulted, and forty-five studies identified. Briefly, the eligibility criteria were studies of university students that had trait extraversion measured using either the Big Five or Eysenck's Personality Questionnaire in addition to a measure of mental health or well-being. Furthermore, at least 50% of the study must have been conducted under lockdown conditions with cross-sectional and longitudinal studies eligible for inclusion. After data screening, three longitudinal and seven cross-sectional studies were identified as eligible for inclusion. Following data extraction, a qualitative narrative synthesis was applied to the extracted data.

Significant results were found for positive affect, negative affect, life satisfaction, quality of life enjoyment and satisfaction, anxiety and depression which suggested extraversion was protective. Non-significant results were also found for anxiety, depression, mental health, global quality of life, perceived stress, COVID-19 student stress and coronavirus anxiety.

The hypothesis that extraversion would be protective for mental health and well-being was accepted unanimously for life satisfaction and tentatively for anxiety. Furthermore, the hypothesis was rejected for depression and stress whose relationship with trait extraversion differed from pre-pandemic findings. The review recommended that extraverted university students should be mindful of the increased risk of depression and stress during lockdown. Additionally, further research should be carried out on extraversion's relationship with stress, an important factor in mental health, and also look at interactions of trait extraversion with other personality traits such as neuroticism.

Epilepsy is one of the most common neurological disorders characterized by an enduring predisposition to generate seizures, which can affect all age groups. Prevalence of overall psychiatric disorders among persons with epilepsy is significantly higher, and children and adolescents with epilepsy were found to have even higher rate of disorders ranging from 35% to 50%. Along with anxiety and depressive disorders, attention deficit hyperactivity disorder (ADHD) is also a common psychiatric disorder in children and adolescents. This study was primarily aimed to estimate the prevalence of psychiatric disorders among adolescents diagnosed with epilepsy. It also looked for any association between such disorders with various sociodemographic and epilepsy related factors.

A cross sectional study was conducted among 117 adolescents aged 11 to 18 years diagnosed with epilepsy. Patients with intellectual disability were excluded. After taking written informed consent and assent from parents and participants, relevant sociodemographic and clinical data were recorded. Prediction of having a psychiatric disorder was made using multi-informant type of Strength and Difficulties Questionnaire (SDQ), with a total score in borderline range suggestive of possible and score in abnormal range suggestive of probable psychiatric disorder. Data were analysed using Statistical Package for Social Sciences (SPSS) software version 22. Chi-square test was used to find association between categorical variables. For all statistical interpretations, p < 0.05 was considered the threshold for statistical significance

Assessment with multi-informant type of SDQ has predicted that 64.1% of adolescents with epilepsy has possible (23.9%) or probable (40.2%) psychiatric disorder.

Prevalence of abnormal scores for hyperactivity subscale was 29.9%, conduct subscale was 29.1%, emotional symptoms subscale was 40.2% and peer-problem subscale was 27.4%.

88 % had high pro-social score suggestive of good social behaviors.

An abnormal or borderline total difficulty score on SDQ was significantly associated with inadequate seizure control (p = 0.029). No significant association was noted between a higher total difficulty score on SDQ with age, sex, sociodemographic status or disease related variables like age of onset, duration and type of epilepsy, monotherapy or polytherapy or family history of psychiatric illness.

A higher proportion of adolescents with epilepsy were identified to risk of having a psychiatric morbidity, which can possibly impair the quality of life and treatment outcome, particularly in Indian context.

Early identification of such disorders using screening tools and a multidisciplinary approach for managing them at the earliest can possibly improve the outcome, for which further research is recommended.

The aim of this research was to explore if exception reporting (ER) has improved the work life balance of junior doctors, and if safeguards proposed during junior doctors’ contract have helped doctors in raising concerns about unsafe work patterns or any missed training opportunities.

This study was reviewed and approved by the Health Research Authority (HRA). We reviewed the number and nature of exception reports completed by trainees between January 2017 and February 2020 by analysing the available ER data (obtained from Guardian of Safe Working) and explored perception of trainees and trainers about exception reporting (ER) by using semi structured and structured surveys. The target population included Core Psychiatry Trainees, GPVTS, Speciality Trainees, Foundation year Trainees and Consultant Psychiatrists.

About 383 exceptions were reported between February 2017 and February 2020 by trainees in BSMHFT. Two separate surveys emailed to trainees and trainers (between December 2020 and July 2021) collected 35 responses from trainees and 22 from trainers.

80% of the trainees had not reported any exceptions in the last one year and 57.14% of the trainers never got involved in exception reporting. Main issues reported were working unsafe hours by trainees (15%), working beyond rostered hours (52.38%) trainers and (52.38%) trainees, failing to achieve educational goals (4.76%) trainers and (10%) trainees, impact on clinical supervision (4.76%) trainers. Reasons for failing ER “Too busy (58.06%), reporting makes no difference (29.03%), a culture to discourage exceptions (29.03%), didn't have logins (16.13%), did not know how to report (35.48%), other reasons. Time off in lieu (TOIL) was commonly reported outcome by trainees (69%) and trainers (62%). 62.07% trainees and 57.14% of trainers neither agreed nor disagreed that ER had improved the quality of training.

Trainees (43.67%) and trainers (58.82%) both did not think that TOIL had resulted in reduction in training time (never 44%). 51.74 % trainees neither agreed nor disagreed that ER made any improvement to their work life balance.

This is the first, mixed method, research looking at both exception reporting data and perception of trainees and trainers. Emerging themes for failure to exception report are guilt, self-blame, culture to discourage, too time consuming, busy workplace, not to offend, reflects being weak.

This research can have wider implications if applied across other trusts nationally, exploring emerging themes. Reasons for declining number of ER needs further exploring of trainees’ anxiety, regarding implications and repercussions of ER, impact of TOIL on continuity of care.

The aim of this poster is to illustrate a systematic review exploring Cognitive Behavioural Therapy (CBT) as a Non-Pharmacological Intervention for School Aged Children with Attention Deficit Hyperactivity Disorder (ADHD). CBT is a common behavioural intervention in several child and adolescent psychopathologies as reported by Ramsay (2010); Solanto et al. (2010); Ramsay (2012); and Lopez et al. (2018). It is recommended as a non-pharmacological intervention alongside parent training, in school-aged children with a moderate severity of ADHD symptoms (National Institute for Health Care and Excellence [NICE] 2018b). This systematic review aimed to evaluate the effects of CBT as an intervention for ADHD in school-aged children. The research objective was to assess the effects of CBT in reducing the core symptoms of ADHD.

A search strategy was developed and a search of four databases initially yielded 1100 results. The search was then limited to randomised controlled trials (RCT) which evaluated the efficacy of CBT compared with treatment as usual, no treatment, and waitlist, in school-aged children. Inclusion criteria included participants who were diagnosed by a medical professional, and participants under the age of 18 in full-time, mainstream education. Those with co-morbid autism or tic disorder and those with an intellectual disability were excluded.

Six RCTs met the inclusion criteria. The age range of participants was 8–18 years. The medication status of participants varied across the included studies. A narrative synthesis of the results included assessment of methodological quality and risk of bias. Jadad scores were used alongside the Cochrane Risk of Bias Tool (RoB 2) for RCTs, to assess the quality of evidence. The studies all included different modalities of CBT intervention and a variety of measurement tools.

The findings support the use of CBT as a non-pharmacological intervention to reduce the severity of ADHD symptoms in adolescents. However, as there were no available studies that included children aged under 8 years, the findings cannot support the use of CBT in the reduction of severity of ADHD symptoms in this group. Methodological issues within the study designs mean the findings need to be treated with caution. Future research is warranted that includes larger sample sizes and younger children with longer follow-up periods. Different modalities of CBT should be explored with and without pharmacological interventions. There is also a case for exploring modalities of CBT that are suitable for targeting in the younger age range of children.

This study investigated the impact of accelerated Transcranial Magnetic Stimulation (aTMS) compared to daily sessions on outcomes in depression patients. While traditional TMS protocols involved daily sessions 4/5 times per week, this can be inconvenient for patients, particularly those travelling long distances to a TMS clinic. Recent well-designed studies have demonstrated that multiple sessions per day (aTMS) can be as effective as daily TMS. It was expected that these findings would be replicated in a clinical setting and that aTMS would be just as effective at reducing symptoms of depression as daily TMS.

A retrospective chart review of 240 patients (126 males, mean age = 42.36, range = 16–86) was analysed using multiple regression. Patients were treated for unipolar depression over the left Dorsolateral Prefrontal Cortex (LDLPFC) using TMS protocols that have been shown to deliver equivalent outcomes (Blumberger et al, 2018).

The aTMS intensity variable (aTMSiv) was calculated by dividing total number of TMS sessions by number of days between the first and last session (minimum of five days for inclusion). Therefore, a patient who had 30 sessions over 15 days would have an aTMSiv of 2. The mean number of sessions delivered was 24.46 (SD = 8.01, Range = 7–45) and the mean days between first and last treatment was 35 (SD = 20.21 Range = 6–105).

The main outcome variable was percentage reduction of PHQ-9 scores from baseline (mean = 17.89) to treatment completion (mean = 10.76). The mean reduction in PHQ-9 was 40%. The independent variables (IVs) included: aTMSiv, PHQ-9 baseline score, number of sessions, age and sex.

Collectively the IVs predicted PHQ-9 reduction at a statistically significant level (F (5,234) =7.91, p = 6.70E-07, R2 = 0.14). Individual analysis of predictors revealed that aTMSiv did not significantly predict PHQ-9 reduction (F (1,238) = 0.05, p = 0.82, R2 = 0.0002). Only number of sessions significantly predicted PHQ-9 reduction in this model (t = 6.04, p = 5.88E-09).

As the aTMSiv did not predict the change in PHQ-9, this suggests the frequency at which TMS is delivered does not affect the outcome when treating depression. Thus, either daily sessions or aTMS can be utilised to best fit the schedule and lifestyle of the patient.