Depression is a leading cause of disability, contributing to the global burden of disease. Low- and middle-income countries (LMICs) carry over 80% of this disease burden. There are high rates of depression in men in Pakistan. Paternal depression is often overlooked and is an under-researched area. Fathers are at risk of depression particularly if their partner is depressed. There is a need for integrated partner inclusive interventions to improve both parent and child outcomes including overall child development. Therefore, this nested qualitative study aims to identify barriers in transition to scale up an innovative low-cost partner inclusive culturally adapted psychosocial intervention for depressed fathers through a process evaluation from the perspective of fathers.

This qualitative study was nested within a cluster randomized controlled trial, with depressed fathers of young children (0–3 years) recruited from 18 towns in Karachi, Pakistan. Face to face or digitally audio-recorded interviews were conducted with depressed fathers (N = 24) from the intervention arm of the trial at end of intervention period (i.e., 4-month post-baseline). The intervention involved twelve sessions of a parenting intervention called Learning Through Play integrated with group Cognitive Behaviour Therapy and manual content from “Focus on Fathers”. Interviews were guided by a semi-structured topic guide to explore perceived usefulness of the intervention with particular focus on exploring any additional benefits or challenges of engaging partners into the intervention. Interviews lasted approximately an hour. Data were analysed using the principles of Framework Analysis. A concurrent analysis of initial interviews directed towards further interviews until data saturation.

Analysis highlighted perceived usefulness of the intervention such as improvement in mood, engagement in routine tasks, healthy thinking patterns, increased attachment with child, improved relationship with the family, improvement in parenting knowledge and more positive attitudes towards child development, supporting partners in household chores, and recommendation to promote this partner inclusive parenting program throughout the country.

Addressing depression in parents is hugely important due to its adverse impact on both parents and children. This low-cost parenting program supported fathers in their parenting role along with improvement in psychological well-being. This has also informed barriers and facilitators to implement the LTP plus parenting program and the possibilities to roll out the intervention at national level.

This review aims to evaluate the lasting advantages of cognitive behavioral therapy (CBT) in alleviating anxiety and depression and improving overall health outcomes post-CABG.

A comprehensive search across databases including Science Direct, PsycINFO, PubMed, Google Scholar, VHL, Cochrane, and Scopus was conducted up to October 2023. The study adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement and Cochrane guidelines. Inclusion criteria involved randomized controlled trials reporting on CBT or CBT-based interventions tailored for CABG patients and control groups had usual care, with anxiety and depression symptoms, as well as quality of life, as primary outcomes. Outcome variations were analyzed through standard deviation, while efficacy was measured via confidence intervals. Evaluation of the intervention process included examining feasibility, adherence, acceptability, inclusion rates, safety, and tolerability.

Three randomized controlled trials including a pilot study in America and Denmark, encompassing a total of 286 patients, were reported in this review. The participants' pooled mean age was 63.19 years (intervention) and 63.9 years (control), the male-to-female ratio was approximately 2:1 [males n = 174 (intervention n = 101; control = 73) while females n = 91 (intervention n = 60; control n = 31)], and cardiac as well as non-cardiac comorbidities including psychiatric diagnosis have been reported. The array of therapies ranged from education on anxiety and depression management skills to a combination of CBT and supportive stress management (SSM), and psychoeducational interventions paired with physical therapy. Results indicated that both CBT and SSM led to improvements in anxiety and depression symptoms, accompanied by reduced hospital stays, decreased hopelessness, lower scores in dysmorphic mood and irritability, lowered perceived cognitive impairment and stress, and increased satisfaction with therapy. The cognitive behavioral therapy demonstrated commendable feasibility, acceptability, safety, and efficacy, with some concerns raised about potential issues of low adherence.

This systematic review emphasizes the positive impact of CBT on depression, anxiety, and quality of life in individuals post-CABG surgery. Future studies should adopt standardized CBT protocols, comprehensively evaluating CBT's influence on overall patient prognosis, considering cardiovascular outcomes across diverse ethnic groups, exploring cost-effectiveness, and specific patient cohorts that could benefit the most from CBT interventions.

This study aims to illuminate the prevalence of various behavioral addictions among health professions students and examine their negative effects on mental health.

In March 2023, a systematic literature search was conducted, encompassing randomized controlled trials, cohort, case-control, and cross-sectional studies from the past five years in PubMed and ScienceDirect. Adhering to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, 19 papers underwent qualitative analysis, while 15 studies were subjected to quantitative analysis following a quality assessment review.

The study included 9,994 health professions students, primarily in the field of medicine, aged between 18 and 23 years. The majority of the students were unmarried, females, and most were in clinical years. The prevalence of behavioral addiction was 36% (95% CI: 20–51), with smartphone addiction being the highest at 46%, followed by internet addiction (42%), social media disorder (22%), and gaming disorder (4%). Substantial heterogeneity was observed among the studies. A funnel plot analysis assessed the potential for publication bias, revealing no significant indication of bias. A significant difference was observed between the groups.

This study identifies five distinct forms of behavioral addictions influencing the mental health and daily activities of health professions students. The findings underscore the need for longitudinal and interventional studies to address this technological threat.

This study aimed to determine the prevalence of irritable bowel syndrome (IBS) among medical students at Khartoum University and to examine its association with generalized anxiety disorder (GAD).

This cross-sectional study was conducted between December 2020 and February 2021, using the Rome IV criteria to diagnose IBS and a 7-item generalized anxiety disorder (GAD-7) scale to assess GAD. A total of 395 self-administered questionnaires were distributed using proportional allocation based on percentages of students in each academic year and their gender. Simple random sampling was used to select participants. The analysis was done using SPSS, and a p-value of <0.05 was considered significant.

We included 325 medical students with a mean age of 21.4 ± 2.2 years, and 69.5% females and 30.5% males. The overall prevalence of IBS was 16.6%, with the most common subtype being IBS-M (35%), followed by IBS-D (31%), IBS-C (28%), and IBS-U (6%). The prevalence of GAD was 22.8%, and anxiety was detected in 54.5% of students. 7.7% of students had both IBS and GAD, and there was a statistically significant relationship between IBS and GAD (Chi-square = 20.385; p < 0.001).

The study findings aligned with previous literature underscoring the prevalence of IBS and GAD among medical students at Khartoum University. Also, sheds light on a substantial association between them. Providing psychological support and stress management programs to medical students is paramount and key to a favorable prognosis.

This study sought to assess and compare the psychological well-being of both children and adults with cleft lip and palate (CLP) in contrast to those without CLP. The focus was on self-satisfaction regarding facial appearance, popularity among peers, and self-esteem.

This study was registered at the University of Dundee, including various study designs such as randomized controlled clinical trials, longitudinal, cross-sectional, and observational studies. Only studies concentrating on non-syndromic CLP in children and adults were considered. No limitations were set on age or language. Self-reports, including validated and unvalidated questionnaires, interviews, and observational/clinical assessments, were deemed suitable. Database searches were performed in Medline, Pubmed, Scopus, Cochrane, and Web of Science (January 2019). An electronic search yielded 334 results, with 74 articles meeting the inclusion criteria. After screening and risk of bias assessment, four articles were included in the qualitative analysis, three of which were included in the meta-analysis.

The review encompassed four studies conducted in China, Japan, Sweden, and the United States, involving 442 participants (non-CLP control group n = 305, CLP group n = 137). While the majority of individuals with CLP did not exhibit significant psychological issues, certain challenges were noted, particularly concerning speech or hearing difficulties, depression, anxiety, and interpersonal relationships. Age did not seem to correlate with the occurrence or severity of psychological problems in CLP patients, with gender playing a significant role, as females tended to be more sensitive to facial appearance. The level of self-satisfaction was not statistically significant between the two groups (OR = 0.85) while the non-CLP group was more likely to rate themselves as being more popular among their peers (OR = 1.48). Also, the non-CLP group has higher self-esteem than CLP patients (OR = 1.05).

Limited evidence suggests that some individuals with cleft lip and palate may face psychological challenges, indicating a need for more structured approaches to assess the psychological well-being of CLP patients.

Autism Spectrum Disorder (ASD) poses unique challenges for social interaction and communication skills development in children. Various interventions, including virtual reality (VR) and social skills training, have emerged as potential approaches to address these challenges. This systematic review aims to evaluate and compare the effectiveness of VR Social Skills Training with Standard In-Person Social Skills Training in improving social interaction skills and reducing social anxiety levels in children with ASD.

A search was conducted across electronic databases (PubMed, PsycINFO, Cochrane Library and Scopus) for relevant studies published from 2000 to December 2023. Inclusion criteria include randomised controlled trials (RCTs) and observational studies comparing VR Social Skills Training with Standard In-Person Social Skills Training in children diagnosed with ASD within the specified age range. Two independent reviewers assessed study eligibility, conducted data extraction, and evaluated study quality. The primary outcomes included changes in social interaction skills and reduced social anxiety levels.

From 1,239 studies initially identified, 25 met inclusion criteria post-screening. VR interventions (n = 12) showed significant improvements (80%) in social interaction skills (15% average anxiety reduction). Varied platforms were utilised, including virtual social scenarios. Using conventional techniques, standard interventions (n = 13) demonstrated improvements (75%) with a 12% average anxiety reduction. Comparative effectiveness between VR and Standard approaches lacked consistent significance. Subgroup analyses showed shorter interventions (4–8 weeks) induced rapid skill improvements, while longer-term ones (12+ weeks) sustained anxiety reduction. Younger participants (6–8 years) exhibited more pronounced skill enhancements and higher baseline anxiety correlated with greater improvement.

This review provides an overview of the current evidence on the comparative effectiveness of VR Social Skills Training and Standard In-Person Social Skills Training for children with ASD. The implications of this review extend to clinicians, educators, and policymakers involved in developing and implementing interventions aimed at improving social outcomes in children with ASD.

The Central Mental Hospital is the Republic of Ireland's only secure forensic hospital and the seat of its National Forensic Mental Health Service (NFMHS). We scrutinised admission patterns in the NFMHS during the period 01/01/2018–01/10/2023; before and after relocating from the historic 1850 site in Dundrum to a modern facility in Portrane on 13/11/2022.

This prospective longitudinal cohort study included all patients admitted during the above period. The study initially commenced in Dundrum and continued afterwards in Portrane. Data gathered included demographics, diagnoses, capacity to consent to treatment, and the need for intramuscular medication (IM) after admission. Therapeutic security needs and urgency of need for admission were collated from DUNDRUM-1 and DUNDRUM-2 scores rated pre-admission. Hours spent in seclusion during the first day, week, and month after admission were calculated. Data were collected as part of the Dundrum Forensic Redevelopment Evaluation Study (D-FOREST).

There were 117 admissions during the 69-month period. The majority were male (n = 98). Most were admitted from prisons (87%). Schizophrenia was the most common diagnosis (55.8%). Mean DUNDRUM-1 triage security scores were in the medium-security range (2.84–3.15) during this period. At the time of admission, 53.8% required seclusion, 25.6% required IM medication, and 79.5% lacked capacity to consent to treatment. Those who required seclusion on admission had worse scores on the DUNDRUM-2 triage urgency scale (F = 20.9, p < 0.001). On linear logistic regression, the most parsimonious model resolved with five predictors of hours in seclusion during the first day and week, which were: D1 item 8 – Victim sensitivity/public confidence issues, D1 item 10 – Institutional behaviour, D2 item 2 – Mental health, D2 item 4 – Humanitarian, and D2 item 6 – Legal urgency. 50% required IM medication during their first week of admission and these patients had significantly worse scores on: D1 item 8 – Victim sensitivity/public confidence issues, D1 item 10 – Institutional behaviour, D2 item 2 – Mental health, and D2 item 4 – Humanitarian (all p < 0.05).

There was an increase in the frequency of admissions since relocating to Portrane. The results suggest that there was no change in overall triage security and urgency needs during the time period in question. Major mental illness related factors impacted the need for seclusion early in the admission, whereas factors linked to prison behaviour or personality-related factors were more associated with an ongoing need for seclusion at month one.

The primary aim of this rapid review was to evaluate the evidence base for the efficacy of ketamine across all formulations and routes of administrations in the treatment of adult patients with treatment resistant depression (TRD).

This rapid review retrieved controlled trials on use of ketamine across all of its formulations, including all isomers and across all routes of administration in TRD patients for achieving response and remission. This review included PubMed and PsycINFO databases. The retrieved studies were screened with the help of a screening tool and data were extracted by using data extraction forms by two authors. The studies were evaluated for quality of evidence, ethical issues and critically analyzed. Narrative synthesis was used for data synthesis.

This review retrieved 10 placebo controlled randomized controlled trials (RCT) on intravenous (IV) ketamine, IV esketamine, intranasal (IN) ketamine and IN esketamine in TRD patients. IV ketamine and esketamine showed higher rates of remission and response in comparison with placebo groups in TRD patients. There was no significant improvement in response and remission rates in TRD patients on IN esketamine in comparison with placebo. The adverse effects in the intervention groups were of mild to moderate severity and short lasting mostly resolving within a day.

This review recommends IV ketamine and esketamine can help in achieving early response and remission in TRD patients and it seems to be a well-tolerated treatment option. Further studies are needed to assess these issues around safety, ease of administration and potential for dependence.

Dementia is a debilitating neurodegenerative disorder that can negatively impact the lives of those affected and their families. Providing safe and person-centered care for individuals living with dementia is a global need with particular emphasis on providing individuals and their families with a rapid diagnosis of their condition following the commencement of symptoms. This study aimed to establish the mean duration of cognitive symptoms before a formal diagnosis of dementia is given in the United Arab Emirates (UAE). We also studied demographic and symptom-specific factors affecting the time for dementia to be formally diagnosed. Our study examined a global issue through a more localized lens to identify areas for improvement.

The study involved extracting and analyzing anonymous data from the electronic medical records of dementia patients at Al-Ain Hospital, UAE. Following ethical approval, the data for individuals diagnosed with any form of dementia from 01/01/2010 to 31/12/2019 were extracted using a set of related diagnostic codes. A short questionnaire was completed for every record that matched the search criteria. Demographic information was collected in addition to details of diagnosis, presenting symptoms, comorbidities, and medications.

A two-tailed independent t-test was conducted to assess the effect of demographic characteristics (gender, nationality, and age) on the time to receive a diagnosis of dementia. A one-way ANOVA was conducted to assess the effect of initial symptoms, including forgetfulness, agitation/aggression, and hallucinations, on the time taken to receive a diagnosis.

Out of the total sample of 825, 442 (53.6%) were females, with 518 (63%) being Emirati citizens. The mean age of the studied sample at the time of diagnosis was 78 years (SD = 11.1). Alzheimer's dementia, 335 (40.6%), was the most common subtype diagnosed. The mean duration of symptoms (DUS) before formal diagnosis was 34.6 months (SD = 28.8). A statistically significant relationship was found between age and DUS, with those over 70 years of age at the time of diagnosis more likely to have a longer DUS (p < 0.001). There was a statistically significant mean difference in the DUS and some initial symptoms, namely agitation/aggression(p < 0.001), lability (p < 0.003), disinhibition (p < 0.001), and hallucinations (p < 0.001).

To our knowledge, this is the first study of its kind in the UAE. Future investigation in this area is much needed, and this study will provide the foundations for dementia awareness campaigns encouraging early presentation to the services.

No financial sponsorship has been received for this study.

Depression disorder is a major public health problem and a serious medical illness which negatively affects people's daily life. The WHO's International Classification of Diseases (ICD–10) defines this set of disorders ranging from mild to moderate to severe. Estimated annual percentage change (EAPC) is a useful statistic that is used to measure trends in rates over time-period.

The aim of this study was to compute the drift in depression prevalence disorder using the EAPC of the prevalence of depression disorder between 1990 to 2019 with corresponding 95% confidence intervals (95% CI) across the GCC countries.

Prevalence of depression disorder data for the GCC countries were downloaded from “Our World in Data” https://ourworldindata.org/mental-health#depression. We computed the drift of depression over 30 years between the 6 GCC countries using the statistical software R.

The greatest decrease was seen for Bahrain which is (–5.2%) followed by Qatar (–3.2%) and United Arab Emirates (–3%). However, the largest increase was observed for Saudi Arabia (2.7%), followed by Kuwait (1.1%) and Oman (0.7%). The reduction in the prevalence of depression disorder seen in Bahrain, Qatar and United Arab Emirates shows a significant achievement in mental health diagnosis, prevention, and treatment.

However, further studies are required to better understand the drifts in the GCC countries. Furthermore, governmental funding for academic and research mental health programs is highly recommended.

In most populations, the prevalence of depression is more significant in women than in men. Nonetheless, the degree of gender disparity varies significantly across countries. The aim of this study is to consider the role of gender inequality in explaining these differences in the Gulf Cooperation Council (GCC) countries.

Data on the ecological prevalence of depression (males versus females) from 1990–2019 from the GCC countries were downloaded from Our World in Data and included in the statistical analysis. A mixed-effects linear model was used to examine the association between males and females, i.e. females regress on males. Year and country variables were used as random effect variables.

The prevalence of depression in the GCC countries shows a gender-specific pattern with a higher prevalence in females than in males 1.218 (95% CI: 1.149–1.285), p-value < 0.001. Higher levels of depression between men and women were observed in Kuwait and Saudi Arabia compared with the other four countries. The lowest depression prevalence was observed in the United Arab Emirates.

The pattern of depression in the GCC countries is based on gender. However, the association between global measures of gender inequality and the gender gap in depression may depend on how the level of depression is measured. More research is needed to investigate the mechanisms that underlie the gendered nature of depression prevalence.

The evidence for the association between vitamin-D deficiency and depression, although equivocal, has been established in several populations in different countries and supported by meta-analytical studies1. Much of the evidence for this comes from Western countries2. Similarly, the evidence for the benefits of supplementation, although shown, also comes from similar populations and is equivocal3. Need for data from different populations and for randomized controlled trials to establish causality is stressed by most researchers. This study aims for presentation reviews of the association between vitamin-D and depression in the GCC, using the publicly available data of Our World in Data.

The statistical analysis used median prevalence depressive disorders data (from 1990–2019) in the GCC countries (both sex and age-standardized (%)), which was downloaded from Our World in Data and was last updated on August 28, 2022. Vitamin D deficiency data were collected through a literature review search using PubMed and Google Scholar. A linear regression model was performed with the median prevalence of depressive disorders data as an outcome. The prevalence of vitamin-D deficiency, population median age and the interaction term between prevalence of vitamin-D deficiency and population median age were used as predictors. The effects of prevalence of depressive disorders both sex age standardized (AS) percentage (%) were estimated with 95% confidence interval (95% CI) using bootstrap covariance matrix estimator. Fitted model's likelihood ratio chi-square (LR χ2) test with corresponding p-value was computed and reported.

A positive association was observed between the median prevalence of depressive disorders and the prevalence of vitamin-D deficiency, adjusted for population median age, were observed (LR χ2 p-value = 0.005) and adjusted R2 = 0.706.

Prevalence of depressive disorders was associated with prevalence of vitamin D deficiency among the population of GCC countries. Future randomized control trials on Vitamin D supplementation are needed to confirm these observations.

The prevalence of emotional problems, such as depressive and anxiety disorders, increases sharply during adolescence. There is evidence for familial clustering of mental health problems during early childhood and adulthood, however no studies have investigated whether adolescent mental health problems cluster within families. This study tests the hypotheses that i) emotional problems during adolescence cluster within families, and that ii) conduct, peer and hyperactivity problems, prosocial behaviour and overall emotional and behavioural difficulties during adolescence also cluster within families.

We used cross-sectional data from a nationally representative survey of UK households, collected between 2019 and 2021, with 4,088 participants aged 10–16 years. Analyses included 1,241 participants who had complete outcome data and complete data on all covariates of interest. The Strengths and Difficulties Questionnaire (SDQ) was used to examine emotional problems, as well as conduct, peer and hyperactivity problems, prosocial behaviour and total difficulties. Multilevel modelling was used to: estimate clustering of i) emotional problems and ii) conduct, peer and hyperactivity problems, prosocial behaviour and total difficulties, within families, after adjusting for several individual- and family-level covariates associated with adolescent mental health problems (including individual and family demographics, school and sibling bullying, quality of parent-child relationship, parent mental health and parent romantic relationship satisfaction).

After adjusting for known covariates of adolescent mental health problems, there was substantial clustering of adolescent emotional problems (ICC: 0.439; CI95%: 0.36–0.52; SE: 0.042) and overall adolescent emotional and behavioural difficulties (ICC: 0.417; CI95%: 0.34–0.50; SE: 0.043) within families. There was also evidence of clustering of adolescent peer problems (ICC: 0.374; CI95%: 0.28–0.48; SE: 0.051), hyperactivity (ICC: 0.332; CI95%: 0.25–0.42; SE: 0.044), prosocial behaviour (ICC: 0.263; CI95%: 0.18–0.37; SE: 0.048) and conduct problems (ICC: 0.232; CI95%: 0.14–0.35; SE: 0.053) within families after adjustment.

We found strong evidence that adolescent emotional problems cluster within families even after accounting for individual- and family-level covariates which are associated with adolescent mental health problems. Over 40% of the variation was accounted for at the family level. This indicates how the contextual characteristics of the family environment may influence the mental health of young people. As such, social policy aiming to prevent or improve the mental health of young people should focus on family context.

The younger generation of today is highly dependent on digital technologies worldwide. Studies on young children's cognitive and socio-emotional development have shown that there can be conflicting effects from using screen-based media or from exposing them to it. The study explored the relation between unsupervised use of digital screen time with student mental health and behavioral problems.

It was a cross sectional descriptive study approached primary and secondary school going children from grades 2–8 (age 6 to 14 years), purposively selected six schools consist of three English and Bangla medium schools from Dhaka city. A total of 420 students along with their parents were enrolled by clustered random sampling. Study explored the effect of the unsupervised screen time on student mental health and social wellbeing through semi structured questionnaires, Strength and Difficulties Questionnaire (SDQ), Pittsburgh Quality of Sleep Scale (PSQI), Spencer Children Anxiety Scale (SCAS) and Development and Wellbeing Assessment Scale (DAWBA).

Students used various forms of digital screens for 4.6 hours every day, and 56% of them used these devices without parental supervision or monitoring. English Medium students spend significantly more time on screens on a daily average (5.5 hours) compared with students at Bangla Medium schools (3.7 hours). 21.2% students had mental health concern, this percentage was higher in the unsupervised group (56.2%) than in the supervised group (43.8%). In the unsupervised group, students experienced higher levels of emotional difficulties (15.7%), behavioral difficulties (28.3%), hyperactivity behavior difficulties (17.4%), peer relations difficulties (28.8%), and pro-social behavior difficulties (6.7%) compared with supervised group. 83.3% of students in the supervised group found higher levels of anxiety compared with the unsupervised group (16.7). In the unsupervised group, 15.4% of the students had experienced sleeping problems, compared with 14% in the supervised group.

These results suggest an impact of unsupervised screen time on the prevalence of mental health problems among students. Appropriate screen usage may be a major intervention target to improve children's mental health and wellbeing.

To investigate if estrogen agents as an adjunct to antipsychotic medication are effective at treating psychosis in post-and perimenopausal females.

A digital search focusing on controlled clinical trials was conducted. Studies were assessed for quality using the Cochrane Risk of Bias tool and GRADE system. The Joanna Briggs Institute (JBI) tools were used to critically appraise articles. The total Positive and Negative Symptom Scale (PANSS) scores were synthesised using a meta-analysis.

Of the studies obtained (n = 11), two used estrogen HT as an augmentation agent, and nine used the SERM Raloxifene. Quality review and critical appraisal found inconsistencies in data and publication bias favouring trials that include Raloxifene. Meta-analysis results indicate Raloxifene plus antipsychotic did perform better than placebo [Std diff in means total = 0.340 (95% CI) p = 0.001] with a small effect size (g = 0.3392).

Though research appears promising, recommendations for the use of estrogen agent augmentation cannot be made at this time as more clinical trials that include a diverse range of treatments are needed.

Individuals with psychosis experience impairments in real-world functional outcomes such as employment and health. Rare copy number variants (CNVs) are established risk factors for psychosis, neurodevelopmental disorders and cognitive impairment. However, little is known about their effect on real-world functional outcomes in individuals with psychosis.

I aimed to establish the effect of rare neurodevelopmental CNVs on real-world functioning in individuals with psychosis.

I identified 1,932 individuals with psychotic disorders (ICD–10 F20–F29) in the UK Biobank using first-occurrence data (from primary care, hospital inpatient and death register records and self-reported conditions). I mapped UK Biobank data to two domains of real-world functional outcomes – health deficits and vocational outcomes. We previously called CNVs using PennCNV, annotating them with 53 CNVs associated with autism spectrum disorder and developmental delay. I conducted regression analyses with neurodevelopmental CNVs as the predictor, real-world functioning as outcomes and with relevant covariates (e.g. age and sex).

Out of 1,932 individuals with psychotic disorders, 2.5% (n = 49) carried a neurodevelopmental CNV.

Health Deficits

I used first-occurrence diagnosis data to establish comorbid psychiatric diagnoses. I summed these diagnoses and dichotomised them into one or more comorbid diagnoses versus no comorbid psychiatric diagnoses. I conducted a logistic regression analysis – neurodevelopmental CNV carrier status was associated with having at least one psychiatric diagnosis in addition to a psychosis diagnosis (OR 2.1, 95% CI 1.1 - 4.1, p 0.034). Post-hoc analyses revealed an increased rate of dissociative and conversion disorders in CNV carriers (OR 4.5, 95% CI 1.26 - 15.99, p 0.021).

I used first-occurrence physical health diagnosis data to establish the burden of the 20 most prevalent chronic non-cancer illnesses. Neurodevelopmental CNV carrier status was associated with chronic physical health multimorbidity in individuals with psychosis (59.2% vs 43.5%, OR 2.30, 95% CI 1.27–4.17, p 0.006), defined as the presence of two or more chronic physical health conditions.

Vocational Outcomes

I conducted an ordinal regression analysis, establishing that among individuals with psychosis, CNV carriers had a lower likelihood of achieving a higher qualification (OR 0.45, 95% CI 0.27–0.77, p 0.003).

Neurodevelopmental CNVs are associated with important real-world functional outcomes in individuals with psychosis. This work provides information that can guide the assessment and management of individuals with both psychosis and neurodevelopmental CNVs.

Psychiatrists frequently diagnose mood disorders in children. However, there is a limited understanding of clinical history and phenomenology of mood disorders in these phases of lifespan, and phenomenological variations in those with and without neurodevelopmental disorders (NDD). The primary objective of the study was to study, comparatively, the phenomenology in children clinically diagnosed with mania, depression and mixed affective disorder. The second objective was to study the phenomenological differences in diagnosed cases of mood disorder children with and without neurodevelopmental disorders.

We conducted a semi-qualitative study of the clinical history and phenomenology in 120 children recruited from a tertiary care child and adolescent psychiatry service. Children with current diagnosis of depression, mania or mixed affective state, age less than 18 years, and appropriate consent/assent were included. Children with comorbid neurological disorders, any underlying organicity, or those currently in remission from their mood episode were excluded. Descriptive summaries were calculated for socio-demographic, clinical and phenomenological data. Chi Square test was used to examine statistical differences in prevalence of various phenomena across the clinical diagnostic groups.

The most common clinical diagnosis was depression (58.3%) followed by mania (25.8%) and mixed affective state (15%). Irritable mood and emotional dysregulation were equally distributed among the three diagnostic groups. With a high prevalence of comorbid NDDs in the sample, we compared phenomena between groups with and without NDDs. In cases of depression, suicidal ideas and guilt feelings were expressed in 61% and 80% of these participants without comorbid NDD (n = 45) respectively, which was significantly high as compared with those with NDD (n = 67). The symptoms of disinhibition (78.9%), impulsivity (84.2%) and emotional dysregulation (10.5%) were more frequently seen in participants with neurodevelopmental disorder. Dissociative and obsessive phenomena were present in about a quarter of our study sample, similarly across mania, depression and mixed state.

Mental status examination of mood disorders in children suggests considerable phenomenological overlap with irritable mood, emotional and behavioural dysregulation, dissociative symptoms, obsessive symptoms, sleep disturbances, nightmares and hyperarousal seen in mania, depression and mixed states. These phenomena may, therefore, not be suitable in differentiating these clinical diagnoses. Children with NDDs may report lesser cognitive phenomena of depression, and the clinician may have to rely on the affective and behavioural manifestations of depression in clinical decision-making.

To quantify and evaluate the gender differences regarding the development of PTSD. This meta-analysis calculates (a) the difference between males and females who develop PTSD, and (b) the difference in gendered relative risk of PTSD development.

Study selection criteria included participant mean age above 18 years, single and direct exposure to a terrorism related traumatic event, and a confirmed diagnosis based on Diagnostic and Statistical Manual of Mental Disorders 5th edition. Data extraction included year and location of terrorist event, the total number of participants in the study, the total numbers of males and females diagnosed with PTSD, and time (in months) of diagnosis following the traumatic event. The number of males and females affected by PTSD was pooled using random effects inverse variance weighted meta-analysis and relative risks (95% confidence interval) were calculated.

Twenty-seven studies met the inclusion criteria of which five had significant information to be included in the meta-analysis. The total number of males in the pooled sample size was 328, and the total number of females was 354 out which a total number of 34 males and 66 females met the PTSD criteria. The mean average of males and females affected by PTSD was 6 and 11, respectively. An independent samples Mann Whitney U test rejected the null hypothesis (p < 0.05) and concluded that the distribution of PTSD between males and females was significantly different. The meta-analysis found an overall relative risk of a diagnosis of PTSD in females to be 1.82 (95% CI 1.25–2.65) compared with males.

This meta-analysis found females to have an elevated risk of developing PTSD following a single terrorism traumatic event. The results of our study are supported by previously published research, which has found females to be at higher risks of developing PTSD. However, such research has proposed gender differences secondary to the types of stressful events experienced, which does not apply to our meta-analysis given the uniformity of the traumatic event we explore. Other factors, therefore, need investigating to understand this phenomenon.

We acknowledge that researching psychological consequences in communities affected by terrorism is complicated and limited by lack of healthcare access, trained clinicians, cultural diversity in the expression and articulation of a community's traumatic experience and of course, the instability of the ground fabric. Other limitations of the included studies are the binary of gender reporting, which limits a fuller understanding of a minoritized community.

This study aimed to analyse contributory factors to serious incidents (SIs) involving adult patients with intellectual disabilities receiving NHS care in a mental health trust. People with intellectual disabilities face considerable preventable harm and disparities in care. In-depth analysis of contributory factors to incidents involving adults with an intellectual disability, using human-factors based frameworks is lacking. Individual SI reports contain useful data, but learning is often limited without aggregated analysis.

Thirty anonymized serious incident reports (2014–2023) from an NHS mental health Trust's intellectual disability service were analysed qualitatively using the Yorkshire Contributory Factors Framework, followed by reflexive thematic analysis (RTA) to identify patterns across the data. This enabled nuanced themes to emerge across errors at the sharp end and systems-level factors at the blunt-end.

Across 30 reports, 606 discrete factors were identified. Situational factors such as behavioural escalations and staff competency gaps were most frequent (n = 187, 31%). Other factors included active failures, such as slips, lapses, mistakes, violations (n = 109, 18%), organisational influences (n = 107, 18%), communication breakdowns (n = 75, 12%), unfavourable working conditions (n = 62, 10%), cultural factors such as reluctance to voice safety concerns (n = 51, 8%), and external system factors (n = 15, 2%).

Using RTA, we identified recurring themes across incidents involving interactions between sharp-end human and blunt-end system factors, with broader issues shaping frontline performance. Patient marginalisation, excessive workloads, lack of resources, and cultures tolerant of shortcuts aligned to permit errors. Deficient coordination across fragmented healthcare systems and overdependence on non-permanent workers and bank staff obstructed comprehensive incident reviews. Failure to adequately probe cultural influences and external pressures further reflect the limited extent of investigational efforts.

Adults with intellectual disabilities are subject to serious incidents caused by interacting human and system-level factors, including organisational, cultural and external factors. Addressing under-resourcing and improving investigation quality are paramount to enhancing safety of care for people with intellectual disabilities.

The course of post-traumatic stress disorder (PTSD) is complex and remains an area of active investigation, as analyses aimed at identifying predictors of PTSD outcomes often produce variable and inconsistent results. This particular study delves into the progression and patterns of PTSD over a two-year period, focusing on individuals who are in the recovery phase from severe physical injuries. The research aims to understand the different trajectories that PTSD can take and to identify the factors that may influence these pathways, with the goal of enhancing our understanding and treatment of this challenging and multifaceted condition.

Patients were recruited from a trauma center at a university hospital in South Korea between June 2015 and January 2021. At baseline, 1142 patients underwent evaluations encompassing trauma and PTSD-related measures, socio-demographic characteristics, pre-trauma characteristics, and peri-trauma assessments. They were subsequently followed up for PTSD using the Clinician-administered PTSD Scale (CAPS) at 3, 6, 12, and 24 months. The analyzed sample consisted of 1014 patients who were followed up at least once after the baseline and 3-month evaluations. Latent class growth analysis was employed to identify distinct trajectory groups, and logistic regression models to ascertain predictors associated with each trajectory.

The study identified five unique trajectories of PTSD progression among the patients: resilient, worsening/recovery, worsening, recovery, and chronic groups. The "worsening/recovery” trajectory, which indicates patients whose symptoms initially worsened but later improved, was predominantly associated with individuals who had experienced previous traumatic events and those who had sustained injuries from traffic accidents. On the other hand, the "worsening” trajectory, where patients' symptoms continuously deteriorated over time, was linked to individuals with higher education levels and elevated depressive symptoms. The "recovery” trajectory, characterized by a gradual improvement in symptoms, was more common in female patients and those with a history of childhood abuse, traffic-related injuries, a dissociative subtype of PTSD, and higher levels of anxiety and depressive symptoms. Lastly, the "chronic” trajectory, where patients experienced persistently severe symptoms, was predicted by the presence of a dissociative subtype of PTSD and heightened anxiety symptoms. These findings illustrate the diverse paths PTSD can take and highlight the importance of various factors in influencing these trajectories.

These findings highlighted the heterogeneity of PTSD symptom development and thus the importance of considering individual characteristics when assessing and addressing PTSD following severe physical injuries.