A diagnostic label can have harms and benefits, particularly when provided following routine health screening tests. Whether these are discussed in clinical encounters is unknown.

To investigate whether potential impacts of diagnostic labelling are discussed before routine screening for non-cancer health conditions and explore the perceived value of such discussions by general practitioners (GPs) and healthcare consumers.

Eleven semi-structured interviews with GPs and two focus groups with eight consumers were conducted. Interviews and focus groups were audio-recorded, transcribed and analysed using thematic analysis methods based on framework analysis.

Prior to routine screening, most GPs did not discuss the potential consequences of diagnostic labelling, and no consumer recalled discussions of this nature. In contrast, many GPs provided information regarding the screening procedure and possible test limitations. Both GPs and consumers identified that it would be valuable to discuss the potential impacts of a diagnostic label; however, preferences varied as to the content and timing (i.e. before or after screening) of this discussion. Six themes that examine the utility of discussing the consequences of diagnostic labelling were identified: patient empowerment, patient variability, condition-specific information, GP and patient interactions and relationship, GP role and responsibilities, and characteristics of screening.

The practice and perceived value of discussing diagnostic labelling consequences were recognised as important by both GPs and consumers. However, preferences regarding the content of discussions and whether these occurred in clinical encounters before or after screening varied.

There is a need for developmentally tailored intervention approaches that empower parents to respond to adolescent school refusal in the context of internalising disorders. Partners in Parenting Plus-Education (PiP-Ed+) is a manualised coach-assisted online parenting programme that has been co-designed with parents, youth and education-sector experts to fill this gap. It addresses multiple parenting factors associated with adolescent school refusal and internalising disorders.

This study aimed to evaluate the acceptability, feasibility and preliminary indications of efficacy of PiP-Ed+.

An open-label, uncontrolled trial was conducted using a mixed-methods design. Participants were 14 Australian parents of adolescents (12–18 years) who had refused school in the context of internalising disorders.

PiP-Ed+ was viewed as highly acceptable and feasible. Coaching sessions in particular were perceived as valuable and appropriate to the parents’ level of need, although longer-term support was suggested to sustain progress. Between baseline and post-intervention, there were significant increases in parents’ self-efficacy to respond to adolescent school refusal and internalising problems, and concordance with evidence-based parenting strategies to reduce adolescent anxiety and depression. Days of school refused and carer burden did not change.

Findings support the value of proceeding to evaluate the efficacy of PiP-Ed+ in a randomised-controlled trial. Results are interpreted in the context of study limitations.

Loneliness and social isolation pose significant public health concerns globally, with adverse effects on mental health and well-being. Although the terms are often used interchangeably, loneliness refers to the subjective feeling of lacking social connections, whereas social isolation is the objective absence of social support or networks.

To investigate the prevalence of loneliness and social isolation and their associations with psychiatric disorders.

This study used data from the Republic of Korea National Mental Health Survey 2021, a nationally representative survey. A total of 5511 adults aged 18–79 residing in South Korea participated in the survey. Loneliness and social isolation were assessed using the Loneliness and Social Isolation Scale, whereas psychiatric disorders were evaluated using the Korean version of the Composite International Diagnostic Interview. Multivariate logistic regressions were performed after adjustment for sociodemographic variables.

Among the participants, 11.8% reported experiencing loneliness, 4.3% reported social isolation and 3.4% reported both. Co-occurrence of loneliness and social isolation was significantly associated with psychiatric disorders (adjusted odds ratio (AOR) 7.59, 95% CI: 5.48–10.52). Loneliness alone was associated with greater prevalence and higher probability of psychiatric disorders (AOR 3.12, 95% CI: 2.63–3.71), whereas social isolation did not show any significant association (AOR 0.88, 95% CI: 0.64–1.22).

The co-occurrence of loneliness and social isolation is particularly detrimental to mental health. This finding emphasises the need for targeted interventions to promote social connection and reduce feelings of isolation.

International students account for a growing proportion of university students and can experience mental health challenges. While the Social Identity Model of Identity Change (SIMIC) highlights the mental health-promoting benefits of preserving and building group memberships, it overlooks the effects of identifying with a particularly salient group such as fellow international students.

This study aimed to explore how SIMIC and international student identification contribute to understanding the protective factors that predict students’ mental health.

A cross-sectional survey of 343 international students employed path analyses to examine the associations among identification with fellow international students, social identity maintenance, new group memberships and psychological distress, with social support and resilience as potential mediators. Indirect effects were evaluated using 95% confidence intervals.

New group memberships (β = −0.01; P = 0.05; 95% CI = −0.03, −0) and identification with international students (β = −0.02; P = 0.05; 95% CI = −0.02, −0) predicted psychological distress, both mediated by social support and resilience. While the maintenance of previous groups did not indirectly predict psychological distress through these mechanisms (β = −0.01; P = 0.13; 95% CI = −0.02, 0), a significant indirect effect (β = −0.04; P = 0.03; 95% CI = −0.09, −0) was observed through social support when accounting for covariates.

Shared international student identity and new group memberships offer a sense of social support and resilience which, in turn, alleviates psychological distress. Interventions could reframe this identity as a source of strength for international students.

Studies have reported conflicting findings on the association between maternal pre- and perinatal depression and autism spectrum disorder (ASD) in offspring.

To examine and consolidate the existing evidence on the association between maternal pre- and perinatal depression and the risk of ASD in children and adolescents.

In this systematic review and meta-analysis, we searched PubMed, Medline, EMBASE, Scopus, CINAHL and PsycINFO from the database inception to 21 February 2024. A meta-analysis was performed using random-effect models, and summary effect estimates were presented as odds ratios with 95% confidence intervals. Heterogeneity was assessed with Cochran’s Q and the I2-statistic test. Additionally, subgroup analysis was conducted to identify the source of potential heterogeneity within the included studies. A funnel plot and Egger’s regression test were employed to evaluate publication bias.

Twelve studies involving over 1.6 million mother–offspring pairs were included in the final analysis. A random-effects meta-analysis of these studies revealed a 52% increased risk (odds ratio 1.52, 95% CI 1.13–1.90) of ASD in the offspring of mothers experiencing pre-pregnancy depression, a 48% increased risk (odds ratio 1.48, 95% CI 1.32–1.64) in those experiencing antenatal depression and a 70% increased risk (odds ratio 1.70, 95% CI 1.41–1.99) in those with postnatal depression.

This systematic review and meta-analysis found that offspring born to mothers with depression before, during and after birth have a higher risk of developing ASD. Our findings underscore the need for early screening and targeted intervention programmes for at-risk children.

It is now accepted that social factors affect not only onset but also mental health treatment outcomes. One such factor is financial difficulty. Within National Health Service (NHS) Talking Therapies, problem debt has been shown to interfere significantly with recovery from mental health problems, estimated as 22% versus 50% recovered with no problem debt. One solution is a combined money advice and psychological therapy intervention to improve treatment outcomes.

The aim of the current study was to trial a combined money advice and psychological therapy service within NHS Talking Therapies, to ascertain its feasibility and acceptability.

This study employed a mixed methods case series of individuals attending high-intensity cognitive–behavioural treatment who were provided with a combined intervention (money advice service plus NHS Talking Therapies). Acceptability and feasibility were evaluated through interviews, and benefit was assessed from comparisons of routinely collected symptom measures and compared to historical recovery estimates.

Some 32 participants, with similar gender distribution but more representation from ethnic minorities, were recruited from NHS Talking Therapies. One-third demonstrated complete recovery on both depression and anxiety, while half showed symptom improvement and modest improvements on the financial outcomes measure. Our interviews with patients, therapists and money advisors suggested the combined intervention was acceptable and beneficial, but that money worries should be identified earlier.

The combined service is acceptable, accessible and could deliver benefit, even in the short term, to those with mental health and debt problems.

A minority of earthquake-exposed individuals develop post-traumatic stress disorder (PTSD), often alongside comorbid depression and anxiety symptoms. No systematic review has examined psychological interventions for adults with substantial earthquake-related PTSD symptoms.

To synthesise studies evaluating psychological interventions for adult earthquake-related PTSD and conduct meta-analyses estimating overall effect sizes.

The review was pre-registered with PROSPERO (CRD42023441020). PsycINFO, MEDLINE, EMBASE, CINAHL and Scopus were searched for studies (last search conducted July 2024). Randomised controlled trials (RCTs), non-randomised and non-controlled studies evaluating psychological interventions for adults with substantial earthquake-related PTSD symptoms were eligible. Outcomes were PTSD, depression and anxiety symptoms. Narrative syntheses and meta-analyses summarised study findings. The Mixed Methods Appraisal Tool guided quality assessments.

Sixteen studies were identified (eight RCTs, four non-randomised and four non-controlled studies), representing 1315 participants receiving psychological intervention. Interventions included cognitive behavioural therapy (CBT), specific CBT variants, eye movement desensitisation and reprocessing, interpersonal psychotherapy and an internet-based intervention focusing on social cognitive theory. Studies generally reported statistically and clinically significant improvements associated with psychological interventions. Among studies included in meta-analyses, overall effect size was 2.11 (95% CI = 0.92, 3.31) for PTSD symptoms and 1.01 (95% CI = 0.50, 1.52) for depression symptoms.

Psychological interventions are associated with good outcomes among adults with earthquake-related PTSD. The most evidence currently exists for CBT-based interventions, which are recommended as first-line treatments. Efficient intervention options, including single-session and group-based treatments, also show promise and are recommended for addressing widespread treatment need.

The risk of cancers associated with psychiatric disorders is understudied.

To investigate whether cancer risk varies with the presence of psychiatric disorders.

Patients diagnosed with psychiatric disorders in South Korea between 1 January and 31 December 2017 were included in the study and referred to as the psychiatric disorder group. The non-psychiatric-disorder group, selected using a stratified random sampling technique based on age and gender, comprised individuals who had never been diagnosed with a psychiatric disorder. The primary outcome was a new cancer diagnosis, assessed over a 5-year period (1 January 2018 to 31 December 2022).

Following 1:1 propensity score matching, the final analysis included data for 686 570 adults (343 285 in each group). The cancer incidence in the psychiatric disorder group from 2018 to 2022 was 15.4% (52 948/343 285), whereas in the non-psychiatric-disorder group, it was 12.8% (43 989/343 285). Cox regression analysis revealed that the psychiatric disorder group had a 23% higher occurrence of cancer compared with non-psychiatric-disorder controls (hazard ratio: 1.23, 95% CI: 1.21, 1.24; P < 0.001). Significant associations between cancer incidence and specific psychiatric disorders were observed in individuals with alcohol-related disorders (hazard ratio: 1.27, 95% CI: 1.23, 1.32; P < 0.001), anxiety disorders (hazard ratio: 1.15, 95% CI: 1.14, 1.17; P < 0.001) and major depressive disorder (hazard ratio: 1.16, 95% CI: 1.15, 1.18; P < 0.001).

Individuals with psychiatric disorders were more likely to develop cancer than those without. We identified associations of alcohol-related disorders, anxiety disorders and major depressive disorder with cancer risk.

In the UK, around 1 in 4 adults over 65 years suffers from depression. Depression case finding followed by alerting patients and their general practioners (GPs) (screening + GP) is a promising strategy to facilitate depression management, but its cost-effectiveness remains unclear.

To investigate the cost-effectiveness of screening + GP compared with standard of care (SoC) in northern England.

Conducted alongside the CASCADE study, 1020 adults aged 65+ years were recruited. Participants with baseline Geriatric Depression Scale (GDS) ≥5 were allocated to the intervention arm and those >5 to SoC. Resource use and EQ-5D-5L data were collected at baseline and 6 months. Incremental cost-effectiveness ratio was calculated. Non-parametric bootstrapping was performed to capture sampling uncertainty. The results are presented using cost-effectiveness acceptability curves. Sensitivity analyses were conducted to assess the robustness of primary findings. Subgroup analyses were undertaken to examine the cost-effectiveness among participants with more comparable baseline characteristics across treatment groups.

Screening + GP incurred £37 more costs and 0.006 fewer quality-adjusted life years than SoC; the probability of the former being cost-effective was <5% at a £30 000 cost-effectiveness threshold. Sensitivity analyses confirmed the base-case findings. Subgroup analyses indicated that screening + GP was cost-effective when patients with baseline GDS 2–7, 3–6 and 4–5, respectively, were analysed.

Screening + GP was dominated by SoC in northern England. However, subgroup analyses suggested it could be cost-effective if patients with more balanced baseline characteristics were analysed. Economic evaluations alongside randomised controlled trials are warranted to validate these findings.

Former prisoners are a vulnerable population, and suicide rates among this group are high, particularly following release from prison.

To explore former prisoners’ engagement with mental health services before death by suicide, and to examine the demographics, clinical history and clinical care of this patient group and compare them with patients who died by suicide who had not been to prison.

The clinical, sociodemographic and care characteristics of patients in contact with mental health services who died by suicide in the UK were examined in a national clinical survey between 1 January 2001 and 31 December 2021, and comparisons were made between former prisoners and patients with no history of being in prison.

Of the 33 381 (median age 46 years, range 10–100; 65.6% male) patients who died by suicide in the UK and had been in contact with mental health services in the 12 months before death, 3335 (11%) were ex-prisoners (male n = 2988, 90%; female n = 347, 10%). Compared with other patients, ex-prisoner patients had higher frequencies of personality disorder, schizophrenia and delusional disorders, as well as childhood abuse. Ex-prisoner patients were more likely to be male, to be aged between 45 and 65 years (median age 39, range 17–89), to live in deprived areas and to have a history of substance misuse. We found no differences in ethnicity.

Mental health services need to focus particularly on patients with a history of being in prison who are experiencing economic adversity and offer substance-use-related interventions to ensure continued patient engagement. The link with deprivation is striking at a time at which rising costs of living are resulting in more health inequalities.

The prevalence of psychiatric disorders in people with epilepsy is as high as 43% and, among them, psychoses represent a severe comorbidity.

This is a narrative review discussing the interplay between epilepsy and psychosis and identifying challenges in diagnosing and managing psychotic symptoms in epilepsy, focusing on the past 10 years.

Articles published between June 2014 and December 2024 were identified through searches in PubMed using the search terms ‘psychosis’, ’seizure, epilepsy and convulsion’, ‘epile*’, ’seizure*’ and ‘convuls*’.

The association between epilepsy and psychosis was shown to be bidirectional, with people with psychosis being at increased risk of epilepsy. In epilepsy, psychotic symptoms may occur in three clinical scenarios, with clinical presentation and management varying in relationship to these: seizure-related (peri-ictal), treatment-related or independent of the former.

There are no guidelines for the management of psychotic symptoms in epilepsy, but it is possible to apply policies for the treatment of psychoses, taking into account the peculiarities and needs of people with epilepsy.

Electroconvulsive therapy (ECT) is often used to treat severe mental disorders in individuals with impaired capacity to consent to the treatment. Little is known about how different types of electrode placement are used in consensual and nonconsensual ECT.

To investigate whether there was an association between ECT consent status and electrode placement, given that ECT electrode placement affects efficacy and cognitive outcomes.

Using a statewide database across 3 years in Victoria, Australia, we performed chi-squared tests to determine whether consent status (consensual versus nonconsensual) was associated with particular electrode placements. A three-way log–linear analysis was then conducted to examine whether age, gender, level of education and psychiatric diagnosis influenced the relationship between consent status and electrode placement. Given the comparable cognitive outcomes of right unilateral and bifrontal ECT, these electrode placements were combined in the analysis.

In total, 3882 participants received ECT in the Victorian public health service during the study period. In the nonconsensual ECT group, 722 of 1576 individuals (45.81%) received bitemporal ECT, compared with 555 of 2306 (24.06%) in the consensual group (χ2 = 200.53; P < 0.0001; odds ratio: 2.6673, 95% CI: 2.3244–3.0608). This association remained significant after adjustment for gender, age, level of education and diagnosis.

Significantly more participants in the nonconsensual ECT group received bitemporal ECT rather than right unilateral or bifrontal ECT compared with those in the consensual group. As bitemporal ECT is associated with more cognitive impairment, this choice of electrode placement in vulnerable patients who lack capacity to consent raises ethical considerations in the practice of ECT.

The transfer from child and adolescent mental health services (CAMHS) to adult mental health services (AMHS) can be challenging, particularly for adolescents with neurodevelopmental disorders (NDDs) requiring long-term follow-up.

To examine the transfer process from CAMHS to AMHS in a university hospital in Türkiye, focusing on challenges, service gaps and barriers to transfer for individuals with NDDs.

Hospital records of children with NDDs followed in CAMHS for at least 5 years were reviewed. Children with at least one annual admission until 2017–2018 were included. A total of 211 patients were categorised into two groups: those who transferred to AMHS by 2018–2019 (transferred group, 81 patients) and those who did not transfer (non-transferred group, 130 patients). Clinical features, such as primary diagnosis and treatments, were compared, and parental views on the transfer process were collected via telephone interviews.

The transferred group included 81 patients (38.4%), whereas the non-transferred group had 130 patients (61.6%). Of the total sample, 55 (26.1%) were female, and 156 (73.9%) were male. Primary diagnoses were similar between groups; however, the transferred group had more comorbidities (P < 0.001) and more frequent antipsychotic prescriptions (P = 0.006). Proactive information from CAMHS doctors (B = 2.46, s.e. = 0.68, P < 0.001) and psychiatric comorbidities predicted transfer. In addition, attention-deficit hyperactivity disorder diagnoses changed during transfer in the transferred group (P = 0.002).

These findings emphasise the need for tailored transition support to enhance mental healthcare for NDD patients and indicate areas where further research is required to address healthcare barriers.

Immune dysregulation contributes to the pathophysiology of depression and is a potential link between depression and comorbid medical conditions. DNA methylation is a dynamic transcriptional regulator of the immune system.

To study changes in DNA methylation of disease- and comorbidity-associated immune genes in patients with and without depression diagnoses from the German BiDirect Study.

We performed a cross-sectional (baseline, y0) and longitudinal (consecutive assessments at 3-year intervals, y0, y3, y6) differential methylation analyses of 382 immune-related genes associated with depression, obesity, diabetes and/or gout in 276 patients with depression and in 207 individuals without a lifetime depression diagnosis from the BiDirect Study. In addition, we applied unsupervised clustering to identify subgroups of individuals with depression based on longitudinal methylation patterns.

There were no significant methylation changes between individuals with depression and controls at baseline. Follow-up analyses used to assess the top (P < 0.05) 151 methylation probes longitudinally identified 42 CpG sites that showed time-dependent changes associated with depression, and defined 3 depression clusters with differential profiles of serum inflammation markers at baseline. The implicated genes corresponded in the majority to those associated with diabetes risk, and were enriched in processes relevant for haematopoiesis.

Our results suggest that immune dysregulation associated with DNA methylation profiles contributes to the pathophysiology of depression and is a plausible link to chronic medical conditions such as diabetes.

Youth suicidal ideation and behaviour are major significant concerns, with suicide being the third leading cause of death among youth. In recent years, the trend toward deinstitutionalisation has caused parents of high-risk youth to face increasing emotional and practical challenges, including managing lethal means restriction (LMR) to reduce suicide risk.

This qualitative study explores the experiences of parents instructed by mental health professionals to restrict their child’s access to lethal means in managing suicidal behaviours.

Twelve Israeli parents of youth aged 12–21 years participated in in-depth interviews. Using interpretative phenomenological analysis, the study investigated the emotional, psychological and relational challenges parents face when implementing LMR.

Findings indicate that parents struggle to understand and implement LMR guidance, experience emotional strain from their role as protectors, and face pervasive anxiety about their child’s safety. The study also highlights feelings of helplessness and the erosion of trust between parents and children. Many parents criticise LMR, viewing it as potentially harmful to their relationship with their child or ineffective at keeping their child safe.

This study underscores the emotional and practical challenges parents face when implementing LMR. To improve its effectiveness, guidance should be re-evaluated and communicated more flexibly, emphasising shared responsibility between the parent and child, and address the emotional toll on parents during this critical period.

Emotional eating, the tendency to eat in response to negative emotions, is rising among adolescents and linked to obesity and mental health issues. While negative life events contribute to emotional eating, the roles of self-control and social support remain unclear.

This study examined the relationship between negative life events and emotional eating in adolescents, testing self-control as a mediator and perceived social support as a moderator.

A sample of 740 Chinese high school students (aged 14–18) completed validated measures of negative life events, self-control, perceived social support, and emotional eating. Data were analyzed using SPSS 25.0 (IBM Corp., Armonk, New York, USA)and PROCESS macro for mediation/moderation effects.

Negative life events predicted higher emotional eating (β = 0.11, p < 0.01), while lower self-control mediated this relationship (β = −0.15, p < 0.001). Perceived social support moderated the association (β = −0.09, p < 0.05), weakening it among adolescents with stronger support.

Negative life events increase emotional eating, but self-control and social support play key roles. Interventions targeting these factors may reduce emotional eating and improve adolescent well-being.

Chronic pain and depression are common in older people, and creative activities may lower the perceived impact and distress related to the symptoms.

This study describes the co-development of a creative arts and crafts protocol for older people with chronic pain and depressive symptoms, and investigates its feasibility and potential effects.

This study had two phases. In phase 1, a multidisciplinary expert panel (n = 10), consisting of professionals, patients and researchers, underwent iterative rounds to co-develop the protocol. In phase 2, a pilot study was conducted among 12 older adults (mean age 71.4 years). Mixed methods were used, including questionnaires at baseline, post-intervention and 3-month follow-up, assessing pain intensity and interference, depressive symptoms and quality of life; observational notes and focus groups. Descriptive and Wilcoxon signed-rank tests were applied to analyse quantitative data, and thematic analysis was used for qualitative data.

Qualitative findings supported the programme’s feasibility. Participants reflected that the process was engaging and empowering and brought them a sense of achievement and recognition. The quantitative findings evidenced the programme’s potential effects in reducing depressive symptoms (Z = −2.60, P < 0.01) and improving mental health-related quality of life (Z = −2.67, P < 0.01) at 3-month follow-up.

Our results support the feasibility of a creative arts and crafts programme and provide preliminary evidence of its impact on reducing depressive symptoms and improving mental health-related quality of life. Given the promising results, a definitive trial is needed to reveal the effectiveness of creative activities in pain management.

Bipolar disorders are a major cause of disability worldwide, with most of the disease burden attributed to those in low- and middle-income countries, including Nigeria. There is limited evidence on culturally appropriate interventions for bipolar disorders in Nigeria.

The study aims to examine the feasibility, and acceptability of culturally adapted psychoeducation (CaPE) for treating bipolar disorders.

A randomised controlled trial (RCT) compared CaPE plus treatment as usual (TAU) with TAU alone among 34 persons with bipolar disorders in Jos, Nigeria. CaPE comprised 12 group sessions of in-person psychoeducation lasting approximately 90 min each, delivered on a weekly basis by clinical researchers supervised by clinical psychologists and consultant psychiatrists. The primary outcome was feasibility, measured by participants’ recruitment and retention rates. Other outcomes included acceptability as measured by the Service Satisfaction Scale (SSS), Brief Bipolar Disorder Symptom Scale (BBDSS), Patient Health Questionnaire (PHQ-9) and Quality-of-Life scale (EQ5D). Outcomes were assessed at baseline and weeks 12 and 24. Focus group (n = 10) and individual interviews (n = 5) were conducted with the CaPE + TAU group, recorded, transcribed verbatim and analysed using interpretative phenomenological analysis.

The CaPE+TAU group (n = 17) recorded a high participant recruitment and retention rate of 86% across 12 sessions, and also recorded a higher level of satisfaction with SSS compared with the TAU alone group; 87.5% indicated very satisfied compared with 66.7% indicated not sure in the TAU group. In terms of clinical outcomes, for PHQ-9 scores the intervention group showed a reduction from baseline to end of intervention (EOI) and follow-up, with differences of −12.01 and −7.39, respectively (both P < 0.001). The EQ5D index showed a notable improvement in the intervention group at both EOI and follow-up (P < 0.001). Lastly, BBDS scores decreased significantly in the CaPE+TAU group at both EOI and follow-up, with differences of −21.45 and −15.76 (both P < 0.001).

The RCT of CaPE is a feasible, acceptable and culturally appropriate treatment option for bipolar disorders in Nigeria. Further adequately powered RCTs evaluating the intervention’s clinical and cost-effectiveness are warranted.