Over 1% of the world’s population have been forcibly displaced. Asylum seekers and refugees (ASR) are at higher risk of serious mental illnesses. Despite a high need for care, little is known about the attitudes, knowledge and competencies of psychiatrists who may treat ASR subjects.

The study aimed to identify perceived gaps in psychiatric training that could help guide medical education and policymaking related to treating ASR mental health.

We conducted the first national survey of UK-based psychiatrists to assess attitudes, knowledge and competencies around treating ASR subjects. The online survey was sent to all psychiatrists (N = 18 182) and registered trainees (N = 4700) on the Royal College of Psychiatrists databases in 2022. We used exploratory and confirmatory factor analyses to identify the optimal factor structure underlying the questionnaire. Variations in scores on extracted latent constructs by sociodemographic and clinical variables were explored using linear regression.

Data from 609 psychiatrists (77%) and trainees (22%) were included in the final analysis. We identified four latent constructs concerning perceived knowledge, positive attitudes, negative attitudes and perceived distress. Only 42% of respondents felt they had sufficient knowledge to work competently with ASR subjects, and 34.7% found the work emotionally distressing. Greater knowledge predicted both more positive (β = 0.26, 95% CI: 0.20–0.33) and more negative (β = 0.17, 95% CI: 0.09–0.26) attitudes, and was associated with less self-reported distress among psychiatrists (β = –0.34, 95% CI: –0.43 to –0.21). Female psychiatrists reported more distress related to treating ASR subjects (β = 0.29, 95% CI: 0.14–0.44).

Less than half of psychiatrists in this survey believed they possessed adequate knowledge to treat ASR subjects, and some found working with such individuals distressing. Our results suggest that these issues could be mitigated by improving knowledge related to treating ASR subjects.

In India, women in rural areas have high rates of depression. They have poor access to mental healthcare resources and, hence, mental health symptoms remain largely unaddressed. Existing mobile telephone applications (apps) do not engage end-users, lack local language options, may not be socioculturally relevant and do not use audiovisual formats. We thus developed a mobile mental health app, Multiuser Interactive Health Response Application (MITHRA), to screen and provide brief behavioural intervention for mild to moderate depression among rural women attending self-help groups (SHGs) in India.

This qualitative study explores the process and findings of focus groups conducted with SHG administrators and women to inform the iterative development of the MITHRA app.

In total, 22 participants were interviewed (17 SHG participants and five administrators), and a thematic analysis of the data was conducted using the acceptability of interventions framework.

Frequent themes across the focus groups were affective attitude, burden, self-efficacy and perceived effectiveness. All women showed a positive attitude towards the app and depression interventions, while older women demonstrated less self-efficacy in using mobile mental health apps.

MITHRA is a promising app in the management of mild to moderate depression in women in SHG. With adequate training and education of family members, MITHRA has the potential to identify and treat women with mild to moderate depression.

People from ethnic minority groups are more likely to be impacted by global disasters than White ethnic groups due to pre-existing vulnerabilities. A lack of trust in mainstream support services, which have often accounted poorly for the needs of those communities, contributes to further discrimination and disadvantage.

This study was conducted in 2022, soon after the COVID-19 pandemic, to survey the overall well-being and healthcare needs of UK families with a Black ethnic background.

A total of 2124 parents completed an online survey that included measures of psychological well-being, children’s difficulties, family healthcare needs and perception of support both before and after the COVID-19 pandemic.

Seventy per cent of parents reported high levels of stress, depression and anxiety, and over half identified high emotional and relational difficulties in their children. Higher levels of distress in parents correlated with greater difficulties in children and poorer parent–child relationships. Community support was associated with greater parental well-being and fewer child difficulties. Parents sought support from formal support networks when health issues were perceived as more severe.

This study engaged a large sample of families from Black ethnic backgrounds, but recruitment may have been biased by sociodemographic characteristics. Levels of psychological distress were high, possibly due to pre-existing and enduring exposure to difficult life circumstances. Support from community networks was perceived as helpful, especially by those with milder levels of psychological distress. The strong association between parents’ and children’s well-being suggests that family-focused interventions could be beneficial, especially if culturally adapted.

People with severe mental illness (SMI) have a higher risk of premature mortality than the general population.

To investigate whether the life expectancy gap for people with SMI is widening, by determining time trends in excess life-years lost.

This population-based study included people with SMI (schizophrenia, bipolar disorder and major depression) alive on 1 January 2000. We ascertained SMI from psychiatric hospital admission records (1981–2019), and deaths via linkage to the national death register (2000–2019). We used the Life Years Lost (LYL) method to estimate LYL by SMI and sex, compared LYL to the Scottish population and assessed trends over 18 3-year rolling periods.

We included 28 797 people with schizophrenia, 16 657 with bipolar disorder and 72 504 with major depression. Between 2000 and 2019, life expectancy increased in the Scottish population but the gap widened for people with schizophrenia. For 2000–2002, men and women with schizophrenia lost an excess 9.4 (95% CI 8.5–10.3) and 8.2 (95% CI 7.4–9.0) life-years, respectively, compared with the general population. In 2017–2019, this increased to 11.8 (95% CI 10.9–12.7) and 11.1 (95% CI 10.0–12.1). The life expectancy gap was lower for bipolar disorder and depression and unchanged over time.

The life expectancy gap in people with SMI persisted or widened from 2000 to 2019. Addressing this entrenched disparity requires equitable social, economic and health policies, healthcare re-structure and improved resourcing, and investment in interventions for primary and secondary prevention of SMI and associated comorbidities.

Self-harm is widespread and often occurs in the community without resulting in hospital presentation. Individuals with depressive symptoms are at elevated risk. There are limited self-harm interventions designed for community and primary care settings. The Community Outpatient Psychological Engagement Service for Self-harm (COPESS) is a brief talking therapy intervention for self-harm based in community settings.

To assess the feasibility of evaluating the COPESS intervention in a community setting in relation to participant recruitment, retention, data collection and the acceptability of the intervention.

We used a mixed-method approach and a single-blind randomised controlled trial design with 1:1 allocation to either COPESS plus treatment as usual or treatment as usual alone. Adults with depressive symptoms and self-harm in the past 6 months were recruited from general practices. Secondary outcome measures were assessed at baseline and 1 month, 2 months and 3 months after randomisation. The trial was pre-registered on clinicaltrials.gov (NCT04191122) on 9 December 2019.

Fifty-five people were randomised (of an initial target of 60). Retention rates at follow-up assessments were high (>75%), as was attendance by all participants for all therapy sessions (93%). At 3 months, there were trends towards lower levels of self-harm urges, depressive symptoms and distress in the COPESS group compared with controls. Fidelity to the manualised COPESS therapy was moderate to high.

All progression criteria were met, supporting further evaluation of the intervention in a full-scale efficacy and/or cost-effectiveness trial. These findings add to the growing evidence base supporting the utility of brief psychological interventions for self-harm. COPESS has potential as a brief primary-care-based intervention for those struggling with self-harm.

Behaviours that challenge are highly prevalent in children with an intellectual disability and can be detrimental to their quality of life and opportunities.

The systematic review aimed to investigate the effectiveness of current interventions in reducing behaviours that challenge in children with an intellectual disability (≤18 years-old).

We searched five databases (PsychINFO, MEDLINE, Embase, Web of Science and CINAHL) on 26 April 2022 and 1 July 2024, and identified 18 randomised controlled trials (1443 participants) eligible for inclusion since 2014 – 11 investigated non-pharmacological and 9 investigated pharmacological interventions. Risk of bias was assessed using the Cochrane Risk of Bias 2 tool.

Non-pharmacological interventions (mostly psychosocial) were significantly effective (Hedges’ g = −0.20; 95% CI [−0.35, −0.05]), whereas pharmacological interventions (including a wide range of drug classes and substances) were not (g = 0.03; 95% CI [−0.17, 0.24]). Studies using the Child Behaviour Checklist reported significant reductions (g = −0.18; 95% CI [−0.34, −0.02]), whereas studies using the Aberrant Behaviour Checklist did not (g = 0.04; 95% CI [−0.16, 0.25]). A random-effects meta-analysis indicated no overall significant reduction in behaviours that challenge (g = −0.12; 95% CI [−0.24, 0.00]).

It is important to note that most studies included were conducted in Western countries and had small sample sizes, and findings may be due to the outcome measures used. Findings support current recommendations that non-pharmacological interventions should be first-line treatment for behaviours that challenge in this population. Evidence highlighted the need for better quality, adequately powered randomised controlled trials.

Women from minoritised ethnic communities experience inequalities in access, experience and outcomes of psychological therapy. Understanding the factors associated with these inequalities could inform improvements to mental health services.

To explore therapists’ experiences of providing treatment to women from minoritised ethnic communities, including insights on adaptations made at the delivery, content and wider organisation levels, and to gather suggestions about potential treatment improvements.

Semi-structured interviews were conducted with 13 therapists working in two National Health Service Talking Therapies for anxiety and depression services and who had experience of treating women from minoritised ethnic communities. Data were analysed using thematic analysis.

Three high-order themes were identified: incorporating ethnicity and culture in the delivery of psychological therapies, challenges associated with delivering therapeutic interventions to women from minoritised ethnic groups and improvements to services that could support better access, engagement and outcomes for women from minoritised ethnic groups.

Findings indicate that therapists viewed cultural adaptation and cultural sensitivity as important to the delivery of appropriate care for minoritised ethnic women. Challenges to appropriate care included limited service resources, communication and language barriers, stigma and existing access and engagement inequalities. Therapists suggested that, to deliver high-quality care and optimise outcomes, improvements are required in cultural sensitivity training, flexibility of service delivery, outreach work with communities to encourage uptake and reduce stigma, support for staff and workforce diversity.

Attention deficit hyperactivity disorder (ADHD) is often associated with psychosocial functioning difficulties and valid measures of disability are needed for this population. The 12-item World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) is widely used to measure disability but has not been validated in the adult ADHD population.

This study aims to assess the psychometric properties of the WHODAS 2.0 in adults with ADHD, and to examine differences in disability levels between ADHD subtypes and gender.

A cross-sectional study was conducted with 577 adults with ADHD (mean age: 38.24, s.d = 12.23; 52.3% male). ADHD severity was assessed using the ADHD Rating Scale (ADHD-RS) and Clinical Global Impression-Severity (CGI-S) Scale, while functionality was measured with the WHODAS 2.0 and the Functioning Assessment Short Test (FAST). Analyses included: (a) Cronbach’s α for internal consistency, (b) Pearson’s correlation for convergent validity, (c) Confirmatory Factor Analysis (CFA) for factor structure and (d) t-tests to compare disability levels across ADHD subtypes and gender.

The WHODAS 2.0 demonstrated good internal consistency (Cronbach’s α = 0.89). Scores were significantly correlated with psychosocial functioning (FAST, r = 0.476, p < 0.001) and clinical measures. CFA supported the original six-factor structure (root mean square error of approximation 0.039, Comparative Fit Index 0.998, Tucker–Lewis Index 0.996). When comparing ADHD subtypes, participants with the combined subtype had higher WHODAS 2.0 total scores than those with the inattentive subtype (p = 0.006). Additionally, gender differences were identified, with females displaying higher disability levels (p = 0.005).

The WHODAS 2.0 demonstrates psychometric properties that suggest it is a valid and reliable tool for assessing disability in adults with ADHD.

Depression is a growing mental health concern among university students worldwide, including in Thailand. Studies show that between 17 and 40% of Thai university students experience depressive symptoms, although these studies often focus on specific groups and use different measures.

This study aimed to investigate the prevalence and associated factors of depressive disorders among university students across Thailand.

Data were collected with the HAPPINOMETER and the Patient Health Questionnaire-9 scale as part of a nationwide cross-sectional survey. A total of 14 621 students from 33 universities participated in the survey. A series of binary logistic regression analyses were performed to examine the effect of sociodemographic characteristics and health behaviours on the presence of depression.

The results revealed that 31.4% of students experienced depressive symptoms, with 14.2% having major depressive disorder. The students who identified as non-binary had the highest odds of having depression (adjusted odds ratio 2.10, 95% CI 1.7–2.6, P < 0.001). Other specific subgroups were also found to be particularly vulnerable, including women, fourth-year students and those studying in Bangkok, without part-time jobs, living alone and engaging in risky health behaviours like smoking, heavy drinking and poor diet.

The findings underscore the need for comprehensive mental health support and targeted interventions within Thai universities, especially for at-risk subpopulations. Leveraging the existing collaborative networks among Thai universities presents a unique opportunity to mount a coordinated effort in developing and implementing comprehensive mental health strategies tailored to the needs of this vulnerable population.

Existing panel studies on the relationships between cognition and depressive symptoms did not systematically separate between- and within-person components, with measurement time lags that are too long for precise assessment of dynamic within-person relationships.

To investigate the bidirectional relationships between cognition and depressive symptoms and examine the effects of sociodemographic characteristics and lifestyle factors via random-intercept, cross-lagged panel modelling (RI-CLPM) in middle-aged and older adults.

The sample comprised 24 425 community-based residents aged 45 years or above, recruited via five waves of the China Health and Retirement Longitudinal Study (2011–2020). Cognition was evaluated using the Telephone Interview of Cognition Status, and depressive symptoms were assessed by the ten-item Center for Epidemiologic Studies Depression Scale. RI-CLPM included sociodemographic and lifestyle factors as time-invariant and -varying covariates. Subgroup analysis was conducted across gender, age groups and urban/rural regions.

RI-CLPM showed a superior fit to cross-lagged panel models. Male, higher education, married, urban region, non-smoking, currently working and participation in social activities were linked with better cognition and fewer depressive symptoms. Overall, cognition and depressive symptoms showed significant and negative bidirectional cross-lagged effects over time. Despite similar cross-lagged effects across gender, subgroup analysis across urbanicity found that cross-lagged effects were not significant in urban regions.

The present study provided nuanced results on negative bidirectional relationships between cognition and depressive symptoms in Chinese middle-aged and older adults. Our results highlight the health disparities in cognitive and emotional health across urbanicity and age groups.

It has been argued that disruptions to epistemic trust are implicated in psychopathology; however, this requires empirical testing, and an existing scale evaluating epistemic trust, the Epistemic Trust, Mistrust and Credulity Questionnaire (ETMCQ), requires improvement.

This study tested a revised version of the Epistemic Trust, Mistrust and Credulity Questionnaire (the ETMCQ-R), examining the strength of associations between the updated scale and mental health symptoms, epistemic vice, psychological resilience, perceived social support, attachment style, history of childhood adversity and an experimental measure of trust, and epistemic stance as a mediator between adversity and psychopathology.

Using an online survey design, 525 participants completed the ETMCQ-R alongside other measures. Exploratory and confirmatory factor analyses were conducted to assess the structure of the ETMCQ-R and correlational and mediational analyses were used to further assess validity of the measure.

The ETMCQ-R possesses greater model fit and a stronger three-factor structure (Trust, Mistrust and Credulity) compared with the ETMCQ. Significant negative correlations were identified between Trust (r = −0.12) and higher scores on global psychopathology severity, while Mistrust (r = 0.41) and Credulity (r = 0.36) showed positive correlations. Trust negatively correlated with borderline features (r = −0.10), whereas Mistrust and Credulity positively correlated (r = 0.54 and r = 0.48, respectively). Mistrust and credulity partially mediated the relationship between childhood adversity and psychopathology, with stronger mediation effects for borderline features than general psychopathology.

The study demonstrated strong psychometric properties of the ETMCQ-R, and further analyses indicate the three factors are differentially related to wider domains of socio-emotional functioning.

Depression, anxiety and post-traumatic stress disorder (PTSD) are prevalent among healthcare workers (HCWs), including those from sub-Saharan Africa (SSA). However, there are limited summary data on the burden and factors associated with these disorders in this region. We conducted this systematic review (registration no. CRD42022349136) to fill this gap.

The aim of this review was to systematically summarise the available evidence on the prevalence and factors associated with depression, anxiety and PTSD, or their symptoms, among HCWs from SSA.

We searched African Index Medicus, African Journals Online, CINAHL, PsycINFO and PubMed for articles published, from database inception to 15 February 2024. The keywords used in the search were ‘depression/anxiety/PTSD’, ‘healthcare workers’, ‘SSA’ and their variations.

Sixty-nine studies met our inclusion criteria, most of which (n = 55, 79.7%) focused on the burden of these disorders during the COVID-19 pandemic. Across studies, wide-ranging prevalence estimates of depressive (2.1–75.7%), anxiety (4.8–96.5%) and PTSD symptoms (11.7–78.3%) were reported. These disorders appear to have been heightened during the COVID-19 pandemic. Several sociodemographic, health-related, COVID-19-related and work-related factors were reported to either increase or lower the risk of these disorders among HCWs from SSA.

The burden of depression, anxiety and PTSD among HCWs from SSA is high and appears to have been worsened by the COVID-19 pandemic. The correlates of these disorders among HCWs from this region are multifactorial. A multi-component intervention could contribute to addressing the burden of mental disorders among HCWs from this region.

Suicide-related stigma (i.e. negative attitudes towards people with suicidal thoughts and/or behaviours as well as those bereaved by suicide) is a potential risk factor for suicide and mental health problems. To date, there has been no scoping review investigating the association between suicide-related stigma and mental health, help-seeking, suicide and grief across several groups affected by suicide.

To determine the nature of the relationship between suicide-related stigma and mental health, help-seeking, grief (as a result of suicide bereavement) and suicide risk.

This review was registered with PROSPERO (CRD42022327093). Five databases (Web of Science, APA PsycInfo, Embase, ASSIA and PubMed) were searched, with the final update in May 2024. Studies were included if they were published in English between 2000 and 2024 and assessed both suicide-related stigma AND one of the following: suicide, suicidal thoughts or suicidal behaviours, help-seeking, grief or other mental health variables. Following screening of 14 994 studies, 100 eligible studies were identified. Following data charting, cross-checking was conducted to ensure no relevant findings were missed.

Findings across the studies were mixed. However, most commonly, suicide-related stigma was associated with higher levels of suicide risk, poor mental health, lowered help-seeking and grief-related difficulties. A model of suicide-related stigma has been developed to display the directionality of these associations.

This review emphasises the importance of reducing the stigma associated with suicide and suicidal behaviour to improve outcomes for individuals affected by suicide. It also identifies gaps in our knowledge as well as providing suggestions for future research.

Understanding gender identity in transgender and gender-diverse (TGD) individuals is crucial for effective care. The Gender Preoccupation and Stability Questionnaire (GPSQ) measures the preoccupation and stability of gender identity, but no Italian validation is available.

This study aimed to translate, culturally adapt and validate the Italian version of the GPSQ in a clinical sample of TGD adults.

The GPSQ was translated with a forward–backward method and completed by 151 TGD adults at a gender clinic. Participants also filled out the Symptom Checklist-58 and Body Uneasiness Test. We assessed structural validity (EFA), internal consistency, test–retest reliability, and examined known-groups and predictive validity.

The EFA supported a four-factor structure – Gender Identity Instability, Cognitive-Affective Salience, Preoccupation, and Distress/Intervention-Oriented Reflection – with good fit (root mean square error of approximation 0.06; Comparative Fit Index 0.95; Tucker–Lewis Index 0.93; standard root mean square residual 0.04). The GPSQ showed solid internal consistency (α = 0.78; ω = 0.73) and excellent test–retest reliability (r = 0.98; intraclass correlation coefficient 0.98). Higher scores correlated with psychological distress (r = 0.55, p < 0.001) and body image concerns (r = 0.48, p < 0.001). Preoccupation was most linked to obsessive–compulsive symptoms, and Cognitive-Affective Salience to body image concerns. Participants not on hormones scored higher (p = 0.010, Cohen’s d = 0.36).

The Italian GPSQ is a reliable and valid tool to assess gender-related preoccupation and identity instability in TGD individuals. Its multidimensional structure makes it useful in both clinical practice and research in the Italian context.

Little is known about the transition process for those returned to prison following treatment in secure psychiatric services. This study is the first internationally to explore the process of discharge/aftercare planning for this population.

To identify the current national discharge and aftercare planning procedures for people returned to prison in England and Wales.

A national survey of current service discharge planning and aftercare arrangement practices in low- and medium-secure psychiatric services and prison mental health teams in England and Wales.

We had a 72% response rate across prison-based and secure mental health services. A summative contents analysis highlighted that outstanding priority areas for improvement, include (a) relationship building to improve communication and understanding between secure psychiatric services, prison mental health services, and the prison estate and (b) significant reform and additional resources to achieve the expected standard of care and to provide people returned to prison with a care package tailored to meet their specific needs.

Effective care planning and management of return to prison from secure psychiatric services has the potential to improve patient health and well-being in prison and up to and beyond their subsequent prison release, with far-reaching effects on prevention of relapse, hospital readmission, reoffending and other adverse events.