Low self-esteem is an important and potentially modifiable risk factor for the development and outcome of psychotic disorders. The factors involved in low self-esteem in psychotic disorders are not yet fully understood. The current study aims to investigate the cross-sectional and longitudinal associations between (changes in) self-esteem and severity of psychotic symptoms, internalized stigma, negative reaction to antipsychotics, personal recovery, childhood bullying, childhood trauma, and social support in symptomatically remitted first-episode psychosis (FEP) patients.

Data from the ongoing longitudinal Handling Antipsychotic Medication: Long-term Evaluation of Targeted Treatment study were used. Participants were in symptomatic remission for 3–6 months after the FEP. Cross-sectional associations (N = 299) were investigated through Pearson’s correlations, and longitudinal changes (N = 238) were investigated via linear regressions with inverse probability weighting.

Cross-sectionally, we found that lower self-esteem was related to higher severity of symptoms, higher internalized stigma, higher childhood trauma (specifically emotional neglect), higher childhood bullying, more negative side effects of antipsychotic medication, lower personal recovery, and lower social support. Longitudinally, contrary to our hypothesis, we found that higher baseline internalized stigma, higher childhood trauma (specifically emotional abuse), and a higher baseline negative subjective reaction to antipsychotics predicted an increase in self-esteem after 6 months. Furthermore, a decrease in psychotic symptoms, internalized stigma, and negative subjective reaction to antipsychotics, and an increase in social support predicted an increase in self-esteem.

Early intervention programs for psychotic disorders should target factors related to changes in self-esteem. This might improve self-esteem and thereby promote recovery.

The concept partnership has developed since Sherry Arnstein first created the ladder of citizen participation. Within mental health discourse, this was first acknowledged by “A Vision for Change” (2006) and later, through adopting co-production (2017). In 2011, the College of Psychiatrists of Ireland, created a collective called Recovery Experience Forum of Carers and Users of Services (REFOCUS) which became a leading example of partnership between stakeholders in the organisation. However, REFOCUS’s impact on stakeholders needs to be examined.

A qualitative investigation using an autoethnography methodology is proposed. The approach allows for the interweaving of personal experiences with culture to create new knowledge. A focus group was conducted, and transcripts were subject to reflexive thematic analysis.

Seven out of fourteen participants, representing all three stakeholders, were available at time of interview. From the process of reflexive thematic analysis, five themes were constructed. Each with a number of sub-themes attached, which in turn represented stakeholder perspectives regarding REFOCUS.

This paper highlights several issues that need addressing in future research on REFOCUS. The paper demonstrates the continuous presence of stigma within Irish mental health services. However, it also highlights a number of beneficial aspects to REFOCUS including informal peer support, service users, and family member involvement in college activities as well as increasing meaning and purpose in one’s life along with a renewed identity different to that of the service user or family member.

We aimed to describe representative activities related to radiation risk management and community-based revitalization in Fukushima following the Fukushima Daiichi Nuclear Power Plant (FDNPP) accident by chronological phase and provide an overview of effective recovery projects and future prospects.

We systematically reviewed projects and research on the FDNPP accident in PubMed. For convenience, we defined the first, second, and third phases as 2011-2014, 2015-2018, and 2019-2023, respectively. The main project, purpose, organization, core location, and validation in each phase after the disaster were briefly summarized.

We found that lessons learned from the FDNPP disaster have been continuously and professionally conveyed across generations, regions, and nations by effectively disseminating easy-to-understand information, avoiding any misunderstanding and prejudice. A continuous flow of scientists, researchers, and trainees from Japan and abroad to the affected areas will create a positive cycle of attracting people and residents, eventually accelerating recovery and contributing to the development of safe and vibrant communities in disaster-affected areas.

Continued efforts are required to enhance expertise at the field level, strengthen organizational capabilities, and promote international cooperation, thereby ensuring that a similar nuclear accident never happens again.

Spatial neglect is a heterogeneous post-stroke disorder with subtypes differing in reference frames, processing stages, and spatial domains. While egocentric peri-personal neglect recovery has been studied, recovery trajectories of allocentric peri-personal visuospatial and personal neglect remain unclear. This study investigated recovery time courses of egocentric and allocentric peri-personal visuospatial and personal neglect during the first 12 weeks post-stroke; whether initial severity predicts recovery and defines distinct patient clusters; and how subtypes interrelate over time.

Forty-one first-ever stroke patients were evaluated at weeks 3, 5, 8, and 12 post-stroke using the Broken Hearts Test, Line Bisection Test, Visuospatial Search Time Test, and Fluff Test. Recovery was analyzed using linear mixed models, clustering with Gaussian finite mixture models, and interrelationships using Spearman correlations.

Significant improvements occurred in egocentric and allocentric peri-personal visuospatial and personal neglect, primarily between weeks 3 and 5, followed by a plateau. The Line Bisection Test detected no changes. Higher initial severity predicted greater residual impairment. Cluster analysis identified near-normal, mild, and moderate-to-severe baseline subgroups with distinct recovery trajectories. Moderate-to-good correlations (ρ = 0.33 – 0.55) emerged between egocentric and allocentric neglect at week 3 and when timepoints were pooled.

Neglect improved mainly between weeks 3 and 5 after which recovery plateaued, mirroring motor and language recovery and suggesting a shared time-limited window. Initial severity was a determinant of recovery, highlighting the value of early severity stratification to monitor and support recovery potential after stroke. As subtypes are distinctive, assessment should include multiple neglect tests.

To evaluate whether and how drafting psychiatric advance directives (PADs) with the support of a peer worker improves recovery outcomes for individuals with severe mental illness.

A mixed-methods design was employed, combining quantitative data from a randomized trial with qualitative interviews. The trial included adults with schizophrenia, bipolar I disorder, or schizoaffective disorder who had experienced involuntary hospitalization in the past year. Participants either completed PADs with peer worker support or without specific facilitation. Recovery was assessed longitudinally using the Recovery Assessment Scale. Thematic analysis of interviews explored mechanisms underpinning the effectiveness of peer facilitation.

A total of 118 participants completed PADs, 84 with peer support. Mixed-effects regression analysis revealed significantly higher recovery scores for those supported by peer workers (coefficient = 4.77, p = 0.03). Qualitative findings highlighted two key mechanisms: peer workers’ boundary role fostering trust and relational symmetry and their facilitation practices promoting critical reflexivity and addressing past psychiatric trauma. Participants emphasized the flexibility and empathy of peer workers, which enabled deeper reflection and empowerment.

Peer facilitation enhances the drafting of PADs, significantly contributing to recovery through trust, critical reflection, and trauma-informed approaches. These findings support the integration of peer workers into PAD frameworks and emphasize the need for tailored training and systemic reforms to maximize their impact.

We examined cognitive performance in children with complicated mild-severe traumatic brain injury (TBI) versus orthopedic injury (OI) using the National Institutes of Health Toolbox Cognitive Battery (NIH TB-CB).

We recruited children ages 3–18, hospitalized with complicated mild-severe TBI (n = 231) or orthopedic injury (OI, n = 146). Cognition was assessed using the NIH TB-CB at six and twelve months post-injury. We used linear mixed models to assess associations of injury group (TBI versus OI), timepoint (six versus twelve months), and the interaction of injury group and timepoint with NIH TB-CB Total Cognition, Fluid Cognition, and Crystallized Cognition composites, adjusted for sex and socioeconomic status (SES), with Bonferroni correction. We evaluated differences in cognition stratified by injury severity (complicated mild–moderate TBI vs severe TBI) using ANCOVA, adjusting for sex and SES.

Neither injury group nor the interaction of group and timepoint were associated with Total (group: p = 0.50; timepoint*group: p = 0.185), Fluid (group: p = 0.297; timepoint*group: p = 0.842), or Crystallized Cognition (group: p = 0.039; timepoint*group: p = 0.017). However, children with severe TBI performed significantly worse on Fluid and Total Cognition than children with complicated mild–moderate TBI at six months (Fluid: p = 0.004, partial η2 = 0.06, moderate effect, Total: p = 0.012 partial η2 = 0.03, small–moderate effect) and twelve months post-injury (Fluid: p < 0.001, partial η2 = 0.11, moderate–large effect, Total: p = 0.002, partial η2 = 0.06, moderate effect).

The NIH TB-CB detects worse cognitive functioning in children with severe TBI six-twelve months post-injury, largely driven by differences in Fluid Cognition. Our findings suggest the NIH TB-CB may be suitable for monitoring cognition in children with TBI.

The high comorbidity of substance use disorders (SUDs) among people with severe mental health conditions (MHCs) poses major challenges to providing effective care, particularly in low- and middle-income countries (LMICs), where treatment options are limited.

The aim of this scoping review was to produce an overview of the current evidence on psychosocial interventions for people with comorbid MHCs and SUDs in LMICs.

The following databases were searched from their inception to 23 July 2024: PubMed/Medline, Global Health, Embase, PsycINFO and Global Index Medicus. We also searched for grey literature, using Google Scholar, ProQuest and Clinicaltrials.gov. Reporting was according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) Checklist. Studies were eligible if they focused on any psychosocial intervention targeting substance use in people with severe MHCs from LMICs. Of the 6304 records screened by titles and abstracts, 138 full-text articles were assessed and included for data extraction.

Of the 6304 records screened by titles and abstracts, 138 full-text articles were assessed and 13 articles were included for data extraction. Many of the studies (n = 9) had a quasi-experimental design, and were from Latin America and South Asia. Four studies were randomised controlled trials. The primary outcomes examined were substance use abstinence, treatment engagement and retention, reduction in psychiatric symptoms, functioning and suicidal behaviours. Despite some heterogeneity in study designs, target populations and evaluated outcomes, interventions including various tobacco cessation programmes, screening and brief intervention with family support, and community-based programmes, have demonstrated positive outcomes in reducing tobacco, alcohol and khat use, respectively.

The review shows that there have been few initiatives to design and test psychosocial interventions for individuals with comorbid severe MHCs and SUDs in LMICs. There is a clear need to design and test feasible, acceptable, and effective interventions to address both severe MHCs and substance use when they co-occur.

Psychosocial interventions for people with mental illness are increasingly focusing on facilitating recovery and self-care. Despite evidence from Europe on the short-term effects of recovery self-planning programs for people discharged from crisis resolution teams, similar programs and supporting evidence in other countries or healthcare contexts are lacking, particularly regarding cultural adaptation and long-term assessment. This randomized controlled trial compared a 4-month peer-facilitated, recovery-focused self-illness management (Peer-RESIM) program for Chinese adults with first-episode psychosis with psychoeducation (PE) and treatment as usual (TAU).

Patients (N = 198) were recruited from four Integrated Community Centres for Mental Wellness in Hong Kong and randomly assigned to the Peer-RESIM, PE, or TAU group (66/group). The primary outcomes were recovery and functioning levels; the secondary outcomes were psychotic symptoms, problem-solving ability, rehospitalization rate, and service satisfaction. Assessments were conducted at baseline and immediate, 9, and 18 months postintervention.

The generalized estimating equation test revealed that the Peer-RESIM group reported significantly greater improvements in recovery, functioning, problem-solving ability, psychotic symptoms, average duration of rehospitalizations, and service satisfaction (p = 0.01–0.04, small to large effect sizes) than the TAU group at all three posttests and the PE group at 18 months postintervention.

The Peer-RESIM can enhance long-term recovery and self-care in adults with early-stage psychosis.

The decision-making process regarding antipsychotic continuation or discontinuation following remission from first-episode psychosis (FEP) remains complex and underresearched. While discontinuation increases the risk of relapse, concerns over long-term side-effects such as metabolic disturbances and extrapyramidal symptoms also exist. Current guidelines recommend maintaining antipsychotics for 1–5 years, emphasising shared decision-making (SDM) between clinicians and patients.

This study aimed to explore the decision-making process and describe the factors influencing the decision to discontinue or continue antipsychotic treatment following remission from FEP, from the patients’ perspective.

A descriptive qualitative study was conducted with 12 individuals in remission from FEP who received care at early intervention services in Quebec, Canada. Data were collected through online semi-structured interviews and analysed thematically to identify key factors influencing treatment decisions.

The decision-making process was activated by treatment reflection triggers and shaped by various perceptions (of illness, treatment and stigma) and relationships (with friends, family and the clinical team), ultimately leading to decisions to either discontinue, continue (at standard or reduced dose) or remain ambivalent. This dynamic process was guided by participants’ motivators, such as well-being and societal contribution. Most participants felt that discontinuation discussions were not initiated by the clinical team.

The decision-making process is driven by motivators that were found to be linked to the concept of personal recovery. This study highlights the need for proactive, personalised discussions between clinicians and patients. Future research should focus on decision aids tailored to the FEP population to support SDM and improve treatment outcomes.

Network analysis is a promising approach for elucidating the dynamics of the transition from psychopathology to well-being. Recently, symptom connectivity strength has been proposed as a measure of plasticity – the capacity to change disease severity. Yet, empirical findings remain inconsistent. We propose that this inconsistency can be resolved by recognizing that the interpretation of connectivity strength varies along the recovery process from depression, whether at baseline or during clinical change.

We analyzed 2,710 depressed patients from the STAR*D dataset, grouped by the magnitude of change in depressive score. Symptom network connectivity was estimated from QIDS-C items at three time points: (i) baseline, (ii) change – defined as when clinical change in depression score occurs, (iii) post-change - corresponding to when the maximum clinical change is achieved.

At baseline, connectivity strength predicts the maximum clinical change, inversely correlating with its magnitude (ρ = −0.95, p = 0.001). At the change time point, connectivity strength parallels clinical change (ρ = 0.92, p = 0.002). A direct and significant association between connectivity strength and depression severity emerges only at the change (ρ = 0.98, p = 0.0003) and post-change (ρ = 0.95, p = 0.001) time points.

The interpretation of connectivity strength for predicting depression trajectories varies by timepoint: at baseline, it measures plasticity -- the capacity for change -- whereas during clinical change, it indicates the magnitude of change in symptom severity. This framework supports the reliability of this prognostic marker for designing personalized therapeutic interventions in psychiatry.