Antipsychotics used to treat severe mental illness (SMI) markedly raise the risk of metabolic syndrome. Early weight gain predicts worse outcomes, making timely intervention vital, particularly within the first 6 months, when the most weight loss is achievable. This meta-analysis evaluated non-pharmacological weight/body mass index (BMI) management interventions during the first 6 months of their use in people receiving antipsychotics for SMI, to identify effective components with the aim of preventing long-term metabolic complications. Systematic searches of five databases (to October 2024) yielded 1483 studies; 8 (643 participants) met inclusion criteria. Interventions included exercise, nutrition, education, monitoring and psychological input, delivered individually or in groups.

Meta-analysis showed significant weight (−1.93 kg) and BMI (−1.12 kg/m2) reductions. Group-based, multi-component programmes with psychological input were most effective.

Group-based, multi-component interventions that include a psychological element produced the greatest reductions in weight and BMI. Future research should focus on refining and embedding psychologically informed, multi-component group programmes into routine psychiatric care to optimise long-term physical health outcomes.

This article explores how clinical language used to describe long-standing and severe eating disorders shapes treatment experiences and outcomes. Drawing on critical discourse theory and the authors’ lived experiences, the paper analyses the impacts of language through intrapersonal, interpersonal and systemic lenses.

The analysis highlights how the language used to describe illness can foster therapeutic nihilism, internalised hopelessness and disengagement from treatment for both clinicians and patients, reducing the impetus for developing or accessing better care. These labels may obscure systemic shortcomings in treatment provision and can become self-fulfilling, undermining clinician motivation and patient recovery.

The authors propose a paradigm shift toward recovery-oriented, co-created language that centres epistemic justice. Clinical discourse should promote therapeutic optimism and support inclusive, patient-centred care. Recovery-focused language can strengthen engagement, improve outcomes and support a treatment culture grounded in mutual respect and hope.

The increasing recognition of neurodivergent conditions in healthcare settings in general highlights the necessity for better understanding and management in neuropsychiatric settings. This study aims to investigate the prevalence and co-occurrence of neurodivergent conditions and traits among patients with neuropsychiatric conditions. A descriptive quantitative cross-sectional study was conducted at a tertiary neuropsychiatric clinic. Participants included 166 consecutive patients, assessed using the Comprehensive Autistic Trait Inventory (CATI) and the Adult ADHD Self-Report Scale (ASRS, version 1.1), with demographic characteristics considered.

In our final analysed cohort (n = 79), among patients with functional neurological disorder (FND) 11% had a confirmed diagnosis of adult spectrum disorder (ASD), 17% were believed to have undiagnosed ASD and 55% exhibited clinically significant ASD traits on the CATI tool. Additionally, 13% had a confirmed diagnosis of attention-deficit hyperactivity disorder (ADHD), 25% were believed to have undiagnosed ADHD and 67% exhibited clinically significant ADHD traits on the ASRS tool.

The findings indicate a higher than expected prevalence of neurodivergent conditions in people with FND. Enhanced early identification and tailored treatment approaches are likely to be crucial for improving clinical outcomes and patient experiences in neuropsychiatric settings.

Recovery Colleges are adult education initiatives supporting personal recovery for individuals with mental health difficulties. We characterised a national (England) inception cohort of mental health service users, students from the Recovery Colleges Characterisation and Testing 2 programme, and compared those attending different Recovery College types on sociodemographic, clinical, service use and student-reported outcomes over the 4 months prior to enrolment. Mixed-effects regression models were used to assess differences.

The cohort comprised 498 students from 36 Recovery Colleges across England; 77.7% attended strengths-oriented Recovery Colleges. Mean age was 39 years (s.d. 12); most were female (72.1%) and White (81.5%). Common diagnoses were mood (31.3%) and anxiety disorders (29.7%). No significant differences were found between students attending strengths- versus community-oriented Recovery Colleges.

Strengths- and community-oriented Recovery Colleges have similar service user student populations. Certain groups that may be underrepresented in Recovery Colleges and Recovery College research include older adults, men, those with developmental disorders and ethnic minority populations.

Sexual violence in psychiatric in-patient care has received increasing attention following persistent evidence of sexual violence and harassment on wards. However, patients’ subjective experiences remain under-examined, limiting the evidence base to inform safeguarding, gender-sensitive design and trauma-informed practice.

To synthesise qualitative evidence on patients’ experiences of sexual violence and perceived risk within psychiatric in-patient settings.

We conducted a systematic review and qualitative synthesis following Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines (PROSPERO registration no. CRD42024595945). MEDLINE, Embase and PsycINFO were searched from inception to October 2024, supplemented by reference list screening and citation tracking. Inclusion criteria were peer-reviewed qualitative studies reporting patients’ first-hand accounts of sexual violence or perceived sexual safety in psychiatric in-patient care. The quality of the included studies was assessed using the Critical Appraisal Skills Programme checklist, and data were analysed by thematic synthesis.

Six studies published between 1998 and 2025 met the inclusion criteria, with most focusing on female patients in mixed-gender wards. Three overarching themes were developed: (a) ‘a culture of permissiveness and dismissal’ – patients downplayed harassment and abuse and staff routinely dismissed concerns; (b) ‘everyday fear, hypervigilance and resistance’ – the constant threat of harm generated chronic distress, with safeguarding responsibility shifted onto the patients; and (c) ‘gendered power dynamics in open or mixed-gender spaces’ – open ward layouts, inadequate boundaries and legal detention compounded vulnerability to harm.

Sexual violence in psychiatric in-patient care is enabled by ward cultures that normalise harm, weak safeguarding and gendered power imbalances. Urgent action is needed to implement trauma-informed, gender-sensitive practices and secure spatial boundaries and consistent incident responses, alongside policies that enable safe disclosure and accountability.

Treatment non-adherence is a well-established predictor of relapse in schizophrenia, yet its broader clinical impact remains unclear. This study examines the association between clinician-recorded treatment non-adherence and clinical outcomes during the first year following a schizophrenia diagnosis. Using a bespoke natural language processing algorithm applied to anonymised electronic health records, we classified the recorded treatment adherence status of 2667 patients. Multivariable and Poisson regression analyses were conducted to assess associations of recorded treatment non-adherence with clinical outcomes.

Compared with the remainder, those classified as non-adherent had greater increases in recorded symptoms and higher frequency and duration of in-patient admissions and crisis care episodes. They were also prescribed a greater number of different antipsychotics and developed a greater number of recorded physical health comorbidities.

Treatment non-adherence is associated with markedly poorer clinical outcomes, emphasising the importance of early identification and targeted interventions to support adherence.

The Mental State Examination (MSE) is a core component of psychiatric assessment and medical training, yet it was developed before feeding or eating disorders (FEDs) were widely recognised. FEDs are now common, clinically severe and frequently missed in routine assessments. We conducted a narrative review of the historical development of the MSE, current UK medical education standards and relevant literature, supplemented by a lived-experience perspective, to examine whether the MSE adequately captures eating behaviour, nutritional status and body image disturbance.

We identified no published studies examining the explicit inclusion of FED-related psychopathology within the MSE. Current frameworks lack systematic prompts for eating behaviours and nutrition, contributing to under-recognition. Contributing factors include historical MSE design, limited curriculum coverage, clinician uncertainty and patient non-disclosure.

Embedding brief, semi-structured prompts into the MSE is a feasible training-aligned approach to improve detection, support curriculum modernisation and enhance patient safety.