Patient-reported outcome measures (PROMs) are central to person-centred mental healthcare, yet evidence from large-scale digital implementation in routine psychiatry is limited.

To describe demographic characteristics and PROMs outcomes in out-patient mental health services across a multicentre Spanish network, and to analyse associations between PROMs and adherence, medication side-effects, self-harm and suicide attempts.

A multicentre, cross-sectional study included adults attending out-patient mental health clinics (October 2023–March 2025) and who participated in a digital PROMs (e-PROMs) program. Validated Spanish versions of the World Health Organization-Five Well Being Index (WHO-5), Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder-7 (GAD-7), Alcohol Use Disorders Identification Test (AUDIT-C), Drug Abuse Screening Test-10 (DAST-10) and Primary Care PTSD Screen for DSM-5 (PC-PTSD-5) scales were deployed via a patient web portal and integrated into the electronic health record. Associations were examined using univariate tests and multivariate logistic regression.

Of 73 140 referred patients, 7925 (10.9%) completed PROMs (median age 48 years; 68.8% women). Well-being was low (WHO-5 median 36). Moderately severe–severe depression affected 38.5%, severe anxiety 30.9% and post-traumatic stress disorder (PTSD) risk 42.4%. Substance misuse risk was identified in 7.2% and hazardous drinking in 14.7%. Women reported lower well-being (p < 0.001) and higher severe depression (40.6 v. 34.0%, p < 0.001), severe anxiety (33.1 v. 26.0%, p = 0.003) and PTSD risk (45.2 v. 36.1%, p = 0.002). Men had higher substance misuse (9.7 v. 6.0%, p = 0.033) and hazardous drinking (16.3 v. 14.0%, p = 0.034).

In multivariate models, the strongest predictors of self-harm (odds ratio >2) included severe depression (odds ratio 4.52, p < 0.001), substance misuse (odds ratio 2.38, p < 0.001), PTSD risk (odds ratio 2.29, p < 0.001) and moderate depression (odds ratio 2.27, p < 0.001). The strongest predictors of suicide attempts included all grades of depression (p < 0.001), PTSD risk (odds ratio 2.39, p < 0.001) and substance misuse (odds ratio 2.37, p < 0.001). Risk of alcohol abuse (odds ratio 0.60, p < 0.001) and substance misuse (odds ratio 0.73, p = 0.003) predicted non-adherence.

Large-scale digital PROMs collection is feasible and clinically informative. PROMs strongly predicted self-harm, suicidality and adherence, supporting their use for early risk detection and measurement-based psychiatric care.

Diabetes and mental health problems are closely linked, yet evidence examining this relationship among international labour migrants in the Gulf region is limited. Labour migrants are exposed to distinct occupational and psychosocial stressors that may increase vulnerability to depression and anxiety, particularly in the context of chronic diseases such as diabetes.

This study examined the prevalence and correlates of depressive and anxiety symptoms among male migrant workers with type 2 diabetes attending out-patient services in Qatar.

A clinic-based, cross-sectional study was conducted among adult male migrants receiving care at endocrinology out-patient clinics in Qatar. Symptoms of depression and anxiety were assessed using Patient Health Questionnaire 9 and Generalized Anxiety Disorder 7. Sociodemographic and clinical variables were collected using structured questionnaires and electronic medical records. Associations between clinical and sociodemographic factors and mental health outcomes were examined using chi-square tests and logistic regression analyses.

A total of 339 participants were included, predominantly of South Asian origin. Clinically significant depressive symptoms were identified in 21.3% of participants, with 14.8% reporting clinically significant anxiety symptoms. Depression severity was significantly associated with diabetes treatment modality and past psychiatric history. Anxiety severity was significantly associated with ethnicity and past psychiatric history. In multivariate analysis, past psychiatric illness independently predicted anxiety symptoms (odds ratio 6.24, 95% CI: 1.91–20.38, p = 0.002). No significant associations were observed between mental health outcomes and glycaemic control or duration of diabetes.

Lower-skilled male labour migrants with diabetes experience a substantial burden of depressive and anxiety symptoms, highlighting a clinically important but often overlooked dimension of diabetes care in this population. Past psychiatric illness and more complex diabetes treatment regimens were associated with poorer mental health outcomes. These findings support the need for integration of mental health assessment and targeted support within routine diabetes services for migrant worker populations.

The COVID-19 pandemic has affected mental health, with a particular impact on depressive symptoms. Metabolic syndrome is also linked to depression, but their combined effects remain unclear.

To examine the independent and combined effects of COVID-19 seropositivity and metabolic syndrome on depressive symptoms, considering demographic and health-related factors.

A cross-sectional analysis was conducted using 2021–2022 Encuesta Nacional de Salud y Nutrición data. Depressive symptoms were assessed with the Center for Epidemiological Studies Depression Scale (CESD-7), including subscales for positive affect, negative affect and somatic symptoms. COVID-19 seropositivity was determined through seroprevalence data, and metabolic syndrome was defined using Adult Treatment Panel III criteria. Logistic and linear regression models evaluated associations between COVID-19 seropositivity, metabolic syndrome and depressive symptoms, adjusting for demographic and health factors.

Among 10 890 adults, 3312 (30.4%) had depressive symptoms. COVID-19 seropositivity (n = 7790, 71.7%) was associated with higher odds of depressive symptoms (odds ratio 1.22, 95% CI 1.08–1.38) and increased CESD-7 scores (coefficient 0.39, 95% CI 0.19–0.58), particularly negative affect (coefficient 0.16, 95% CI 0.05–0.27) and somatic symptoms (coefficient 0.23, 95% CI 0.12–0.34). Metabolic syndrome was associated with depressive symptoms (odds ratio 1.17, 95% CI 1.02–1.33), mainly through negative affect (coefficient 0.27, 95% CI 0.12–0.41). No significant interaction was found between COVID-19 seropositivity and metabolic syndrome.

COVID-19 seropositivity and metabolic syndrome independently increase depression risk, highlighting the need for integrated mental and metabolic health screening.

Homelessness is a complex, multidimensional and often underrecognised public health concern. Women experiencing homelessness are often vulnerable to chronic stress, violence, mental health problems, substance use and poorer quality of life. Despite these vulnerabilities, research on substance use and psychological well-being among homeless women are limited in the Indian scenario.

This study aimed to evaluate the patterns and proportion of substance use, as well as the psychological well-being and quality of life, among homeless women utilising services from shelter homes in Delhi.

A cross-sectional observational study was conducted across five urban shelter homes in Delhi, providing a sample of 152 homeless women. Participants were interviewed using a semi-structured questionnaire designed for the survey, the Perceived Stress Scale, Patient Health Questionnaire-9 and -15, Generalised Anxiety Disorder-7, World Health Organization Quality-of-Life Scale and World Health Organization Alcohol, Smoking and Substance Involvement Screening Test Version 3.0. Statistical analysis was done using SPSS version 29.

Among 152 homeless women, lifetime use of substances was reported as tobacco (48%), alcohol (9.2%), inhalant (4.6%), opioid (2.0%) and cannabis (0.7%). Tobacco was the most common substance used followed by alcohol. Only 4.2% of the participants had ever sought treatment for substance use. A higher percentage of homeless women reported intimate partner violence in the form of emotional abuse (60.9%), physical violence (59.6%) and sexual violence (41.7%). Clinically relevant symptoms of depression and anxiety were observed in approximately a quarter of the participants. Furthermore, over 80% of the participants exhibited moderate-to-severe perceived stress.

Homeless women are considered a hard-to-reach and vulnerable population. Although residing in shelter homes may alleviate some difficulties, challenges still persist. The study emphasises the need for integrated, gender-sensitive and context-specific interventions. To effectively address the multifaceted issues by this population, tailored intervention programmes and policies should be designed unique to this population.

It remains unclear which patient and treatment characteristics are associated with greater cognitive and functional gains from individualised occupational therapy (IOT) in schizophrenia.

To explore predictors of changes in cognition and functioning and their maintenance among patients with schizophrenia who received IOT.

This secondary analysis used data from a randomised controlled trial and its follow-up. Participants allocated to the group occupational therapy plus IOT arm who received IOT during their hospital stay and had available outcome data were included (n = 34; with follow-up data available for 32 participants). Changes in cognition (Brief Assessment of Cognition in Schizophrenia) and functioning (modified Global Assessment of Functioning – social functioning subscale) were examined. Linear mixed-effects models were used to evaluate patient- and treatment-related predictors of change and maintenance.

Greater improvement in cognition was associated with lower baseline cognition (β = −0.40, p = 0.003). Maintenance of cognitive improvement was associated with fewer prior hospital stays (β = −0.21, p = 0.031) and better post-treatment quality of life (β = 5.61, p < 0.001). Greater improvement in functioning was associated with lower baseline functioning (β = −0.50, p < 0.001) and fewer physical comorbidities (β = −8.43, p = 0.004), whereas maintenance of functional improvement was associated with better post-treatment cognition (β = 2.27, p = 0.014) and greater engagement in self-monitoring (β = 0.27, p = 0.026).

Both patient characteristics and engagement in specific IOT components were associated with variability in changes in outcomes and their maintenance. These findings may inform more personalised occupational therapy strategies for schizophrenia.

Attention-deficit hyperactivity disorder (ADHD) is a common neurodevelopmental disorder that substantially affects behaviour, social functioning and daily performance. However, long-term population-based evidence on its burden in Jordan remains limited.

This study aimed to assess trends in incidence, prevalence and years lived with disability (YLDs) due to ADHD in Jordan from 1990 to 2023.

A population-based descriptive analysis was conducted using data from the Global Burden of Disease (GBD) 2023 study. ADHD incidence, prevalence and YLDs in Jordan from 1990 to 2023 were extracted and stratified by gender and age group (2–9, 10–19 and 20–69 years). Estimates were reported as rates per 100 000 population, and absolute numbers with 95% uncertainty intervals, following standard GBD methods.

ADHD burden was observed across all age groups in Jordan. Among children aged 2–9 years, incidence ranged from 279.9 to 352.3 per 100 000, prevalence exceeded 5000 per 100 000 in both 1990 and 2023 and YLD rates ranged from 214.8 to 262.8 per 100 000. In adolescents, the burden was concentrated among those aged 10–14 years, with prevalence around 526 per 100 000 and YLDs of 21 per 100 000 in both years; no estimates were reported for ages 15–19 years. In adults aged 20–69 years, although no incident cases were recorded, prevalence remained notable in 2023, ranging from 1626.8 per 100 000 (20–49 years) to 535.2 per 100 000 (50–69 years), with YLD rates between 69.1 and 22.4 per 100 000. Males consistently showed higher burden estimates than females across all age groups.

ADHD is a prevalent and a major source of non-fatal health loss in Jordan from early childhood through adulthood. These findings provide a comprehensive, long-term assessment of ADHD burden in Jordan and establish a robust evidence base for national, regional and global comparisons.