Clinically relevant anxiety can be detected in patients with amyotrophic lateral sclerosis (ALS), but its prevalence and determinants have not yet been fully assessed.

This study aimed at assessing the prevalence and clinical underpinnings of anxiety in ALS.

Non-demented ALS patients (N = 433) and healthy controls (N = 313) were administered the State- and Trait-Anxiety Inventory – Form Y (STAI-Y1 for state-anxiety and STAI-Y2 for trait-anxiety) and the Beck Depression Inventory (BDI). Patients were further assessed for cognition (Edinburgh Cognitive and Behavioural ALS Screen), behaviour (Frontal Behavioural Inventory) and motor status (disease duration, ALS Functional Rating Scale-Revised and progression rate). The prevalence of clinically significant state- and trait-anxiety were estimated by applying age-stratified cut-offs to STAI-Y1/-Y2 t-scores. Linear and logistic regressions were run to test the determinants of STAI-Y1/-Y2 scores.

STAI-Y1 and -Y2 scores above cut-off were detected in 18.2 and 13.9% of patients, respectively – with proportions being higher in cases versus controls (ps < 0.001). BDI, but neither cognitive/behavioural nor motor variables, was identified as a significant predictor of STAI-Y1/-Y2 scores (ps < 0.003). The cognitive–affective subscale of BDI was the sole predictor of scores above cut-off on both STAI-Y1 and STAI-Y2 (ps < 0.001).

Clinically significant levels of state- and trait-anxiety occur in ∼18 and ∼14% of non-demented ALS patients, respectively, mostly driven by cognitive and affective facets of depression, and are independent of motor and cognitive/behavioural features.

Prolonged grief disorder (PGD) is characterised by persistent yearning and intense emotional pain, and is often accompanied by identity disruption and social withdrawal. Research has identified various PGD risk factors; however, limited research has examined how relationship to the deceased relates to PGD risk.

This study introduces ‘simpatico’, a novel construct assessing a mourner’s perceived similarity and connection to the deceased as a risk factor for PGD. Grounded in the micro-sociological theory of bereavement, the study hypothesises that simpatico relationships heighten PGD risk because of the particular social deprivations their absence creates.

This cross-sectional study was conducted in Turkey via online surveys with 400 bereaved. Data were analysed using exploratory and confirmatory factor analyses, as well as correlation- and regression-based analyses.

A nine-item Simpatico Scale was validated within a Turkish bereaved adult sample (N = 400), demonstrating good internal consistency (Cronbach’s α = 0.90). Regression analyses revealed that elevated simpatico scores, particularly felt similarities with the deceased, were significantly associated with PGD symptom severity (β = 0.31, p < 0.001), even when controlling for demographic, cause of death, relationship to deceased and social support variables.

Results identify simpatico as a new, particularly influential, interpersonal risk factor for PGD. Further, according to the micro-sociological theory, results suggest that promotion of simpatico relationships among bereaved persons may compensate for the social deprivations resulting from simpatico relationship losses. In these ways, this study identifies mourners at risk and suggests promising ways to intervene to reduce mourners’ risk of PGD.

In The Netherlands, it is unknown whether the number of youth suicide-related emergency department visits has changed over time. Also, insight is needed in the hospital costs for managing these patients, as a first step toward the economic evaluation of suicide prevention measures.

This study examines (a) changes in emergency department-recorded suicide attempts, suicidal ideation and non-suicidal self-injury in youth, including repeat emergency department visits; and (b) related hospital costs for these patients, from a health insurer perspective.

In this cross-sectional study, data from various sources was combined to identify all youth aged ≤27 years visiting a Dutch inner-city emergency department between 2016 and 2023 for a suicide attempt, suicidal ideation or non-suicidal self-injury. Hospital records were reviewed manually to determine inclusion. Ambiguities were discussed within an expert panel and descriptive analyses, Poisson regression and logistic regression analyses were performed. For a subset of 30 patients, invoiced costs were determined.

The number of suicide attempts increased by approximately 5% annually, peaking in 2022 (n = 172); there were significantly more female patients (71%), and the median age was 21 years. Cases of suicidal ideation showed a similar trend, whereas the number of recorded non-suicidal self-injuries reduced. A total of 28.5% of all patients (n = 281) had one or multiple repeat visits for the above reasons. Median suicide attempt-related costs per case were €930, range €385–€33 473.

Since 2016, an increasing number of youth visited the emergency department of a Dutch hospital after a suicide attempt, but this increase does not seem to continue after 2022. Hospital-invoiced costs differ substantially between patients.

Diabetes distress, whereby people with diabetes experience distressing psychological symptoms associated with living with their condition, is an emerging problem in India. Diabetes distress leads to self-care deficits, suboptimal glycaemic control (which can lead to increasing risks of complications) and impaired quality of life.

To determine the burden of diabetes distress and its associated factors in an Indian tertiary care centre in Trichy, Tamil Nadu, India, covering a population of 1.25 million.

This prospective observational study involved a structured questionnaire covering demographic and clinical details, which was given to patients. The Diabetes Distress Scale 17 (DDS-17) was used to assess diabetes distress levels. The DDS-17 also measures four subdomains: emotional burden, physician-related distress, regimen-related distress and diabetes-related interpersonal distress. Patients were divided into two groups based on their DDS-17 score: no diabetes distress (DDS-17 score <2) versus diabetes distress (DDS-17 score ≥2) and compared. Correlation analysis, chi-squared tests and t-tests were used, with P < 0.05 considered statistically significant.

Of 1019 respondents (mean age 56 years; 59.6% male, 40.4% female), diabetes distress was reported in 24.4% (n = 249). Factors significantly associated with higher DDS-17 scores were younger age (<45 years) (P < 0.0001), long-standing diabetes (>10 years) (P < 0.0001), and smoking and alcohol (P < 0.05). Significant protective factors for diabetes distress included working, daily exercise, no comorbidities and medical insurance cover (P < 0.05). Significant positive correlation between DDS-17 score and all four subdomains was observed (P < 0.0001).

Our findings highlight the need for routine psychological screening and holistic management strategies in diabetes care, to improve patient outcomes and quality of life.

The COVID-19 pandemic has been described as a prolonged societal trauma providing new understanding of long-term post-traumatic stress reactions, both generally and in specific at-risk populations.

The present study examined the longitudinal course of post-traumatic stress disorder (PTSD) symptoms within one of the most high-profile risk groups (i.e. healthcare staff).

The sample comprised 439 healthcare staff who completed the Northern Ireland longitudinal COVID-19 Staff Wellbeing Survey on a minimum of 3 out of 4 distribution time points. The survey was administered repeatedly over 4 years, spanning both peri- and post-pandemic periods (2020–2023), and contained the Impact of Event Scale-Revised, as well as bespoke items on COVID-19, demographics, occupational issues and support factors.

Three distinct classes emerged from a three-class, latent class growth analysis model. A ‘resilient’ group (74%) displayed symptoms that remained below cut-offs for clinically significant moderate–severe post-traumatic stress throughout the pandemic, whereas a ‘recovering’ group (23%) exhibited moderate–severe symptoms during the pandemic, which then decreased to subthreshold levels post-pandemic. A key at-risk group was the ‘chronic’ class (4%), which had moderate–severe post-traumatic stress symptoms peri-pandemic that continued to increase post-pandemic. Significant predictors of the ‘recovering’ and ‘chronic’ classes included perception of poor communication within the healthcare organisation; increased exposure to COVID-19 outside their work; and increased personal health risk factors for COVID-19.

Post-pandemic PTSD monitoring and support for healthcare staff may be warranted alongside the development of internal communication strategies within healthcare systems to protect staff and services going forward.

Patient satisfaction is an important indicator of mental healthcare quality. The Client Satisfaction Questionnaire-8 (CSQ-8) is widely used, but its psychometric performance and contextual relevance have not been examined in humanitarian settings.

To assess the reliability and validity of the CSQ-8 in a sample of displaced and conflict-affected Syrian mental health and psychosocial support (MHPSS) service users.

Structured telephone interviews were conducted with Syrian MHPSS service users in North-West Syria. Psychometric analysis assessed the internal consistency and construct validity of the CSQ-8. Convergent validity with therapeutic alliance was examined using the Working Alliance Inventory Short Revised. Item comprehension and contextual relevance were examined using open-ended qualitative responses.

Among 337 participants, the CSQ-8 demonstrated strong internal consistency (ω = 0.92), but suboptimal model fit (comparative fit index 0.922; Tucker–Lewis index 0.890; root mean square error of approximation 0.132). Convergent validity with therapeutic alliance confirmed the importance of service user–practitioner relationships to satisfaction. Item 4 (‘Would you recommend the service?’) and item 8 (‘Would you return to the service?’) showed large ceiling effects and weaker psychometric properties. Qualitative data indicated responses to these items were shaped by community stigma, low expectations and a lack of alternative services, rather than satisfaction. A secondary analysis of the CSQ-4 showed good reliability (ω = 0.81) and improved model fit (comparative fit index 0.993; Tucker–Lewis index 0.980; root mean square error of approximation 0.065).

In this humanitarian setting, items about a willingness to recommend and intent to return to a service may lack conceptual validity and should be used cautiously. Shorter forms such as the CSQ-4 may be a useful alternative.

People with schizophrenia spectrum disorders (SSD) experience high rates of type 2 diabetes (T2D), mainly due to antipsychotic medication side-effects and lifestyle factors (e.g. suboptimal nutrition and physical inactivity). Digital technologies may reduce T2D risk by complementing face-to-face and pharmacological treatments, through the provision of flexible and personalised psychoeducation and behavioural prompts tailored to end-users.

This study tested the preliminary efficacy of the Schizophrenia and diabetes Mobile-Assisted Remote Trainer (SMART), a co-designed text message-facilitated intervention, designed to reduce the risk and/or improve self-management of T2D, along with its acceptability and feasibility.

Using an uncontrolled pre–post design, 29 out-patients of an endocrinology mental health clinic and two community-based rehabilitation mental health facilities used SMART for 12 weeks. The primary outcome was patient activation, measured using the Patient Activation Measure. Secondary outcomes were combined objective cardiometabolic and self-reported health and mental health indicators. Pre–post changes were analysed with a linear mixed model, accounting for within-participant variation.

Significant improvements (p < 0.05) were detected in patient activation, confidence in diabetes self-management and general health management, health literacy and mental health recovery. High levels of acceptability and feasibility were confirmed, with recruitment, retention and adherence rates of 67.4, 92.9 and 93.0%, respectively.

SMART is a world-first digital intervention aimed at improving metabolic health in individuals with SSD. This study provides evidence of its preliminary efficacy in self-management of metabolic health while confirming its high acceptability and feasibility, supporting expansion towards a sufficiently powered controlled trial to assess its clinical effectiveness.

The treatment of eating disorders by the National Health Service in England and Wales adheres to the National Institute for Health and Care Excellence (NICE) guidelines, which were informed by an experimental evidence base.

As the presentation and treatment of eating disorders have been shown to vary on the basis of age, we aimed to review the representation of older people in the evidence base for the NICE guidelines.

The evidence base was reviewed by identification of participant ages and the recruitment methods used in the experimental literature. The use of clinician referral was of particular interest, owing to the age-dependent risk of eating disorders being misdiagnosed in older adults.

The results highlighted low participant ages across the evidence base, most notably in anorexia nervosa samples. In accordance with the age data, a high frequency of clinician referral was used to recruit participants, with the highest rate identified in anorexia nervosa samples.

NICE guidance fails to consider the economic, social, political and health contexts around onset or chronological development of an eating disorder, with no reference to comorbidities which are commonly reported with older people or how this might affect diagnosis, formulation and treatment recommendations. Research is urgently required to inform clinical recommendations for older adults.

International evidence suggests that Early Intervention for Psychosis (EIP) services are both effective and cost-effective. Such evidence, however, comes almost exclusively from high-income countries.

Our aim was to estimate the cost-effectiveness of EIP services in a Latin American setting.

We compared EIP services against community mental health teams (CMHT) from the Chilean health system perspective. We developed a six-state Markov model to estimate the costs, benefits (measured as quality-adjusted life-years (QALYs)) and incremental cost-effectiveness ratio (ICER) for a 10-year time horizon. The model was populated with data from a Chilean EIP cohort, published literature and expert opinion. We characterised uncertainty through probabilistic sensitivity analysis and calculated the value of information to reduce such uncertainty.

In the base case analysis, EIP was cost-effective compared with CMHT, with an ICER of 5 550 044 Chilean pesos per QALY (USD 13 742 adjusted for purchasing power parity). Uncertainty analysis revealed an 80% probability of EIP services being the most cost-effective option at a willingness-to-pay threshold of one gross domestic product per capita (USD 15 923). Sensitivity analysis showed that the results were sensitive to parameters such as intervention effectiveness and cost, suggesting that a new trial might be worthwhile to reduce uncertainty.

This model suggests that implementing EIP services in Chile may cost more, but it is likely to be cost-effective. Nonetheless, more evidence about affordability, equity and broader perspectives is needed to improve the economic case of implementing EIP services in less-resourced settings, such as in Latin America.

Shared decision-making is essential to patient-centred care, but remains underutilised in psychiatry, particularly when deciding whether to continue, reduce or stop antipsychotic medication after remission from first-episode psychosis (FEP). Existing decision aids do not fully address recovery goals such as autonomy, identity and social reintegration.

To co-develop a patient decision aid (PDA) prototype that supports individuals in making the decision to continue, reduce or stop antipsychotics following remission from FEP.

We used a patient-centred design process informed by International Patient Decision Aid Standards (IPDAS), User Centered Design (UCD-11) and the CHIME framework. A multidisciplinary steering group – including individuals with lived experience, clinicians, and researchers – co-developed the PDA. Iterative feedback was collected from an external advisory group of patient partners, caregivers and healthcare providers (n = 7). Acceptability was evaluated with structured questionnaires.

The final prototype, structured into five sections (decision overview, personal values, risks and benefits, planning and real-life experiences), demonstrated strong acceptability across stakeholders. Ratings improved with each iteration, with version 3 receiving near-perfect scores on clarity, usefulness and balance. Users described the tool as relatable and empowering. The inclusion of real-life stories and visual decision exercises were particularly valued. However, some clinicians expressed concerns about time constraints and workflow integration.

This recovery-oriented PDA prototype offers a practical, evidence-based resource to facilitate shared decision-making with respect to continuing, reducing or stopping antipsychotics after FEP. Although early feedback is promising, pilot testing is needed to evaluate its impact on decision quality, satisfaction and treatment outcomes.

Youth in low- and middle-income countries (LMICs) bear a disproportionate burden of mental health conditions, alongside low health-seeking behaviours and limited access to services. These gaps underscore the need for accessible strategies such as youth peer-based mental health programmes and supports (Y-PBMHPS).

To examine whether Y-PBMHPS can help address the mental health needs of LMIC youth.

We conducted a rapid review of peer-reviewed literature, searching Medline, PsycINFO, CINAHL, CAB Global Health, Science Citation Index and Social Sciences Citation Index for studies of Y-PBMHPS in LMICs published in English between 1 January 2002 and 19 September 2025. Two review authors performed title/abstract screening and full-text review. Study quality was assessed by one review author using Joanna Briggs Institute critical appraisal tools. The primary outcome was change in mental health status, expressed in standardised difference units.

Of 6105 unique records identified, 329 studies were reviewed in full and 34 were included. All studies were conducted in Asia or Africa; 17 were quantitative studies (including randomised controlled trials), 9 were qualitative studies and 8 used quantitative designs with qualitative findings. Y-PBMHPS included counselling, psychotherapy, psychoeducation and self-help groups, with peers acting as leaders, facilitators, educators or service providers. Quantitative studies most frequently assessed anxiety and depression, reporting negligible to moderate effects. Qualitative findings indicated good fidelity, adherence and acceptability, alongside some feasibility challenges.

Y-PBMHPS can broaden youth mental health support and services in LMICs. Clearer guidelines on peer selection, training and supervision and further research in other LMICs, including cost-effectiveness evaluations, would strengthen the evidence base.

Cognitive complaints are common in multiple sclerosis, but their relationship to non-cognitive symptoms such as fatigue, sleep dysfunction and psychopathology has not been systematically examined in patients referred for specialist cognitive evaluation. These potentially modifiable symptoms may warrant attention in a clinical context.

This study aimed to characterise common patterns of cognitive and non-cognitive symptoms in a referred patient cohort and determine whether cognitive complaints are associated with clinically significant fatigue, sleep dysfunction and psychopathology.

Cognitive complaints were captured using (a) a binary classification derived from clinical impression and (b) a severity rating from a self-report instrument. Objective cognitive performance was measured across five cognitive domains. Patients also completed self-report measures of fatigue, sleep dysfunction and psychopathology.

Fifty-one patients were included. Although 98% had cognitive complaints, only 29% had objective cognitive impairment. Most (90%) had significant non-cognitive symptoms, primarily fatigue (86%), sleep dysfunction (28%) and depression (26%). Pattern analysis revealed that the most common symptom phenotype was cognitive complaints with significant non-cognitive symptoms, occurring in the absence of objective cognitive impairment. More severe cognitive complaints were associated with greater psychopathology (r = 0.57, BF10 = 2188.48), fatigue (r = 0.53, BF10 = 366.44) and sleep dysfunction (r = 0.47, BF10 = 69.27).

Cognitive complaints in multiple sclerosis may reflect broader non-cognitive symptom burden rather than objective cognitive impairment, even among patients referred for specialist evaluation. Their presence should prompt consideration of fatigue, sleep disturbance and psychopathology as potential targets for intervention.

Functional neurological disorder (FND) is a common condition, but there remain substantial gaps in our understanding of its effects, particularly on severity of disability and health status.

To characterise disability, quality of life and psychological and somatic symptom comorbidity in individuals with FND attending a specialist multidisciplinary clinic in Australia.

We conducted a cross-sectional analysis of patients assessed at an FND clinic in Sydney, Australia, between August 2022 and February 2025. We assessed disability (World Health Organization Disability Assessment Schedule (WHODAS 2.0)), health-related quality of life (EQ-5D five-level version (EQ-5D-5L), 36-Item Short Form Health Survey), psychological distress (Depression Anxiety and Stress Scale-21, Kessler Psychological Distress Scale (K10)) and somatic symptom severity (Patient Health Questionnaire-15 (PHQ-15)).

The cohort (N = 105) was predominantly female (74.3%), with a mean age of 35.4 (s.d. = 13.3) years. Functional seizures (46.7%) and functional weakness (45.7%) were the most common presentations. Only 33.7% were employed; 42.9% were unable to work because of FND. The average delay from diagnosis to clinic assessment was 356 days (s.d. = 463). WHODAS 2.0 scores indicated high levels of disability, exceeding international norms for both physical and mental illness. EQ-5D-5L scores were low, with 15.8% reporting a health state rated as ‘worse than death’. Psychological distress and somatic symptom severity were high: 49.5% scored in the K10 ‘very high’ range and 54.5% had high PHQ-15 scores.

FND is associated with significant functional disability, poor quality of life and high levels of psychological and somatic symptom comorbidity. Delays in accessing appropriate care and high rates of vocational disruption highlight the need for earlier diagnosis and better access to integrated, multidisciplinary FND services in Australia.

Clozapine is the gold-standard treatment for treatment-resistant schizophrenia but carries serious cardiac risks, including sudden cardiac death (SCD). Specific risk factors for SCD in clozapine-treated patients remain poorly defined.

To systematically identify and synthesise evidence on risk factors for SCD and sudden unexplained death (SUD) in clozapine-treated patients, to guide clinical monitoring.

We conducted a systematic review following Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines (PROSPERO, no. CRD420250646384). Five databases were searched from inception to 13 October 2025. Studies reporting SCD or SUD in clozapine-treated patients were included without restrictions on study design, demographics or diagnosis. Two reviewers independently screened studies and extracted data. Quality was assessed using Joanna Briggs Institute checklists and Risk Of Bias In Non-randomised Studies of Exposures tools. Given study heterogeneity, we performed structured narrative synthesis.

Twenty-one studies (1989–2023) were included, comprising 498 cases of SCD/SUD in clozapine-treated patients. Risk factors were grouped into four categories: treatment intensity (high doses (≥525 mg/day), rapid titration), drug interactions (valproate, benzodiazepines, polypharmacy), lifestyle factors (smoking, obesity, diabetes, substance use) and monitoring. Two patterns emerged: early inflammatory myocarditis (weeks 2–6) and late-onset cardiomyopathy (months–years).

Clozapine-associated SCD appears multifactorial. These findings suggest a role for gradual titration, avoidance of high-risk co-medications, baseline biomarker monitoring and ongoing management of metabolic and cardiovascular risk factors. Increased multidisciplinary surveillance may help identify patients at higher risk and inform clinical decision-making in clozapine-treated patients.

Sleep hygiene plays a crucial role in mental well-being, yet its influence on the relationship between anxiety and sleep quality in young adults remains underexplored.

This study examines whether sleep hygiene mediates the bidirectional association between anxiety and sleep quality, identifying key behavioural targets for intervention.

A cross-sectional study was conducted with 405 randomly selected college students who completed validated assessments of sleep hygiene, anxiety and sleep quality. Mediation and network analyses were employed to investigate the underlying mechanisms.

Sleep hygiene significantly mediated the relationship between anxiety and sleep quality, emphasising the role of consistent sleep–wake schedules. Network analysis identified irregular sleep patterns and specific sleep quality components – wakefulness behaviours, sleep initiation and self-reported sleep quality – as primary factors.

These findings highlight sleep hygiene as a modifiable, non-pharmacological strategy to mitigate anxiety and improve sleep quality. Future research should explore longitudinal interventions.

Global initiatives to reduce restrictive practices in mental health settings have gained increasing attention. However, discrepancies in restrictive practice rates create uncertainties about whether these variations reflect true differences in clinical practices or arise from inconsistent classification and reporting methods.

This study investigated how healthcare professionals classify and report potential restrictive practice scenarios, and examined variations in classification and documentation across diverse facilities.

This was an international survey conducted using an online questionnaire via the Qualtrics platform. Healthcare professionals working in adult mental health in-patient settings were recruited through multiple media platforms and snowball sampling. The questionnaire included 44 potential restrictive practice case scenarios. Participants rated each scenario as follows: (a) whether it should be classified as a restrictive practice; (b) whether it should be recorded as such; (c) whether it would be classified as a restrictive practice within their facility; and (d) whether it would be reported as a restrictive practice in their facility. Survey development was guided by systematic reviews and co-design work with stakeholders. Data were analysed using ordered regression models, with clustering by participant identity and country. Robust standard errors were applied to ensure accurate estimation of variability.

A total of 491 healthcare professionals from 41 countries participated. Results indicated substantial inconsistencies in clinicians’ perspectives regarding what constitutes restrictive practices and whether a given action should be reported as a restrictive practice. Although participants frequently identified scenarios as restrictive practices, their intention to report them was considerably lower. Additional discrepancies were observed between clinicians’ individual perspectives and their expectations of how these practices were actually being classified and reported as restrictive practices within the in-patient facilities where they work.

Discrepancies between healthcare professionals’ classification of restrictive practices and their reporting intentions, as well as between their perspectives and actual institutional practices, highlight potential errors in current reporting systems. These findings underscore the need for standardised definitions, enhanced reporting frameworks and structured training programmes and monitoring mechanisms to improve consistency in the management of restrictive practices across mental health settings.

Depression is common in end-stage kidney disease (ESKD) and is associated with poorer outcomes and higher mortality. However, treatment guidance is inconsistently applied.

To investigate screening measures, somatic symptoms, comorbidities and psychosocial and cultural influences on depression diagnosis in ESKD patients.

We recruited 300 people with ESKD receiving maintenance hospital haemodialysis in a deprived ethnically diverse area. We assessed depression using validated screening tools (Hamilton Depression Rating Scale and Patient Health Questionnaire 2) and a definitive ICD-10 diagnosis using a structured interview (Clinical Interview Schedule-Revised). We considered the role of adverse life events, co-occurring medical conditions, as well as age, sex and ethnicity, using descriptive statistics and multiple logistic regression.

An ICD-10 diagnosis of moderate or severe depression was made in 8% of the sample, taking care to exclude potentially confounding symptoms associated with chronic kidney disease and depression. Applying validated thresholds on commonly used screening tools yielded substantially higher prevalence estimates. An ICD-10 diagnosis of moderate and severe depression associated with loss events: death of a spouse, child or parent (odds ratio 3.62, 95% CI: 1.09–12, p = 0.04), financial strain (odds ratio 3.51, 95% CI: 1.04–11.87, p = 0.04), type 2 diabetes (odds ratio 5.32, 95% CI: 1.34–20.76, p = 0.02) and education, whereby university graduates were less likely to have depression than school-only attendees (odds ratio 0.18, 95% CI: 0.03–1.02, p = 0.05). Ethnicity and sex were not significantly associated with moderate or severe depression.

We found a lower prevalence of moderate to severe depression than commonly reported. Future research should consider careful diagnostic assessment, financial strain, loss events and physical co-occurring medical conditions such as diabetes.

The QualityRights initiative has shown benefits in decreasing coercive practices and enhancing the recognition of human rights in healthcare.

To translate the World Health Organization’s (WHO) QualityRights Practices Questionnaire into Spanish and assess the relationships between coercive practices in healthcare settings, perceptions of mental disorders, and attitudes and commitment to human rights among primary healthcare professionals from multiple disciplines. Also, we sought to compare these variables between trained and untrained professionals, and evaluate longitudinal outcomes of integrating QualityRights training into undergraduate medical education.

A quasi-experimental study with a non-equivalent control group was conducted. Instruments included the Community Attitudes Toward the Mentally III, Human Rights Exposure in Social Work and Human Rights Engagement in Social Work scales, and the WHO QualityRights Practices Questionnaire. A total of 260 professionals from 12 Colombian regions participated in the study. Multiple linear regression analyses were conducted to examine the effects of the QualityRights initiative on various dimensions related to human rights.

Translation and validation of the WHO QualityRights Practices Questionnaire yielded excellent psychometric properties (Kaiser–Meyer–Olkin value: 0.945; Cronbach’s α = 0.891–0.923; single component explaining 73.4% of variance). The QualityRights initiative was significantly associated with greater human rights knowledge and lower endorsement of coercive practices and authoritarian beliefs. In relation to coercive practices, the initiative was significantly associated with lower scores on the QualityRights Practices Questionnaire (B = −3.118, p < 0.001).

In Colombia, incorporating the QualityRights initiative into medical education appears to be a promising strategy for reducing stigma, enhancing knowledge and commitment to human rights, and minimising coercive practices in primary mental healthcare.