Questions have been raised whether the patient organisations assessments of coercion – often critical – captures the breadth of patient experiences of coercion. Existing systematic reviews have not captured the full scope of reported experiences, necessitating a more comprehensive approach.

To identify the existing body of qualitative studies reporting patients’ experiences of coercion; map study distribution over time, regions, and type of coercion; and synthesise broad categories of reported experiences.

The review protocol was preregistered (PROSPERO identifier CRD42021248744). We searched 12 databases (MEDLINE, Embase, APA PsycINFO, CINAHL, Web of Science, Sociological Abstracts, Scopus, ASSIA, Norart, SveMed+, OpenGrey.eu and Google Scholar) for qualitative studies published from 1 January 1991 to 3 June 2025. Peer-reviewed studies and approved doctoral theses were included. We used EPPI-Reviewer for screening, data extraction and coding. Study quality was assessed with a modified Critical Appraisal Skills Programme tool.

We included 291 studies, 18 of them from low-and middle-income countries. The most studied coercive practices were involuntary admissions, coercive measures and community treatment orders. Quality concerns included limited author reflexivity and lack of involvement of experts by experience. At least one negative experience was reported in 279 of the studies, while mixed and positive experiences appeared in 166 and 167, respectively.

A large body of qualitative research reporting patient experiences of coercion exists, with a near-universal presence of negative experiences. Improved patient involvement in research, and more studies from low-and middle-income countries and on involuntary medication are needed.

Post-migration stressors can exacerbate post-traumatic stress disorder (PTSD) and reduce treatment effectiveness among refugees. Evidence for integrated care models in high-income settings remains limited.

To compare treatment as usual (TAU) with an add-on integrated care intervention for unemployed refugees with PTSD.

We conducted a two-arm, parallel-group superiority trial with 1:1 randomisation to TAU or TAU with an add-on integrated care intervention, delivered at a specialised out-patient clinic in Denmark (ClinicalTrials.gov NCT04244864). TAU included sessions with a psychologist and physician over 8–12 months. The integrated care intervention also included structured collaboration with employment services. The primary outcome was functioning, using the 12-item World Health Organization Disability Assessment Schedule 2.0 (WHODAS) interview. Secondary outcomes included symptoms, quality of life and post-migration stressors. Analyses followed the intention-to-treat principle, using analysis of covariance and linear regression with multiple imputations.

The study included 195 patients in treatment from 2020 to 2025. No difference was observed in WHODAS score between groups pre- to post-treatment (mean difference 0.30, 95% CI −2.40 to 3.00; P = 0.825). Similarly, no differences were found for secondary or exploratory outcomes, and overall change was limited. However, the integrated care group had a lower rate of early dropout (P = 0.042) and higher level of treatment satisfaction (P = 0.035).

Integrated care was feasible but not superior to TAU in improving outcomes for refugees with longstanding symptoms and unemployment. Future research should examine how the timing and intensity of integrated care interventions influence outcomes, including earlier implementation and adequate support for refugees with longstanding and complex needs.

Individuals with schizophrenia have shown distinct cancer incidence patterns.

We aimed to assess whether their cancer-related mortality differs from the general population overall, by gender and by specific cancer types.

We systematically searched Scopus, Web of Science, PsycINFO, PubMed and Embase, up to December 2025. Each record was independently screened by two reviewers, and data were independently extracted by two investigators. Two authors assessed the quality of the included articles with the Newcastle–Ottawa Scale. Analyses were conducted using Stata version 16; between-study heterogeneity was evaluated with Cochran’s Q-statistic and the I2-statistic, and potential sources of heterogeneity were further examined through exploratory meta-regression.

Meta-analysis of cohort studies showed that individuals with schizophrenia had a 55% higher risk of cancer-related death than the general population (standardised mortality ratio (SMR) 1.55; 95% CI 1.16–2.07). In gender-stratified analyses, SMRs for all cancers combined were 1.37 (95% CI 1.01–1.87) in men and 1.43 (95% CI 1.15–1.79) in women. Site-specific SMRs were 1.77 (95% CI 1.17–2.68) for breast, 2.40 (95% CI 2.35–2.45) for respiratory, 1.54 (95% CI 1.35–1.76) for gastrointestinal, 2.32 (95% CI 0.72–7.45) for haematologic, 4.43 (95% CI 0.71–27.62) for skin and soft tissue, 3.03 (95% CI 1.96–4.69) for urogenital and 1.01 (95% CI: 0.36–2.83) for other cancers, although precision varied considerably across cancer sites.

Schizophrenia was associated with substantially elevated cancer-related mortality compared with the general population. These findings underscore the need for earlier cancer detection and guideline-concordant, integrated physical and mental healthcare for this high-risk group.

The integrated motivational–volitional (IMV) model of suicidal behaviour has received growing empirical support, yet few studies have tested its core pathways (defeat → entrapment → suicidal ideation → suicide attempts) in clinical psychiatric adolescent populations. Evidence on volitional moderators influencing the transition from ideation to action remains limited.

This study aimed to (a) test the core pathways of the IMV model and (b) examine whether volitional moderators differentiate between adolescents with suicidal ideation and those who have attempted suicide.

In this cross-sectional study, 203 Danish adolescents aged 13–19 years were recruited from an out-patient child and adolescent psychiatry department, including patients in treatment or referred for initial assessment. Participants completed validated measures assessing IMV constructs. Path analysis tested the core pathways and multinomial logistic regression examined associations between volitional moderators and group membership (no suicidal behaviour, suicidal ideation only and suicide attempt), with Wald tests comparing effects across outcomes.

Findings supported the core IMV pathway, with the entrapment–ideation pathway being weakest. Volitional moderators were more strongly associated with suicide attempts than suicidal ideation, with significant differences confirmed by Wald tests. A dose–response pattern showed increasing likelihood of suicide attempts with greater exposure to volitional moderators; effect sizes differed significantly between ideation (odds ratio 2.21) and attempts (odds ratio 3.94).

Results support the IMV model and highlight the role of volitional moderators in differentiating between suicidal ideation and attempts. These findings support a shift towards theory-informed psychosocial assessment in clinical adolescent populations.

Discriminatory practices and barriers to care are increasingly recognised as a significant challenge for mental healthcare institutions. Yet, little research has considered what measures people with experience of using mental health services and mental healthcare service providers recommend to implement anti-discrimination within mental healthcare.

This study aims to explore the perspectives and recommendations of marginalised people with experience of using mental health services, mental healthcare service providers and psychosocial counsellors, to inform more equitable mental healthcare.

Between May 2022 and June 2023, we conducted 17 semi-structured qualitative interviews and 2 focus groups with psychosocial counsellors, people with experience of using mental health services and mental healthcare service providers. Data analysis followed structuring qualitative content analysis, combined with participatory methods.

Study participants recommended interpersonal, organisational and structural measures to address mental healthcare inequities. On an interpersonal level, they emphasised providers’ behaviour and attitudes toward discrimination. Organisationally, they called for a comprehensive intersectional care framework, fostering inclusive therapy environments, increasing staff diversity and implementing continuous anti-discrimination training. Structurally, they advocated for discrimination-critical therapy materials, revised curricula and removing barriers to medical education and healthcare.

The study yielded suggestions for anti-discriminatory, critical consciousness-based and inclusive practices on the interpersonal, organisational and structural levels of mental healthcare. It offers important insights for research devoted to implementing and evaluating such measures.

Task-sharing with non-specialist providers offers a promising solution to the mental health workforce shortage in low-resource settings. Supervision is essential to ensure treatment quality, but is often constrained by limited specialist availability.

This study evaluated the costs of developing PEERS, a smartphone app that can facilitate registering and scheduling supervision sessions, collecting patient outcomes, rating therapy quality and assessing supervision quality among community-based non-specialist providers delivering behavioural activation for depression.

The PEERS digital application was developed between June 2021 and September 2022 for use in Madhya Pradesh and Goa, India. Development involved contributions from researchers, clinicians, technology experts and end users. Activity-based costing was used to systematically document the inputs and expenditures involved in developing the PEERS app and its accompanying training materials from a health systems perspective. Key cost components included human resources, leadership, IT support and infrastructure.

Total development costs were US＄130 027, with the costs of information technology accounting for the largest share (81%; US＄105 110). Human resource contributions accounted for 17% (US＄22 523), which included oversight and contributions from international research collaborators. Additional costs included overhead and infrastructure (US＄2393).

Digital tools are increasingly being used to expand access to and support the delivery of mental health interventions in low-resource settings, yet few studies report on the development costs. By estimating the costs and resources required for developing a digital app for peer supervision, this study can inform efforts to facilitate broader implementation and adaptation of the app for use in other settings.

Afghan refugees experience high levels of cumulative trauma and psychosocial adversity, yet attachment-related trauma has rarely been examined at the narrative level. Narrative attachment assessments may capture culturally embedded expressions of distress beyond post-traumatic stress disorder (PTSD)-focused symptom models.

This study examined narrative attachment-related trauma markers in Afghan refugees receiving out-patient psychological treatment. It investigated whether trauma marker frequency differed between resolved and unresolved attachment representations and whether it was associated with psychological symptom severity.

In an exploratory cross-sectional study, 40 Afghan refugees (mean age = 25.4 years; 75% male) receiving out-patient psychological treatment completed the Adult Attachment Projective Picture System, a narrative-based attachment interview. Trauma markers were identified and quantified within the narratives. Associations with attachment representations (resolved versus unresolved) and psychological symptom severity were examined in a subsample with available self-report data (n = 27).

Participants with unresolved attachment representations showed higher trauma marker frequencies than those with resolved representations. Trauma marker frequency was positively associated with depressive symptoms and overall psychological distress (Spearman’s effect size estimate (r) = 0.40–0.51; 95% bias-corrected and accelerated (BCa) confidence intervals excluding zero) but not with PTSD symptom severity.

Trauma markers captured clinically relevant distress in Afghan refugees beyond PTSD-specific symptomatology, particularly depressive symptoms and general psychological burden. Narrative, attachment-based approaches may be especially valuable in clinical encounters in which distress is conveyed implicitly, relationally, or in culturally contextualised ways rather than through explicit symptom reporting. Culturally sensitive applications of such methods, supported by well-trained interpreters, are essential for clinical understanding and meaningful clinical engagement.

Clozapine reduces overall mortality and suicide risk in schizophrenia, but the specific causes and clinical contexts of death among clozapine-treated patients remain less well characterised.

We aimed to characterise causes of death in clozapine-treated patients within a defined UK catchment area over 17 years (2009–2025); compare features across predefined mortality clusters (suicide, expected, unexpected); compare unexpected death cases with a clozapine-treated comparison cohort alive in 2019 and examine temporal mortality patterns.

We conducted a retrospective, descriptive cohort study of all deaths among clozapine-treated patients within a UK mental health National Health Service Trust between 1 January 2009 and 31 December 2025. Deaths were classified into suicide, expected and non-intentional unexpected, using a previously established framework. Variables were compared across clusters and between unexpected death cases and a clozapine-treated comparison cohort alive in 2019.

Of 87 deaths, 11 (12.6%) were suicides, 29 (33.3%) were expected and 47 (54.0%) were non-intentional unexpected. Malignancy was the most common cause (21/87, 24.1%), followed by cardiovascular (13/87, 14.9%) and respiratory or infective causes (9/87, 10.3%). Age differed across clusters (p = 0.005), with suicides at younger ages. Compared with the 2019 cohort, patients who died unexpectedly were older (55.0 v. 48.6 years, p = 0.006) and more likely to smoke (75.0 v. 34.6%, p < 0.001). Annual mortality peaked in 2021 and was not fully explained by direct COVID-19 deaths.

Mortality in clozapine-treated patients arises across diverse clinical contexts, with more than half classified as non-intentional unexpected. Findings support sustained physical health monitoring, closer attention to smoking and other modifiable risks, and continuity of care.

Peritraumatic dissociation and distress are among the most frequently studied early correlates of post-traumatic stress disorder (PTSD), yet their temporal role following large-scale disasters remains insufficiently understood.

This study examined the temporal relationship between peritraumatic dissociation, peritraumatic distress and PTSD symptoms across 3 waves spanning 2 years following the February 2023 Turkey earthquakes.

Data were collected approximately 2 months (Time 1; N = 261), 1 year (Time 2; n = 182) and 2 years post-earthquake (Time 3; n = 131). PTSD symptoms, peritraumatic dissociation and peritraumatic distress were assessed using validated self-report instruments. Pearson correlation analyses and parallel-process latent growth curve models (LGMs) were used to examine temporal changes and longitudinal associations.

Higher initial levels of peritraumatic dissociation (β = 0.40, p < 0.001) and distress (β = 0.46, p < 0.001) significantly predicted greater initial PTSD severity. However, neither peritraumatic dissociation nor distress predicted the slope of PTSD symptoms over time, and slope covariances were non-significant. All three variables declined substantially across waves (ηp2 = 0.75 to 0.79).

Peritraumatic reactions appear to function primarily as indicators of early PTSD severity rather than determinants of long-term symptom trajectories. These findings support multi-stage screening approaches that extend beyond early peritraumatic assessments to incorporate post-traumatic cognitive, social and environmental factors.