Women’s authorship position in science, technology, engineering, mathematics and medicine research reflects career progression, especially the transition from first to last (usually senior) author. Employment of women in mental health sciences has increased, and so should have had an impact on the change to senior author position.

To identify if first or last women’s authorship has changed, and mental health has better representation.

We investigated women’s authorship position in a systematic review and meta-analyses, following PRISMA guidelines and using random-effects regression analyses.

We identified 149 studies with sampling periods from 1975 to 2020 (excluding potential COVID-19 pandemic effects) that showed a large variation of women authors, and found an average proportion for first (26.2%) and last (16.1%) author position. In mental health (psychology and psychiatry), there was a higher representation, with 40% first author and 36.7% last author position, whereas medicine was 25.9% and 19.5%, respectively. The rate of change for psychology and psychiatry women authors was also higher every 10 years: 8.56% (95% CI 6.44–10.69%) for first and 6.86% (95% CI 4.57–9.15%) for last author, and rate was 2.35% higher for first author and 2.65% higher for last author than in medicine. Different methods of classifying gender and identification method did not affect our results.

Although mental health topics seem to fare better, our comprehensive review highlighted that the proportions of women first compared with last authors shows the same leaky pipeline as in other analyses, so we cannot be complacent about gender equality and career progression.

Knowledge on efficient approaches to the provision of post-disaster psychosocial care is urgently needed. To prevent unmet healthcare needs, proactive follow-up by municipal contact persons was recommended for survivors of the Utøya youth camp attack in Norway.

To examine characteristics of the survivors by whether or not they had a contact person in the early (0–5 months), intermediary (5–15 months) and long-term (20–32 months) aftermath of the attack, and to describe the survivors’ experiences with the contact person.

We analysed data from three waves of interviews with survivors conducted 4–5, 14–15 and 30–32 months after the attack, as well as register-based data on the use of mental health services from 3 years before until 3 years after the attack.

Survivors with a contact person early post-attack were less likely to receive care from mental health services concurrently or to have anxiety/depression symptoms subsequently compared with survivors without a contact person in the same period. Survivors with a contact person in the intermediary aftermath were more satisfied with the overall help they received, but also more likely to have long-term anxiety/depression symptoms. Survivors with a contact person in the long term were more likely to be financially disadvantaged. Approximately half of the survivors with a contact person found this highly or very highly useful, whereas one-third found it of little use or not at all useful.

The proactive outreach reached survivors across sociodemographic characteristics during the recommended first year of follow-up, which could be conducive to prevention of unmet healthcare needs. Still, there was considerable variation in the perceived usefulness and duration of the follow-up.

A lifetime history of non-suicidal self-injury (NSSI) is a risk factor for subsequent behavioural and emotional problems, including depression, aggression and heightened emotional reactivity. Traumatic experiences, which are frequently reported by individuals with NSSI, also show predictive links to these mental health problems. However, the exact connections between these areas and their subdomains remain unclear.

To explore in detail the relationships of specific characteristics of NSSI (e.g. termination in adolescence, duration, frequency, reinforcement mechanisms) and various types of traumatic experience (emotional, physical, sexual) with distinct aspects of emotional reactivity (sensitivity, intensity, persistence), aggression (behavioural, cognitive, affective) and severity of depression in university students.

Via online survey, 150 university students aged 18 to 25 years, who had self-injured at least once, provided information on NSSI, and completed questionnaires including the Childhood Trauma Questionnaire, Patient Health Questionnaire, Emotion Reactivity Scale, and Aggression Questionnaire. Regression analyses were conducted to determine risk factors linked to increased depression scores, aggression and emotional reactivity. The study was pre-registered in the German Clinical Trials Register (DRKS00023731).

Childhood emotional abuse contributed to emotional reactivity, aggression and depressive symptom severity (β = 0.33–0.51). Risk factors for sustained NSSI beyond adolescence included increased automatic positive reinforcement (odds ratio: 2.24).

Childhood emotional abuse significantly contributes to emotional and behavioural problems and needs to be considered in NSSI therapy. NSSI was found to persist into adulthood when used as an emotion regulation strategy.

Family and friends (family carers) provide substantial support to those with mental ill health, often affecting their own well-being. Subsequently, family carers have their own recovery journeys. Research highlights numerous benefits of attending Recovery Colleges, but whether these apply for family carers remains unexplored.

We aimed to explore family carers’ experiences of attending Recovery Colleges across England, to understand current provision and how this might better include and support family carers.

Together with lived experience researchers, this qualitative focus group study used collaborative thematic analysis of online focus groups and interviews with family carers and Recovery College staff from across England.

We generated six superordinate themes: ‘The “carer” identity is not clearcut’, ‘Recovery ethos applies to family carers too’, ‘Power of lived experience’, ‘Educational focus is appealing’, ‘Family carers deserve recognition and provision’ and ‘Reaching out and fitting around family carers’. Attending Recovery Colleges developed family carers understandings and gave them skills to navigate services and support themselves and others, which furthered their own recovery journeys. Shared learning spaces were helpful, but participants felt these were not always oriented to include family carers. Our findings revealed ways Recovery Colleges could increase their relevance and accessibility to family carers.

The unique characteristics of Recovery Colleges suited the recovery needs of family carers. However, more resources are needed to develop this potential and reach more family carers. Family carer co-researchers enriched our findings, and discussions with the Recovery College community furthered our recommendations for practice.

There is an urgent need to understand explanatory factors of poor mental health before (pre-) and during (peri-) the COVID-19 pandemic in university students, especially those from underrepresented and minority groups.

To examine potential differences and explanatory factors for psychological distress, clinical risk and impact of problems on academic outcomes pre- and peri-pandemic in university students.

A repeated cross-sectional design was used with routine data between August 2018 and July 2022 at the registration stage from a student counselling and mental health service at a UK university. Wilcoxon signed-rank tests were used to examine pre- and peri-pandemic differences in outcomes. Unadjusted and adjusted linear regression models were conducted to assess potential explanatory factors for poor outcomes.

A total of 9517 university students had completed sociodemographic and outcome data and were included in analysis. Psychological distress and impact of problems on academic outcomes were not significantly different between pre- and peri-pandemic groups. Clinical risk was significantly higher in the pre-pandemic than peri-pandemic group. Potential explanatory factors for poorer outcomes included being younger, female or non-binary/genderqueer, sexual minority, from a minority ethnic group, having home fee status and having a disability registration.

Poor student mental health profiles and related explanatory factors may not have changed drastically between pre- and peri-pandemic. Longitudinal methods and intersectional approaches should be used in future research. Further understanding of how universities and student mental health services can most efficiently and effectively support the mental health of university students is crucially warranted.

Adolescence is the peak life stage for the development of mental illness. Whole-school approaches to mental health and well-being, modelled on the World Health Organization’s Health-Promoting Schools Framework, hold vast potential in this developmentally sensitive period. However, the evidence base for these interventions is inconclusive.

Our study examines the effectiveness of The Resilience Project School Partnership Program, a whole-school intervention involving students, teachers and parents, centred around concepts of gratitude, empathy, emotional literacy and mindfulness.

A quasi-experimental study with an intervention and a control arm was used to evaluate the programme in 40 149 students across 102 schools in 2023. Data collected included sociodemographic information and outcomes derived from validated scales, comprising life satisfaction, hope, coping skills, anxiety and depression. Intervention schools were stratified by the number of years they had implemented the programme, and mixed-effects regression models were used to evaluate the programme.

After adjusting for confounders, participants at schools who had been implementing the programme for 6 years or longer demonstrated significantly better outcomes across all five domains (life satisfaction: B = 0.627, 95% CI 0.465–0.789; hope: B = 2.135, 95% CI 0.895–3.347; coping skills: B = 0.438, 95% CI 0.250–0.625; anxiety: odds ratio = 0.658, 95% CI 0.559–0.774; depression: odds ratio = 0.534, 95% CI 0.459–0.620). Only depression was significantly lower among participants at schools in their fourth or fifth year of implementing the programme (odds ratio = 0.941, 95% CI 0.935–0.948).

Our findings indicate that whole-school interventions may require long-term investment to realise their potential and highlight implementation duration as an important consideration for future evaluations of whole-school interventions.

A systematic review/meta-analysis synthesising the existing evidence regarding the prevalence of loneliness and social isolation among individuals with mild cognitive impairment (MCI) or dementia is lacking.

A systematic review and meta-analysis was conducted to investigate the prevalence and factors associated with loneliness and social isolation among individuals with MCI or dementia.

A search was conducted in five established electronic databases. Observational studies reporting prevalence and, where available, factors associated with loneliness/isolation among individuals with MCI and individuals with dementia, were included. Important characteristics of the studies were extracted.

Out of 7427 records, ten studies were included. The estimated prevalence of loneliness was 38.6% (95% CI 3.7–73.5%, I2 = 99.6, P < 0.001) among individuals with MCI. Moreover, the estimated prevalence of loneliness was 42.7% (95% CI 33.8–51.5%, I² = 90.4, P < 0.001) among individuals with dementia. The estimated prevalence of social isolation was 64.3% (95% CI 39.1–89.6%, I² = 99.6, P < 0.001) among individuals with cognitive impairment. Study quality was reasonably high. It has been found that living alone and more depressive symptoms are associated with a higher risk of loneliness among individuals with dementia.

Social isolation, and in particular loneliness, are significant challenges for individuals with MCI and dementia. This knowledge can contribute to supporting successful ageing among such individuals. Future research in regions beyond Asia and Europe are clearly required. In addition, challenges such as chronic loneliness and chronic social isolation should be examined among individuals with MCI or dementia.

Evidence indicates that the COVID-19 pandemic has led to an increase in self-harm among adolescents; however, little is known about the trends in prevalence after the end of the pandemic.

This retrospective cross-sectional database study evaluates changes in the prevalence and clinical characteristics of self-harm among adolescents who sought attention from the emergency service of the largest children’s psychiatric hospital in Mexico before, during and after the COVID-19 pandemic.

After comparing the clinical characteristics of self-harm between the three periods, we calculated the monthly prevalence of self-harm among patients (n = 3520) visiting the hospital’s emergency psychiatric services over a period of 58 months. Using joinpoint regression, we evaluated temporal trends in self-harm prevalence.

Affective disorders and hitting as a method of self-harm were more frequent during and after the pandemic in comparison with the pre-pandemic period. The prevalence of self-harm diminished from March 2019 to March 2023, a trend followed by an increase coinciding with the end of the pandemic and the return to normal activities.

The significant increase in prevalence observed after the end of the pandemic suggests a long-term impact on mental health of adolescents. This underscores the need for monitoring this population during post-pandemic years to provide timely interventions.

Second-generation antipsychotics (SGAs) can cause corrected QT interval (QTc) prolongation as a side-effect. This may limit their clinical use and pose safety concerns for patients.

To analyse the risk of QTc prolongation associated with eight second-generation antipsychotics and observe the timing characteristics of QTc prolongation events and subsequent changes in medication strategies.

Using data from the hospital information system of a large mental health centre, this retrospective cohort study included 5130 patients (median follow-up: 141.2 days) treated between 2007 and 2019. A marginal structural Cox model was used to compare the hazard ratios for QTc prolongation associated with various SGAs.

The mean age of the cohort was 35.54 years (s.d. = 14.22), and 47.8% (N = 2454) were male. Ziprasidone, amisulpride and olanzapine were the only SGAs associated with QTc prolongation. Ziprasidone presented the highest risk (hazard ratio 1.72, 95% CI: 1.03–2.85, adjusted P = 0.03), followed by amisulpride (hazard ratio 1.56, 95% CI: 1.04–2.34, adjusted P = 0.03) and olanzapine (hazard ratio 1.40, 95% CI: 1.02–1.94, adjusted P = 0.04).

Ziprasidone, amisulpride and olanzapine are associated with increased risk of QTc prolongation. Regular electrocardiogram monitoring is recommended when clinicians prescribe such drugs.

Oral contraceptive pills (OCP) have received increased critical attention recently owing to their perceived link with mental health, especially among adolescent girls. The empirical literature, however, includes mixed findings on whether OCP use is associated with poorer mental health.

To examine the association between the use of OCP and internalising problems in adolescent girls.

This study was embedded in the iBerry study, a population-based cohort of adolescents oversampled for behavioural and emotional problems from the greater Rotterdam area, The Netherlands. In 372 girls, internalising problems were measured using the Youth Self Report, and use of OCP was determined by parental interview and self-report questionnaire across two subsequent waves (mean ages 14.9 and 17.9 years, respectively). Multiple regression analyses were performed to determine the association. Analyses were adjusted for various sociodemographic factors and adjusted for previous internalising problems assessed at a mean age of 14.9 years.

In total, 204 girls (54.8%) used OCP. OCP use was associated with fewer internalising problems in adolescent girls compared with non-use (adjusted β = −2.22, 95% CI [−4.24, −0.20]; P = 0.031).

In this research, we found that adolescent girls using OCP reported fewer internalising problems compared with non-users. This association was most prominent for girls with pre-existing internalising problems. Although healthy user bias may have a role, our observations suggest a potential therapeutic benefit for those with greater baseline challenges.

There is currently no definitive method for identifying individuals with psychosis in secondary care on a population-level using administrative healthcare data from England.

To develop various algorithms to identify individuals with psychosis in the Mental Health Services Data Set (MHSDS), guided by national estimates of the prevalence of psychosis.

Using a combination of data elements in the MHSDS for financial years 2017–2018 and 2018–2019 (mental health cluster (a way to describe and classify a group of individuals with similar characteristics), Health of the Nation Outcome Scale (HoNOS) scores, reason for referral, primary diagnosis, first-episode psychosis flag, early intervention in psychosis team flag), we developed 12 unique algorithms to detect individuals with psychosis seen in secondary care. The resulting numbers were then compared with national estimates of the prevalence of psychosis to ascertain whether they were reasonable or not.

The 12 algorithms produced 99 204–138 516 and 107 545–134 954 cases of psychosis for financial years 2017–2018 and 2018–2019, respectively, in line with national prevalence estimates. The numbers of cases of psychosis identified by the different algorithms differed according to the type and number (3–6) of data elements used. Most algorithms identified the same core of patients.

The MHSDS can be used to identify individuals with psychosis in secondary care in England. Users can employ several algorithms to do so, depending on the objective of their analysis and their preference regarding the data elements employed. These algorithms could be used for surveillance, research and/or policy purposes.

Preliminary evidence suggests that a ketogenic diet may be effective for bipolar disorder.

To assess the impact of a ketogenic diet in bipolar disorder on clinical, metabolic and magnetic resonance spectroscopy outcomes.

Euthymic individuals with bipolar disorder (N = 27) were recruited to a 6- to 8-week single-arm open pilot study of a modified ketogenic diet. Clinical, metabolic and MRS measures were assessed before and after the intervention.

Of 27 recruited participants, 26 began and 20 completed the ketogenic diet. For participants completing the intervention, mean body weight fell by 4.2 kg (P < 0.001), mean body mass index fell by 1.5 kg/m2 (P < 0.001) and mean systolic blood pressure fell by 7.4 mmHg (P < 0.041). The euthymic participants had average baseline and follow-up assessments consistent with them being in the euthymic range with no statistically significant changes in Affective Lability Scale-18, Beck Depression Inventory and Young Mania Rating Scale. In participants providing reliable daily ecological momentary assessment data (n = 14), there was a positive correlation between daily ketone levels and self-rated mood (r = 0.21, P < 0.001) and energy (r = 0.19 P < 0.001), and an inverse correlation between ketone levels and both impulsivity (r = −0.30, P < 0.001) and anxiety (r = −0.19, P < 0.001). From the MRS measurements, brain glutamate plus glutamine concentration decreased by 11.6% in the anterior cingulate cortex (P = 0.025) and fell by 13.6% in the posterior cingulate cortex (P = <0.001).

These findings suggest that a ketogenic diet may be clinically useful in bipolar disorder, for both mental health and metabolic outcomes. Replication and randomised controlled trials are now warranted.

Decision-making capacity (DMC) is key to capacity-based mental health laws. In 2017, Norway introduced a lack of DMC as an additional criterion for involuntary care and treatment to strengthen patient autonomy and reduce involuntary care. Health registry data reveal an initial reduction followed by rising involuntary care and treatment rates post-2017. Despite jurisdictions moving towards capacity-based mental health laws, little is known about their impact.

To explore the impact of introducing a capacity-based mental health law governing involuntary care and treatment.

Semi-structured interviews and focus groups were conducted in 2018 with 60 purposively sampled stakeholders, including patients, families, health professionals and lawyers. Of these, 26 participated in individual follow-up interviews in 2022–23. The transcribed interviews were thematically analysed following Braun and Clarke.

Four themes emerged: (a) increased awareness of patient autonomy and improved patient involvement; (b) altered thresholds for involuntary admission and discharge and more challenging to help certain patient groups; (c) more responsibility for primary health services; and (d) increased family responsibility but unchanged involvement by health services.

Introducing a capacity-based mental health law appears to raise awareness of patient autonomy, but its impact depends on an interplay of complex health, social and legal systems. Post-2017 changes, including rising involuntary care and treatment rates, higher thresholds for admissions and increased pressure on primary health services and families, may be influenced by several factors. These include implementation of decision-making capacity, legal interpretations, formal measures for care of non-resistant incompetent individuals, reduced in-patient bed availability, inadequate voluntary treatment options and societal developments. Further research is needed to better understand these changes and their causes.

Parents of children with autisma demonstrate elevated traumatic stress symptoms, but seldom receive diagnoses of post-traumatic stress disorder (PTSD) or complex PTSD. An accurate assessment of Criterion A is essential for a valid diagnosis of these disorders, yet it is uncertain whether Criterion A, as defined by the two primary international diagnostic systems (DSM-5-TR and ICD-11), yields consistent interrater reliability, when psychologists rely solely on self-report from these parents for assessing PTSD or complex PTSD.

This study aims to investigate interrater reliability across psychologists when assessing Criterion A events against the ICD-11 and DSM-5-TR.

Ten Australian psychologists rated parents’ self-reported traumatic events related to parenting, using the Life Events Checklist for DSM-5-TR and ICD-11 Criterion A. Data from 200 randomly selected parents of children, all meeting symptom thresholds for PTSD or complex PTSD, were analysed. Bootstrapping calculated kappa coefficients, differences between ICD-11 and DSM-5-TR criteria, and self-reports of threat/no threat, with 95% confidence intervals for these differences.

Interrater reliability varied from poor to moderate. The ICD-11 had significantly higher reliability than the DSM-5-TR for Criterion A (κdifference = 0.105, 95% CI 0.052–0.153, P < 0.001). The interrater reliability was lower when parents reported life threat, serious injury or death (κdifference = 0.096, 95% CI 0.019–0.176, P = 0.007).

This study highlights challenges in assessing PTSD and complex PTSD Criterion A in parents of children with autism, using DSM-5-TR and ICD-11 criteria with the Life Events Checklist, revealing less than adequate interrater reliability.

Research indicates that treatment outcomes are poorer for people with long-term physical health conditions (LTCs) in Talking Therapies services (formerly known as Improving Access to Psychological Therapies). However, the impact of having an LTC on attendance at assessment and treatment appointments within Talking Therapies remains unclear. Internet-enabled therapies may be one way to overcome barriers to treatment engagement in Talking Therapies. However, their effect on engagement and the influence of LTC status on receipt of internet-enabled therapies is unknown.

To explore the association between LTC status and assessment attendance, treatment engagement and internet-enabled therapy receipt within Talking Therapies services, and whether receipt of internet-enabled treatment bolsters engagement.

We used anonymous patient-level data from two inner London Talking Therapies services during January to December 2022 (n = 17 095 referrals). Binary logistic regression models were constructed to compare differences between LTC and non-LTC groups on (a) assessment attendance, (b) engagement and (c) internet-enabled therapy receipt. In our regression models, we controlled for key clinical and demographic covariates.

There were no differences between patients with or without an LTC in assessment attendance or treatment engagement, after controlling for covariates. Across the whole sample, receiving internet-enabled treatment increased engagement. People with an LTC were less likely to receive an internet-enabled treatment.

Having an LTC does not negatively affect assessment attendance and engagement with talking therapies. However, receiving an internet-enabled treatment bolstered engagement in our regression models. People with an LTC were less likely to receive internet-enabled treatment.