Aims: The DIALOG scale has been implemented as a routine patient outcome and experience measure (PROM/PREM) in East London Foundation Trust (EL FT). We used large routinely collected DIALOG data to assess impact of treatment across different domains of life and whether the impact of treatment changed with Community Mental Health Transformation CMH (NHS Long Term Plan). We also carried out secondary disaggregation analysis of pooled data based on protected characteristics interrogating through an equity lens.

Methods: EL FT had commissioned University of Plymouth for the review of CMH transformation. Anonymised pooled data set was obtained from the electronic patient records that were collected as a part of routine clinical practice. DIALOG (PROM and PREM) scores captured routinely from CMH services in ELFT over two time periods (2018–19 and 2021–22) were collected for this purpose.

The anonymised and pooled data was linked with stages of treatment e.g. assessment, review and at discharge and protected characteristics (age, gender, ethnicity and a proxy of social deprivation).

14,813 DIALOG scores from 6,538 unique patients were identified. We analysed each domain of DIALOG separately and the numbers of return of scores on each domain varied depending on response rate. We compared domain based descriptive statistical analyses of mean pooled DIALOG scores looking at means across a range of variables for each domain and then conducted a series of multiple regressions for each of the DIALOG domains, to control for multiple variables together

Results: Our results showed that service user satisfaction in each domain improved with treatment stage (from assessment to review to discharge) reaching statistical significance at each stage. There were minor differences between the two time periods (2018–19 and 2021–22) in a few domains. There was variation in outcomes across ethnicity, age and gender in a few domains.

Conclusion: Large data sets of routinely collected DIALOG data offer valuable insight into the needs of the local population and impact of treatment. Assessment of the impact of the CMH service transformation was confounded by the pandemic. Disaggregated data on protected characteristics reveal interesting and useful information about experiences and outcomes of different population groups over time. Our study also validates DIALOG as a quality of life measure and patient experience measure scale that is sensitive to measure change. It affirms the value and depth that intelligence routine outcome data gathering can offer both to measure change as well as offering an assessment of population need.

Aims: Non-suicidal self-injury (NSSI) has been increasingly observed among adolescents as a maladaptive coping mechanism to alleviate emotional distress. Despite its high prevalence, the neurobiological underpinnings linking interpersonal distress to cognitive control deficits remain underexplored. Electroencephalography (EEG) studies suggest that the no-go P3 component may serve as a biomarker for impulsivity and response inhibition, offering insights into the mechanisms underlying NSSI behaviours. This study aimed to investigate the relationship between psychological characteristics, neural activity, and cognitive control in adolescents with NSSI compared with healthy controls (HC).

Methods: A total of 51 adolescents with NSSI and 50 HC were recruited. Psychological characteristics were assessed using standardized scales, including the Interpersonal Needs Questionnaire (INQ) and Short UPPS-P Impulsivity Scale (SUPPS-P). EEG was recorded during a go/no-go task to measure P3 amplitudes. Source analysis was performed to localize neural activity. Group differences were analyzed using ANCOVA to control depression and anxiety, followed by partial correlation and mediation analyses to evaluate relationships among variables.

Results: The NSSI group exhibited significantly lower no-go P3 amplitudes at all electrodes compared with the HC group (p<0.001), even after controlling for depression and anxiety. No-go P3 amplitudes were negatively correlated with INQ scores, suggesting that interpersonal distress impacts response inhibition. Source analysis revealed reduced neural activity in the right superior frontal gyrus, inferior parietal gyrus, and other regions associated with cognitive control and emotional regulation in the NSSI group. However, these differences disappeared after adjusting for depression and anxiety, indicating their potential mediating role.

Conclusion: These findings highlight the interplay between interpersonal distress, depression, anxiety, and cognitive control deficits in adolescents with NSSI. Future longitudinal studies are needed to confirm these pathways and explore therapeutic interventions targeting interpersonal distress and emotional regulation to mitigate NSSI behaviours.

Aims: Approximately 2% of students in higher education are diagnosed with autism, a figure likely underreported due to non-disclosure and diagnostic challenges. Autistic students in higher education face unique challenges that impact their academic persistence and success. These students experience higher dropout rates compared with their neurotypical peers. Identifying the factors leading to high dropout rates is essential for developing interventions that promote a more supportive academic environment for autistic students.

This review systematically investigates and analyses the factors that influence dropout rates among autistic students in higher education, focusing on firsthand accounts of autistic students. It draws on qualitative and mixed-method studies to address the question: What are the key factors influencing dropout rates among autistic university students across various degree programmes and institutions worldwide? The aim is to identify insights that can inform interventions to improve educational outcomes for autistic adults.

Methods: This meta-synthesis, adhering to PRISMA guidelines, utilised the PICOS framework for a systematic review conducted in July 2024. Searches across Scopus, PsychINFO, Medline via OVID, and ERIC yielded 2,303 initial articles. Thirteen studies were selected based on relevance and peer review, involving 521 participants aged 18–54, primarily diagnosed with autism spectrum disorder and based in the UK, USA, and Australia. All participants had either considered dropping out, actually dropped out, or deferred a year. These studies examined dropout rates and potential contributory factors, with findings appraised for quality using the CASP checklist and determined to be of moderate to good quality.

Results: Analysis of the thirteen studies found significant challenges faced by autistic students in higher education, revealing an overarching theme of 'Environmental Discord’ – systemic mismatches between educational structures and autistic students’ needs that exacerbate academic and mental health challenges. Mental health emerged as a critical factor influencing dropout rates with exacerbated conditions such as higher burnouts, anxiety and depression due to academic pressures and social isolation. Additionally, the studies highlighted academic challenges that hinder effective learning and engagement. The analysis also identified gaps in support strategies, indicating that existing services often fail to meet the specific needs of autistic students, necessitating tailored interventions.

Conclusion: This review proposes proactive restructuring of educational environments to better accommodate diverse student needs, enhance success and reduce dropout rates. Further, the review calls for future research to develop and evaluate personalised interventions aimed at the specific challenges faced by autistic students.

Aims: To find out the effectiveness of different strategies of behaviour modification techniques on children having intellectual disability in specific time period under controlled setting and compare pre and post scores.

Methods: 36 children diagnosed with intellectual disability were included in current studies, comprised of 20 boys and 16 girls. A diagnostic criterion of DSM–V for intellectual disability was applied to diagnose the children. Portage Guide to Early Education (PGEE) was selected to then find out the developmental age of children and in some of the cases to find out the functional level of intellectually impaired children. For diagnostic point of view intelligence test including Slosson Intelligence test was administered for screening children and Coloured Progressive Matrices was used to find out the level of mental maturity. Behaviour modification techniques that were selected for administration of IEPs in specific areas were reinforcement techniques, shaping, chaining, prompt-fading and negative punishment. The training programme consists of five days per week and four hours per day by the help of team of trained professionals; specifically all were trained clinical psychologists.

Results: Repeated measure t-test has shown significant statistical difference between pre and post ratings of the Intellectually Disabled children on all the domains including Self Help, motor, cognitive, language and socialization of PGEE, results shows the difference respectively; t (35)=−8.82, −8.393, −7.496. −7.541 and −7.4295, p=0.000 two tailed on above mentioned domains. Intellectually disabled children scored higher in post ratings (M=52.25, SD=15.39); (M=54.58, SD=12.46); (M=37.25, SD=18.13); (M=43.44, SD=19.00); (M=52.56, SD=17.33) on Self Help, motor, cognitive. Language and socialization domains of PGEE then pre test rating (M=44.67, SD=16.44); (M=44.78, SD=13.52); (M=29.53, SD=18.13); (M=36.47, SD=19.74); (M=43.75, SD=16.83).

Conclusion: IEPs do work effectively in dealing with children having special needs with use of behavioural intervention as it was found in our research with drastic change in post rating of each adaptive area like self-help, motor, cognitive, language and socialization.

Aims: Chronotype refers to the distribution of an individual’s diurnal preference, ranging from morning type (MT) to intermediate or neither type (NT) to evening type (ET). Chronotype manifests in various physiological functions and influences numerous physical and psychological activities. Addiction is one of the most prevalent mental health issues, with individual studies indicating that ETs are at a greater risk of developing addiction. Given the nonexistence of a systematic review addressing this topic, this study aimed to synthesize results that explored the relationship between chronotype and addictive disorders to define the at-risk population.

Methods: A search strategy was developed using the keywords 'chronotype', 'circadian preference', 'diurnal preference', 'morningness', 'eveningness', 'circadian rhythms’, and 'chronobiology'. And 'addiction', 'dependence', 'problematic use’ and 'abuse'. After registering the protocol with PROSPERO, a data extraction form was developed based on the strict inclusion and exclusion criteria for the selection of studies. Selected articles were screened and the data were extracted. The results of the 16 selected studies were synthesised.

Results: ET had a significant association with substance addiction in four out of six studies and all ten studies of behavioural addiction. One study showed no association with chronotype and one showed a significant association with MT.

Conclusion: ET has a higher risk of developing an addiction. Designing and conducting longitudinal cohort studies would be beneficial in delineating the bidirectional relationship and establishing causality if present. This would also pave the way for developing chronotherapies for addiction.

Aims: Primary hyperparathyroidism (PHPT) is characterized by hypercalcaemia with an elevated or inappropriately normal parathyroid hormone level. In clinical psychiatry, it is often detected through routine blood investigations for hypercalcaemia. PHPT is the most common cause of persistent hypercalcaemia and the third most prevalent endocrine disorder after diabetes and thyroid disease. Although it can occur at any age, it typically presents later in life, with a mean age of diagnosis of 65 years. Women are affected three to four times more frequently than men. As awareness of PHPT screening increases, the number of individuals receiving mental health treatment who also have PHPT is likely to rise.

This literature review was prompted by the presentation of several patients with primary hyperparathyroidism (PHPT) or lithium-associated hyperparathyroidism (LAH) in our clinical practice. Our aim was to synthesize the available evidence to provide an updated overview for clinicians regarding the relationship between PHPT and both depression and cognitive impairment, as well as to review the existing literature on LAH.

Methods: We conducted a narrative review of the literature, focusing on the relationship between PHPT and both depression and cognitive impairment. We did not explore the association between PHPT and psychosis due to the limited literature in this area, which is primarily confined to case reports. Our search yielded 42 full-text articles, which were reviewed in detail by all authors for inclusion in this study. We discussed the findings and reached a consensus. Additionally, we developed three fictionalized case reports based on amalgamated patient presentations from our clinical experience.

Results: Moderate to severe depressive symptoms occur in approximately one-quarter of individuals with PHPT before parathyroidectomy, and about two-thirds show improvement one year post-surgery. Further research is needed to guide antidepressant treatment, particularly regarding when to withdraw this post-operatively if the depression may be attributed to PHPT.

Conclusion: Patients diagnosed with PHPT should be referred to endocrinology clinics. Current surgical criteria primarily focus on classical PHPT symptoms, such as osteoporosis. However, expert panels recognize that non-specific symptoms, including depression, often improve following parathyroidectomy. This suggests that surgery may be a cost-effective intervention to prevent further health deterioration.

Aims: To explore the current availability of psycho-education as a primary prevention against substance misuse in unplanned pregnancies for adolescents in the UK. It was noted that 80% of young adults registered with drugs and alcohol services started misusing substances under the age of 15 years. This poses an apparent risk of young mothers who are abusing drugs to have unplanned pregnancies. Moreover, pregnancies occurring sooner than desired are associated with higher risks to the health of the fetus because of delayed recognition. A study from the United States shows that women who reported using hard drugs, cannabis or smoking cigarettes at age 18 had an increased likelihood of risk behaviours and subsequent unplanned pregnancies.

Methods: The National Office of Statistics and the UK Government website were scanned to retrieve data appropriate to adolescent substance misuse and unplanned pregnancies. It was found that the conception rate for women aged under 18 years in England and Wales in 2021 was 13.2 per 1,000 women. Additionally, 11,326 young people were found to be in contact with alcohol and drug services between April 2021 and March 2022. Out of which 234 (5%) were young mothers or pregnant.

Results: The need for psychological intervention for young women focussing on substance misuse has been an ongoing dilemma. The UK government introduced programmes such as the 10-year Teenage Pregnancy Strategy for England which aimed to reduce the conception rate for women under 18 years. However, medical services often do not have data on substance misuse in young people with unplanned pregnancies as they have not had prior contact with the service. This puts them at increased risk of health complications during the pregnancy and ultimately risk of neonatal withdrawal syndromes. This demonstrates an increasing requirement to introduce psycho-education accessible to adolescents between 16–18 years to create awareness of risks of substance misuse and unplanned pregnancies.

Conclusion: Even though there are programmes preventing and educating regarding unplanned pregnancies, there is little support available to adolescent mothers who have ongoing substance misuse behaviours. Misusing substances while pregnant poses a risk not just to the fetus, but increases the complexities of bearing the responsibility of being a parent with a misuse disorder. Therefore, there is an emergent need for psycho-education accessible to adolescents to educate them against substance misuse during unplanned pregnancies.

Aims: Studies have shown an elevated risk of psychosis among migrants and ethnic minorities, but there has been little investigation of risks for Irish and Chinese ethnic groups in the UK. The aim of this study is to investigate the risk of first-episode psychosis in White Irish and Chinese ethnic groups compared with the White British population in West Yorkshire.

Methods: Data from local census and two Early Intervention in Psychosis services for individuals aged 15–34 with first episode psychosis between 2013–2015 was collected. Risk ratios for combined locations were calculated using Mantel–Haenszel fixed effects models.

Results: The White Irish group showed a non-significant but consistent trend of around a 2-fold elevated risk of first episode psychosis (RR 2.27, 95% CI 0.95 to 5.46). The Chinese group did not show a significantly elevated risk (RR 0.4, 95% CI 0.13 to 1.25).

Conclusion: Although not statistically significant, the study suggests a consistent trend of elevated psychosis risk in the White Irish group. Further research is needed to validate these findings and determine key contributing factors.

Aims: With reform planned for the England and Wales (E&W) Mental Health Act (MHA)1983 as amended by the MHA 2007, a comparison of the current E&W Act with the Australian Capital Territory (ACT) MHA 2015 was undertaken, including to examine whether differences were associated with variations in involuntary hospitalisation and Tribunal reviews.

Methods: A comparative analysis was conducted examining the E&W and ACT MHAs. Cross-jurisdictional analysis incorporated datasets from the Office for National Statistics (E&W) and ACT Health Services for three key metrics: per capita involuntary admission rates, mean duration of detentions, and frequency of Tribunal reviews, and analysed in relation to both legislative frameworks.

Results: The ACT mental disorder definition is narrower, includes intellectual disability but not personality disorder. Applications for the 3-month renewable ACT Psychiatric Treatment Order (PTO), limited to mental illness, are made to the ACT Civil and Administrative Tribunal (ACAT). It applies in hospital, the community, or correctional facilities. In E&W, the comparable Section 3: Admission for treatment detention period is 6 months. ACAT can authorise compulsory medication and ECT, a role in E&W of a Second Opinion Appointed Doctor (SOAD).

Criminal courts can request ACAT to assess a defendant for fitness to enter a plea and if not guilty by reason of mental impairment. This is the criminal courts’ role alone in E&W.

In E&W Crown Courts can make 'hybrid orders', a sentence of imprisonment allowing for treatment in hospital ensuring offenders are placed where their mental health needs can be best met.

Comparing E&W with ACT, the respective approximate populations served were 56 million and 431,000 and the annual involuntary hospitalisation numbers were 48,000–50,000 compared with 300–350 (statistically not significant; 0.087% compared with 0.075% of the population).

The average detention length was longer in E&W (30–45 days compared with 21–35) which has more Forensic units than the ACT.

Annual numbers of Tribunal reviews were 7000–8000 in E&W, while in ACT 200–250, per detained patient significantly more (p<0.0001).

Conclusion: The definition of mental disorder differs between the two legislations. The new MHA reforms in E&W will raise threshold for detention and require faster access to Tribunals. The ACT PTO applies to patients not only involuntarily hospitalised, but to those in the community and correctional facilities. This, with shorter detention periods and more frequent Tribunal reviews, may be factors in the shorter detention lengths in hospital in ACT compared with E&W.

Compared with E&W, there is a much greater role for the ACAT Mental Health Tribunal, including in authorising mental health orders, medication and ECT, which likely accounts for the significantly greater use of Tribunals in ACT.

In comparison to E&W, ACAT hearings are briefer and rely more on written than oral evidence. Innovatively, ACAT can be delegated by a Criminal Court to determine medico-legal issues in defendants.

Aims: Alzheimer’s disease continues to be a huge health concern around the globe. Although similar recent developments in anti-amyloid therapy are promising, there is concern about some side effects like ARIA. The purpose of this meta-analysis was to systematically review and compare the safety characteristics of three of the most promising anti-amyloid drugs: lecanemab, donanemab and aducanumab, specifically, the frequency of ARIA-E (oedema) and ARIA-H (haemorrhage).

Methods: The present systematic review included only high-quality randomized controlled trials, randomized controlled trials with non-parametric data, and meta-analyses. Data was analysed and visualized by using forest plots, funnel plots and bubble plots. The degree of heterogeneity was examined by I2 of statistics.

Results: The antibody lecanemab had the lowest ARIA-E rate at 12.6% and the highest infusion reaction rate at 26.4%. Mild ARIA-E was evident in 24.0% of the participants, whereas mild ARIA-H was detected in 19.7% of the subjects.

Of the four candidates, aducanumab showed the highest rate in ARIA-E (30.7%) but the lowest rate in infusion reaction (1.2%). The overall ARIA-H rates appeared to be moderate for all drugs (17.3–19.7%).

The odds ratios in the forest plot were above 1 for all the outcomes suggesting increased adverse event risk. There was moderate to high heterogeneity in all the studies examined (I2 = 84.7%).

Conclusion: In essence, the risks and benefits of each drug are different. The ARIA-E risk associated with lecanemab is lower than with aducanumab; however, infusion reaction rates remain high. There is reason to believe that such an aggressive ARIA-E profile would ultimately restrict the value of aducanumab and lecanemab. However, donanemab does bring a kind of medium between the two. This review emphasizes the importance of individualized interventions in treating Alzheimer’s dementia.

Future Directions: More research is thus needed to understand some of the factors that have confounded heterogeneity, and to find ways of managing some of the risks associated with ARIA. The current study indicates the importance of long-term safety data along with head-to-head comparisons regarding clinical decision-making.

Aims: Elevated prolactin levels due to antipsychotic drugs are prevalent in elderly patients and may cause multiple complications. Hence, the purpose of the present study is to compare the effectiveness of changing existing antipsychotic treatments with prolactin-sparing antipsychotics or adding dopaminergic agents to the existing treatment in patients with clinically insignificant hyperprolactinaemia in later life.

Methods: The sample for this systematic review was identified using a broad search strategy in key electronic databases including Pubmed, SIGLE, CINAHL, Web of Science and OVID. To complete the search, only citations that included elderly or geriatric patient populations and hyperprolactinemia associated with antipsychotic medications were used. Normalization of prolactin levels, psychiatric status, and side effects were the main results measured.

Results: The review flagged several main studies: The efficacy of antipsychotic aripiprazole use in the treatment of schizophrenia is discussed about its impacts on prolactin levels in individuals of different ages and gender. There was no effect on prolactin plasma concentrations in postmenopausal patients with depression and a small but significant positive impact in schizophrenia patients.

An innovation that supplements the pattern of traditional Chinese medicine together with a low dose of aripiprazole can be useful for treating antipsychotic-induced amenorrhea. Prolonged exposure to prolactin-elevating antipsychotics was found to raise the risk of fractures, a finding that provided insight into other health risks.

Conclusion: The approach to the management of antipsychotic-induced hyperprolactinemia in older adults is beyond general management. Although studies that counter the aversive effects of antipsychotics with drugs like aripiprazole seem promising, its benefits are somehow relative across populations. Since there may be long-term health risks such as fractures in the future, it is taken fairly seriously and requires vigilance with a concrete individual management plan.

Regarding the limitation of the present study, it is recommended that future research incorporates different antipsychotics, follow-up outcomes longer, and provide strategies to avoid such risk factors among this population.

Aims: This study aims to design and implement a digital health promotion intervention aimed at reducing mental health inequalities among low-income, urban youth in North West England. The intervention is grounded in the hypothesis that a combined approach – incorporating peer mentorship, digital technology, and community-driven initiatives – will enhance mental health awareness, reduce stigma, and increase engagement with mental health services in this vulnerable population.

Methods: The intervention consists of three key components: (1) Training 50 peer mentors to deliver mental health workshops in local schools, (2) Developing a culturally relevant digital mental health app that offers self-help tools and anonymous counselling, and (3) Hosting five community-based mental health awareness events to engage families and local leaders. The intervention is evaluated using a mixed-methods approach. A sample of 500 students will complete pre- and post-intervention surveys to assess changes in mental health literacy, stigma, and help-seeking behaviours. Focus groups will capture qualitative insights into participant experiences, while app analytics will track usage patterns, such as downloads, active users, and interaction with features. School attendance records will also be reviewed to assess the potential impact on student well-being. The evaluation will provide both quantitative and qualitative data to determine the intervention’s effectiveness and acceptability.

Results: The intervention is expected to significantly increase mental health awareness and literacy, with an anticipated 20% reduction in self-reported symptoms of anxiety and depression. The app is projected to achieve 1,000 downloads and 300 active users within the first 18 months of implementation. The peer mentorship programme is expected to foster a supportive environment in schools, helping to reduce mental health stigma and encouraging students to engage with available services. Additionally, the community-based events are predicted to engage over 300 young people and their families, further reducing stigma and promoting open conversations about mental health.

Conclusion: This intervention has the potential to significantly improve mental health outcomes for low-income, urban youth by addressing both systemic and individual barriers. The predicted results suggest that the model is feasible, scalable, and adaptable to similar socio-economic contexts. The next steps involve expanding the intervention to additional regions, enhancing collaboration with key stakeholders, and refining the digital components of the intervention based on user feedback. Acceptance of this study at this conference would offer an opportunity to share insights into community-driven approaches to tackling mental health inequalities and enhancing access to mental health resources.

Aims: The increasing recognition of neurodivergent conditions within healthcare frameworks highlights the necessity for better understanding and management in neuropsychiatric settings. These conditions often overlap with complex neuropsychiatric diagnoses, complicating both diagnosis and treatment. This study aims to investigate the prevalence and co-occurrence of neurodivergent conditions and traits among patients with neuropsychiatric conditions.

Methods: A descriptive, quantitative cross-sectional study was conducted at a tertiary regional neuropsychiatric outpatient clinic in London. Participants included 166 consecutive patients, assessed using the Comprehensive Autistic Trait Inventory (CATI) and the Adult ADHD Self-Report Scale (ASRS-v1.1), with demographic characteristics considered.

Results: The study identified significantly higher rates of ASD and ADHD traits among patients with various neuropsychiatric conditions, particularly in those diagnosed with Functional Neurological Disorder (FND). Statistical analyses reinforced the heightened prevalence of these traits compared with general population estimates.

Conclusion: The findings indicate a higher-than-expected prevalence of neurodivergent conditions in patients with Functional Neurological Disorder. Enhanced early identification and tailored treatment approaches are crucial for improving clinical outcomes and patient experiences in neuropsychiatric settings.

Aims: Non-invasive brain stimulation (“neuromodulation”) techniques, including transcranial magnetic stimulation (TMS) and transcranial electrical stimulation (TES), are used to modulate brain excitability and connectivity. TMS is approved for treating depression in the United Kingdom and preliminary evidence suggests that combining TMS and TES may enhance therapeutic effects. While neuromodulation is generally well-tolerated in research settings, its acceptability among the broader patient population remains unclear due to limited exposure, awareness, and information accessibility. Understanding prospective acceptability, defined as the perceived appropriateness of an intervention before its application, is crucial for improving treatment uptake and addressing concerns about safety and feasibility. We aimed to co-produce a survey with lived experience experts to assess the acceptability of individual and combined neuromodulation techniques among potential service users.

Methods: The study was co-developed with our Neuromodulation Experts-by-experience Advisory patient and public involvement (PPI) group. We underwent three rounds of iterative feedback to refine the survey focus, structure, and questions. A scoping review of existing literature on prospective acceptability of neuromodulation techniques informed the content, alongside the Theoretical Framework of Acceptability. Given the novelty of combined (TMS+TES) neuromodulation, no prior informational materials exist. PPI members advised it was critical to produce accompanying videos and leaflets to briefly illustrate the different neuromodulation techniques. The video scripts and leaflet content were produced in collaboration with three PPI members who tried the neuromodulation techniques, to avoid rehearsed scripts and ensure honest reviews of the techniques.

Results: The final survey version was adapted to maximise clarity of questions, engagement, and completion rates. The survey incorporated questions on awareness, perceived effectiveness, ethical considerations, and practical burden of different neuromodulation techniques. Online and paper versions of the survey were created to ensure accessibility. We successfully produced three information videos within 90-second target duration featuring PPI members and lead researchers. We developed a supplementary infographic leaflet for enhanced comprehension and accessibility.

Conclusion: Engaging stakeholders through PPI was instrumental in developing the survey to ensure accessibility and relevance for diverse participants with lived experience of mental health conditions. End-user involvement in the design process improved survey comprehensibility, highlighting the importance of co-production in developing effective research tools. Findings from this survey will provide insights into the acceptability of novel neuromodulation techniques, ultimately informing future clinical implementation and patient-centred research strategies.

Aims: This study aimed to review prior research on tabletop role-playing games (TTRPG) as a therapeutic tool for neurodiverse individuals and identify gaps in the field to direct future research.

Methods: A comprehensive systematic review of available literature on the use of TTRPGs in the neurodiverse population was completed, with no limitations to publication language or date. This was completed using appropriate medical subject headings (MeSH terms) and ProQuest to search 21 electronic data bases. Papers were superficially reviewed using the title and abstract to determine if they met the inclusion criteria and relevant articles were reviewed in full.

Results: The systematic search resulted in the identification of 5 relevant articles, containing a combination of peer-reviewed journal articles (n=3), and dissertations/theses (n=2). The majority of papers (n=3) were published in the western world, with others coming from Japan (n=1) and Brazil (n = 1).

Conclusion: Existing literature suggests that TTRPGs offer significant benefits for neurodiverse individuals, particularly in enhancing social skills, communication, and overall social functioning. Kato’s (2019) qualitative case study showed that TTRPGs improved social functioning, intentional communication, and cooperative decision-making in youth with autism spectrum disorder (ASD). Henning et al. (2024) echoed these findings, though they were not statistically significant. The benefits of TTRPGs were also demonstrated by Parks (2021), remarking that TTRPGs allow autistic young adults to practice social roles and skills at their own pace. Atherton et al. (2024) expanded this by showing that TTRPGs helped autistic adults form social connections in a safe, structured setting, promoting community and friendship. A shift in focus was seen in the study presented by Rubin-Budick (2022), which focused on the perspective of the therapist over the participants. This research gave an overriding consensus on the effectiveness of TTRPGs in improving emotional attunement and social engagement. Whilst the current body of research highlights these potential benefits, it is important to note that the studies conducted so far have been limited by small sample sizes and narrow participant demographics, with an overriding focus on ASD over other neurodiverse conditions.

Overall, available literature suggests that TTRPGs can enhance social development, communication, and emotional well-being in neurodiverse individuals. This review has also highlighted the need to explore the role of TTRPGs as a therapeutic tool in a wider range of neurodiverse conditions, with particular reference to attention deficit hyperactivity disorder (ADHD).

Aims: Virtual reality (VR) is becoming readily recognised as a transformative force in healthcare. In recent times there have been rising waiting lists, barriers to accessing care and a need to rapidly scale treatment provision for mental health conditions including depression, anxiety, anorexia, and phobias. As a result, the feasibility and design of current home-based VR mental health treatments has been evaluated to synthesise cohesive guiding principles for further development and implementation of Virtual Reality technologies.

Methods: A multi-method approach was employed, utilising both secondary data from literature reviews and primary data collection through semi-structured expert interviews and surveys to gain insights from all potential stakeholders. These were thematically coded through the COM-b behavioural model to produce a qualitative analysis uncovering key themes hindering and facilitating the adoption of VR technology. Survey data was subject to quantitative analysis to understand attitudes and guide our recommendations.

Results: Analysis of the results ascertained the key barriers and opportunities to provide improved VR mental health services for patients. The two main overarching themes found were: optimisation of the design of technology, and provision of a supportive deployment environment. Within design a significant theme was immersion; This allows simulated environments to replicate the benefits of in-vivo interventions. Presence, a subtheme, is key to supporting immersion and can be thought of as the suspension of disbelief in one’s surroundings, allowing for the mimicking of the effects of in vivo exposure. Personalisation and interaction also contributed to enhancing the design. For the higher theme of creating a supportive deployment environment, the main considerations were acknowledging inequalities regarding both technical barriers and financial challenges.

A patient centered framework was developed to support engagement and adoption of VR, using the COM-B model. The model shows the interaction between the capability to participate in an action, the opportunity, which is determined by external factors that allow behavioural change, and the motivation to implement these changes.

Conclusion: The evidence for VR’s therapeutic efficacy on home mental health is growing rapidly, however, translating evidence-based practices into the NHS can be a lengthy process. A theory driven framework of practical recommendations is vital for implementing VR interventions. Focus should be centred on holistic design and prioritization of facilitators, which address barriers under multiple domains to support patient and clinician confidence, and thus the successful adoption of VR.

Aims: Subjective Cognitive Decline (SCD) represents the earliest, reversible stage in Alzheimer’s dementia (AD) spectrum, marked by self-appraised cognitive deterioration, that escapes objective detection. The intricate fine-tuning of cognition by cerebellum has been substantiated by the Cerebellar Cognitive Affective Syndrome and “Dysmetria of thought” theory. However, the role of cerebellum in SCD is understated in research. This study aims to determine the relationship between cerebellar neuroimaging parameters and cognition in patients with SCD.

Methods: Patients with SCD, with a Clinical Dementia Rating score of 0, were assessed on Addenbrooke’s Cognitive Examination-III (ACE). Multiparametric MRI (Volumetric analysis of cerebellum, Diffusion tensor imaging at Middle Cerebellar Peduncles (MCP), Magnetic resonance spectroscopy (MRS)) was carried out. Relationship between cognition and neuroimaging parameters was determined.

Results: A total of 28 SCD patients with a mean age of 70.89±3.89 years were included. There were significant positive correlations of attention with axial diffusivities (AxD) at bilateral MCP; fluency with right cerebellar white matter volumes (CWMV); visuospatial function with left CWMV and fractional anisotropy (FA); total ACE scores with total CWMV, bilateral AxD. Significant negative correlations of myoinositol/creatine (mI/Cr) with attention, fluency and memory were revealed on MRS. Linear regression analysis exhibited significant associations between total ACE scores and CWMV; attention and axial diffusivities; memory and right cerebellar volume; fluency and CWMV, Cerebellar cortical volumes; Visuo-spatial function and FA at left MCP.

Conclusion: The aforementioned significant relationships highlight the unique role of multiparametric neuroimaging in early detection of cerebellar ultrastructural alterations, and the modulatory impact of cerebellum in cognition during initial stages of AD continuum. Furthermore, longitudinal studies are warranted to predict long term cognitive outcomes in SCD using cerebellar neuroimaging parameters.

Aims: COVID-19 affected many countries globally, including the UK, to which the UK responded by placing lockdown measures throughout the country. This meant that many people were restricted in their everyday lives, including students. This study is used to understand the impact of these measures on sixth form students.

Methods: The Warwick–Edinburgh Mental Wellbeing Scale was sent to students in a sixth-form grammar school in September 2021 to assess students’ mental well-being. A semi-structured proforma was then also sent in May 2022 to compare students’ experiences and mental health before and after the lockdown measures.

Results: On the well-being scale, 47.1% of sixth-form students scored below 44 (average to low mental well-being), while 31% of the 1st year sixth-form students and 27% of the 2nd year sixth-form students scored 40 and below (lower than average mental well-being). In the semi-structured proforma, 73.90% of students (n=69) experienced quarantine since the pandemic started. 69.10% of them felt that the quarantines negatively impacted their mental health. In response to the question ‘In your own words, what was the most difficult thing that you experienced during the COVID pandemic?’ (n=55), 5 general themes were identified: Isolation, not socialising, loneliness, loss of teenage life/youth, and online learning.

Conclusion: The study showed that the mental well-being of sixth-form grammar school students in Cumbria was mostly negatively affected by the lockdown measures. The authors concluded that more accessible and approachable support should be provided to students in case of a similar event. More research is needed to understand the long-term impacts of such measures on students’ school and social lives.

Aims: The aim of this study is to evaluate the literature for COVID-19 induced psychosis in a child and adolescent population.

Methods: This review included a comprehensive literature search across major databases, including MEDLINE, EMBASE, PsycINFO, and the Cochrane Library. The inclusion criteria encompassed case reports, case series, longitudinal studies, and observational studies involving children or adolescents (under 18 years) who had a diagnosis of COVID-19 or a recent history of COVID-19 vaccination and presented with features of psychosis. Data extraction focused on key demographic information, such as age, gender, and past medical and psychiatric history. Additionally, details regarding COVID-19 treatment and the management of psychosis were recorded.

Results: Eight studies included patients with a history of COVID-19 infection or vaccination who subsequently presented with psychosis. Five were male (62.5%), and three were female (37.5%). COVID-19 infection was confirmed by PCR (50%), antibody tests (25%), positive viral swabs (12.5%), or positive lateral flow tests (12.5%). Most patients were managed conservatively for COVID-19 (50%), while others received steroids (37.5%) or antibiotics (12.5%). Antipsychotic medication was the primary treatment for psychosis in most cases (75%), with some patients also receiving lithium (12.5%), SSRIs (12.5%), or benzodiazepines (12.5%). Regarding prior psychiatric history, 62.5% of patients had no previous psychiatric diagnoses. However, 25% had a history of learning disabilities, and 12.5% had a history of depressive disorder and illicit drug use.

Conclusion: Neuropsychiatric manifestations of COVID-19 in adolescents are less frequently reported compared with adults. Common presentations include insomnia, mood disorders, and, less commonly, psychosis. The precise mechanisms underlying these neuropsychiatric complications remain unclear, but they are hypothesized to be linked to an exaggerated immune response, including cytokine storms, triggered by the infection. This review highlights the need for further research and the development of specific management guidelines for these patients within this population.

Aims: This study aims to evaluate the attitudes of resident doctors toward the use of artificial intelligence (AI) in clinical psychiatric practice. As AI technology continues to advance, its potential to support patient care is becoming increasingly significant, and understanding the perspectives of resident doctors provides crucial insights into how AI can be integrated effectively into psychiatric practice.

Methods: An anonymised online survey was sent to resident and speciality doctors of different grades to elicit their views on the use of AI in psychiatric practice. The survey consisted of Likert scale and multiple-choice questions relating to attitudes towards AI and perceived barriers to its clinical use. Participants were also invited to share their thoughts in a free-text question at the end of the survey.

Results: 41 resident doctors replied to the survey. 83% of responders had used AI personally, 78% of whom had used ChatGPT. There was clear consensus that AI could help with written tasks, with 85% of doctors reporting that they felt AI could help with summarising notes, and 78% indicating that it could support writing clinical letters. Only 34% of responders felt that AI could help with more complex generative tasks, such as guiding risk assessment, suggesting treatment options or interpreting investigation results.

There were evident barriers to the adoption of AI with lack of trust in the accuracy/reliability of the information produced (82%) and concerns about possible bias in the algorithms/data used by AI (84%). Legal (71%) and ethical concerns (67%) were also widely reported as barriers to its adoption.

Attitudes to using AI initially varied, with 29% of doctors reporting that they were “very unlikely” or “unlikely” to use AI in their clinical practice. After engaging with the concepts presented in the survey, attitudes demonstratably shifted with this figure dropping to 20%.

Conclusion: This study demonstrates the diversity of opinion surrounding the use of AI among resident doctors in psychiatry. The majority of respondents agreed that AI would be of use in administrative tasks, but felt that the main barriers to its use included concerns about the accuracy of the generated information, and ethicolegal considerations, particularly related to information governance.