To address the treatment gap for common mental disorders in low- and middle-income countries facing humanitarian challenges, it is crucial to build the capacity of primary healthcare workers (PHCWs) and integrate mental healthcare into primary care settings.

To investigate the effectiveness of a Mental Health Gap Action Programme Humanitarian Intervention Guide (mhGAP-HIG) adapted for use in Pakistan to build the capacity of PHCWs in Khyber Pakhtunkhwa.

Six mhGAP-HIG training workshops were conducted, each lasting for 5 days, across six districts of Khyber Pakhtunkhwa. A total of 105 PHCWs (74 primary care physicians and 31 clinical psychologists) were trained through these workshops. We used multiple triangulations for data collection and analyses. Paired-sample t-tests were applied to compare scores on knowledge questionnaires pre- and post-training and after 8 months. We also conducted thematic analysis to examine participants’ feedback regarding the training, and performed content analysis on the participants’ reflections on the adapted guide.

Our findings demonstrated significant improvements in PHCWs’ knowledge related to the mental health conditions in the mhGAP-HIG. Their scores improved by 12.08%, increasing from 73.86% pre-training to 85.94% post-training. Noticeable improvements in knowledge were recorded for the modules ‘Harmful use of alcohol and drugs’ (22.56%), ‘General principles of care’ and ‘Other significant mental health complaints’ (15.15%), ‘Acute stress’ (13.80%) and ‘Suicide’ and ‘Epilepsy’ (13.13%). The thematic analysis of the feedback of the PHCWs and trainers recommended the use of the guide to strengthen pre-service training and broaden the scope of the initiative to train PHCWs across the province.

This study underscores the feasibility of implementing an adapted mhGAP-HIG for training primary care physicians and clinical psychologists within the existing healthcare resources of Khyber Pakhtunkhwa. The preliminary findings endorse the scalability across other districts in the province.

Schools are a crucial part of child and adolescent care systems, especially in low- and middle-income countries. In today’s complex and rapidly evolving educational landscape, the role of high school teachers extends far beyond delivering academic content. School teachers are in a good position to identify common mental health problems in adolescents. However, their mental health literacy levels remain unclear.

To evaluate high school teachers’ mental health literacy about anxiety and depression and its determinants in three countries (Kenya, Pakistan and Colombia).

A self-administered questionnaire comprising the Anxiety Literacy Questionnaire (A-Lit), Depression Literacy Questionnaire (D-Lit) and statements from the teachers’ quiz in the Mental Health and High School Curriculum Guide was used to collect data.

We received 748 responses from teachers in the three countries; 56.6% of respondents identified as females. Mean scores on the A-Lit and D-Lit were low: 9.14 (s.d. = 3.14) and 9.36 (s.d. = 3.10) respectively (maximum score: 22 on each instrument). Many statements on the Mental Health and High School Curriculum Guide also had low proportions of correct answers. Country of residence (Colombia) and prior training in child mental health were positively correlated with total scores on the D-Lit (P < 0.05). Only 30.3% of teachers had confidence in helping students with anxiety and depression.

The participating high school teachers had low mental health literacy about anxiety and depression. By using teacher training and awareness programmes in schools, policymakers could work towards creating a more supportive and informed environment for students facing mental health challenges.

Iraq is among the countries most vulnerable to climate change, and it is faced with extreme heat, drought and environmental degradation.

To examine the prevalence of climate anxiety and its association with depression and generalised anxiety disorder in the Iraqi population.

A cross-sectional survey recruited 1019 adult participants (47.8% males, 52.2% females). Most participants were aged 18–41 years (n = 854, 83.8%); 16.2% (n = 165) were aged 42–72 years. Regionally, 75.6% (n = 770) were from the Kurdistan Region and 24.4% (n = 249) from provinces in central and southern Iraq. The study used the Climate Change Anxiety Scale (CCAS), Patient Health Questionnaire-9 (PHQ-9) and Generalised Anxiety Disorder-7 (GAD-7). Statistical analyses, included descriptive analysis, analysis of variance (ANOVA), t-tests, Pearson’s correlations and regression models, examined variations in climate anxiety by demographics and associations with depression and anxiety.

Overall, 71.4% of participants reported severe climate anxiety, with a higher prevalence in the Kurdistan Region (73.2%) compared with central and southern Iraq (65.9%). Five provinces were found to have significantly higher levels of climate anxiety: Ninawa, Basrah, Najaf, Duhok and Erbil. Age was a significant predictor, and older participants (42–72 years) reported higher levels than younger participants (P = 0.008). A positive correlation was observed between climate anxiety and both depression (r = 0.382, P < 0.001) and generalised anxiety (r = 0.361, P < 0.001). Simple linear regression revealed that climate anxiety was significantly associated with both depression (β = 0.25, P < 0.001) and generalised anxiety (β = 0.214, P < 0.01), accounting for the 14.6 and 13% variance, respectively.

Climate anxiety is prevalent in Iraq and significantly associated with mental health problems. The findings endorse the need for integration of mental health into Iraq’s national climate adaptation and public health policies.

Psychiatric disorders are a major risk factor for suicidal behaviors. However, increasing attention is being given to anxiety disorders, which have also been associated with suicidal risk.

This study aims to examine the prevalence of social anxiety disorder (SAD) among university students, explore its association with suicidal risk and assess the role of depression as a potential confounding factor in this relationship.

We conducted a cross-sectional, multicentre study involving students from Abdelmalek Essaâdi University. Data were collected face-to-face using a structured questionnaire designed on the REDCap platform. The Moroccan Arabic version of the MINI (Mini International Neuropsychiatric Interview) was used to assess SAD, depression and suicidal risk. All students present and consenting were included. Data were analysed using descriptive statistics and multivariate logistic regression to evaluate the independent association between SAD and suicidal risk.

Among the 1168 students surveyed, 59.1% were women, and the average age was 20.63 years. The prevalence of social anxiety was 9.9% (95% CI: 8.3–11.8). Social anxiety disorder is an independent risk factor for suicide, even after adjustment for other well-known variables such as depression, with an adjusted odds ratio of 1.84 (95% CI: 1.12–3.04).

SAD is a major risk factor for suicidal behaviors. These results highlight the importance of early identification and appropriate management of SAD among students in order to prevent suicidal risks.

Contraceptive use among women of reproductive age has increased significantly worldwide. However, little is known about contraceptive use and mental health among women in sub-Saharan African countries.

This study sought to investigate contraceptive use and self-reported measures of depression and anxiety symptoms among reproductive-age women in Mozambique using the most recent national data.

The study used secondary data from the 2022–2023 Demographic and Health Survey of Mozambique. A total of 6910 (weighted) sexually active women aged 15–49 years were included in this analysis. Anxiety and depression scores were measured using self-report questionnaires. Linear regression analysis was conducted to assess the associations between depression and anxiety and contraceptive use.

The prevalence of contraceptive use was 36.41%. About half of the hormonal contraceptive users (49.38%) were using injectables and 25.99% were using implants. In total, 9.14 and 2.83% of the women had moderate or high scores of self-reported anxiety respectively. Additionally, 5.24 and 5.42% reported moderate or high scores of depressive symptoms respectively. The use of hormonal contraceptives decreased anxiety symptoms by 0.47 units (β = −0.47; 95% CI −0.75 to −0.18; P < 0.001) compared with no contraceptive use. The use of hormonal contraceptives decreased depressive symptoms by 0.75 units (β = −0.75; 95% CI −1.11 to −0.39; P < 0.001) compared with no contraceptive use.

This study has demonstrated a naturalistic association between contraceptive use, particularly hormonal contraceptives, and decreased anxiety and depression among Mozambican women of reproductive age. This likely reflects a complex, bi-directional relationship, the nature and mechanism of which should be investigated in further experimental research.

Menopausal transition is a period of psychological vulnerability, yet suicidality remains underassessed. Hormone replacement therapy (HRT) may influence mood symptoms, but its mental health effects – particularly regarding suicidality – are poorly understood.

To evaluate changes in depressive symptoms, menopause-related distress and suicidality among menopausal women attending a specialist clinic, and explore whether outcomes differed across HRT regimens and baseline risk factors.

We analysed routinely collected data from 957 women attending a UK menopause clinic. All participants received some form of treatment following their initial consultation. Participants completed the Patient Health Questionnaire-9 (PHQ-9) and Menopause Depression Rating Scale (MENO-D) at baseline and follow-up (2–6 months later). Mixed-design analyses of variance assessed changes over time, including interaction effects for HRT type and baseline risk factors (body mass index (BMI), smoking, suicidality, antidepressant use).

Depressive symptoms and menopause-related psychological distress significantly declined over time (around 46% reduction on average). The largest improvements were observed among women receiving oestrogen–progesterone–testosterone combinations, although similar gains were also seen in oestrogen–progesterone and oestrogen–testosterone groups. Suicidality (PHQ-9 item 9) decreased by 92% among those with baseline ideation, but this was not moderated by HRT type. Self-worth (MENO-D item 4) also improved, but similarly showed no significant moderation by HRT regimen. Higher BMI was associated with worse baseline mental health, but did not moderate treatment outcomes.

Combined HRT, including formulations with testosterone, was associated with substantial improvements in mental health outcomes. Suicidality was a distinct symptom profile, often underdetected by general depression scores. However, findings are exploratory and should be interpreted cautiously because of the lack of a control group, observational design and small sample sizes in some subgroups. These results highlight the need for menopause-sensitive mental health assessments and integration of psychological screening into routine menopausal care.

In the North-West Region of Cameroon (NWR) there is limited research available to shape mental health programmes and policy, and this gap has been compounded by the ongoing sociopolitical crisis. Developing a comprehensive research agenda is crucial to guiding mental health research and informing evidence-based interventions.

This paper presents a proposed research agenda for priority mental health, mental disorders and related issues in the NWR. It aims to enhance awareness about the need for research on mental health issues, including evidence about what is needed and effective.

The study used a modified Delphi process with a multidisciplinary team of researchers and mental health practitioners. The study included a literature review, consultation with participants and reaching agreement on the most pressing research needs and approaches.

Priority mental health research areas include (a) broad studies (e.g. situational analysis, prevalence studies); (b) mental health interventions; and (c) understanding mental health issues in depth, especially research involving persons with lived experience of mental health conditions and their families. Intervention studies are needed to better develop and evaluate treatments for trauma and post-traumatic stress disorder, and interventions that are grounded in local realities. Research exploring mental distress and poverty, and gendered analysis of mental health conditions, were also identified as key research priorities. Locally appropriate methods for conducting mental health research, reviewing of mental health-related research conducted at universities and supporting students in research were recognised as relevant to achieving these goals.

This work provides priorities to guide future mental health research in the NWR. This agenda has the potential to enhance understanding of local mental health challenges and to accelerate the development of contextually relevant, evidence-based solutions. Sustained commitment and multi-stakeholder partnerships will be crucial for translating this agenda into impactful research and practice.

The formative years of childhood and adolescence shape the course of future mental health. The COVID-19 pandemic has been associated with increased mental health problems in young people. This study aimed to examine changes in referrals and clinical activity in a child and adolescent mental health service (CAMHS) in Qatar following the pandemic.

To explore changes in referral trends and clinical activity in CAMHS, including referral numbers, reasons, sources, demographics, urgency and multidisciplinary team (MDT) allocation, comparing pre-pandemic (2019) with post-pandemic periods (2021, 2022).

A retrospective analysis of referral data from CAMHS was conducted. Data were collected from the administrative paper data archived in the relevant department for the years 2019, 2021 and 2022. Referral data included: source, reason, urgency, patient demographics and outcome. Chi-square analysis was employed to compare referral trends and patient characteristics across the 3 years. Binary logistic regression was used to identify factors associated with urgent referrals.

A significant increase in referrals was observed post-pandemic, with notable changes in referral reasons (increased mood and anxiety disorders), sources (increased referrals from public and private hospitals) and urgency (higher proportion of urgent referrals). MDT allocation shifted towards psychiatrists, with a decrease in joint assessments.

The COVID-19 pandemic had a substantial impact on CAMHS referrals and clinical activity in Qatar. The observed changes highlight the urgent need for additional resources and services. Adapting service delivery models and strengthening collaboration between healthcare sectors are crucial to addressing the evolving mental health needs of children and adolescents effectively.

Societal pronatalist ideologies link womanhood to motherhood and create social pressures that often cause psychological distress when unmet. While previous research has documented the impact of these external pressures, much less is known about how women’s internal belief systems shape their responses to societal expectations. Recognising this gap, we examined the perspectives and concerns about motherhood and childlessness among child-free Greek women, their psychological distress and the potential mediating role of early maladaptive schemas (EMS) in this relationship. To provide context, we compared these findings with those of mothers, considering both their mental health and their assessments of similar issues after becoming parents.

We conducted an online, cross-sectional survey comparing child-free Greek women and mothers aged 30–50 years. Through custom-designed questionnaires, we evaluated concerns about motherhood and childlessness among child-free women, and we asked the mother group to assess the same aspects post-motherhood. Mental health was assessed using Depression, Anxiety and Stress Scale 21, while EMS were measured with the Young Schema Questionnaire. We used mediation analysis to examine whether EMS mediated the connection between pronatalist pressures and mental health outcomes.

The study included 1341 women, comprising 503 without children and 838 with children. Child-free women, who were predominantly involuntarily child-free, tended to be younger, more educated and had lower household incomes than mothers. They also reported more diverse sexual orientations, higher levels of depression and anxiety and elevated scores on EMS, which appear to exacerbate distress caused by societal pronatalist pressures. In contrast, mothers were typically older and more financially stable. Although they reported fulfilment from motherhood, they also faced challenges, including demanding caregiving responsibilities and financial or logistical barriers to having more children. Mothers’ psychological profiles were characterised by lower EMS scores and less overall distress.

This study revealed distinct demographic and psychological profile differences between child-free women and mothers. Our findings underscore that women’s mental health in the context of reproduction is shaped by a complex interaction of social pressures, psychological schemas and structural factors. Specifically, EMS – particularly in the domains of Emotional Deprivation, Mistrust/Abuse and Vulnerability to Harm – were identified as a key mechanism, mediating the relationship between pronatalist pressures and psychological distress. Furthermore, occupational disparities emerged as a significant stressor, affecting both child-free women in high-pressure careers and mothers who were home-makers.

Previous studies have indicated that depression is common among young adults. However, these studies have mainly focused on risk factors rather than protective factors, especially in the context of Vietnam.

To explore protective factors such as self-compassion and the mediating role of gratitude, crucial for informing targeted interventions aimed at reducing depression in this population.

A cross-sectional study was conducted in September 2023 using convenience sampling of individuals aged 18–25 years (n = 356, mean age 21.23 years) living in Ho Chi Minh City, Vietnam, recruited via online surveys distributed through social networks. The required sample size was determined using Monte Carlo power analysis to ensure adequate statistical power for mediation analysis. Data were analysed to examine the mediating role of gratitude (Gratitude Questionnaire – Six Item Form, GQ-6) in the relationship between self-compassion (Self-Compassion Scale – Short Form, VSCS-SF) and depression (Patient Health Questionnaire-9, PHQ-9).

Self-compassion showed a significant negative association with depression (β = −0.50, t = −11.42, p < 0.001), accounting for 27% of the variance in depression scores. Gratitude significantly mediated this relationship, with an indirect effect of a × b = −0.07 (s.e. = 0.02, 95% CI −0.11 to −0.04]). Specifically, self-compassion positively predicted gratitude (β = 0.34, t = 6.80, p < 0.001), and gratitude, in turn, negatively predicted depression (β = −0.20, t = −4.42, p < 0.001). The direct effect of self-compassion on depression remained significant after controlling for gratitude (β = −0.43, t = −9.52, p < 0.001), indicating a complementary partial mediation. Bootstrap analysis with 5000 resamples further confirmed the robustness of the indirect effect.

The pivotal roles of self-compassion and gratitude in mitigating depression among young adults were explored, informing tailored intervention strategies for mental health practitioners.

Motivational interviewing is a patient-centred communication approach designed to facilitate behavioural change by enhancing intrinsic motivation. Despite its widespread global utility, research on the training and applications of motivational interviewing among resident physicians in Oman remains untapped.

To examine the awareness, training experiences and clinical implementation of motivational interviewing among psychiatry and family medicine residents enrolled with the Oman Medical Specialty Board (OMSB).

A qualitative study was conducted using semi-structured interviews and focus group discussions with 22 resident physicians from psychiatry and family medicine programmes. Data were analysed using thematic analysis to identify key themes regarding motivational interviewing training and its application in clinical settings.

Three primary themes emerged: (a) residents’ understanding and application of motivational interviewing principles, (b) barriers to the integration of motivational interviewing into clinical practice, such as time constraints and insufficient training, and (c) the need for culturally adapted approaches to motivational interviewing tailored to Omani patients. Although participants appreciated the utility of motivational interviewing to improve patient engagement, they reported inconsistent training and limited opportunities to practise the technique in clinical settings.

The study highlights significant gaps in motivational interviewing training and practice within Oman’s residency programmes. It underscores the necessity for comprehensive, structured motivational interviewing curricula that are sensitive to the local context. Enhancing practical training opportunities may improve the integration of motivational interviewing into patient care, particularly in managing chronic diseases and addiction.

Compulsive buying behaviour (CBB) is a growing concern with detrimental impacts on mental health. Females’ mental health, compared with males, is reported to be increasingly affected by CBB. Despite existing research on CBB, the mental health factors influencing it remain understudied, especially among this demographic in urban settings.

To explore differences in mental health between females with high and low CBB; to evaluate the effects of stress, anxiety and depression on CBB in female urban office workers, and whether mental well-being mediates these relationships.

A cross-sectional study was conducted with 369 female office workers, aged 20–50 years, living and working in Ho Chi Minh City, Vietnam. Data were collected using online surveys distributed via social media platforms. The study used the Compulsive-Buying Index (CBI), the Depression, Anxiety and Stress Scale (DASS-21) and the World Health Organization-Five Well-being Index (WHO-5). Data were analysed using SPSS 25.0 and SmartPLS 4 to assess the relationships among variables and the mediating effect of well-being.

Stress and anxiety were significantly higher among those with higher CBB. Additionally, significant findings revealed that stress and well-being both positively predicted CBB (β = 0.43, p < 0.001 and β = 0.15, p = 0.010 respectively). Well-being was found to mediate the indirect relationship between depression and CBB (β = −0.08, p = 0.018), whereas anxiety had no significant effect. Stress and well-being explained 23.3% and 12.9% of the variance in well-being and CBB respectively.

The study shows that both stress and well-being directly influence CBB, whereas depression has an indirect effect via well-being, highlighting multifaceted relationships between mental health and CBB.

Mental health disorders, including depression and anxiety, pose significant public health challenges globally, and in Saudi Arabia. Despite this, psychiatry suffers from a critical shortage of specialists. This study investigates factors influencing medical students’ career decisions in regard to psychiatry, aiming to enhance understanding of, and address workforce deficiencies in, mental healthcare.

This study aims to investigate the factors influencing medical students’ decision to choose psychiatry as a future career.

This cross-sectional study conducted an online survey among Saudi Arabian medical students from 28 December 2023 to 28 April 2024, employing validated questions refined through pilot testing. Participant selection included male and female students across preclinical and clinical stages, excluding non-medical students and those outside Saudi Arabia.

This study explores the perceptions and interest of 430 medical students in Saudi Arabia regarding psychiatry as a career. The majority were female (69.3%), with most in their preclinical years (60.2%). Key findings include limited personal connections to psychiatry (9.5% with a family psychiatrist), and primarily influenced by medical school (55.3%) and social media (42.1%). While 65.1% perceive psychiatry as mentally demanding, uncertainties exist about career prospects and stigma persists (39.1%). Gender differences were observed, with more females (34.6%) than males (22.7%) interested in psychiatry (P = 0.014). Early inspiration in medical education significantly increased interest (P = 0.001).

Early exposure, personal connections and gender-specific factors significantly influence medical students’ interest in psychiatry as a career. Integrating psychiatry education early in medical curricula and addressing stigma are critical for fostering positive perceptions and attracting diverse students to the field.