This study explored the association among dissociative experiences, recovery from psychosis and a range of factors relevant to psychosis and analysed whether dissociative experiences (compartmentalisation, detachment and absorption) could be used to predict specific stages of recovery. A cross-sectional design was used, and 75 individuals with psychosis were recruited from the recovery services of the Gloucestershire Health and Care NHS Foundation Trust. Five questionnaires were used – the Dissociative Experiences Scale – II (DES), Detachment and Compartmentalisation Inventory (DCI), Questionnaire about the Process of Recovery, Stages of Recovery Instrument (STORI), and Positive and Negative Syndrome Scale – and a proforma was used to collect demographic data.

Our findings indicated that compartmentalisation, detachment and absorption, as measured by DES and DCI, do not predict stages of recovery as measured by the STORI.

The results of this study suggest that there is no simple relationship between dissociative and psychotic symptoms. They also suggest a need to assess these symptoms separately in practice and indicate that special approaches to treatment of psychosis may be needed in cases where such symptoms have a significant role.

Neuropsychiatry training in the UK currently lacks a formal scheme or qualification, and its demand and availability have not been systematically explored. We conducted the largest UK-wide survey of psychiatry trainees to examine their experiences in neuropsychiatry training.

In total, 185 trainees from all UK training regions completed the survey. Although 43.6% expressed interest in a neuropsychiatry career, only 10% felt they would gain sufficient experience by the end of training. Insufficient access to clinical rotations was the most common barrier, with significantly better access in London compared with other regions. Most respondents were in favour of additional neurology training (83%) and a formal accreditation in neuropsychiatry (90%).

Strong trainee interest in neuropsychiatry contrasts with the limited training opportunities currently available nationally. Our survey highlights the need for increased neuropsychiatry training opportunities, development of a formalised training programme and a clinical accreditation pathway for neuropsychiatry in the UK.

Non-attendance at out-patient appointments of adult attention-deficit hyperactivity disorder (ADHD) services incurs significant costs and contributes to lost service provision and unmet clinical needs. This cross-sectional study of clinical contacts, between 1 July 2022 and 30 June 2023 in a specialist adult ADHD service, aimed to identify factors, including type of consultation, associated with non-attendance.

Of 3673 organised clinic appointments, 2815 (77%) were attended: 2314 (82%) by telephone and 501 (18%) as in-person appointments; non-attendance rates were 17 and 42%, respectively. Patient characteristics associated with improved attendance included: female gender, age >30 years and presence of other psychiatric diagnoses.

This study will assist adult ADHD service providers to maximise patient attendance. The role of telephone (or virtual) clinics must be considered. Enhanced appointment reminders and improving access to services targeting at-risk groups could also improve attendance rates.

An equitable child mental health service provides access to treatment proportionally to the need of individual demographic groups. Despite qualitative and survey-based evidence of barriers disadvantaging some demographic groups, it is not well understood how these barriers translate into quantifiable inequities. We calculated the treatment access rate for English children aged 6–16 years in 2021–2022, using the patient-level Mental Health Services Data Set and Mental Health of Children and Young People Survey.

The number of primary school children in treatment needs to increase nationally by 173%, the number of boys by 65% and the number of children from a White ethnic background by 31%, to achieve equity in treatment access. There was no evidence of inequities by area deprivation.

Child mental health services in England should not only increase overall access rates, but also pay more attention to equity in access across different demographic groups.

In the UK, Black doctors experience higher levels of discrimination, bullying and harassment compared with other doctors. This study aims to explore the impact of this on perceived well-being and mental health. A UK survey of 109 Black psychiatrists asked about racism, othering, microaggressions, bullying and harassment, plus any links to career progression or mental well-being.

Sixty-three survey participants (57.8%) had faced workplace microaggressions, 44 (40.4%) had experienced workplace bullying and 41 (37.6%) had faced workplace harassment. Forty-seven (43.1%) participants reported a detrimental impact on their mental health, with 35 (32.1%) considering quitting and 24 (22%) reporting a poorer work performance.

These experiences are unacceptable and can be traumatic. The impact of racism and discrimination can also undermine effective service delivery. Barriers to reporting can prolong mistreatment and deter professional aspirations among Black psychiatrists. Collective action is needed to drastically improve the workplace environment, including the widespread institutional adoption of an anti-discriminatory stance.

Advances in generative artificial intelligence, particularly through large language models, like GPT-4, have opened opportunities to develop cognitive agents to enhance clinical productivity, especially in complex secondary and tertiary care settings. However, as artificial intelligence begins to occupy the cognitive space traditionally held by human clinical reasoning, transparency becomes a significant concern. Unlike human decision-making, artificial intelligence-generated outputs may not be traceable to a transparent chain of clinical reasoning, potentially impacting safety if used without adequate ‘clinician reach’ into the reasoning space of artificial intelligence.

We highlight the need for a consensus framework to guide the responsible use of generative artificial intelligence in mental healthcare, which, it is argued, has cognitive demands and features distinct from physical medicine. We propose such a framework, Clinical Reach into the Cognitive Space (CRITiCS), to support clinician involvement in the deployment of these technologies.

This paper aims to spark dialogue and interest in both the clinical and artificial intelligence development communities.

This study examines more than 5.8 million bed days of data from private and National Health Service care providers who contribute to the Mental Health Services Monthly Statistics in the UK. The use of oral chemical restraint is compared with provider size, and the relative use of oral chemical restraint as opposed to seclusion is investigated.

The data-set has large amounts of missing data. The use of oral chemical restraint is proportional to provider size in terms of bed days. Analysis of those providers who reliably submit data demonstrates patterns of reported use of oral chemical restraint versus use of seclusion.

Further research is required into the institutional characteristics that are correlated with increased use of oral chemical restraint. Efforts to investigate the use of restrictive interventions in mental health settings are frustrated by inconsistent reporting.

To investigate the impact of the widespread availability and use of the semi-synthetic cannabinoid hexahydrocannabinol (HHC) on hospital admissions owing to psychosis. Medical records of patients admitted for psychotic illness to University Hospital Galway were examined to assess HHC or other illicit drug use before admission.

Of the 214 total admissions for psychotic illness, 28 admissions (13.1%) were preceded by use of HHC, nine of whom used only HHC. Sixteen (34%) admissions of first-episode psychosis were preceded by HHC use, with seven of these using only HHC.

Clinicians should explicitly enquire about the use of HHC in patients presenting with first-episode and relapse of psychotic illness. Sufficient evidence has now accumulated from research of a link between HHC and psychosis. Such psychoses appear to be more prominent in young people with early-phase psychosis, and highlights the need for authorities to change legislation to avoid further harm.

Non-pharmacological interventions (NPIs) are recognised for their potential in treating dementia symptoms. However, little is known about the extent of their use. In this study, we conducted structured interviews with people with dementia and their family caregivers (n = 50), professional caregivers (n = 42) and dementia care coordinators (n = 42) on the use of 14 NPIs.

Cognitive stimulation/training, physical activity and occupational therapy were implemented by most participants, whereas neurofeedback, drama therapy and phototherapy were rarely used. Most NPIs were carried out weekly. People with dementia and their caregivers reported using significantly fewer NPIs than other participants (P < 0.001). Participants perceived effects for, on average, 90.3% (s.d. = 31.3%) of the NPIs that they used.

Providing targeted support and funding might help to increase the use of NPIs by family caregivers as well as in institutional care settings.

To determine the most acceptable term for borderline personality disorder (BPD). We conducted a cross-sectional study of patients who know what it feels like to be diagnosed with a mental disorder. The main outcome measures were the proportion of participants offended and confused by alternative terms for BPD.

Seventy-two people participated in the study. Being diagnosed with a condition was more offensive than being diagnosed with a disorder (χ2 = 41.18, d.f. = 1, P < 0.01). Fluxithymia offended the fewest participants (13%), but was the most confusing term (31%). Emotionally unstable personality disorder was the most offensive term (63%). After fluxithymia, emotional intensity disorder was the least offensive term, and not especially confusing (11%). Changing BPD to emotional intensity disorder would avoid an offensive event every 3.6 diagnostic announcements.

The diagnostic term BPD should be replaced with emotional intensity disorder, because this term provides a balance of clarity and inoffensiveness.

The British Paediatric Surveillance Unit of the UK Royal College of Paediatrics and Child Health contacts participating consultant paediatricians each month to survey whether particular rare conditions or events have been seen in their services. This national surveillance of rare paediatric events has allowed a large amount of research into multiple paediatric conditions. In 2009, the Royal College of Psychiatrists established a similar system – the Child and Adolescent Psychiatry Surveillance System (CAPSS) – to survey consultant psychiatrists in UK and Ireland. Since many conditions involve mental and physical health features, seven studies have been run using reporting to both systems, with simultaneous surveillance across both paediatricians and psychiatrists. Given the desire by policymakers, commissioners and clinicians for well-integrated physical and mental healthcare (‘joined-up working’), and if the surveillance systems were functioning well, the CAPSS Executive expected high rates of parallel reporting of individual patients to the two systems. The current study synthesises the rates of parallel reporting of cases to those two systems. We assimilate rates of parallel reporting across the seven studies using figures that have already been published, and by contacting contributing research groups directly where the relevant figures are not currently published. No new primary data were collected.

Of the 1211 confirmed cases, 47 (3.9%) were reported by both psychiatrists and paediatricians. No parallel reporting occurred in four of the seven studies.

Our findings raise questions about whether joined-up working in mental and physical healthcare is happening in practice. Research into challenges to obtaining comprehensive surveillance will help epidemiologists improve their use of surveillance and control for biases.

Venous thromboembolism (VTE) is a fatal condition affecting older people. This study aims to identify specific risk factors for VTE in older psychiatric in-patients within mental hospital settings. Using predefined search terms, we searched five databases to capture studies evaluating risk factors associated with the occurrence of deep vein thrombosis and pulmonary embolism in older psychiatric in-patients.

Thirteen studies were identified, and a narrative synthesis performed. Increasing age was a consistent risk factor for VTE. Diagnosis and psychotropic medication use were inconsistent. Depression, catatonia and use of restraint in people with dementia were associated with higher risks.

Older psychiatric in-patients differ from medical and surgical in-patients in their risk profiles. Screening tools used in general hospital patients are of limited use among older adults in psychiatric hospital settings. An exclusive screening tool to identify VTE risk factors in older psychiatric in-patients is needed.

The covert administration of medicines is associated with multiple legal and ethical issues. We aimed to develop a natural language processing (NLP) methodology to identify instances of covert administration from electronic mental health records. We used this NLP method to pilot an audit of the use of covert administration.

We developed a method that was able to identify covert administration through free-text searching with a precision of 72%. Pilot audit results showed that 95% of patients receiving covert administration (n = 41/43) had evidence of a completed mental capacity assessment and best interests meeting. Pharmacy was contacted for information about administration for 77% of patients.

We demonstrate a simple, readily deployable NLP method that has potential wider applicability to other areas. This method also has potential to be applied via real-time health record processing to prompt and facilitate active monitoring of covert administration of medicines.

Previous meta-analysis of the efficacy of mobile phone applications (mHealth apps) for depression has several limitations, including high risk of bias and heterogeneity in effect sizes across studies, and gaps in understanding of variability in treatment outcomes. We aimed to provide more reliable and clinically relevant findings by conducting a systematic literature search on PubMed, Embase and PsycInfo, focusing on newer studies with minimal risk of bias.

Analysing 17 randomised controlled trials (n = 2821) published between 2020 and 2025, we found a pooled standardised mean difference (s.m.d.) of –0.46 (95% CI –0.64 to –0.28; P < 0.001) relative to the control groups, which indicates a significant reduction in depressive symptoms. Subgroup analyses confirmed efficacy in both adolescents (s.m.d. = –0.42) and adults (s.m.d. = –0.49). Despite evidence of publication bias, 70% of the studies had a low risk of bias, supporting the robustness and reliability of these findings.

The results underscore the clinical relevance of mHealth apps as scalable and accessible tools for bridging gaps in mental healthcare. Their effectiveness across age groups highlights their potential for broad implementation, with future research needed to refine personalisation, engagement strategies and methodological rigour.

This paper advocates for a holistic approach to the menopause transition and challenges the current dominant narrative that frames this transition primarily in biological terms. It examines the psychological, social and cultural dimensions, addresses the stigma faced by older women and advocates for the vital role psychiatrists have to play in supporting postmenopausal women.

To truly understand the efficacy of attention-deficit hyperactivity disorder (ADHD) psychoeducation, we need to know what is commonly included in it. This scoping review aims to describe the content of psychoeducation interventions for ADHD in published research. A literature search was conducted to identify relevant papers. Descriptions of psychoeducation aimed at children, parents/carers, adults and teachers were identified and compared narratively.

After screening, 57 papers were identified for data extraction and coding. Content themes included ‘information about ADHD’; ‘practical advice’; ‘impact of ADHD’; ‘treatment of ADHD’; ‘co-occurrence’; and ‘self-image/self-esteem’. ‘Information about ADHD’ and ‘practical advice’ were the most common themes, with variance on inclusion of other themes. Most of the identified research involved psychoeducation for parents of children with ADHD.

This review provides greater understanding of the content and delivery of ADHD psychoeducation. Further research could use this understanding to ascertain the efficacy of different content themes in supporting those with ADHD.