This study investigated mental health diagnoses in autistic adults to determine whether there were any sex differences in presentation. Autistic adults attending the neurodevelopmental service at Surrey and Borders Partnership NHS Foundation Trust were included.

As part of a service audit, 150 random adults (75 males and females) were selected and their case notes were reviewed. Mental health diagnoses were common: 36% had current suicidal ideation, 20% had attempted suicide, 40% had a past or current diagnosis of anxiety and 62% had a past or current diagnosis of depression. There were more women diagnosed with an eating disorder (9% female, 0% male) and with a historical suicide attempt (21% female, 9% male). However, using a Holm–Bonferroni correction, there were no statistically significant sex differences between mental health diagnoses. Among both sexes, a significant number had been exposed to prenatal and early childhood trauma, nearly 10% had experienced physical trauma, abuse, neglect or assault, and nearly a third had been through parental separation.

This demonstrates that autistic people presenting to a National Health Service diagnostic clinic are more at risk of experiencing trauma, which subsequently increases their risk of mental illness, alongside any neurological predisposition.

Postnatal depression (PND) can disrupt maternal communication during early interactions, affecting infant socioemotional development. Singing is a natural form of caregiver–infant communication and a promising intervention to enhance maternal well-being and bonding. However, its effects on observed communication and perceived attachment in clinical PND populations remain underexplored.

Within the Scaling-Up Health-Arts Programs: Postnatal Depression trial, 199 mothers with PND were randomized 2:1 to a 10-week group singing intervention (Breathe Melodies for Mums) or a non-singing community activity. One hundred participants (singing = 70; control = 30) completed video-recorded interactions at baseline, week 10, and week 36. Maternal speech was coded using the Parental Cognitive Attributions and Mentalization Scale (PCAMS) for mentalization, affective tone, and attentional focus. Perceived maternal attachment was assessed separately via self-report using the Maternal Postnatal Attachment Scale.

At week 10, singing mothers showed greater improvement in communication with their infants than controls, with about 1.7-fold higher proportions of mentalizing comments (p = 0.01), 1.4-fold more infant-focused speech (p < 0.001), 2.4-fold less parent-focused speech (p < 0.001), and fivefold less negative speech (p < 0.001). These effects were maintained at week 36. Perceived attachment improved significantly across both groups (p < 0.001), but only singing mothers showed further gains from week 10 to week 36 (p = 0.02), indicating continued strengthening of attachment perceptions.

Group singing enhanced maternal communication and perceived attachment in mothers with PND. Findings support community-based, arts-informed interventions as accessible approaches to strengthen early relational health and complement perinatal mental healthcare.

In this study, we aimed to elucidate the underlying structural mechanisms that generate a desire for hastened death (DHD) in patients with terminal cancer from a whole-person perspective based on insights from palliative-care professionals (PCPs).

We conducted semi-structured interviews with 36 PCPs experienced in caring for patients with terminal cancer and DHD, followed by a thematic analysis based on Boyatzis’ hybrid approach.

We identified 6 themes that characterize the underlying structural mechanisms of DHD. DHD arises from feelings such as loss of self-control, inability to escape adverse circumstances, confronting death and letting go of life, pain of loneliness, being unable to accept living life as it is, and feeling unable to live with the thought of being an inconvenience to others, in addition to physical and psychological pain. In contrast, certain patients who had built good relationships with family members and/or PCPs found new meaning and value in their current lives, expressing a desire to live in the moment and choosing to continue living until the end.

This study provides the first comprehensive analysis of the underlying structural mechanisms of DHD in patients with terminal cancer from a whole-person perspective. DHD with spiritual pain is linked to the loss of future orientation, autonomy, and meaningful relationships through interconnected structural pathways, leading to feelings of worthlessness and existential meaninglessness. The identified framework demonstrates that these underlying mechanisms operate through an interplay of existential, relational, and autonomy-related factors extending beyond physical and psychological symptoms, reflecting an interconnected human experience across physical, psychological, social, and spiritual dimensions. This study established an evidence-based framework enabling healthcare professionals to implement whole-person approaches to recognize the multidimensional nature of DHD and address existential distress across all dimensions of human experience in end-of-life care.

The individual effects of genetic factors and adverse childhood experiences (ACEs) on risk of psychosis, including schizophrenia (SCZ) and bipolar disorder (BIP), have been widely acknowledged, but their interaction effects on individual psychopathological symptoms remain unclear.

Based on data from 163,704 individuals in the UK Biobank, we investigated the joint effects of polygenic risk scores (PRSs) of SCZ and BIP and ACEs on psychopathology. ACEs status and 55 psychopathological symptoms from seven domains were measured retrospectively using an online mental health questionnaire in 2016. Recent genome-wide association studies for SCZ and BIP were combined with genotype data to generate PRSs. Logistic regression analyses were then conducted to explore univariate and joint main effects of PRSs and ACEs on psychopathological symptoms, as well as their additive and multiplicative interaction effects.

The interaction mechanisms for PRSs and ACEs varied across symptom domains: additive interactions were observed on the depression (RERIBIP-ACEs = 0.20–0.25), anxiety (RERISCZ-ACEs = 0.20; RERIBIP-ACEs = 0.22–0.26), help-seeking (RERISCZ-ACEs = 0.24; RERIBIP-ACEs = 0.23), and cognition domains (RERISCZ-ACEs = −0.23 to -0.17), whereas multiplicative interactions were only detected on the psychotic (betaSCZ-ACEs = −0.543; betaBIP-ACEs = −0.181), mania (betaBIP-ACEs = −0.195), self-harm or suicide (betaSCZ-ACEs = −0.118), and cognitive domains (betaSCZ-ACEs = −0.204 to −0.157).

The interplay mechanisms for genetic liability to SCZ and BIP and ACEs vary across symptom domains. This study reveals heterogeneity in gene–ACEs interaction mechanisms underlying psychosis and may provide personalized guidance for psychological care after ACEs.

Pediatric acute care cardiology is a distinct subspecialty field within paediatric cardiology that has grown rapidly in recognition, with previously documented heterogeneity in its practice across 31 centres surveyed in 2017. Unit composition and care delivery across centres participating in the Paediatric Acute Care Cardiology Collaborative (PAC3) have not been formally reassessed and shared, despite significant growth in the field.

A 214-stem question Hospital Survey was created with 454 total response fields across eight domains important to paediatric acute care cardiology such a demographics, staffing, resources and therapies, and standard practices. PAC3 centres were surveyed in September 2023 via REDCap. Descriptive statistics were performed.

Surveys were completed by 100% (47/47) of PAC3 centers. Diverse unit composition exists with 37% of centres utilising a single, dedicated acute care cardiology unit, 28% using mixed-specialty acute care units, and 19% using acuity adaptable units, housing critical and acute care patients in one physical space. Since 2017, acute care cardiology-dedicated multidisciplinary staff has increased (physical therapy (PT): 0 to 4; occupational therapy (OT): 1 to 5; speech-language pathology (SLP): 0 to 4; PharmD: 7 to 26). There is heterogeneity in utilisation of many of the resources and therapies used in acute care cardiology, and use of ventricular assist devices on the acute care cardiology unit has increased.

Significant variability exists in unit structure and care delivery models across a diverse group of centres providing acute care cardiology services. The Hospital Survey may assist in identifying best practices for similar centres across PAC3.

Haiti is experiencing a severe humanitarian crisis characterised by political instability and economic and security hardship. These adversities contribute to significant mental health challenges, which are also exacerbated by poor access to psychological support due to a shortage of specialised professionals. Problem Management Plus (PM+), a scalable and low-intensity intervention developed by the World Health Organization, is based on a task-sharing approach to address the treatment gap by training non-specialist helpers to provide psychosocial support.

This study aimed to explore the implementation process of PM+ in Haiti, focusing on the barriers and facilitators that influenced its delivery. Specifically, the study focused on understanding the contextual factors affecting intervention accessibility, participant experiences and potential adaptations to enhance its effect.

A qualitative study was conducted across three Haitian cities, where trained helpers delivered PM+. Data were collected through the PSYCHLOPS tool with end-users and via cognitive interviews with stakeholders. Thematic analysis was conducted incorporating Lund’s social determinants of mental health model and Bronfenbrenner’s ecological systems theory to interpret findings.

Sixteen end-users and five stakeholders participated in the study. Key barriers to implementation and its success mainly included economic constraints and safety concerns. Facilitating factors included strong community engagement, adaptive implementation strategies (such as flexible scheduling, remote supervision and culturally responsive adjustments), alongside strong organisational support. End-users described substantial difficulties in managing everyday problems and emotional distress, as reported during pre-intervention qualitative assessments.

PM+ appeared feasible in the Haitian context from an implementation perspective; however, its implementability depends on cultural adaptations, economic considerations and sustained support for facilitators. Addressing systemic barriers and integrating task-sharing interventions within existing health structures could enhance the long-term impact.