Psychotic disorders are severe mental health conditions frequently associated with long-term disability, reduced quality of life and premature mortality. Early Intervention in Psychosis (EIP) services aim to provide timely, comprehensive packages of care for people with psychotic disorders. However, it is not clear which components of EIP services contribute most to the improved outcomes they achieve.

We aimed to identify associations between specific components of EIP care and clinically significant outcomes for individuals treated for early psychosis in England.

This national retrospective cohort study of 14 874 EIP individuals examined associations between 12 components of EIP care and outcomes over a 3-year follow-up period, by linking data from the National Clinical Audit of Psychosis (NCAP) to routine health outcome data held by NHS England. The primary outcome was time to relapse, defined as psychiatric inpatient admission or referral to a crisis resolution (home treatment) team. Secondary outcomes included duration of admissions, detention under the Mental Health Act, emergency department and general hospital attendances and mortality. We conducted multilevel regression analyses incorporating demographic and service-level covariates.

Smaller care coordinator case-loads and the use of clozapine for eligible people were associated with reduced relapse risk. Physical health interventions were associated with reductions in mortality risk. Other components, such as cognitive–behavioural therapy for psychosis (CBTp), showed associations with improvements in secondary outcomes.

Smaller case-loads should be prioritised and protected in EIP service design and delivery. Initiatives to improve the uptake of clozapine should be integrated into EIP care. Other components, such as CBTp and physical health interventions, may have specific benefits for those eligible. These findings highlight impactful components of care and should guide resource allocation to optimise EIP service delivery.

The aim of this rapid scoping review was to provide a summary of the available evidence on the development and implementation of peer support work in mental health services. The specific objectives were: to undertake a comprehensive review of the literature on peer support work; and identify how such work may be best implemented.

A rapid scoping review was identified as the most appropriate approach to reviewing the literature mainly because the objectives of this review were relatively broad and there was a short timeframe. In a rapid scoping review the data extraction and reporting are focused and limited to provide an overview of existing evidence.

From the initial database results of 7406 records, 663 were identified as meeting the inclusion criteria. The most relevant of these were then selected (n = 26) to be reported in this review with existing reviews of the research evidence (n = 7) being prioritised. The findings were organised into a number of sections: definitions, values and the role; development and implementation of peer support work; experiences of peer support workers; perceptions of others about peer support work; recruitment of peer support workers; training; supervision and support; and research on effectiveness.

There are excellent sources of guidance, considerable qualitative research about experiences and some encouraging, but limited, findings about the impact of peer support work specifically on recovery-oriented outcomes. There is a need for further rigorous research on the key aspects and effectiveness of peer support work.

Patients with psychosis face an elevated risk of cardiovascular mortality and are more likely to disengage from care. While antipsychotics are essential for treatment, they further increase this risk. Despite this, Ghana lacks a national policy for monitoring cardiovascular risk factors in individuals on antipsychotics.

To evaluate disengagement in care and weight changes among newly diagnosed psychotic patients at Accra Psychiatric Hospital, and to inform clinical practice.

A retrospective review of medical records was conducted for patients newly diagnosed with non-affective psychotic disorders between June 2022 and May 2023. Patients were reviewed for 6 months, with assessments at baseline, 3 months and 6 months. Outcomes included antipsychotic prescription patterns, dropout rates, cardiovascular disease monitoring and weight changes. Descriptive statistics, multinomial logistic regression and linear mixed-effects models were used for analysis.

The number of patients disengaged from care within the first month was 53.1%, and within 6 months 75.5%; 62.8% received olanzapine at baseline. Weight gain was exponential, with 40% experiencing clinically significant weight gain at 3 months, increasing to 58% at 6 months. Less than 50% of patients had their blood sugar and lipid profiles checked before starting antipsychotics. Higher baseline weight was associated with increased weight over time (β = 0.96, t = 80, P < 0.001, 95% CI 0.93, 0.98).

High disengagement rates, low cardiovascular disease monitoring and exponential weight gain were observed. Targeted interventions, robust monitoring protocols and further research are needed to improve patient outcomes.

With the increasing accessibility of tools such as ChatGPT, Copilot, DeepSeek, Dall-E, and Gemini, generative artificial intelligence (GenAI) has been poised as a potential, research timesaving tool, especially for synthesising evidence. Our objective was to determine whether GenAI can assist with evidence synthesis by assessing its performance using its accuracy, error rates, and time savings compared to the traditional expert-driven approach.

To systematically review the evidence, we searched five databases on 17 January 2025, synthesised outcomes reporting on the accuracy, error rates, or time taken, and appraised the risk-of-bias using a modified version of QUADAS-2.

We identified 3,071 unique records, 19 of which were included in our review. Most studies had a high or unclear risk-of-bias in Domain 1A: review selection, Domain 2A: GenAI conduct, and Domain 1B: applicability of results. When used for (1) searching GenAI missed 68% to 96% (median = 91%) of studies, (2) screening made incorrect inclusion decisions ranging from 0% to 29% (median = 10%); and incorrect exclusion decisions ranging from 1% to 83% (median = 28%), (3) incorrect data extractions ranging from 4% to 31% (median = 14%), (4) incorrect risk-of-bias assessments ranging from 10% to 56% (median = 27%).

Our review shows that the current evidence does not support GenAI use in evidence synthesis without human involvement or oversight. However, for most tasks other than searching, GenAI may have a role in assisting humans with evidence synthesis.

There is a significant mortality gap between the general population and people with psychosis. Completion rates of regular physical health assessments for cardiovascular risk in this group are suboptimal. Point-of-care testing (POCT) for diabetes and hyperlipidaemia – providing an immediate result from a finger-prick – could improve these rates.

To evaluate the impact on patient–clinician encounters and on physical health check completion rates of implementing POCT for cardiovascular risk markers in early intervention in psychosis (EIP) services in South East England.

A mixed-methods, real-world evaluation study was performed, with 40 POCT machines introduced across EIP teams in all eight mental health trusts in South East England from March to May 2021. Clinician training and support was provided. Numbers of completed physical health checks, HbA1c and lipid panel blood tests completed 6 and 12 months before and 6 months after introduction of POCT were collected for individual patients. Data were compared with those from the South West region, which acted as a control. Clinician questionnaires were administered at 2 and 8 months, capturing device usability and impacts on patient interactions.

Post-POCT, South East England saw significant increases in HbA1c testing (odds ratio 2.02, 95% CI 1.17–3.49), lipid testing (odds ratio 2.38, 95% CI 1.43–3.97) and total completed health checks (odds ratio 3.61, 95% CI 1.94–7.94). These increases were not seen in the South West. Questionnaires revealed improved patient engagement, clinician empowerment and patients’ preference for POCT over traditional blood tests.

POCT is associated with improvements in the completion and quality of physical health checks, and thus could be a tool to enhance holistic care for individuals with psychosis.

To examine the extent and nature of food and non-alcoholic drink advertising displayed on public transport and infrastructure on school routes.

Audit of outdoor advertisements on government-controlled public transport and associated infrastructure (e.g. tram shelters, bus stops) on busy school routes in Victoria, Australia. Using a strict protocol, trained field workers collected data on the type and content of outdoor advertising during February 2023 (start of school year). Food/drink advertising was classified (unhealthy or healthy) according to the Council of Australian Governments Health Council National interim guide to reduce children’s exposure to unhealthy food and drink promotion (2018).

Government-controlled buses, trams and public transport infrastructure on routes from eleven of the busiest train stations in metropolitan Melbourne and regional Victoria, Australia to fifty public primary and secondary schools. Stations were chosen based on annual patronage, area-based socio-economic area (SEA) and regionality).

156 out of 888 advertisements were for food and non-alcoholic drinks. Of these, almost six in ten (58 %) were deemed unhealthy irrespective of SEA or regionality. Marketing appeals most featured were taste (31 %), convenience (28 %) and emotion (9 %). A significantly higher proportion of unhealthy advertisements were displayed within 500 m of schools v. outside this radius (91 % v. 57 %, P < 0·01).

Given the detrimental impacts of exposure to unhealthy food/drink advertising on children’s diets, the pervasive, powerful presence of such advertising across government public transport assets, particularly around schools, contradicts public health recommendations to protect children from exposure to and influence by this harmful marketing and warrants government action.

The presence of nodal disease at presentation of a head and neck mucosal-based squamous cell carcinoma has a significant impact upon outcomes.

This is a retrospective, ethics-approved study in which patients with squamous cell carcinoma of the larynx, oropharynx, hypopharynx and oral cavity were reviewed and compared with respect to nodal disease (N0 vs N1–N2 vs N3). Patient, disease and treatment parameters were evaluated with ultimate local control, regional control, cancer-specific survival and overall survival investigated.

In the cohort of 1265 patients, 764 presented with nodal disease (N3 = 60). The majority of the N3 group had oropharynx squamous cell carcinoma (52%) and experienced worse ultimate local control (63%; p < 0.001), regional control (67%; p < 0.001) and both squamous cell carcinoma and overall survival (log rank p < 0.001).

Patients presenting with N3 nodal disease had poor regional control, a lower cancer-specific survival and a worse overall survival compared to patients with lesser to no nodal disease.

Scalable assessment tools for precision psychiatry are of increasing clinical interest. One clinical risk assessment that might be improved by such approaches is assessment of violence perpetration risk. This is an important adverse outcome to reduce for some people presenting to services for first-episode psychosis. A prediction tool (Oxford Mental Illness and Violence (OxMIV)) has been externally validated in these services, but clinical acceptability and role need to be examined and developed.

This study aimed to understand clinical use of the OxMIV tool to support violence risk management in early intervention in psychosis services in terms of acceptability to clinicians, patients and carers, practical feasibility, perceived utility, impact and role.

A mixed methods approach integrated quantitative data on utility and patterns of use of the OxMIV tool over 12 months in two services with qualitative data from interviews of 20 clinicians and 12 patients and carers.

The OxMIV tool was used 141 times, mostly in new assessments. Required information was available, with only family history items scored unknown to any notable degree. The OxMIV tool was deemed helpful by clinicians in most cases, especially if there were previous risk concerns. It was acceptable practically, and broadly for the service, for which its concordance with clinical judgement was important. Patients and carers thought it could improve openness. There was some limited impact on plans for clinical support.

The OxMIV tool met an identified clinical need to support clinical assessment for violence risk. Linkage to intervention pathways is a research priority.

This study aimed to explore health professionals’ use, barriers, confidence, and preferences for technology and smartphone apps to assist clients with self-managing low back pain (LBP).

Prospective observational cross-sectional survey of registered Australian health professionals that managed clients with LBP.

In total, 52 survey responses were included (mean age 43 ±13.8 years). Most did not personally use healthy lifestyle apps (60%) and did not recommend apps due to a lack of knowledge of app effectiveness (93%). The largest barrier to recommending apps was the potential for apps to be misused as a substitute to health professional diagnosis. Fifteen recommended smartphone apps (mean age 36 ±10.6 years) and were at least moderately confident in choosing/recommending apps (94%) and assessing app quality (80%). Those more likely to recommend apps personally used apps for healthy lifestyle behaviours (odds ratio (OR) 5.1 (p = 0.009)) were physiotherapists (OR 0.13 (p = 0.035) c/f chiropractors in their profession for <10 years (OR 8.6 (p = 0.015)) c/f >30 years. Increasing age decreased the odds (OR 0.94 (p = 0.013)) of recommending apps.

Health professionals do not recommend LBP self-management apps due to a lack of knowledge of their effectiveness. Those that do recommend apps are confident with app choice, recommendation, and app quality assessment. Physiotherapists with <10 years’ experience were most likely to recommend apps.

Refugee experiences of trauma and displacement can significantly disrupt established social networks. While social functioning has been routinely associated with mental health, to our knowledge, no study has tested the direction of influence between social and psychological functioning within displaced refugee communities. This study investigated the temporal association between psychological symptoms (PTSD, depression, anger) and multiple facets of social functioning (including community connectedness, perceived social responsibility, positive social support and negative social support).

A culturally diverse sample of refugees (N = 1,235) displaced in Indonesia completed an online survey at four time-points, six months apart. Longitudinal structural equation modelling was used to investigate the temporal ordering between psychological symptoms and social functioning.

Findings revealed that greater psychological symptoms were associated with a subsequent deterioration in social functioning (decreased positive social support and community connectedness and increased negative social support and perceived social responsibility). Greater perceived social responsibility was also associated with subsequent increases in psychological symptoms, while positive social support and community connectedness were bi-directionally associated over-time.

These findings highlight the potential utility of mental health interventions for displaced refugees as a means to improve social functioning and inclusion with host communities. Findings have important implications in guiding the development of interventions and allocation of resources to support refugee engagement and wellbeing in displacement contexts.