Aims: The unique demands of studying for a healthcare-related degree are associated with an increased risk of developing mental health problems. Stigma and fear of repercussions for their future careers may be a barrier to these students seeking professional help. Mental Health First Aid (MHFA) is a globally disseminated psycho-education course, training members of the public to recognise and respond to people experiencing mental health problems in their communities. Training healthcare professional (HCP) students in MHFA may help them support their peers and optimise their own wellbeing.

We aimed to review the literature regarding experiences of MHFA in medical, nursing and allied HCP students and its impact on mental health knowledge, confidence and skills in supporting others, stigmatising attitudes, self-care, peer support and student wellbeing.

Methods: This systematic review was conducted in accordance with PRISMA guidelines and registered on PROSPERO (ID: CRD42024589509). Electronic databases (Ovid, Medline, PsycINFO, CINAHL and ERIC) were searched on 9/10/2024 for primary studies evaluating the impact of MHFA in HCP students. Data was extracted independently by two authors. Study quality was assessed using the MMERSQI (Modified Medical Education Research Study Quality Instrument) and Cochrane Risk of Bias tool.

Results: Searches identified 1613 studies, 25 of which met inclusion criteria. Study types were heterogeneous, including four randomised controlled trials (RCTs) and four qualitative studies. Eight studies reported that MHFA significantly improved post-test knowledge and mental health literacy. Fourteen studies reported enhanced confidence in providing MHFA post-training. Three studies described outcomes based on performance on simulation assessments, and eight studies reported reduction in discriminatory attitudes following MHFA training. Data on peer support and student wellbeing was limited. Qualitative studies suggested that MHFA clarified misconceptions around mental illness, facilitated supporting friends and family, and helped with self-care and seeking professional support for their own mental health. Student pharmacists felt that skills gained from MHFA were particularly advantageous in their professional roles. Qualitative data also suggested that tailored content for HCP students and increased pace of delivery would be beneficial.

Conclusion: The evidence base on this topic is limited, with many small studies and few RCTs. However, the available literature suggests that MHFA may be a promising strategy to improve mental health literacy, confidence, skills, and reduce stigma in HCP students. Findings suggest that there is demand for bespoke MHFA courses for HCP students, which may fulfil an unmet need in facilitating them to provide support to their peers, and optimise their own wellbeing.

Aims: The study aimed to explore the experience and opinions of third year medical students regarding the use of escape rooms as a teaching modality in undergraduate psychiatry education. This research will help inform whether escape rooms have a viable role in medical education.

Methods: This was a mixed method study using quantitative and qualitative elements. Quantitative data was captured on Likert scales, through survey completion, immediately after completion of an escape room (n=64) based on their psychiatry curriculum at a revision day. The qualitative element of study included two focus groups of students (n=7), who had attended the revision day, to discuss their experience of escape rooms in medical education. Focus groups were audio-recorded and transcribed. The transcripts were then analysed using thematic analysis.

Results: 97% of surveyed students found the escape room an enjoyable experience. 57 (89%) students reported a positive improvement in knowledge, with only one student disagreeing. 72% of students reported it had improved their clinical skills. Free text responses included ‘really good revision exercise’ and ‘made revision good fun’. The main themes identified from focus groups were that escape rooms were an interactive and enjoyable learning experience which improved knowledge and allowed students to identify knowledge gaps to focus their revision. They enjoyed working in smaller groups, which they found inclusive, and some students felt this improved their team working skills. Some students found that the timed and competitive element detracted from the educational aspect and negatively impacted team working skills, whilst others valued this.

Conclusion: The findings of this study suggest that escape rooms could provide an innovative approach to teaching methods in undergraduate psychiatry. In this study, students found the escape room an enjoyable and beneficial experience that improved their knowledge, and they perceived a benefit for revision as the day was situated close to final year examinations. Equally, escape rooms could be used in a myriad of other ways to support learning in different contexts. Given the popularity of experiential learning in medical education this may be an option to provide positive experiences in undergraduate psychiatric education as well as meaningful educational experiences.

Aims: The national emphasis on improving rates and timeliness of dementia diagnosis is dependent on accessibility of investigative tools. Through locally accessible, point-of-care brain scans, LFMRI has the potential to improve the experience of dementia assessment pathways and time to diagnosis, and to reduce inequalities in access to dementia assessment.

The aim of this qualitative research was to explore perspectives regarding the use of LFMRI scanning within dementia diagnosis pathways, within communities where it may have the greatest impact. We also aimed to learn more about views regarding future LFMRI research, including priorities, concerns and potential facilitators and barriers to participation.

Methods: The qualitative design incorporated focus groups and interviews with individuals with dementia and their carers. The study took place within urban, rural and coastal communities in Kent. 35 participants took part in either a focus group (n=20) or interview (n=15) with an average age of 72 years. Focus groups and interviews were recorded and transcribed verbatim for thematic analysis using NVivo software.

Results: Participants described both positive views as well as caution about the use of this new investigative tool. Five subthemes were identified: access to local neuroimaging, improvement of assessment pathways, accuracy of LFMRI, concerns about expense to the NHS and engagement in future LFMRI research.

Participants were optimistic about the potential of LFMRI within dementia diagnosis pathways. They valued the possibility of access to local scanners and the benefit this would have on timely diagnosis with improved diagnostic pathways. However, there were concerns about the accuracy of these scanners and the cost implications within the NHS.

Conclusion: While the technology will not mean the replacement of traditional MRI scans, LFMRI may have the potential to improve dementia diagnosis pathways. LFMRI may be a lower cost alternative to help to reduce wait times while improving access to pathways for those in underserved communities. This would be welcomed by people with dementia and their carers, if there was trust in the accuracy of the scans. Participants expressed willingness to be involved in further research using LFMRI scanners to support improvements in the dementia diagnostic pathways for others.

Aims: The Kent and Medway Psychiatry Undergraduate Scheme (KAMPUS) aims to provide medical students with experience in psychiatry at an early stage in their training, and psychiatry trainees the opportunity to develop mentoring and leadership skills.

Early exposure to psychiatry improves student perceptions of the specialty. KAMPUS is based on a similar programme in a London medical school which has reported positive outcomes. KAMPUS was adapted for the structure and geography of the local medical school and mental health trust.

Methods: A committee of psychiatrists, trainees and student representatives co-developed KAMPUS and wrote handbooks for students, trainees and clinical supervisors. Year 1–2 students and core psychiatry trainees were invited to participate. 18 students and 15 trainees registered for KAMPUS in the 2023–2024 academic year. Lead mentors supported small groups of students virtually, and clinic-based mentors were trainees based near the school, who provided clinical shadowing opportunities. Combined educational/social events were organised in collaboration with the Psychiatry Society, and a formal day of mentoring training was provided for trainees.

Results: Trainees provided regular mentoring and shadowing opportunities. Lead mentor group discussion topics included training pathways, case presentations and practice exam questions. Two educational/social events were attended by students and trainees. Trainees gave positive feedback regarding mentoring training.

Conclusion: KAMPUS is deliverable across the wide geographical area covered by the medical school and mental health trust in Kent. It has provided early experience in psychiatry for students and a development opportunity for trainees, with positive initial feedback.

Aims: Intergenerational programmes provide meaningful social contact for older people, and address negative stereotypes of ageing in children. Reading aloud improves language acquisition and literacy in children, however in regions of socio-economic deprivation, many children lack this opportunity. The aim of this qualitative research was to explore the experiences and perspectives of teachers and volunteers involved in an intergenerational reading project within a primary school in an area of high socioeconomic deprivation.

Methods: In the ROCKET project, senior volunteers (aged >75) were supported to join an established volunteer reading scheme in a primary school with the support of an existing volunteer. The students who took part in the project were those identified by teachers to have the greatest need for support with reading. This qualitative study incorporated semi-structured interviews with teachers and volunteers in June–August 2024, a year after the project began. Seven participants took part in an interview, including four teachers, an existing volunteer lead and two volunteers over the age of 75 years old. Videos were audio-recorded and transcribed before thematic analysis by two of the authors.

Results: Thematic analysis identified six subthemes: improved reading ability in children, children’s social development, reduced loneliness, volunteers’ sense of purpose/enjoyment and future potential of ROCKET and challenges to overcome.

Volunteers valued the social interaction, the sense of purpose, enjoyment and improved confidence that participating provided them. The teachers described students as benefiting from improved confidence and reading ability, and the positive impact of meeting people outside of their usual social sphere. Participants were optimistic about the future potential of ROCKET and felt it could expand beyond literacy to other subjects such as maths or comprehension, and include other year groups. They also felt that communication could be improved between teaching staff and volunteers involved within the project.

Conclusion: Data from this small qualitative study suggests that the ROCKET project has the potential to improve student’s literacy skills and confidence, and to positively impact volunteers through reduced loneliness, a sense of purpose and being a part of a community. Participants felt that improved communication between volunteers and teacher would enhance its success, and that there was scope to broaden the project to include other school subjects and a wider range of students.

Recent changes to US research funding are having far-reaching consequences that imperil the integrity of science and the provision of care to vulnerable populations. Resisting these changes, the BJPsych Portfolio reaffirms its commitment to publishing mental science and advancing psychiatric knowledge that improves the mental health of one and all.

Background: Mild cognitive impairment (MCI) may represent a transitional stage between normal functioning and dementia. Following the initial criteria developed by Petersen et al. in 1999, which focused on memory deficit in the context of otherwise normal cognition and general functioning, the concept has evolved with the introduction of subtypes of MCI and improved understanding of etiology. Our aim was to investigate current practice as well as familiarity with and attitudes toward the concept of MCI amongst UK old age psychiatrists.

Method: We sent an anonymized postal survey to all clinicians on the Royal College of Psychiatrists Old Age Psychiatry register. Questions covered attitudes toward the concept of MCI in addition to diagnostic criteria and assessment tools used.

Results: The response rate was 39% (453 of 1,154 questionnaires returned completed). The majority of respondents were consultants (83%) and 91% diagnosed MCI. Only 4.4% of the respondents thought that the concept of MCI was not useful and 79% of them required a memory complaint from either the patient or an informant for a diagnosis, but the majority did not have a specific cut-off on cognitive testing. Eighty-two percent reported that they required no or minimal impairment in activities of daily living for a diagnosis of MCI. The two most frequently used tools for assessment were the Mini-Mental State Examination and the Addenbrooke's Cognitive Examination–Revised.

Conclusions: Our survey shows that in the United Kingdom, the term MCI has become part of everyday clinical practice in psychiatry, suggesting that clinicians find it a useful term to conceptualize the transitional stage between normal aging and dementia. However, there is variability in diagnostic practice.

White matter alterations, leukoaraiosis (LA) on structural MRI, are associated with cognitive deficits and increased risk of dementia. LA may also impact on subjective memory complaints in otherwise healthy older adults. Little is known about the interplay between LA memory complaints and cognition. We investigated cognitive phenotypes associated with LA in 42 non-demented older adults categorized as having subjective cognitive complaints with no objective cognitive impairment—the subjective cognitive impairment group (SCI; n = 12), amnesic mild cognitive impairment (aMCI; n = 20), or healthy controls (HC; n = 11). We measured LA severity on MRI with a 40-point visual rating scale. Controlling for age and Mini-Mental State Examination (MMSE) score, analyses revealed multiple between-group differences. Follow-up linear regression models investigating the underlying contributors to each clinic group's cognitive profile indicated that LA contributed to learning slope variance (after accounting for age and MMSE) but only for the SCI group. Although the SCI group showed a significantly steeper learning slope when compared to HC and aMCI, increasing LA severity negatively impacted this group's rate of learning. This, in conjunction with the significant contribution of age on SCI learning slope performance variance suggests that greater LA burden at a younger age may contribute to subtle changes in learning for individuals with subjective cognitive complaints. (JINS, 2011, 17, 1104–1112)

Over the past ten years, dopaminergic imaging has become increasingly part of the assessment and diagnosis of dementia. There are numerous PET and SPECT ligands available that target different steps in the process of neurotransmission. Abnormalities in dopaminergic imaging measures are consistent features of dementia with Lewy bodies (DLB) and other parkinsonian syndromes, and can be used to facilitate diagnosis, particularly in distinguishing between DLB and Alzheimer's disease. This review summarizes present knowledge in this area and the implications for current and future clinical practice.

Background: The study aim was to conduct a systematic review of the evidence from randomized, placebo controlled trials related to the efficacy of donepezil, rivastigmine and galantamine in the treatment of behavioral and psychological symptoms of Alzheimer's disease.

Methods: Electronic database searches of MEDLINE, EMBASE and the Cochrane Central Register of Controlled Trials were carried out using multiple search terms. Articles included were original publications of randomized, placebo-controlled trials of monotherapy of donepezil, rivastigmine or galantamine that reported a behavioral outcome measure.

Results: 14 studies were identified that matched inclusion criteria. Nine were of donepezil, three of galantamine and two of rivastigmine. Median study treatment length was 24 weeks (range 12–170). Most studies used the Neuropsychiatric Inventory as a behavioral outcome measure although three used specific scales for either agitation or apathy. Four studies were specifically designed to assess behavioral outcomes whilst in the majority of studies behavioral outcomes were only secondary measures. Three studies found statistically significant, albeit modest, differences in the change of NPI total score between drug and placebo. The interpretation of the results of many studies is limited by methodological considerations, including generally low NPI scores at baseline and the investigation of behavioral and psychological symptoms of dementia (BPSD) as secondary outcomes.

Conclusions: The evidence base regarding the efficacy of cholinesterase inhibitors in BPSD is limited, in part due to methodological considerations. In the absence of alternative safe and effective management options, the use of cholinesterase inhibitors is an appropriate pharmacological strategy for the management of BPSD in Alzheimer's disease.