It is now accepted that social factors affect not only onset but also mental health treatment outcomes. One such factor is financial difficulty. Within National Health Service (NHS) Talking Therapies, problem debt has been shown to interfere significantly with recovery from mental health problems, estimated as 22% versus 50% recovered with no problem debt. One solution is a combined money advice and psychological therapy intervention to improve treatment outcomes.

The aim of the current study was to trial a combined money advice and psychological therapy service within NHS Talking Therapies, to ascertain its feasibility and acceptability.

This study employed a mixed methods case series of individuals attending high-intensity cognitive–behavioural treatment who were provided with a combined intervention (money advice service plus NHS Talking Therapies). Acceptability and feasibility were evaluated through interviews, and benefit was assessed from comparisons of routinely collected symptom measures and compared to historical recovery estimates.

Some 32 participants, with similar gender distribution but more representation from ethnic minorities, were recruited from NHS Talking Therapies. One-third demonstrated complete recovery on both depression and anxiety, while half showed symptom improvement and modest improvements on the financial outcomes measure. Our interviews with patients, therapists and money advisors suggested the combined intervention was acceptable and beneficial, but that money worries should be identified earlier.

The combined service is acceptable, accessible and could deliver benefit, even in the short term, to those with mental health and debt problems.

To identify trajectories of Indonesian children and adolescents BMI-z scores between 1993 and 2014, examine whether the pattern differs by sex, and assess associations with host, agent and environmental factors.

Longitudinal data were from the Indonesian Family Life Survey with up to five measurements of height and weight. Group-based trajectory models investigated change in BMI-z score across time; differences by sex were investigated using random effect (mixed) models. The association between the trajectories and host, agent and environmental factors were examined using multinomial logistic regression.

Thirteen provinces in Indonesia.

Indonesian children and adolescents aged 6-18 years (n=27 394 for BMI-z trajectories; n=8805 for risk factor analyses).

Mean BMI-z score increased from −0.743 standard deviation (SD) in 1993 to −0.414 SD in 2014. Four distinct trajectory groups were estimated with mean BMI-z increasing more rapidly in the most recent time periods. One group (11.7% of participants) had a mean BMI-z entirely within the moderately underweight range; two had trajectories in the normal range; and one (5.6%) had a mean BMI-z starting in the overweight range but within the obesity range by 2014. There were differences in trajectory groups by sex (p<0.001). Those born in 2000s, frequent consumption of meat, fast foods, soft drinks, and fried snacks, and living in urban areas were associated with rapid gain weight.

These trajectories highlight the double burden of malnutrition and suggest that the prevalence of overweight and obesity is likely to increase substantially unless public health interventions are implemented.

It remains unclear which individuals with subthreshold depression benefit most from psychological intervention, and what long-term effects this has on symptom deterioration, response and remission.

To synthesise psychological intervention benefits in adults with subthreshold depression up to 2 years, and explore participant-level effect-modifiers.

Randomised trials comparing psychological intervention with inactive control were identified via systematic search. Authors were contacted to obtain individual participant data (IPD), analysed using Bayesian one-stage meta-analysis. Treatment–covariate interactions were added to examine moderators. Hierarchical-additive models were used to explore treatment benefits conditional on baseline Patient Health Questionnaire 9 (PHQ-9) values.

IPD of 10 671 individuals (50 studies) could be included. We found significant effects on depressive symptom severity up to 12 months (standardised mean-difference [s.m.d.] = −0.48 to −0.27). Effects could not be ascertained up to 24 months (s.m.d. = −0.18). Similar findings emerged for 50% symptom reduction (relative risk = 1.27–2.79), reliable improvement (relative risk = 1.38–3.17), deterioration (relative risk = 0.67–0.54) and close-to-symptom-free status (relative risk = 1.41–2.80). Among participant-level moderators, only initial depression and anxiety severity were highly credible (P > 0.99). Predicted treatment benefits decreased with lower symptom severity but remained minimally important even for very mild symptoms (s.m.d. = −0.33 for PHQ-9 = 5).

Psychological intervention reduces the symptom burden in individuals with subthreshold depression up to 1 year, and protects against symptom deterioration. Benefits up to 2 years are less certain. We find strong support for intervention in subthreshold depression, particularly with PHQ-9 scores ≥ 10. For very mild symptoms, scalable treatments could be an attractive option.

Current approaches to identifying individuals at risk for psychosis capture only a small proportion of future psychotic disorders. Recent Finnish research suggests a substantial proportion of individuals at risk of psychosis attend child and adolescent mental health services (CAMHS) earlier in life, creating important opportunities for prediction and prevention. To what extent this is true outside Finland is unknown.

To establish the proportion of psychotic and bipolar disorder diagnoses that occurred in individuals who had attended CAMHS in Wales, UK, and whether, within CAMHS, certain factors were associated with increased psychosis risk.

We examined healthcare contacts for individuals born between 1991 and 1998 (N = 348 226), followed to age 25–32. Using linked administrative healthcare records, we identified all psychotic and bipolar disorder diagnoses in the population, then determined the proportion of cases where the individual had attended CAMHS. Regression analyses examined associations between sociodemographic and clinical risk markers with psychotic and bipolar disorder outcomes.

Among individuals diagnosed with a psychotic or bipolar disorder, 44.78% had attended CAMHS (hazard ratio = 6.28, 95% CI = 5.92–6.65). Low birth weight (odds ratio = 1.33, 95% CI = 1.15–1.53), out-of-home care experience (odds ratio = 2.05, 95% CI = 1.77–2.38), in-patient CAMHS admission (odds ratio = 1.49, 95% CI = 1.29–1.72) and attending CAMHS in childhood (in addition to adolescence; odds ratio = 1.16, 95% CI = 1.02–1.30) were all within-CAMHS risk markers for psychotic and bipolar disorders.

A substantial proportion (45%) of future psychotic and bipolar disorder cases emerge in individuals who had attended CAMHS, demonstrating large-scale opportunities for early intervention and prevention within CAMHS.