This brief report examines physical and mental health symptom profiles among older adults approximately 5 months after Hurricane Helene–related flooding in Southern Appalachia.

Survey data were collected from 233 older adults and assessed physical health symptoms, posttraumatic stress disorder, depressive symptoms, flood event exposure, environmental contaminant exposure, and post-flood stressors. Cluster analysis was conducted to identify post-disaster physical and mental health symptom profiles, and analysis of variance and chi-square tests were conducted to examine differences in disaster exposure, post-flood stressors, and sociodemographic characteristics across profiles.

Three distinct post-disaster health symptom profiles were identified: a lower symptom profile, an elevated mental health symptom profile, and a combined elevated physical and mental health symptom profile. Disaster exposure, contaminant exposure, and post-flood stressors increased in a graded manner across profiles, indicating a dose–response framework of disaster-related health impacts. Higher symptom burden profiles were disproportionately represented among older adults with disabilities/chronic illness and among older age groups.

Findings highlight heterogeneity in post-disaster health experiences among older adults and underscore the value of identifying high-risk subgroups and implementing recovery strategies that address co-occurring physical and mental health needs among older adults following flood events.

Rapid weight gain commonly occurs following the onset of first-episode psychosis (FEP), leading to cardiometabolic disease. Most weight gain in FEP occurs in the first 3 months of treatment, offering a critical window for prevention. Despite this, most studies aiming to prevent antipsychotic-induced weight gain include people with chronic illness or people who have had lengthy exposure to antipsychotic medication. We aimed to synthesize and analyze the literature on interventions aimed at preventing antipsychotic-induced weight gain.

We conducted a systematic review in PsycInfo, MEDLINE, CINAHL, and EMBASE of studies that examined the effectiveness of interventions in preventing antipsychotic-induced weight gain in FEP. We examined their effect on weight gain and a range of cardiometabolic markers.

We screened 2,092 articles, 13 of which were eligible. Behavioral interventions, all three of which consisted of a multidisciplinary team approach, resulted in a mean of 3.05 kg less weight gain than treatment-as-usual (95% CI 1.36 kg to 4.73 kg). Pharmacological interventions displayed marked clinical and statistical heterogeneity, with each of the seven trials in adults using a different pharmacological intervention. Few studies collected comprehensive data on metabolic health. Only two pharmacological studies, and five studies in total, have been published since 2010.

Despite the importance of preventing weight gain in FEP, there have been few recent studies investigating this topic. Our results indicate that multidisciplinary team interventions are effective in preventing weight gain in FEP and should be offered to all patients.

People living with severe mental illness (SMI) experience a shorter life expectancy and poorer physical health than those without SMI. Cardiometabolic illness accounts for a significant proportion of this health inequality. Pharmacological management could reduce the noted inequalities.

This umbrella review aimed to synthesise evidence from systematic reviews for pharmacological interventions to manage cardiometabolic outcomes in adults with SMI.

Databases (Embase, MEDLINE, Cochrane Database of Systematic Reviews) were searched from inception to 11 June 2024 for systematic reviews of pharmacological interventions for all cardiometabolic outcomes in adults. Titles, abstracts and full texts were independently screened by two reviewers. Corrected cover area was calculated, and quality was assessed using AMSTAR 2. Results were analysed and a narrative synthesis conducted.

Thirty-three systematic reviews were included following screening of 1723 titles. Metformin, the most commonly studied intervention (n = 18), was effective in preventing and treating weight gain, dyslipidaemia (total cholesterol and triglycerides) and dysglycaemia.

Topiramate and glucagon-like peptide-1 agonists demonstrated efficacy in treating weight gain, but the effect across other parameters was less consistent. Licensed treatments, such as statins for dyslipidaemia, were reviewed in low numbers (n = 2). Nicotine replacement, bupropion and varenicline were effective for smoking cessation, an outcome that can significantly lower cardiometabolic risk.

The corrected cover area was 6.3%, indicating moderate overlap. Most reviews (n = 16, 48%) were rated critically low quality using AMSTAR 2, and the remainder rated either low (n = 7, 21%), moderate (n = 2, 7%) or high quality (n = 7, 24%).

Pharmacological interventions can improve cardiometabolic outcomes in adults with SMI when non-pharmacological interventions are either insufficient alone, impractical or unacceptable. However, licensed treatments have been reviewed in relatively low numbers. Improving cardiometabolic outcomes is a key area in psychiatry, and the results of this review will be important in shaping future guidance.

Intellectual disability is defined as an IQ of 70 or below. Women with intellectual disability frequently experience menstrual distress leading to the use of hormonal medications such as depot medroxyprogesterone acetate (DMPA). Despite risks such as reduced bone mineral density (BMD) and weight gain, DMPA is widely used in this cohort, prompting investigation into its suitability and risks.

A narrative review and local service evaluation were conducted to determine whether clinical management reflected recommendations in the literature.

PsycINFO and Medline were searched for articles post-1995 on contraception in menstruating women with intellectual disability. Contraceptive use in 100 randomly selected women was evaluated. Data were collected on physical health issues, general practitioner records were reviewed for contraceptive administration and risk discussions, and surveys assessed risk understanding and satisfaction.

The review identified 27 papers with higher DMPA use in the intellectual disability population compared to the general population, and specific BMD risks. The case series found 23 women with intellectual disability using DMPA, and revealed knowledge gaps in risk and monitoring, inappropriate use given individual risk, and poor proactive risk management.

Findings indicate disproportionate DMPA use in women with intellectual disability, with inadequate clinical justification and risk awareness. Many women and carers were unaware of BMD risks, and DMPA alternatives were rarely considered. Individualised contraceptive management and closer review of DMPA use in this cohort is needed. Monitoring could include dual X-ray absorptiometry (DEXA) scans, vitamin D and calcium supplementation, and weight management. Further research is needed into higher DMPA use and risks within this population.

Work stress levels rose among health and educational workforces during the COVID-19 pandemic, and can affect employee well-being and organisational efficiency.

To explore the association of work stress with mental health, including suicidal ideation and physical health, as well as presenteeism, as aspects of organisational efficiency in UK healthcare and university workers.

A total of 328 UK participants completed self-report questionnaires between April 2022 and September 2023 in the context of the European Platform to Promote Wellbeing and Health in the Workplace (EMPOWER) study. Cross-sectional analyses were conducted.

Two hundred and ninety-two (90%) employees reported work-related stress (Mini-Psychosocial Stressors at Work Scale). Depressive, anxiety and somatic symptoms were reported (61, 55 and 75%, respectively); 11% of the participants reported suicidal ideation (Patient Health Questionnaire 9) and 56% reported presenteeism (iMTA Productivity Cost Questionnaire). Psychological and somatic symptoms were worse when suicidal ideation or presenteeism was reported. Stressful work factors included having too much work to do (63%), a bad working atmosphere (28%), poor work–home balance (32%) and working hours hindering private life (35%). Spearman correlations showed significant associations between work stress and suicidal ideation (0.225), depressive (0.290), anxiety (0.299) and somatic symptoms (0.245) and presenteeism (0.311), but not with having a chronic medical condition.

Given the association between work stress, suicidal ideation and presenteeism, research should explore how psychosocial risk factors linked to work stress could be reduced for healthcare and higher education employees. The findings warrant the development of policies to address work stress, and to provide employee support for suicidal ideation and presenteeism in the work setting.

Unhealthy lifestyle behaviors are prevalent among people with mental illness (MI), affecting their physical and mental health. Most research has focused on the isolated effects of lifestyle behaviors, leaving the interconnectedness between these behaviors and health outcomes unexplored. This study aimed to examine these relationships and identify the most strongly connected lifestyle behavior or health outcome within a network.

We conducted a cross-sectional study with 423 inpatients with MI, receiving care as usual. Lifestyle behaviors, physical and mental health outcomes were assessed through questionnaires and routine data. A Gaussian Graphical Model was estimated, and strength centrality was calculated to identify the most influential nodes.

Mean age was 55.5 years, 42% were female, and 41% were diagnosed with schizophrenia. Psychological and physical quality of life (QoL), nighttime sleep problems, and overall sleep quality were the most strongly connected nodes. Sleep was strongly associated with physical QoL. Furthermore, there were negative associations between healthy food intake and cholesterol ratio, and positive associations between daily doses of antipsychotics and length of hospital stay. Node strength was stable (CS(cor = 0.7) = 0.75). No clear pattern emerged among other lifestyle behaviors and health outcomes.

This study offers insights into the interrelatedness of lifestyle behaviors and health outcomes. Addressing sleep problems could enhance QoL and potentially influence other health outcomes. Psychological and physical QoL were also strongly associated, emphasizing the importance of perceived well-being in health outcomes. Future research could explore causal pathways to identify treatment targets to improve care.

Digital peer support interventions have the potential to promote healthy lifestyles and better mental health. This systematic review and meta-analysis synthesizes evidence on the effectiveness of digital peer support interventions for enhancing physical and mental health in healthy individuals rather than those diagnosed with a clinical condition.

First, we evaluated the impact of digital peer support interventions on physical and mental health outcomes by attending to sources of peer support (informal, naturally occurring peer support; formal support from trained peers), effectiveness demonstrated through different study designs (pre–post comparison vs. well-controlled experimental conditions) and long-term effects of interventions. Second, we examined whether features of digital peer support interventions – specifically, dosage, uptake and platform affordances – moderated intervention effectiveness. Third, we considered moderating effects of individual differences (age and existing health conditions) and country.

Using random-effects modelling, which included 47 studies with 76 effect sizes on physical health, and 73 studies with 118 effect sizes on mental health, we found a moderate effect of digital peer support in improving physical health (standardized mean difference (SMD) = 0.35, p < 0.001; 95% CI: 0.30–0.41) and a large effect in enhancing mental health (standardized mean difference(SMD) = 0.53, p < 0.001; 95% CI: 0.46–0.61), which were similar across ages and individuals with varying degree of existing health conditions. Different sources of peer support demonstrated similar effects on physical health, but informal, naturally occurring peer support was more effective in bolstering mental health than formal support from trained peers, producing large effects that were comparable to online professional support. Positive effects on physical health were sustained over follow-up assessments, but weakened for mental health over time. Greater dosages of intervention had decreased effectiveness, but uptake of intervention did not moderate the effects on health. Interventions delivered on platforms that afford greater interactivity (apps, social networking sites and video conferencing) were more effective than those with lower interactivity (forums, websites and emails). Digital peer support interventions had stronger effects on improving physical health in Western countries than Eastern countries, but stronger effects on improving mental health in Eastern than Western countries.

Our findings contribute to the nascent conceptual models of digital peer support, lend credence to digital peer support as a scalable preventive intervention with real-world benefits in bolstering individuals’ physical and mental health and provide important insights into best practices.

In individuals with severe mental illness (SMI), low muscle strength heightens the risk of mortality and chronic disease development. Routine muscle strength assessments could identify vulnerabilities, thereby reducing the growing burden associated with SMI. However, integration into clinical settings faces obstacles because of limited resources and inadequate healthcare staff training. The 5 sit-to-stand (5-STS) test offers an alternative for measuring muscle strength compared with more complex or demanding tests. Nevertheless, its validity in individuals with SMI remains unexplored.

This study aimed to analyse the criterion validity of the 5-STS test in SMI, considering potential age, gender and body mass index influences.

In a cross-sectional study following the ‘STrengthening the Reporting of OBservational studies in Epidemiology’ (STROBE) guidelines, 82 adults with SMI (aged 18–65, 24 women) were assessed. Participants underwent both the 5-STS test and the isometric knee extension strength (KES) test.

Analysis revealed a significant moderate correlation coefficient and intraclass correlation coefficient (−0.58 for both) for all participants, indicating that the measures are valid and assess related aspects of the same construct. Strong agreement was observed in women and the older age groups. The 5-STS test demonstrated accuracy, with a standard error of estimate lower than the within-subject variability on the KES test. Bland–Altman plots showed limits of agreement values of −3.39 and 3.52 for the entire sample, and heteroscedasticity analyses indicated consistent differences between the 5-STS and KES tests across all groups analysed, except in the women's group.

The 5-STS test seems to be a valid test for assessing muscle strength in individuals with SMI, supporting its usefulness for routine assessment in clinical settings, facilitating detection and intervention in critical situations.

Physical health conditions are more common in individuals with autism. Some, like epilepsy, have considerable evidence supporting their increased prevalence, but many diseases lack literature to make strong conclusions.

To investigate the prevalence of physical health comorbidities in autism.

We undertook a nested cross-sectional study, using a sample from the National Centre for Mental Health database. It included participants from England and Wales who reported a clinician-made diagnosis of autism (n = 813), and a control sample without autism or mental illness (n = 2781). Participants had provided a medical history at enrolment. Analysis was carried out by binomial logistic regressions controlling for age, gender, smoking status, and antipsychotic and mood stabiliser use. A subanalysis of individuals with concurrent intellectual disability (n = 86) used binomial logistic regression with the same control variables.

Many physical health conditions were significantly more common in autism. Sixteen out of 28 conditions showed increased odds, with the highest odds ratios observed for liver disease, chronic obstructive pulmonary disease, kidney disease, osteoporosis and rheumatoid arthritis. A subanalysis demonstrated a similar pattern of physical health in individuals with autism with and without concurrent intellectual disability. Some conditions, including osteoporosis, hyperthyroidism, head injury and liver disease, had larger odds ratios in individuals with concurrent intellectual disability.

Physical health conditions occur more commonly in individuals with autism, and certain conditions are further increased in those with concurrent intellectual disability. Our findings contribute to prior evidence, including novel associations, and suggest that people with autism are at greater risk of physical health problems throughout adulthood.