In this systematic review, we identify and critically appraise randomised controlled trials of effectiveness of available educational, behavioural, cognitive, and self-management support interventions for individuals with chronic migraine.

Non-pharmacological interventions have the potential to help people living with chronic migraine. Little is known about their true effectiveness.

We searched Cochrane, Embase, Medline, PsychINFO, Scopus, and Web of Science for randomised controlled trials assessing the effectiveness of educational, behavioural, cognitive, and self-management support interventions, compared to usual care, for adults with chronic migraine. Our outcomes of interest were headache frequency, headache-related disability, quality of life, pain intensity, medication consumption, and psychological wellbeing at baseline and follow-up.

We included six randomised controlled trials (713 participants) whose interventions met our inclusion criteria: two educational, two psycho-educational, and two behavioural interventions. Trial heterogeneity precluded statistical pooling. Several small trials reported some between-group differences. One trial (N = 177) found more people had ≥50 reduction in headache frequency at 12 months following a psychological (mindfulness-based) intervention added to acute medication withdrawal in people with medication overuse headache: 43/89 (48%) control vs. 69/88 (78%) intervention, p < 0.001. However, the largest included study (N = 396) had effectively excluded the possibility that their intervention had a worthwhile effect on headache-related disability at 12 months; mean difference in Headache Impact Test (HIT-6) 0.7 (95% Confidence Interval −0.65 to 1.97). Current evidence does not support the use of educational, behavioural, cognitive, and self-management support interventions for individuals with chronic migraine to improve headache-related symptoms and quality of life. Very limited evidence suggests they may contribute towards headache frequency reduction.

There is no consensus on core curriculum content for neuropsychiatry and behavioural neurology training and the breadth of topic coverage is poorly understood. Using a scoping review, we identified 23 unique syllabuses from Australia, Argentina, Chile, Mexico, New Zealand, South Africa, the USA and the UK, and one explicitly international in scope.

Syllabuses addressed a wide range of neuropsychiatric conditions, encompassing not only overlapping psychiatric and neurological disorders, but also functional, behavioural and cognitive disorders. Training integrated knowledge from neuropsychology, philosophy, ethics and social sciences. Core elements included clinical assessment, intervention skills and case management in social and institutional settings. Neuropsychiatry and behavioural neurology training integrates a broad spectrum of knowledge and skills, is aimed at a range of professionals and is delivered as both specialist training and embedded components within core training.

The core components of neuropsychiatry curricula identified in this study provide a foundation for institutions to develop or enhance their neuropsychiatry training programs.

Insight into psychosis is a multidimensional construct involving awareness of illness, attribution of symptoms, and perceived need for treatment. Despite extensive research, substantial variability in how insight is conceptualized and measured continues to hinder clinical assessment and cross-study comparisons.

Following Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols guidelines and a registered International Prospective Register of Systematic Reviews protocol (CRD42024558386), we conducted a systematic search across five databases (n = 2,184). Twenty-nine studies met the inclusion criteria, comprising 15 primary scale development papers and 10 independent validation studies. We included instruments explicitly designed to assess insight in schizophrenia-spectrum, and evaluated them using the COnsensus-based Standards for the selection of health Measurement INstruments Risk of Bias checklist. Psychometric domains assessed included content validity, structural validity, construct validity, criterion validity, internal consistency, reliability, responsiveness, and interpretability.

Fifteen distinct insight scales were identified, comprising nine clinician-rated instruments, five self-report tools, and one hybrid format. Most demonstrated adequate content and structural validity, with 11 achieving ‘very good’ reliability ratings. Four scales showed the strongest overall psychometric support. However, responsiveness to clinical change was rarely tested, and cross-cultural validation remained limited. Earlier instruments primarily emphasized clinician-rated illness awareness, whereas more recent tools incorporated cognitive, neurocognitive, and subjective dimensions. Discrepancies between self-report and clinician ratings were common and often clinically meaningful. These findings underscore the need for multidimensional, psychometrically robust, and context-sensitive tools to advance both clinical assessment and research on insight in psychotic disorders.

Hypoplastic left heart syndrome is considered one of the most severe CHDs and occurs in approximately 2–3% of all CHD cases. Hybrid procedures have been introduced as an alternative to traditional surgical techniques, such as the Norwood procedure, particularly for neonates at high risk. Although hybrid approaches claim to reduce surgical risks and improve recovery, little is known regarding their comparative effectiveness and safety. This review aims to describe the contribution of hybrid procedures in hypoplastic left heart syndrome management regarding survival rates, postoperative complications, and quality of life, through recovery outcomes and long-term results, in light of conventional surgical techniques.

A systematic review was carried out following the PRISMA guidelines. Data were retrieved from PubMed, Scopus, Web of Science, and Cochrane Library. The search articles were published from January 2014 to November 2024. Inclusion was focused on paediatric patients diagnosed with hypoplastic left heart syndrome and studies comparing hybrid procedures versus traditional surgical methods. All screening, data extraction, and quality assessment were done by two independent reviewers.

This review analysed data from 11 studies comprising 934 neonates with hypoplastic left heart syndrome, of whom 371 underwent hybrid procedures (HP) and 563 received the Norwood procedure. The findings demonstrated that both approaches achieved comparable survival rates at 1, 3, and 5 years. Hybrid procedures were linked to slightly earlier interventions (standardised mean difference = −0.10, 95% confidence interval: −0.61 to 0.41, p = 0.77) and were favored for high-risk neonates due to reduced invasiveness. However, hybrid procedures showed a higher rate of interstage events (risk ratio = 0.81), 95% confidence interval: −0.62 to 2.25, p = 0.09) and higher rates of pulmonary artery stenosis requiring reinterventions (30% vs. 18% for Norwood). Norwood procedures were associated with fewer reinterventions and lower interstage event rates, highlighting their effectiveness for stable patients.

Hybrid procedures offer a practical alternative to the Norwood procedure, especially for high-risk neonates. Although both approaches show similar long-term survival rates, hybrid procedures are associated with a higher risk of complications, including increased interstage mortality. These challenges highlight the need for continued advancements to refine hybrid techniques and to improve long-term outcomes. This review emphasises the critical role of tailored patient selection and calls for further research to enhance hybrid procedure protocols and optimise their effectiveness for specific patient populations.

Euthymic bipolar disorder (BD) is associated with general and domain-specific cognitive impairment, which predicts poor occupational and social functioning.

We searched Embase, Medline, and PsycInfo for articles published between database inception and June 2024, examining cognitive domains in euthymic BD. We conducted meta-analysis, meta-regressions, including premorbid IQ, demographic, and clinical variables. Newcastle Ottawa Scale, I2 statistic, and funnel plots/Egger’s and Begg’s Test were used to assess quality, heterogeneity, and publication bias, respectively. The Benjamini-Hochberg (BH) procedure was utilised for multiple comparisons.

We identified 95 groups from 75 studies (N = 4,404 BD & 4,037 HC). BD showed significant impairment in general cognitive functioning (Hedge’s g = −0.58, 95%CI: −0.79, −0.37, p <.01), verbal memory (Hedge’s g = −0.70, 95%CI: −0.79, −0.60, p <.01), executive function (Hedge’s g = −0.69, 95%CI: −0.78, −0.60, p <.01), visuo-spatial memory (Hedge’s g = −0.68, 95%CI: −0.83, −0.53, p <.01), attention/processing speed (Hedge’s g = −0.64, 95%CI: −0.75, −0.54, p <.01), working memory (Hedge’s g = −0.61, 95%CI: −0.74, −0.49, p <.01), and premorbid IQ (Hedge’s g = −0.24, 95%CI: −0.36, −0.12, p <.01). Demographic and clinical factors were not associated with cognitive performance, except for a statistically significant, but small positive correlation between years of education and lower impairment in verbal memory, β = .066, adjusted p <.05.

Our findings highlight cognitive domains impaired in euthymic BD, indicating targets for interventions. Substantial variance is unexplained, warranting focus on larger samples of individual-level data.

The treatment response for the negative symptoms of schizophrenia is not ideal, and the efficacy of antidepressant treatment remains a matter of considerable controversy. This systematic review and meta-analysis aimed to assess the efficacy of adjunctive antidepressant treatment for negative symptoms of schizophrenia under strict inclusion criteria.

A systematic literature search (PubMed/Web of Science) was conducted to identify randomized, double-blind, effect-focused trials comparing adjuvant antidepressants with placebo for the treatment of negative symptoms of schizophrenia from database establishment to April 16, 2025. Negative symptoms were examined as the primary outcome. Data were extracted from published research reports, and the overall effect size was calculated using standardized mean differences (SMD).

A total of 15 articles, involving 655 patients, were included in this review. Mirtazapine (N = 2, n = 48, SMD −1.73, CI −2.60, −0.87) and duloxetine (N = 1, n = 64, SMD −1.19, CI −2.17, −0.21) showed significantly better efficacy for negative symptoms compared to placebo. In direct comparisons between antidepressants, mirtazapine showed significant differences compared to reboxetine, escitalopram, and bupropion, but there were no significant differences between other antidepressants or between antidepressants and placebo. No publication bias for the prevalence of this condition was observed.

These findings suggest that adjunctive use of mirtazapine and duloxetine can effectively improve the negative symptoms of schizophrenia in patients who are stably receiving antipsychotic treatment. Therefore, incorporating antidepressants into future treatment plans for negative symptoms of schizophrenia is a promising strategy that warrants further exploration.

Trauma- and stressor-related disorders (TSRD) are debilitating mental health conditions. Given the barriers to traditional services, remote and online technologies are increasingly used in treating TSRD.

This mixed-methods systematic review aimed to identify remote technologies and assessed their feasibility and acceptability in treating adults with post-traumatic stress disorder (PTSD), acute stress disorder and adjustment disorder (AjD).

The databases MEDLINE, CINAHL, Embase, PsycInfo, PubMed and the Cochrane Library were screened to identify studies investigating the feasibility and acceptability of remote interventions for PTSD, acute stress disorder and AjD in adults. Studies that obtained poor-quality ratings on critical appraisal tools were excluded. Results were synthesised using a narrative review approach.

In total, there were 74 studies evaluating 27 remote interventions for TSRD: online interventions (k = 47, 63.51%), mobile applications (k = 17, 22.97%), video conferencing (k = 9, 12.16%) and message-based systems (k = 1, 1.35%). Findings from the review showed higher feasibility and acceptability for interventions with an interactive clinician–patient component. Among self-directed interventions, only two applications and eight online interventions provided a clinician component. Most studies targeted PTSD, with few targeting other diagnoses.

Recommendations related to remote interventions for TSRDs should be broadened to include AjD and other underrepresented diagnoses, and tailored to individual patients’ profiles, including their ability to sustain engagement and clinical needs, using a stepped-care approach.

Under the Universal Health Care Act of the Philippines, all health technologies should undergo health technology assessment. This manuscript details the process of the development of the Philippine guidance document for the use of real-world evidence (RWE) in the clinical evaluation of health technologies.

This study consisted of two phases. Phase 1 was a comprehensive, systematic review of all available HTA methods guides and literature related to the use of RWE in the clinical evaluation of health technologies. Based on the results of the review, a draft HTA methods guide on the use of RWE was created. Phase 2 was a validation study by expert consultation through key informant interviews (KIIs), and pilot assessment of the methods guide.

Seventy-nine articles and nine guidance papers were included, with pertinent information extracted and organized into sections. The first draft covered definitions of RWE, guidance for RWE utilization, scoping and selecting RWE, critical appraisal, data extraction, and synthesis and analysis of RWE. Changes were made to this draft based on the KIIs and pilot assessment results to produce the final output of the methods guide.

This document describes the process of creating a Philippine guidance document that covers the definition of RWE and the appropriate methods for conducting systematic search, screening, critical appraisal, data extraction, data analysis, and synthesis of RWE.

With the increased prevalence of major depressive episodes with mixed features specifier (MDE-MFS), the pharmacological treatment for MDE-MFS has attracted great clinical attention. This study aimed to investigate the efficacy and safety of medication use for MDE-MFS.

Commonly used databases were searched for the meta-analysis. Primary efficacy outcomes included response rate and the change in the Young Mania Rating Scale scores; the primary safety outcome was the rate of treatment-emergent hypomania/mania. Effects were expressed as relative risk (RR) or standardized mean difference (SMD).

In patients with MDE-MFS, antipsychotics significantly improved depressive (RR = 1.46 [95% CI: 1.31, 1.61]) and manic (SMD = −0.35 [95% CI: −0.53, −0.17]) symptoms without increasing the risk of manic switch (RR = 0.91 [95% CI: 0.53, 1.55]). However, subgroup analysis of bipolar disorder (BD) patients with MDE-MFS indicated that antipsychotics had limited effects on manic symptoms. Mood stabilizers, especially valproate, demonstrated significant effects in BD patients with MDE-MFS by relieving depressive and manic symptoms. For MDE-MFS in patients with major depressive disorder, trazodone has shown potential effectiveness in retrospective studies, while the effectiveness of antidepressants on BD patients with MDE-MFS lacked evidence.

While antipsychotics are first options for MDE-MFS, their effect on manic symptoms in BD patients with MDE-MFS is still unclear. Mood stabilizers may also be considered, and the use of antidepressants remains a topic of controversy. Since our findings are mostly based on post-hoc analyses, the evidence remains preliminary, highlighting the need for further research to produce more conclusive evidence.