Sexual minority (lesbian, gay, bisexual, queer and other non-heterosexual) people experience significant disparities in addiction problems compared with heterosexual people.

We aimed to answer the question, what are the barriers and facilitators to accessing drug/alcohol addiction treatment services for sexual minority adults?’.

A systematic review was conducted by searching Medline, PsycINFO, CINAHL, Web of Science, and Sociological Abstracts for any English-language primary research article (qualitative, quantitative or mixed methods) relevant to the study aims, from inception up to 18 April 2025. Quality of included studies was assessed using the Mixed-Methods Appraisal Tool (MMAT-2018). Barriers and facilitators were categorised into ‘service-related’ and ‘patient-related’ dimensions of accessibility, and synthesised narratively.

We screened 3282 abstracts, with full-text review of 238 articles; 62 studies met the inclusion criteria. Common service-related barriers included explicit harassment, discrimination, violence or abuse toward sexual minority people in services and lack of expertise or ‘culturally competent’ provision for their specific addiction problems. Facilitators included affirming, non-judgemental staff attitudes and sexual minority-specific treatment or outreach services. Patient-related barriers included ambivalence around drug/alcohol use and a fear of stigma (e.g. around sexualised drug use). Facilitators included signposting to services via community networks or peer advocates, and allowing patients to set their own treatment goals.

Although barriers and facilitators vary across global contexts and time periods, both qualitative and quantitative research highlighted similar key issues. Implementing practical changes to address these may improve sexual minority people’s access to addiction services, reducing the burden of addiction-related health inequity for this community.

Existing reviews on mental health disparities between deaf and hard‐of‐hearing (DHH) and hearing populations have focused predominantly on children, adolescents, or older adults, leaving a gap for working-age adults. We conducted a systematic review comparing the prevalence, incidence, and severity of any DSM-5-TR or ICD-11 mental disorder between DHH and hearing adults aged 18–60 years. We aimed to quantify disparities and examine disorder-specific patterns to inform future research, policy, and service development.

On 13 December 2025, we searched Ovid Medline, Embase, APA PsycINFO and Web of Science. We included analytical observational studies involving DHH and hearing adults aged 18–60 years, reporting mental disorder prevalence, incidence, or severity. Two researchers independently extracted data, and risk of bias (RoB) was assessed using the modified CLARITY tool. We narratively synthesised findings by aggregating outcomes at the study level using two approaches: summary and majority of the effect directions within a study. Subgroup syntheses examined outcome type, study RoB, age group and mental disorder category.

Sixty studies (n = 8 578 466) met inclusion. In the summary-direction synthesis, 58.3% (35/60) of studies reported higher mental disorder outcomes for DHH adults, 21.7% (13/60) found no difference and 20.0% (12/60) had mixed findings; none indicated lower mental disorder outcomes for DHH. Under the majority-direction approach, 65.0% (39/60) showed higher mental disorder outcomes and 35.0% (21/60) no difference. These patterns were consistent across prevalence (62.8–72.1% higher) and severity (61.1% higher). Studies with higher RoB more often reported higher mental disorder outcomes (66.7–72.2%) than lower-RoB studies (54.8–61.9%), though both mirrored the overall synthesis. Effects were similar across younger (61.9–71.4%) and older adult samples (61.1–66.7% higher). Disorder-specific syntheses identified psychotic disorders, post-traumatic stress disorder and suicidal outcomes as having the strongest disparities (≥72.2% higher), followed by general mental disorders, anxiety and depression. Fewer than five studies examined each of the other disorders, thereby limiting conclusions for these disorders.

Most available evidence indicates that the prevalence and severity of mental disorders are higher among DHH adults aged 18–60 years than among hearing adults, with limited evidence on incidence. No studies reported lower aggregated mental disorder outcomes for DHH adults. Addressing these disparities requires targeted intervention research, supported by population-based, longitudinal and (quasi-)experimental studies including comprehensive reporting of participant characteristics. This will inform more tailored interventions, improve screening and ultimately contribute to better mental health and quality of life for DHH adults.

To synthesize and quantify the association between household food insecurity (HFI) and various forms of malnutrition that includes stunting, wasting, underweight, overnutrition, and anaemia among Indonesian children under five years of age.

Systematic review and meta-analysis conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines. The study included literature search, screening, data extraction, quality assessment using Joanna Briggs Institute (JBI) tools, and meta-analysis using Review Manager 5.4.

Studies conducted in Indonesia, covering urban, rural, and mixed settings across multiple provinces.

Children under five years of age residing in Indonesia, from households assessed for food insecurity using validated tools.

A total of 32 studies met the inclusion criteria, of which 26 were eligible for meta-analysis. HFI was significantly associated with higher odds of stunting (case-control: OR = 4.66; 95% CI: 3.39–6.40; P < 0.001; cross-sectional: OR = 4.61; 95% CI: 4.17–5.11; P < 0.001;), wasting (OR = 1.92; 95% CI: 1.60–2.32; P < 0.001), underweight (OR = 5.26; 95% CI: 2.12–13.04; P < 0.001), and overnutrition (OR = 1.66; 95% CI: 1.49–1.85; P < 0.001). Children in food-secure households had significantly lower odds of anaemia (OR = 0.41; 95% CI: 0.30–0.58; P < 0.001).

Household food insecurity is strongly associated with multiple forms of malnutrition among Indonesian children under five. These findings highlight the urgent need for integrated, nutrition-sensitive strategies that address food security to improve child health and reduce malnutrition in Indonesia.

To examine the impact the COVID-19 pandemic in Ireland on symptoms and functioning in individuals across a range of mental health disorders.

A systematic bibliographic search of case reports, cross-sectional and longitudinal studies was conducted between March 12th, 2020, and December 20th, 2024, among studies evaluating the impact of the COVID-19 pandemic on symptoms and functioning for individuals with pre-existing mental health disorders and for those who presented with self-harm or died by probable suicide in the Republic of Ireland. Studies were independently screened by two reviewers according to inclusion and exclusion criteria, with selected variables extracted and summarised. Risk of bias assessments and narrative synthesis of included studies were conducted.

Twenty-eight studies met inclusion criteria. Findings were heterogeneous and disorder specific. An increase in presentations of self-harm, anxiety disorders, and eating disorders to child and adolescent mental health services and emergency departments was noted, with relative stability of symptoms in other cohorts including bipolar disorder and treatment-resistant schizophrenia. Significant symptom deterioration, with poor quality of life and functioning was demonstrated in individuals with emotionally unstable personality disorder both cross-sectionally and longitudinally.

Most people with pre-existing mental disorders did not experience significant exacerbation associated with the pandemic, with exception of those with eating disorders and EUPD.

Depression is the most common mental illness globally and is a leading cause of years lived with disability. The manifestation of depressive symptoms can vary among ethnic groups. Individuals in South Asian countries experience higher levels of somatic symptoms than those in other regions, but it is not known whether this pattern extends to the South Asian diaspora.

To provide a qualitative synthesis of what is known regarding depression symptoms among the South Asian diaspora in English-speaking countries.

A systematic scoping review was conducted following Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Scoping Reviews guidelines, based on a pre-registered protocol (doi.org/10.17605/OSF.IO/5E6ZK). The review included qualitative, quantitative and mixed-methods primary research, reporting depression symptoms based on samples of adults of the South Asian diaspora in English-speaking countries with substantial South Asian populations. Qualitative content analysis was used to identify widely reported symptoms of depression among the South Asian diaspora.

Commonly reported symptoms included physical pain, heart-related symptoms and repetitive negative thinking, none of which are included in ICD-11 diagnostic criteria for depressive disorders. Sleep-related disturbances are also widely reported in research into experiences of depression among the South Asian diaspora.

Current diagnostic criteria for depression might not capture symptoms of some South Asian individuals, which may cause missed opportunities for intervention.

Acupuncture is a clinically recognized treatment for major depressive disorder (MDD), but the associations of efficacy with dosage, treatment course, frequency, acupuncture modality, needle retention time, and manipulation remain unclear. This study evaluated the efficacy and safety of acupuncture for MDD and explored potential moderating factors.

Randomized controlled trials of acupuncture for MDD were searched in CNKI, VIP Database, Wanfang Data, SinoMed, PubMed, Embase, Web of Science, and the Cochrane Library from inception to May 2025. Risk of bias was assessed using RoB 2, and certainty of evidence using GRADE. Data were analyzed in Stata 18.0.

36 trials involving 3843 participants were included. Compared with sham/placebo acupuncture, acupuncture showed greater antidepressant effects (SMD −1.12, 95% CI −1.57 to −0.67, P < 0.01). Very low-quality evidence suggested similar efficacy between acupuncture and antidepressants. Electroacupuncture was superior to manual acupuncture (SMD −0.24, 95% CI −0.42 to −0.07, P < 0.01). High- and moderate-dose acupuncture were more effective than low-dose regimens, and meta-regression suggested a linear dose-response relationship, with 30 sessions as the optimal dosage. Better outcomes were associated with treatment course >6 wk, 3 times weekly, needle retention time of 20–30 minutes, and electroacupuncture. No significant difference was found between needle manipulation and non-manipulation.

Acupuncture significantly alleviates depressive symptoms in MDD. Efficacy appears to be influenced by dosage, acupuncture modality, treatment course, frequency, and needle retention time, with 30 sessions, treatment course > 6 wk, 3 sessions weekly, 20–30 minutes retention, and electroacupuncture showing the most favorable outcomes.

Despite the high prevalence of mental health difficulties in young refugees and asylum seekers, evidence suggests that they underutilise mental health services. It is important that we understand their use of, and access to, mental health services.

To examine quantitative evidence on mental health service utilisation and access among young refugees and asylum seekers.

We searched MEDLINE, PsycINFO, Embase, Global Health and The International Bibliography of the Social Sciences. Searches were supplemented by reference list screening and forward-and-backward citation tracking of included studies. Results were synthesised narratively. Our review was pre-registered on PROSPERO (no. CRD42024540885) and followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.

Twenty-two studies were included. We found an overall pattern of underutilisation of services by young refugees in comparison with majority population peers, particularly for out-patient services and psychotropic medication. In contrast, there was evidence of increased emergency service use. Service use was particularly decreased for those from low- and middle-income countries, and increased in unaccompanied minors. Service use for trauma-related disorders and schizophrenia was most common, and less likely for neurodevelopmental disorders. Only one study contained data on access-related factors, which identified language as a potential barrier.

There is a disparity between the mental health needs and service use of young refugees, suggesting a need for greater efforts to increase access and use in this population. Future research should explore barriers and facilitators, and build on primary research examining service use in asylum seekers and unaccompanied minors, because both remain underrepresented within the literature.

Recent decades have seen a steady increase in antidepressant prescribing, but little is known about prescribing trends during and following the COVID-19 pandemic.

This preregistered systematic review, following Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines, aimed to investigate antidepressant prescribing trends for adults in the UK and Republic of Ireland during and after the pandemic. It also compared prescriptions by drug and location.

We searched six databases: APA PsycInfo, CINAHL, MEDLINE, Scopus, medRxiv and Preprints.org. The review included primary research articles reporting trends in antidepressant prescriptions, including at least one time point after March 2020 in the UK and Republic of Ireland. This review has been preregistered on PROSPERO (ID: CRD42024498503).

We identified 7,320 studies, of which ten met the search criteria for the review. Studies were grouped on the basis of time period (2020: n = 5; 2021: n = 3; 2022: n = 2), location (England, Scotland, Northern Ireland, Republic of Ireland, UK) and drug type (serotonin–noradrenaline reuptake inhibitors, selective serotonin reuptake inhibitors, tricyclics, and others (e.g. monoamine oxidase inhibitors)). Most studies (eight of ten) demonstrated increased antidepressant prescribing over time. Two studies highlighted a decrease between March and May 2020. Demographic variables reflected higher rates of prescribing for women, and the modal group receiving antidepressants comprised middle-aged adults.

The commonly reported increase in antidepressant prescribing corroborates pre-pandemic trends and may suggest further, increased demands for mental health support to meet the unique challenges of the pandemic. Future research is required to evaluate the appropriateness of treatment decisions and to explore psychosocial factors that influence individual prescribing choices.

To compare the clinical efficacy and prognosis of Ozaki procedure and Ross procedure in the treatment of paediatric aortic valve disease.

According to the predetermined inclusion and exclusion criteria, relevant clinical studies were comprehensively searched in three databases, and relevant data were extracted for analysis and comparison.

This meta-analysis included four retrospective cohort studies with a total of 243 patients (117 undergoing Ozaki procedure and 126 undergoing Ross procedure). There were no significant difference in the in-hospital all-cause mortality [odds ratio = 1.38; 95% confidence interval: 0.38, 5.07, p = 0.63] and all-cause mortality during the follow-up period [odds ratio = 1.85; 95% confidence interval: 0.54, 6.32, p = 0.32] between Ozaki procedure and Ross procedure. The reoperation on the aortic valve [odds ratio = 10.48; 95% confidence interval: 2.22, 49.40, p = 0.003] was higher in the Ozaki procedure than in the Ross procedure. There were no patients who underwent pulmonary valve reoperation after Ozaki procedure [odds ratio = 0.21; 95% confidence interval: 0.03, 1.23, p = 0.08]. The cumulative reoperation rate after Ozaki procedure [odds ratio = 2.29; 95% confidence interval: 0.93, 5.66, p = 0.07] was higher than that of Ross procedure, but the difference was not statistically significant. The cardiopulmonary bypass time after Ozaki procedure [odds ratio = −32.09; 95% confidence interval:−45.05, −19.14, p < 0.00001] was shorter than that of Ross procedure. The incidence of postoperative complications [odds ratio = 0.24; 95% confidence interval: 0.04, 1.62, p = 0.14], aortic cross-clamping time [odds ratio = −20.39; 95% confidence interval: −43.68, 2.90, p = 0.09], ventilator assistance time [odds ratio = 1.71; 95% confidence interval: −42.70, 46.13, p = 0.94], and ICU time [odds ratio = −0.38; 95% confidence interval: −0.93, 0.16, p = 0.17] in Ozaki procedure was not statistically significant compared to Ross procedure.

In the treatment of children with aortic valve disease, there is no statistically significant difference between the Ozaki procedure and the Ross procedure in terms of freedom from reoperation and all-cause mortality.

Quality of life (QoL) is an important clinical outcome in mental health. However, evidence on its progression and predictors in individuals at clinical high risk for psychosis (CHR-P) remains limited. This meta-analysis examined correlates, impact, and longitudinal changes in QoL among CHR-P individuals.

Following PRISMA guidelines (PROSPERO: CRD42024560092), we systematically searched multiple databases from inception to 27 May 2025. Eligible studies included CHR-P participants assessed with validated QoL instruments. Data extraction was performed independently, and meta-analyses, meta-regressions, heterogeneity, and publication bias analyses were conducted. Risk of bias was evaluated using a modified Newcastle–Ottawa Scale (NOS).

Thirty-one studies were included (2,288 CHR-P individuals; mean age = 21.47 years; 48.9% female). Compared with healthy controls (HC), CHR-P participants showed significantly poorer QoL (Hedges’ g = 1.39, 95% CI = 0.97–1.83). Longitudinal analyses indicated QoL improvements after 1 year (Hedges’ g = 1.40, 95% CI = 0.74–2.07) and at 2–3 years follow-up (Hedges’ g = 3.24, 95% CI = 0.73–5.75). Substantial heterogeneity was observed across analyses. Meta-regressions showed no significant influence of age, sex, functioning, symptom severity, or study quality. Study quality scores ranged from 1 to 8 (median = 6, mean = 5.8, SD = 1.13).

Individuals at CHR-P present markedly poorer QoL compared with healthy controls. Longitudinal data suggest possible improvements over time; however, heterogeneity and limited long-term evidence warrant cautious interpretation. Further longitudinal studies are needed to better characterize QoL trajectories and identify subgroups requiring sustained intervention.

Systematic literature reviews (SLRs) are essential for evidence synthesis in healthcare decision making, including health technology assessment (HTA), but their time and resource demands are substantial. Artificial intelligence (AI) may enhance efficiency of conducting SLRs, but its acceptance by HTA bodies remains underexplored. This SLR quantifies published health-related SLRs reporting AI use, identifies AI tools used at each SLR stage, and evaluates HTA guidance on AI in evidence synthesis.

We searched Embase, Medline, and the Cochrane Library (up to 9 September 2025), supplemented by hand searches and reviews of HTA agency websites. Titles and abstracts were screened in Rayyan by a single reviewer, with full-text review confirming eligibility. Data were extracted and synthesized narratively along key themes.

In total, 112 studies covering 111 unique SLRs were identified, reporting 134 implementations of 45 unique AI tools (29 publicly available; 16 custom-built). AI use has risen since 2013 and was most frequently applied during title and abstract screening (88 of the 134 implementations). Human oversight remained essential, with no fully autonomous AI reported. Three HTA agencies (CDA-AMC, IQWiG, NICE), EUnetHTA, JBI and Cochrane have provided guidance, indicating the formal integration of AI into HTA processes.

This SLR provides a quantitative overview of AI use in health-related SLRs and current HTA guidance. These findings may inform development of clearer methodological recommendations and support integration of AI-assisted evidence synthesis in HTA submissions. Further research and policy development are needed to optimize its role in evidence synthesis and healthcare decision making.

Electroconvulsive therapy (ECT) is highly effective for major depressive disorder (MDD), but about 50% of patients relapse within 1 year. A comprehensive review of all potential relapse-prevention strategies is lacking.

This systematic review aimed to identify, summarise and critically evaluate the available evidence on pharmacological, neuromodulatory, psychological and combination strategies to prevent relapse following successful ECT for MDD.

A systematic review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines (PROSPERO: no. CRD42023392575). We searched PubMed, Embase, PsychInfo and Cochrane Library up to March 2025. Eligible studies included adults (>18 years) with unipolar MDD who responded to acute ECT and were followed for ≥3 months. We included randomised controlled trials (RCTs), cohort studies and case series (over ten cases). Risk of bias and quality were assessed and a narrative synthesis conducted.

A total of 28 studies (N = 11 119) were included. Lithium (alone or with antidepressants) was most consistently associated with reduced relapse in 10 studies. Continuation ECT (C-ECT), particularly when combined with pharmacotherapy, also reduced relapse in several RCTs. Evidence for psychotherapy (e.g. cognitive–behavioural therapy) is limited (two studies), warranting further studies. No studies on repetitive transcranial magnetic stimulation or ketamine were found. Study quality varied, with some being underpowered or having used inconsistent definitions of relapse.

Pharmacotherapy with lithium and, separately, C-ECT combined with medication, showed the strongest evidence for relapse prevention following ECT. The evidence base is limited by heterogeneity, small sample sizes and few studies on novel or psychological strategies. More robust clinical studies are needed to identify optimal long-term strategies.