The Generalized Anxiety Disorder 7-Item Scale (GAD-7) is a brief self-reported measure for screening for anxiety symptoms. However, the evidence about its cross-cultural validity is fragmentary and usually focused on specific settings. Therefore, we aimed to critically review and synthesize the existing evidence about the cross-cultural validity of the GAD-7.

We conducted a systematic review of studies assessing the cross-cultural validity of the GAD-7 in following the PRISMA guidelines. Additionally, the quality of the studies was assessed following the COSMIN guidelines, and the quality of the evidence was assessed with the GRADE. Data were synthesized narratively.

Out of 1,965 unique records, 9 unique studies were deemed eligible for the COSMIN appraisal and the narrative synthesis (total sample: 11,894, 53.7% females and 20 different cultural groups). Most studies (7) had adequate quality and showed evidenced of the unitary structure of the GAD-7 across cultural groups. In 4 studies also assessing possible cultural bias, the effect on the general score was deemed negligible.

The evidence about the cross-cultural validity of the GAD-7 is very limited. Although more research is needed, the evidence available shows that the GAD-7 could be a cross-culturally valid tool for the assessment of anxiety symptoms in clinical contexts and epidemiological studies. Until new high-quality evidence will be available, these results would constitute a key first step for supporting the use of the GAD-7 in multi-cultural clinical settings and to inform clinical, public health and global health decision making in relation to anxiety.

Paranoia is a transdiagnostic symptom and is associated with cognitive and social impairments. Attentional bias toward threat is thought to maintain paranoia.

Despite many studies, attentional biases in paranoia have not been systematically summarised, which was the aim of the current work.

We conducted a systematic review and meta-analysis, identifying 10 964 studies, of which 35 met inclusion criteria for review and 15 for meta-analysis.

Findings showed a significant negative attentional bias (average standardised effect size 0.26; 95% CI 0.01–0.52; p = 0.046). Preliminary indications suggested bias was strongest for paranoia-related stimuli (average effect size 0.30; 95% CI 0.03–0.57; p = 0.027) and stronger for words than faces (average effect size 0.41; 95% CI 0.05–0.77; p = 0.027), but more data is needed to confirm these effects. Limitations were primarily statistical and included likely underestimation of the overall effect size of the association between negative attentional bias and paranoia and a lack of sufficient studies to robustly examine moderators.

Summarising this literature provides a rationale for existing and new interventions for paranoia that target biased attentional mechanisms.

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 synthesise and quantify the association between household food insecurity (HFI) and various forms of malnutrition that include stunting, wasting, underweight, overnutrition and anaemia among Indonesian children under 5 years of age.

A systematic review and meta-analysis was 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 5 years of age residing in Indonesia, from households assessed for food insecurity using validated tools.

A total of thirty-two studies met the inclusion criteria, of which twenty-six 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).

HFI is strongly associated with multiple forms of malnutrition among Indonesian children under 5 years of age. 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.

This systematic review evaluates specialized psychosocial and complex interventions for early bipolar disorder (BD), early borderline personality disorder (BPD), early depression, early psychosis, and first-episode mental illness in general (FEMI).

We included systematic reviews and randomized controlled trials (RCTs) of interventions with psychosocial components, excluding trials that focused on pharmacological-only interventions and stand-alone psychotherapies. Searches were conducted in January 2023 across five databases. Review quality was assessed using AMSTAR-2 and risk of bias for RCTs using the Cochrane tool.

Ten studies met the inclusion criteria: seven reviews and three RCTs. High-to moderate-quality evidence supports complex psychosocial interventions combined with pharmacotherapy for early psychosis. The most robust effects were reductions in relapse and improvements in psychosocial functioning; additional benefits were observed for symptom burden, remission, treatment discontinuation, and hospital admissions. Benefits were most sustained in longer-duration, community-based programs. For early BD, limited evidence suggests that combining pharmacotherapy with family-focused therapy or structured psychoeducation may improve the course of illness and treatment satisfaction. One RCT in early BPD reported improved engagement with a developmentally tailored program. Two FEMI RCTs found that nurse-led psychoeducation and psychosocial programs improved in-patient duration, symptoms, insight, self-efficacy, quality of life, and engagement. No eligible studies addressed early-stage depression, indicating a notable evidence gap for multimodal psychosocial interventions.

Complex psychosocial interventions are strongly supported for early psychosis. Preliminary data in BD, BPD, and FEMI suggest consistent benefits for engagement, but further rigorous trials – especially in early depression – focusing on different outcomes – are required.

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.