Known influences on tic severity include medical, biological and contextual factors.

We aimed to further understanding of contextual factors by exploring if tic severity is influenced by calendar month.

This study used data from the Calgary Child Tic Registry. Children are extensively clinically phenotyped at their first visit and followed prospectively until adulthood. We evaluated the mean Yale Global Tic Severity Scale-Revised (YGTSS-R) total tic severity score based on the calendar month. Multivariable linear regression models were fit to assess the individual months adjusted for age, gender, comorbidity and tic treatment variables.

The study included 370 participants, with 549 assessments of tic severity performed. In the univariable analysis based on calendar month, August had the lowest tic severity, with a mean YGTSS-R total tic severity score of 15.68 (95% CI 13.41–17.95). This was significantly lower than the month with the highest tic severity, February, with a mean score of 20.41 (95% CI 18.19–22.63). In multivariable models adjusted for age, gender, comorbidity and treatment for tics, the omnibus test for whether month contributes to a better fit were not significant (YGTSS-R total tic score P-value: 0.495). The only significant predictors of increased tic severity were treatment for tics (P < 0.0001), diagnosis of depression (P = 0.003) and diagnosis of obsessive–compulsive disorder (P = 0.02).

While our univariate analysis of tic severity by calendar month supported significantly lower tic severity in August compared with February, this association was no longer statistically significant when controlling for other variables known to impact tic severity.

In 2018, the UK government commissioned National Health Service Talking Therapies (NHS TT) services to provide integrated mental and physical health care for individuals with a long-term condition (LTC) and coexisting depression and/or anxiety. Nevertheless, evidence on the effectiveness of NHS TT in physical LTCs remains inconsistent.

This review aims to evaluate the impact of NHS TT on mental health outcomes among adults with physical LTCs.

We conducted a systematic review and meta-analysis of quantitative studies published between 2008 and 2024. We used several databases for the search, including Embase, MEDLINE, Cochrane Library, NHS Evidence, PsycINFO, Bielefeld Academic Search Engine and ProQuest. We combined terms related to NHS TT, LTCs and mental health outcomes to identify eligible studies. The Population, Intervention, Comparison, Outcomes and Study framework guided the development of the inclusion criteria. We employed the random-effects model for meta-analysis and assessed heterogeneity bias using the I2 statistic, and the Newcastle–Ottawa scale to evaluate the overall quality of the evidence.

Twenty-four studies met the inclusion criteria. The meta-analysis revealed a significant pre–post NHS TT intervention effect on reliable improvement (odds ratio 0.77, 95% CI: 0.60–0.98) and reliable recovery (odds ratio 0.80, CI: 0.68–0.95). There were no significant differences in NHS TT accessibility (e.g. treatment engagement) between participants with and without LTCs (odds ratio 0.97, 95% CI: 0.82–1.14). However, heterogeneity between the studies was high (>90%).

The observed evidence provides reassurance for individuals with LTCs engaging with treatment; however, the association with post-treatment distress is still of concern. Furthermore, extensive and rigorous research is needed to strengthen and guide service development for individuals with LTCs, thereby improving effectiveness.

Bipolar disorder and attention-deficit/hyperactivity disorder (ADHD) share overlapping clinical symptoms and cognitive deficits. Up to 20% of individuals with bipolar disorder also meet the criteria for ADHD (bipolar disorder + ADHD), a subgroup that may experience greater cognitive and functional impairments than those with bipolar disorder or ADHD alone.

To (a) characterise cognitive profiles in bipolar disorder, ADHD and bipolar disorder + ADHD compared with healthy controls; (b) examine associations between cognitive and occupational functioning; and (c) investigate associations between cognitive function and polygenic scores (PGS) for bipolar disorder, ADHD and educational attainment.

In this observational study, 477 euthymic individuals with bipolar disorder (including 78 with bipolar disorder + ADHD), 59 adult individuals with ADHD and 171 healthy controls completed standardised neuropsychological testing. Full-scale IQ and final school grades indexed current and premorbid cognitive ability, respectively. Occupational functioning was evaluated both cross-sectionally and through 5 years of registry-based follow-up. PGS were available for 295 bipolar disorder and 132 healthy control participants.

All patient groups performed significantly below healthy controls across most cognitive domains. Bipolar disorder + ADHD exhibited poorer working memory than bipolar disorder (d = −0.35, 95% CI [−0.66, −0.03]). Occupational function was lowest in bipolar disorder + ADHD (versus bipolar disorder, d = −0.44, 95% CI [−0.69, −0.19]). In bipolar disorder, poorer executive function (standardised regression coefficient (standβ) = 0.20, 95% CI [0.09, 0.31]) and older age predicted reduced occupational outcomes. PGS for educational attainment was associated positively with cognition in both bipolar disorder (working memory: standβ = 0.19, 95% CI [0.08, 0.30]) and healthy controls (executive function: standβ = 0.20, 95% CI [0.09, 0.32]), while PGS for bipolar disorder or ADHD were not significantly associated with cognitive performance.

Individuals with bipolar disorder + ADHD showed disproportionate working memory and functional impairment compared with bipolar disorder or ADHD alone. Executive function is a key predictor of occupational outcomes in bipolar disorder and is partly shaped by genetic propensity for educational attainment. These findings highlight the importance of considering ADHD comorbidity and cognitive profiles when evaluating functional prognosis and tailoring interventions.

To characterise hospital-treated multimorbidity patterns in people who subsequently died a drug-related death in Scotland, and to identify clinically meaningful associations among conditions and decedent to inform prevention and care.

A register-based retrospective cohort study using nationally linked hospital admission (1996–2019) and mortality (2008–2019) records for 5,749 decedents. We identified hospital admissions for Elixhauser comorbidities using ICD-10 codes. Correlation analysis, network analysis, and Bayesian clustering were used to describe co-occurring conditions and identify patient clusters with distinct comorbidity profiles.

Over half (50.9%) of decedents had at least one admission for an Elixhauser comorbidity. The most frequent were related to alcohol use (38.2%), drug use (29.1%), other neurological disorders (18.0%, mainly epilepsy/seizures/anoxic brain injury), depression (15.2%), and psychoses (12.5%). Network analysis highlighted drug use, alcohol use, psychoses, depression, and neurological disorders as central conditions. Bayesian clustering identified seven distinct patient clusters, including groups characterised by: high psychiatric and drug-use admissions; extensive physical comorbidities; alcohol and liver disease; dominant neurological issues and depression.

Individuals experiencing drug-related deaths exhibit substantial multimorbidity with distinct patterns often dominated by substance use and mental ill-health but also including significant physical health clusters. These distinct profiles underscore the need for integrated, tailored care strategies addressing substance use, psychiatric, and physical health needs to mitigate mortality risk.

While prior studies have analyzed Skin Picking Disorder as a unitary condition, little research has been done examining clinical and neurocognitive characteristics of specific subtypes. The objective of this study is to analyze differences in impulsivity, emotional regulation, symptom severity, cognitive performance, and the presence of comorbid psychiatric conditions between focused and automatic subtypes of Skin Picking Disorder.

83 adults aged 18–65 with skin picking disorder were enrolled at the University of Chicago and separated into 4 skin picking subtype groups based on high or low levels of focused and automatic picking scores on the Milwaukee Inventory for the Dimension of Adult Skin Picking. The 4 subtype groups were separated using K-means clustering. Each group completed the same clinical and neurocognitive assessments. ANOVA or Chi-Squared tests were used to analyze differences in assessment outcomes.

Higher focused picking scores were significantly associated with greater symptom severity and impairment. Differences in levels of automatic/focused picking were not associated with impulsivity, emotional/behavior regulations, or neurocognitive outcomes.

The findings suggest that focused skin pickers are likely to have more impairment due to their behavior compared to automatic or mixed pickers; however, overall, the groups did not differ in clinical or neurocognitive measures. Thus, it is unclear whether focused and automatic picking are particularly useful clinically in subtyping skin picking disorder.

The aim of this study is to determine the prevalence and type of mental disorders associated with pathological gambling/gambling disorder (GD) in the general population.

Systematic review and meta-analysis of adult population-based studies reporting on psychiatric comorbidity of GD according to International Classification of Diseases (ICD-10/ICD-11), Diagnostic and Statistical Manual of Mental Disorders (DSM-IV/DSM-5) criteria, or widely used assessment instruments. PubMed, Scopus, and Web of Science databases were searched for relevant studies in English. The study’s protocol was preregistered in PROSPERO (CRD42024574210).

Of 454 articles published between 1993 and 2024, 12 met the inclusion criteria. Most studies used DSM-IV or DSM-5 criteria (only two ICD-10 criteria), and were evenly distributed across Europe, North America, and Southeast Asia. The weighted average prevalence of any mental disorder in individuals with GD was 82.2%. High comorbidity rates were found for substance use disorders (SUDs) (34.2%), mood disorders (30.9%), and anxiety disorders (29.9%), followed by personality (14.3%) and psychotic (5.9%) disorders. Meta-analysis indicates that individuals with GD are 10.7 (95% confidence interval [CI]: 5.7;20.1) times more likely to develop any mental disorder than the general population. The odds ratio for mental disorders associated with GD were 5–12 times higher for nicotine dependence, drug use disorder, alcohol use disorder, and SUD, and 3–4 times higher for anxiety and mood disorders.

These findings add weight to the view that GD is associated with a significantly increased risk for addictive behaviors, mood, and anxiety disorders.

Benzodiazepine use among physicians is an important public health issue related to physicians’ well-being and patient safety.

This study aimed to evaluate the patterns and correlates of benzodiazepine use in physicians by comparing the characteristics of heavy users with those of low-dose users.

We identified 4844 physicians with a history of benzodiazepine use as the benzodiazepine cohort from 32 080 physicians from the population-based Taiwan National Health Insurance Research Database from 2014 to 2020. Benzodiazepine users were divided into low-dose, intermediate and heavy users based on their yearly equivalent dosage of <20, 20–150 and >150 defined daily dose (DDD) per year, respectively. Differences in demographic characteristics and specialities between the benzodiazepine and control cohorts were compared via univariate and multivariate logistic regression models. A generalised estimating equation was used to investigate the relationship between benzodiazepine use and comorbidities.

Among all of the physicians, 15.1% used benzodiazepine. Male physicians were more likely to use benzodiazepines and become heavy users. Older age, sleep disorders and depression were significantly associated with heavy benzodiazepine use. Regarding physician specialities, the highest prevalence of benzodiazepine use was observed in otorhinolaryngology (19.8%), followed by family medicine (19.1%). Odds of benzodiazepine use were 2.20 and 2.90 times greater in physicians with sleep disorders and depression, respectively.

Comorbidities of depression and sleep disorders are associated with increased probability of benzodiazepine use. Providing stress-coping strategies and appropriate treatment for mental disorders is recommended to support the overall well-being of physicians.

The co-occurrence of cannabis use and internalizing symptoms, such as depression and anxiety, during emerging adulthood (18–25 years) is well documented. However, while bidirectional relationships are often assumed, empirical evidence is mixed. This study investigates bidirectional longitudinal relationships between cannabis frequency and consequences and internalizing symptoms (depressive and anxiety) among high-risk emerging adults.

Data came from seven assessments collected over a 2-year period among 961 (54% female) high-risk emerging adults participating in two longitudinal cohorts (Ontario, Canada; Tennessee, USA). Assessments were at 4-month intervals spanning 2018–2020. Latent curve models with structured residuals were used to explore bidirectional between- and within-person relationships between cannabis-related variables and internalizing symptoms.

At baseline, higher levels of cannabis frequency and consequences were associated with higher internalizing symptoms. In between-person model components, cannabis-related and internalizing variables decreased across emerging adulthood. Significant within-person bidirectional relationships were observed, partially supporting both symptom-driven and substance-induced pathways, but the findings were specific to negative cannabis consequences, not frequency, and for depressive symptoms, not anxiety symptoms, for symptom-driven pathways. These bidirectional relationships were more pronounced among females and those surpassing clinical thresholds for internalizing symptoms at baseline.

This study found evidence of bidirectional relationships between cannabis consequences and internalizing symptoms across emerging adulthood, with the prevailing direction from cannabis-related negative consequences to increases in internalizing symptoms. These findings highlight the importance of cannabis intervention in emerging adults, both to reduce consequences and to prevent internalizing disorders, especially targeting females and those with clinically elevated internalizing symptoms.

The British Paediatric Surveillance Unit of the UK Royal College of Paediatrics and Child Health contacts participating consultant paediatricians each month to survey whether particular rare conditions or events have been seen in their services. This national surveillance of rare paediatric events has allowed a large amount of research into multiple paediatric conditions. In 2009, the Royal College of Psychiatrists established a similar system – the Child and Adolescent Psychiatry Surveillance System (CAPSS) – to survey consultant psychiatrists in UK and Ireland. Since many conditions involve mental and physical health features, seven studies have been run using reporting to both systems, with simultaneous surveillance across both paediatricians and psychiatrists. Given the desire by policymakers, commissioners and clinicians for well-integrated physical and mental healthcare (‘joined-up working’), and if the surveillance systems were functioning well, the CAPSS Executive expected high rates of parallel reporting of individual patients to the two systems. The current study synthesises the rates of parallel reporting of cases to those two systems. We assimilate rates of parallel reporting across the seven studies using figures that have already been published, and by contacting contributing research groups directly where the relevant figures are not currently published. No new primary data were collected.

Of the 1211 confirmed cases, 47 (3.9%) were reported by both psychiatrists and paediatricians. No parallel reporting occurred in four of the seven studies.

Our findings raise questions about whether joined-up working in mental and physical healthcare is happening in practice. Research into challenges to obtaining comprehensive surveillance will help epidemiologists improve their use of surveillance and control for biases.

Bipolar disorder (BD) is commonly comorbid with other psychiatric conditions, such as obsessive-compulsive disorder (OCD). Despite increasing interest in this comorbidity, quantitative data on its clinical characteristics remain limited. This systematic review and meta-analysis aimed to evaluate the clinical impact of OCD comorbidity in BD by comparing individuals with BD and OCD (BD-OCD) to those with BD without OCD.

We systematically searched the PubMed/MEDLINE, Scopus, PsycINFO, and Web of Science databases up to April 15, 2024. Meta-analyses were conducted to compare BD-OCD and BD without OCD groups across multiple clinical domains.

From 11,959 initial records screened, 26 studies were included in the qualitative synthesis, with 22 eligible for meta-analysis. Individuals with BD-OCD showed higher odds of experiencing chronic mood episodes (OR = 9.42; 95%CI = 2.23, 39.9), rapid cycling (OR = 1.92; 95%CI = 1.04, 3.53), comorbid eating disorders (OR = 3.37; 95%CI = 1.99, 5.7), panic disorder (OR = 3.3; 95%CI = 2.11, 5.2), substance use disorders (OR = 1.39; 95%CI = 1.02, 1.89), and lifetime suicide attempts (OR = 1.85; 95%CI = 1.21, 2.84). Additionally, they presented earlier onset of BD (SMD = -0.27; 95%CI = -0.52, −0.01) and reduced functioning (SMD = -0.42; 95%CI = -0.59, −0.24). Most data were derived from adult populations, limiting the evidence available for children and adolescents.

BD-OCD presents a more severe and complex clinical profile, requiring specialized assessment and integrated treatment approaches. Identifying these features may support earlier recognition and inform personalized interventions for this population.