This article explores how clinical language used to describe long-standing and severe eating disorders shapes treatment experiences and outcomes. Drawing on critical discourse theory and the authors’ lived experiences, the paper analyses the impacts of language through intrapersonal, interpersonal and systemic lenses.

The analysis highlights how the language used to describe illness can foster therapeutic nihilism, internalised hopelessness and disengagement from treatment for both clinicians and patients, reducing the impetus for developing or accessing better care. These labels may obscure systemic shortcomings in treatment provision and can become self-fulfilling, undermining clinician motivation and patient recovery.

The authors propose a paradigm shift toward recovery-oriented, co-created language that centres epistemic justice. Clinical discourse should promote therapeutic optimism and support inclusive, patient-centred care. Recovery-focused language can strengthen engagement, improve outcomes and support a treatment culture grounded in mutual respect and hope.

The Maudsley 3-item visual analogue scale (M3VAS) was developed as a novel and intuitive patient-reported measure for depression, focusing on core symptoms and suicidality.

To evaluate the longitudinal validity of M3VAS for capturing symptom change over time.

Both M3VAS and the Patient Health Questionnaire (PHQ-9, as reference standard) were administered in an observational study (RHAPSODY, no. NCT04939818) at weeks 0, 2 and 4 to both depressed patients (n = 50) and matched controls (n = 24). We serially tested factor structure, internal consistency and convergence (correlation) over time, assessing responsiveness by both correlation of change in score and effect of time across scales (analysis of variance and effect size).

M3VAS exhibited strong factor loadings and high item interrelatedness (Cronbach’s alpha 0.78–0.83) at all time points. Total scores correlated strongly with PHQ-9 at each time point (r > 0.8, P < 0.001). Correlation of score change over the study period (r = 0.65, P < 0.001) also confirmed responsiveness. In the depressed group, an effect of time on score was seen for both M3VAS (F = 4.942, P = 0.010) and PHQ-9 (F = 12.505, P < 0.001), with standard response mean (Cohen’s d) of 0.58 and 0.74, respectively. No effect of time was seen in the control group.

Following previous cross-sectional validation against the Quick Inventory of Depressive Symptomatology–Self-report, this present study demonstrated appropriate longitudinal measurement properties for M3VAS as a measure of depression, including responsiveness. Evaluating the ability of M3VAS to discern responses with a variety of treatments is a key future goal.

Despite overlapping diagnostic criteria and aetiology, the frequency of complex post-traumatic stress disorder (C-PTSD) in people being treated for borderline personality disorder (BPD) is unknown.

To establish the frequency and correlates of probable C-PTSD in people meeting the diagnostic criteria and being treated for BPD.

C-PTSD was assessed in 87 patients meeting the diagnostic criteria for BPD and initiating treatment in out-patient personality disorder services in the UK, using the Structured Clinical Interview for DSM-IV Axis II Personality Disorders diagnostic interview, items from the Structured Interview for Disorders of Extreme Stress – Self Report and other measures. The cross-sectional association between C-PTSD and demographics, trauma and clinical variables was evaluated with logistic, ordinal and linear regression.

A total of 93% of participants reported a trauma history (95% CI 88–98%), and 57% met the criteria for probable C-PTSD (95% CI 47–67%). Previous sexual trauma increased the odds of probable C-PTSD (odds ratio 6.22, 95% CI 2.21–17.54, P < 0.001). Probable C-PTSD was associated with an increased odds of self-harm in the past 12 months (odds ratio 9.41, 95% CI 1.87–47.27, P = 0.01) and higher levels of abandonment fears (odds ratio 2.78, 95% CI 1.17–6.55, P = 0.02), abandonment–avoidant behaviour (odds ratio 4.25, 95% CI 1.30–13.91, P = 0.02) and identity instability (odds ratio 4.39, 95% CI 1.79–10.78, P < 0.01).

C-PTSD symptoms are likely to be common in people diagnosed with BPD, and are associated with higher overall psychiatric severity, with potential implications for formulation and treatment.

Research exploring delusions among individuals with psychosis often focuses on form, rather than content, and on prevalence, rather than change in a cohort over time. While delusional forms are mostly consistent across cultures and historical periods, the content of delusions is shaped by sociopolitical factors.

We explored the form and content of delusions in a modern sample of individuals with psychosis, examining the extent to which the internet and new technologies become incorporated into delusional frameworks. We investigated whether there was a change in the prevalence of technology delusions over time and how gender, age and education level impacted the probability that a subject would experience technology delusions.

We reviewed the medical records of 228 adults with psychosis who were seeking treatment at a large academic medical centre between 2016 and 2024 and extracted any description of delusional thought content. We characterised delusions into subtypes and explored the ways these delusions feature the internet and new technologies. To examine temporal trends in the content of delusions, we conducted a binary logistic regression analysis with year as the predictor variable and the presence of technology-related content in delusions as the outcome variable.

Most subjects (88.2%) reported delusional thought content, with over half (51.7%) describing technology delusions. Logistic regression between the year and technology-related delusion outcome revealed statistically significant (β = 0.139, p = 0.038, 95% CI (0.008, 0.270)) correlation. For each 1-year increase, the odds of a subject presenting with technology delusions increased by approximately 15% (odds ratio 1.15).

Among individuals with psychotic disorders, the internet and new technologies are increasingly salient in delusional frameworks. Clinicians should be aware of these themes while eliciting symptoms from patients and also while educating trainees.

Attention-deficit/hyperactivity disorder (ADHD) is more commonly missed or diagnosed later in females than in males. One explanation is that diagnostic criteria have been informed by research primarily based on male samples and may not adequately capture the female presentation of ADHD.

This study used a qualitative approach to better understand female ADHD in childhood, from the perspective of young women and non-binary adults with ADHD.

Twelve young adults (10 women and 2 non-binary individuals assigned female at birth, aged 18–25 years) with ADHD were interviewed to describe their lived experiences of ADHD throughout childhood. Interviews were transcribed verbatim and qualitatively analysed using the framework method, a codebook approach to thematic analysis.

Participants reported experiencing a range of ADHD symptoms, some of which are not included in current diagnostic criteria. Four core themes were identified: (a) socially oriented and internalised symptoms, (b) social impacts, (c) masking and compensation and (d) the importance of context. Theme one describes how girls with ADHD may experience symptoms as more socially oriented (e.g. losing track of thoughts in a conversation), non-disruptive (e.g. doodling) and internalised (e.g. feeling frustrated) than those described by current diagnostic criteria. Theme two highlights the importance of social impacts of ADHD on friends, home and school. Theme three describes the desire to ‘fit in’ socially, behaviours and strategies used to mask symptoms and associated unfavourable consequences. Theme four highlights variability in symptoms across different environmental contexts.

This study suggests that the presentation of ADHD symptoms in girls may be socially oriented, internalised and especially influenced by the social context. Also, female ADHD symptoms may be less visible due to scaffolding, masking and context. Future research should consider whether current ADHD diagnostic criteria require adjustment, to aid earlier recognition and diagnosis of ADHD in children and young people, especially in females.

In the past decade, no meta-analytical estimates of the prevalence of post-traumatic stress disorder (PTSD) among children and adolescents have been published, despite a host of new prevalence studies and updated DSM-5 criteria.

We set out to estimate the prevalence rates of PTSD in trauma-exposed children and adolescents on the basis of DSM-IV and DSM-5 criteria, and investigate differences in prevalence across trauma type, gender, time since exposure, type of informant and diagnostic measures.

Studies identified in a previous meta-analysis were combined with more recent studies retrieved in a new systematic literature search, resulting in a total of 95 studies describing 64 independent samples (n = 6745 for DSM-IV, n = 12 644 for DSM-5) over a 30-year period. Three-level random-effects models were used to estimate prevalence for DSM-IV and DSM-5 criteria separately, and for testing coded variables as moderators.

The DSM-IV meta-analysis estimated a PTSD prevalence of 20.3% (95% CI 14.9–26.2%) using 56 samples with age range 0–18 years, and revealed moderating effects of gender, trauma type and diagnostic interview type. The DSM-5 meta-analysis found an overall prevalence of 12.0% (95% CI 3.7–24.2%) using eight samples with age range 1–18 years. There was insufficient data for moderation analyses.

Although most trauma-exposed children and adolescents do not develop PTSD, a significant proportion (20% under DSM-IV criteria and 12% under DSM-5 criteria) do, particularly girls and individuals exposed to interpersonal trauma. These findings highlight the urgent need of continuous efforts in prevention, early trauma-related screening, and effective diagnostics and treatment to address the substantial burden of PTSD.