This case reports aim to describe the clinical presentation, diagnostic evaluation, and treatment response of an adolescent male with Kleine-Levin Syndrome, thereby increasing clinical awareness and contributing to the limited evidence on effective management strategies for this rare condition.

A 16-year-old adolescent male with a one-year history of recurrent episodes of hyperphagia, excessive sleepiness, hypersexuality, cognitive impairment, and behavioural disturbances was evaluated. Each episode lasted approximately one week and recurred every 2-3 months, with complete inter episodic recovery. Detailed clinical history and comprehensive physical, neurological, and psychiatric examinations were performed. Laboratory investigations, karyotyping, brain magnetic response imaging, and electroencephalography were conducted to exclude alternative neurological, metabolic, and psychiatric diagnoses. The diagnosis of Kleine-Levin syndrome was established based on clinical features and fulfilment of the International Classification of Sleep Disorders, Third Edition (ICSD-3) criteria. Pharmacological treatment with methylphenidate and carbamazepine was initiated, and the patient was followed up at two-month intervals to assess treatment response.

Baseline investigations, including laboratory tests, MRI, and EEG, were unremarkable. Following treatment initiation, the patient demonstrated significant clinical improvement. The duration of hypersomnia episodes decreased from approximately seven days to three to four days, and episode frequency reduced from every 2-3 months to every 4-5 months. The severity of associated hypersexual behaviour, cognitive disturbances, and irritability also diminished. Inter episodic functioning and overall quality of life improved, with no reported adverse effects from treatment.

This case highlights the importance of considering Kleine-Levin syndrome in adolescents presenting with recurrent episodic hypersomnia and behavioural changes. Early diagnosis and appropriate pharmacological intervention may reduce symptom severity and episode frequency. Further research is required to better understand the pathophysiology and establish standardized treatment guidelines for KLS.

Our patients are referred locally and out of area but it was noted relapse prevention plans were not documented in sufficient detail. We wanted to improve relapse prevention and post-discharge care. Our aims were to:-

• • Audit details of alcohol relapse prevention work started pre-admission and post-discharge plans

• • Assess if alcohol relapse prevention work was considered from a bio-psycho-social perspective.

Retrospective audit of electronic referral forms for patients admitted between 3rd November 2025-28th November 2025. We reviewed referrer details, preparatory work, relapse prevention plans, relapse prevention medication (RPM), psychological support, mental health and social situation.

22 patients were admitted between 3rd November 2025-28th November 2025. 19 (86.36%) were out of area and 3 (13.64%) were from the local service.

Information on preparatory work was not available in 16 of the 22 referrals (72.73%). There were written plans in 15 of the 22 referrals (68.18%). Of the 7 going to rehab, 2 did not have a written plan (28.57%).

RPM was mentioned in 18 of the 22 referrals (81.82%). 12 (54.55%) had requested acamprosate. 2 (9.09%) had requested disulfiram and 1 (4.55%) had requested naltrexone. Two or more options were considered in 2 referrals (9.09%) and 1 was undecided (4.55%).

13 of the 22 referrals (59.09%) mentioned psychological support. Relapse prevention plans included 1:1 sessions, group work, rehab and skills training. Groups included support groups, formal recovery groups, local groups and community groups. Skills included workshops, psychology and employment support. One was homeless and they had a housing plan (100%).

Mental health was mentioned in 19 of the 22 referrals (86.36%). Of the 19, 4 (21.05%) were known to a local mental health team (LMHT) and 1 (5.26%) mentioned plans to refer to LMHT. 13 (68.42%) did not mention plans to refer to LMHT and 1 (5.26%) had declined a referral. Information on mental health was not available in 2 of the 22 referrals (9.09%).

The majority of patients were out of area, which made it difficult to access clinical notes. Therefore, it is important preparatory work and a robust relapse prevention plan is provided.

RPM was well documented but more information was needed on mental health and pre-admission. Following this, we refined the form to capture more detail on preparatory work and to prompt consideration for any mental health support required.

Genetic factors are thought to play an important role in antipsychotic-induced weight gain (AIWG). Polygenic risk scores (PRS) could provide a measure of genetic predisposition to antipsychotic drug induced weight gain (AIWG). We conducted a study to examine how a PRS, generated using SNPs, identified from a recent meta-analysis, related to weight-change over time in people with first episode-psychosis (FEP).

The PRS included SNPs in six different genes, identified as having significant associations (p<0.05) with AIWG. These were HTR2C rs3813929; MTHFR rs1801133; ADRA2A rs1800544; MC4R rs489693; LEPR rs1137101 and CNR1 rs1049353. An additive PRS and a risk allele based weighted PRS were created based on risk allele counts and presence or absence of risk alleles respectively. The additive PRS was also used to create low/high genetic risk groups for analysis. The association between PRS and weight gain per day (WGPD) in grams/day as well as BMI percentage change (=>7%) was investigated using regression models.

In multiple regression analysis, the additive PRS significantly predicted AIWG in females (adjusted r²=0.59, B: unstandardised regression coefficient=24.4 grams/day p <0.05), but not in males. ANCOVA showed that high genetic risk groups had greater WGPD (p=0.018), with significant PRS gender interactions driven by markedly higher WGPD in high-risk females (p=0.039).

Follow-up comparisons indicated that in females, those with ≥7 risk alleles had substantially higher WGPD scores (adjusted Mean=138.8 grams/day, 95% CI [99.6, 178.1]) compared with those with ≤6 alleles (adjusted Mean=40.4 grams/day, 95% CI [−5.5, 86.2]). In males, WGPD scores were not significantly different across genetic risk categories.

We report a PRS that is predictive of weight gain in women treated for first episode psychosis, accounting for 59% of the variance daily weight-gain over time. Validation of the PRS in an independent cohort is required, as is determining whether it is feasible to apply the PRS prospectively in real world clinical settings to inform lifestyle measures and pharmacotherapeutic decisions in the treatment of FEP

‘et al’

Dr Adrian Phillipson, Sheffield Hallam University

Prof. Gavin P. Reynolds, Sheffield Hallam University

Prof. Caroline Dalton, Sheffield Hallam University

Type 1 diabetes mellitus (T1DM), an autoimmune disease resulting in insulin deficiency and hyperglycaemia, is associated with a considerable burden of psychiatric comorbidities, particularly mood, anxiety and eating disorders. As such, regular mental health screening for T1DM patients has been recommended to allow earlier intervention. This audit aimed to investigate whether T1DM patients in our trust (County Durham and Darlington Foundation Trust, CDDFT) had received psychological screening at time of diagnosis and within the past year.

A questionnaire consisting of six clinician-designed self-report items assessing patient recall of mental health screening at diagnosis and within the past year was distributed at regular T1DM clinic appointments at University Hospital of North Durham and Chester-Le-Street Community Hospital by clinicians involved in T1DM care. All patients with T1DM under regular follow-up within these centres were eligible; there were no defined exclusion criteria regarding age or other demographic factors.

A total of 23 responses were received, of which four were excluded due to inconsistencies. Of the 19 included responses, 32% (n=6) stated that they had received mental health screening at diagnosis. When analysed further by age, it was found that none of the seven individuals diagnosed before the age of 18 had received screening at diagnosis. Overall, only 26% (n=5) of respondents indicated that they had received mental health screening as part of their T1DM care within the past year. Interestingly, only 21% (n=4) of respondents stated that they would appreciate more frequent mental health screening, while 32% (n=6) did not answer this question, with one individual responding “Only if it meant extra support”.

Given the high impact of a T1DM diagnosis on psychological wellbeing, and the strong link to various psychiatric conditions, the reported low levels of mental health screening are concerning. At present, mental health screening in T1DM care at CDDFT is clinician-dependent with no standardised process. It is interesting to consider whether factors such as a lack of awareness, time pressure within appointments, or a perceived ‘helplessness’ on the part of the clinician in terms of organising appropriate mental health follow-up, are resulting in the low rates of screening identified, although limitations including risk of recall bias and small sample size are important to take into account. Going forward, we aim to present this data to clinicians involved with T1DM care within the trust and recommend starting all consultations with a short, validated screening tool such as the Diabetes Distress Scale.

Stable housing is a key determinant of mental health outcomes. Discharge from acute psychiatric inpatient services into temporary accommodation may reflect system pressures and can threaten recovery, continuity of care, and social stability. Despite this, limited data is available on discharge to temporary accommodation among psychiatric inpatients.

This service evaluation aims to describe patterns of discharge to temporary accommodation from acute adult inpatient psychiatric wards within one NHS Trust during the 2023–2024 financial year. We identified the types of temporary accommodation used, associated psychiatric diagnoses, and patient demographics.

All patients discharged from acute adult inpatient wards to temporary accommodation between April 2023 and March 2024 were identified. We reviewed electronic patient records to identify primary diagnosis, discharge destination, and patient demographics. Temporary accommodation was grouped into categories including bed and breakfast (B&B) or hotel, supported living, care homes, and other temporary housing. Descriptive analysis examined distributions across accommodation type, diagnosis, and demographics.

During the 2023–2024 financial year, 146 patients were discharged from acute adult inpatient mental health wards to temporary accommodation. Psychotic disorders were the most common diagnosis (n=77), followed by personality disorders (n=38) and non-psychotic affective disorders (n=16). The remaining patients had diagnoses including dementia, anorexia nervosa, substance use disorders, or no recorded mental disorder.

Over half were discharged to B&B or hotel placements (n=77). Other discharge destinations included family or friends (n=27), interim housing (n=14), supported living (n=9), care homes (n=8), or no fixed abode (n=5). A small number were discharged to other temporary arrangements.

Patients with psychotic disorders formed ~50% those discharged to B&B or hotel accommodation (n=38), followed by patients with personality disorders (n=27). Of those discharged with no fixed abode, 3 had a diagnosis of personality disorder, 1 had a psychotic disorder, and 1 had a substance use disorder.

Over half of patients discharged to temporary accommodation were placed in B&B or hotel settings, with psychotic disorders comprising ~50% of these patients. This highlights a notable amount of patients with severe mental illness being discharged to temporary, non-therapeutic accommodation. Patient discharge is a complex interplay of system pressures, clinical presentation and social support, yet stable housing is vital in holistic, patient-centred care. These results identify a need for further review of discharge pathways and raises the importance of the biopsychosocial model in understanding the relationship between mental health and social context.

This quality improvement project aimed to assess and improve NR legal understanding, confidence, and perceived emotional support within Springs Services. The primary objective was to increase the proportion of NRs who felt adequately informed about their role under the MHA to at least 80%.

Nearest Relatives (NRs) have a statutory safeguarding role under the Mental Health Act (MHA) 1983; however, existing evidence indicates that many feel inadequately informed about their legal rights and responsibilities. Prior research describes inconsistent explanations and assumptions of prior knowledge, contributing to uncertainty and distress during compulsory admissions. These challenges may be particularly pronounced in autism-informed inpatient services, where families are often navigating complex clinical and legal processes simultaneously.

A structured baseline survey was distributed to NRs of patients admitted to Springs Services. The questionnaire included Likert-scale items assessing understanding of the NR role, clarity of MHA explanations, involvement in care and discharge planning, confidence in raising concerns, and emotional support, alongside yes/no questions and free-text comments. Twenty completed responses were analysed descriptively. Qualitative feedback was reviewed thematically to identify priority areas for improvement. Informed by baseline findings, service-level interventions were introduced, including an autism-informed NR information leaflet, a standardised admission explanation script, a brief NR support check-in, and focused staff guidance on trauma and autism informed communication.

Baseline data demonstrated variable NR experiences. While approximately 60% of respondents agreed or strongly agreed that they understood their role as an NR, fewer (around 45%) reported confidence in their legal rights or a clear understanding of the distinction between Nearest Relative and Next of Kin. Only around 50% recalled receiving written information about their role at the point of admission. Communication from the ward was rated positively by approximately two-thirds of respondents; however, lower scores were reported for emotional support (around 40%) and involvement in discharge planning(approximately 35%). Confidence in speaking up or asking questions was reported by just over half of respondents. Free-text comments highlighted confusion about legal processes, uncertainty about who to contact for advice, and a desire for earlier, clearer explanations delivered in accessible language.

This project identified measurable gaps in NR legal literacy, confidence, and emotional support within an autism-informed inpatient service. Baseline findings support the need for structured, accessible information and proactive engagement with NRs to strengthen safeguards under the MHA. Ongoing data collection will evaluate whether these targeted interventions increase the proportion of NRs who feel adequately informed and supported, with the aim of embedding sustainable improvements in statutory practice and family involvement.

Adult ADHD remains largely defined by behavioural criteria developed for childhood presentations. In adult psychiatric practice, however, many individuals present with burnout, anxiety, or emotional exhaustion rather than overt attentional complaints. These patients often describe functioning well in some contexts but struggling disproportionately with routine, low-urgency, or poorly defined tasks. This work aims to explore whether adult ADHD is better conceptualised as a disorder of salience and arousal regulation rather than a simple deficit of attention or impulse control, and whether such a formulation better accounts for late diagnosis and masked presentations.

This work draws on repeated clinical observations from general adult psychiatricpractice, including experience in adult ADHD assessment services, synthesised into anonymised composite vignettes to identify recurring patterns of cognition, behaviour, and emotional experience. These observations were considered alongside established executive, motivational, and salience-based models of ADHD, and contemporary neurobiological accounts of dopamine and noradrenaline modulation, sensory gating, and time perception, to develop a clinically coherent formulation. An exploratory evolutionary perspective was used cautiously to illustrate environmental mismatch rather than ancestral advantage.

Consistent features extended beyond standard diagnostic criteria and included reliance on urgency or interest to initiate tasks, development of highly personalised systems of working, rapid associative thinking alongside episodes of task paralysis, conversational working-memory bottlenecks, and difficulties maintaining awareness of objects or people once out of view. Many individuals also described strong internal value systems and high personal standards, with particular sensitivity to inefficiency or perceived unfairness. Hyperfocus and distractibility could be understood within a single salience-arousal framework rather than as opposing phenomena. Functional decline commonly occurred at points of developmental or occupational transition and following additional stressors, consistent with cumulative compensatory fatigue rather than late onset.

Conceptualising adult ADHD as a regulation phenotype provides a clinically useful account of context-dependent functioning, burnout, and late diagnosis. This framework supports improved recognition of masked ADHD across adult services and encourages formulations that integrate pharmacological treatment with psychoeducation and environmental adaptation. Moving beyond checklist-driven assessment towards pattern-based clinical understanding may reduce secondary morbidity and improve long-term functional outcomes in adults with ADHD.

We wanted to develop a dedicated pathway to support people through their rehab journey from the start of their inpatient admission until 18 months post discharge. The overarching aim of this pathway is to improve the service user journey whilst saving the trust money at the same time.

A thorough service evaluation across the five boroughs within North London Foundation Trust (NLFT) in order to map out the current processes in place and discrepancies between services.

Literature review of current practices in rehabilitation psychiatry across the country, cross referenced with NICE guidelines to establish the best evidence-based pathway.

Most importantly qualitative research from interviews with service users, carers and staff in order to develop a co-produced pathway that is driven by the needs of those we are trying to support.

The above methods were used to co-produce a pilot rehabilitation pathway in Haringey which began in May 2024.

Our pilot project has reduced the number of rehab bed days by 2695 (projected for end of May 2026), which is a reduced Integrated Care Board (ICB) spend of £1540,000 (based on average cost of rehab bed of £4000/week).

Our re-admission shows 302 days saved at a cost saving of £172,571.

Our qualitative data shows service users under the pathway are able to live more independently, are engaging with our Occupational Therapy (OT) and psychology groups, have reductions in their package of care needs and as a result of the reduction in out of area beds we are able to deliver our care, closer to home.

The Haringey Rehabilitation Pathway is an excellent example of a co-produced pathway that addresses the needs identified from a robust service evaluation.

The outcomes of the pilot pathway show considerable financial savings to the trust and ICB. There has been a dramatic reduction in the number of rehabilitation bed days, out of area placements and readmission rates and our service users feedback is proof that this pathway is supportive and enables independence by focussing on relationship building and development of life skills.

Future developments include rolling out our pathway across the whole trust.

Data on survival rates of patients with dementia is sparse in Asian populations. Thus the aim of this study is to determine rates of survival of patients with dementia in Sri Lanka.

A descriptive cross-sectional analysis of data was done using the data of patients who have registered at the National Institute of Mental Health Sri Lanka, Older Persons Mental Health Clinic (largest governmental psychogeriatric service provider in Sri Lanka) from 2021 to 2023.

Total registries were 366. Prevalence of Alzheimer’s, vascular and mixed aetiology were 149 (40.41%), 83 (22.67%), 112 (30.6%) respectively. 203 (55.46%) had defaulted up to 2025. Out of 163 under regular follow up 17 (10.43%) had passed away. Mean years of survival with the disease was 3.7 years. Cause of death was dementia and related complications in 13 (76.47%) and vascular events in the rest. Mean age of death had been 77 years and male to female ratio was 0.7. Out of the defaulted 74 (36.45%) had beencontactable. Out of them 57 (77.03%) had passed away. Mean years of survival had been 2.01 years. Cause of death was dementia and related complications in 39 (68.42%) and vascular events in the rest. In the 146 surviving patients under regular follow up mean age was 73. Male to female ratio was 0.55. Mean years of life they had been living with dementia was 4.03 up to 2025. Among 17 surviving contactable patients who had defaulted it was 3.18 years. Odds of death in patients under regular clinic follow up compared with defaulted was 0.035 (Fisher’s exact p-value 2.5´ 10−24)

Regular clinic follow up is associated with a statistically significant lower rate of death compared to defaulters among patients with dementia.

Tobacco use remains highly prevalent among individuals with severe mental illness and is a major contributor to excess physical morbidity and premature mortality. Institutional smoking cessation policies aim to standardise nicotine dependence assessment, nicotine replacement therapy (NRT) prescribing and monitoring, patient education, and dischargeplanning in psychiatric inpatient settings. However, local data evaluating adherence to these standards in routine clinical practice are limited. This audit aimed to assess adherence to the institutional Smoking Cessation Policy across inpatient psychiatric services at Hamad Hospital, with a focus on documentation of nicotine dependence, NRT prescribing and monitoring, patient education, referral practices, and discharge continuity. It was hypothesised that documentation quality and continuity-of-care components would demonstrate lower compliance than initial screening processes.

A retrospective clinical audit was conducted between January and August 2024 across inpatient psychiatric units at Hamad Hospital. A total of 144 inpatient medical records were reviewed using the Cerner electronic health record system. Audit standards were derived from the institutional Smoking Cessation Policy and included documentation of smoking status, nicotine dependence screening and severity assessment, initiation and monitoring of NRT, documentation of side effects, delivery of patient and family education, provision of motivational interventions, referral to the Tobacco Control Center, and smoking cessation planning within discharge summaries. Data were extracted using a standardised audit tool and analysed descriptively.

Approximately 40% of admitted patients were identified as current smokers. Nursing compliance with initial nicotine dependence screening was high, exceeding 97%. In contrast, documentation of nicotine dependence severity was recorded in only 30.2% of cases. Appropriate NRT strength was documented in 12.3% of smokers, while monitoring for NRT-related side effects was not documented in any record. Only 20% of identified smokers received NRT, while 29% declined treatment. Referral to the Tobacco Control Center was documented in 18% of cases, with a further 13% documenting patient refusal. Motivationalinterventions were documented in 1.8% of cases. No records contained documentation of patient or family education or provision of educational materials. Discharge summaries showed limited continuity planning, with NRT prescriptions documented in only 3.3% of cases.

This audit demonstrates significant gaps between institutional smoking cessation policy standards and routine clinical practice within psychiatric inpatient services, particularly in documentation quality, patient education, and discharge continuity. While initial screening processes were consistently completed, downstream interventions and continuity-of-care measures were poorly documented. Targeted staff training, improved access to educational resources, and structured monitoring and documentation systems are required to strengthen implementation of smoking cessation policy and improve tobacco-related health outcomes for psychiatric inpatients.

To assess the time difference in creating CDDs and EDDs manually versus using Copilot in general adult psychiatry.

To assess the quality of AI generated CDDs and EDDs.

Resident doctors will be asked to time themselves while writing a CDD and EDDmanually for a selected patient. They will then use the Copilot agent to generate a CDD and EDD for the same patient and record the time taken. The time difference will be analysed to determine the efficiency gains. Qualitative feedback will also be collected regarding the usability and accuracy of the Copilot-generated documents.

Rationale: The audit was prompted by the auditor’s personal experience with dyslexia and the challenges of managing discharge documentation in a high-pressure clinical environment. The Copilot agent offers a potential solution to reduce documentation time and improve patient flow.

Service areas/teams included: The audit was carried out in Royal Cornhill hospital and included data from general adult psychiatry.

Sample Size: 5 patient cases.

Metrics Recorded:

• • Time taken with Copilot vs. without Copilot,

• • Number of TrakCare pages referenced,

• • Number and nature of mistakes,

• • Qualitative comments on errors,

• • Minutes saved and percentage time saved,

For CDDs:

• • Average time saved: 13 minutes 13 seconds per case.

• • Average percentage time saved: 75.3%

• • Largest amount of time saved: 17 minutes 34 seconds (≈74.5% reduction).

• • Largest percentage of time saved: 76.6%.

For EDDs:

• • Average time saved: 26 minutes 22 seconds per case.

• • Average percentage time saved: 76.7%.

• • Largest amount of time saved: 33 minutes 34 seconds (≈79.9% reduction).

• • Largest percentage of time saved: 81.5%.

Error Analysis: Common issues included missing clinical data (e.g., blood results, imaging) due to incomplete inpatient records, medication discrepancies caused by changes not reflected in TrackCare, and errors linked to prior documentation (e.g., suspected perforation). Not all CDDs and EDDs contained all the information about medications due to inaccurate or incomplete record keeping on TrakCare. No errors were due to hallucination by the AI.

Observations: Significant time savings were achieved in most cases. Accuracy depends on completeness of source documentation and integration with TrackCare.

The Copilot agent demonstrates substantial potential to reduce documentation time while maintaining acceptable accuracy. However, integration with real-time clinical data and improved handling of medication updates are essential for reliability.

The Collaborative Learning and Improvement Programme (CLIP) is a hospital-wide educational initiative on medication safety, co-visioned and co-produced by interdisciplinary members of the Changi General Hospital (CGH) Medication Safety Committee (MSC). CGH is a public hospital in Singapore, where CLIP has been operational since October 2023 and various educational materials have been implemented into hospital-wide junior, senior doctor and interprofessional education and training. In September 2024, inspired by a departmental case conference which triggered discussions on Neuroleptic Malignant Syndrome (NMS), the MSC Chairperson from the department of Psychological Medicine worked with departmental trainees on developing CLIP educational material on NMS. We aimed to design a CLIP educational infographic on NMS and implement this in hospital-wide mental health training.

Digital technology-enhanced learning using the infographic, with microlearning as the pedagogy, formed the framework to design the CLIP interprofessional educational infographic.

The design phase involved engaging stakeholders and end-users from the department, including Psychiatry trainees, from September–October 2025. Pharmacist, nursing and medical members of the MSC were engaged at the committee meeting in November 2025 to ensure interdisciplinary stakeholder contribution to designing the infographic. The final version of the infographic was implemented and shared in a mental health training session for the hospital’s Internal Medicine department conducted by a Psychiatry consultant in December 2025.

Qualitative feedback was captured at the planning, design and iteration phases.Qualitative and quantitative methodology was employed to capture end-user feedback from medical doctors in the implementation phase.

Qualitative feedback in the design phase led to various iterations of the infographic content, design and aesthetics, with the finalised infographic incorporating the themes captured from this feedback.In the implementation phase, quantitative feedback captured from end-users showed improvements in self-rated awareness of risk factors (69.6% to 100%) and signs and symptoms (60.9% to 100%) of NMS, and confidence in recognizing and managing NMS (4.3% to 70.6%). All participants rated the infographic as useful in aiding recognition and management of NMS. Qualitative feedback centred on the usefulness of the infographic’s design, organization and informativeness.

We designed a trainee-led infographic on NMS underpinned by interdisciplinary feedback, the implementation of which in the mental health training of general medical doctors has shown promising results, reinforcing the value of the CLIP. The CLIP NMS infographic will be made accessible to all hospital staff via the hospital intranet as a systems intervention and will be incorporated into interdisciplinary CLIP educational programmes.

Different teaching modalities are used within medical curricula to educate students about the principles and intricacies of psychiatry. Given the advancement in digital technology, medical education is evolving to include new digital based interventions and learning approaches, including the use of artificial intelligence (AI) based interventions. This review aims to systematically identify how artificial intelligence is used within medical curricula when teaching students about psychiatry, and is unique as reviewers are at different stages of training.

An advanced literature search was undertaken using OVID (MEDLINE), and Web of Science. Four key search terms were used within these databases – ‘psychiatry*’ AND ‘medical education’ AND ‘artificial intelligence’ AND ‘students’. Studies commenting or focusing on artificial intelligence-based interventions within healthcare education were included, and no restriction on the country, language or methodology. PRISMA checklist utilised. Results were thematically analysed.

332 studies were retrieved (19 were excluded due to duplication). 313 studies were screened, and 16 full texts were screened and 4 studies were deemed suitable for inclusion.

Key areas highlighted within these studies suggest AI can be in a versatile manner to help shape educational interventions. One study highlighted numerous roles that ChatGPT can undertake within an educational setting, including providing prompts for debates within students, facilitating self-directed learning, providing information to students, and can be used to create further learning materials, including vignettes for hypothetical cases – after a relevant prompt. However, the study highlighted key limitations to consider when using this novel approach as follows: the likelihood of inaccuracies leading to misinformation, differences between languages/translation, and lackof replicability and reproducibility of responses and results.

Another study showcased the creation of a web-based AI supported educational tool developed for psychiatric education, and students reported significant user satisfaction and mentioned that the platform was effective and supported them through their placements.

This review highlights the limited availability of literature surrounding the use of artificial intelligence to teach medical students about psychiatry. Additionally, the limited available literature highlighted that AI can be used in a versatile manner to create learning prompts, aides, and to create realistic case studies and vignettes that can help improve learning. However several limitations have been highlighted about the use ofAI-related materials within medical education, and further research and innovation is required within this area.

Multiple sclerosis (MS) is the most common demyelinating neurological diseases worldwide. Around 2.3 million people globally and 100,000 people in the UK were living with MS. Psychotic presentation is rare, but it may affect 2-4% of the individuals with MS, which is more than in the general population (1%). The psychotic symptoms reported in multiple sclerosis included both affective and schizophrenia-like symptoms with a predominance of positive psychotic symptoms, most frequently persecutory delusions.

Case reports

Patient X is a 35-year-old female of Asian origin, with an established diagnosis of Multiple sclerosis, presented to the crisis team with thoughts to end her life as she firmly believed with impregnable conviction that her husband was unfaithful and was having an affair with the patient’s mother for the last 3 months. It impacted her sleep and overall quality of life as she used to keep up throughout the night to gather evidence of her husband’s infidelity. She was diagnosed with ‘Secondary psychotic syndrome, with delusions’ according to ICD 11. (6E61.1) The diagnosis of Multiple sclerosis was established around two years prior to her psychotic presentation which was treated with Natalizumab infusion. During the time of her presentation to our service, the symptoms related to MS was stable with no significant findings on neurological examination. X was commenced on a low dose of antipsychotic, initially Quetiapine (which she declined to take due to metabolic side effect) and then on Aripiprazole, 10 mg once daily. X showed considerable improvement within four weeks of initiation of the antipsychotic along with psychosocial support. She has been followed up by local neurology specialist teams actively and remained stable with respect to the demyelinating process secondary to MS on repeat MRI.

Discussion:

Psychotic symptoms may develop during the onset of MS or more frequently during illness as seen in this case. Regarding management, presence of Multiple sclerosis also makes the individual vulnerable to the side effects of antipsychotic drug like extrapyramidal side effects. Psychotic symptoms can be secondary to the demyelination process or results as a side effect of medication to treat MS like corticosteroids and beta- interferon.

Although, cognitive and affective symptoms like depression are very common in pertinent among patients with MS, psychotic symptoms among them are more than the general population. Considering these, it is important to explore the organic underpinning of patients presenting with psychosis.

The National Psychiatry Student Conference (NPSC) is an annual student-led conference supported by the RCPsych Choose Psychiatry programme. The 2026 NSPC was hosted by Kent and Medway Medical School. Understanding student perspectives of such enrichment activities is important to inform future conference design and maximise educational impact. This mixed-methods study aimed to examine students’ perceptions of thequality, relevance and impact of the conference, including attitudes towards psychiatry and future career intentions.

All student delegates attending the 2026 NSPC were invited to complete an anonymous post-conference questionnaire including Likert-scale items and free-text responses exploring overall experience, session quality and perceived impact. A purposive sample of respondents was invited to take part in semi-structured interviews to explore experiences in greater depth. Questionnaire data were analysed descriptively, and interview data were analysed using thematic analysis.

Of 103 delegates, 68 students completed the questionnaire and 11 were interviewed.

Questionnaire data indicated positive experiences of the conference overall (98% were satisfied or very satisfied), and of the individual programmed activities, with an average session score of 4.5/5. The most popular sessions included a consultant’s journey through their career and lived experience of mental illness, functional neurological disorder, interactive workshops, and a subspeciality panel Q&A. Ninety percent of respondents reported that the conference had increased their interest in psychiatry as a career.

Interview data aligned closely with these findings. Students described the conference as well organised, welcoming and engaging, and valued opportunities to hear directly from clinicians about career pathways and the breadth of psychiatric practice. Many reported that the conference challenged preconceptions about psychiatry and increased awareness of the range of subspecialties and research opportunities.

For many delegates, this was their first academic conference. Barriers to attendance included travel distance and cost, with subsidised accommodation and low-cost tickets described as important enablers of participation.

This mixed-methods evaluation demonstrates that a student-led national psychiatry conference was experienced as engaging and educationally valuable by attending, self-selecting students, with delegates reporting more positive attitudes towards psychiatry as a career and a deeper understanding of the specialty. Findings also highlighted practical barriers to participation, particularly cost and travel. Overall, the results support the value of student-led conferences within undergraduate psychiatry, and emphasise the importance of accessibility in maximising their impact and reach.

Recent large registry studies report associations between GLP-1 RA use and reduced substance-related harms. We synthesize this evidence, identify critical knowledge gaps, and define research priorities needed before clinical translation.

A targeted evidence synthesis was conducted across three domains:

1. Large registry studies examining outcomes in people with AUD or opioid use disorder (OUD) prescribed GLP-1 RAs.

2. Real-world cohort studies comparing overdose and hospitalisation rates between GLP-1 RA users and non-users.

3. Neuroscience literature describing GLP-1 receptor activity in reward-related brain regions.

Multiple observational studies show associations between GLP-1 RA use and reduced substance-related harms.

In a Swedish cohort of 227,866 individuals with AUD, semaglutide was associated with reduced alcohol-related hospitalisations (Lähteenvuo 2024). US data (>500,000 OUD, >800,000 AUD patients) showed lower opioid overdose and alcohol intoxication rates among GLP-1 RA users (Qeadan 2024; Wang 2024).

All current human findings are observational, but several human randomised controlled trials are now underway, including trials of semaglutide and exenatide for AUD, semaglutide for cocaine use disorder, and liraglutide for nicotine dependence.

The overlap between metabolic and addiction pathways may explain these associations, as GLP-1 signaling modulates reward processing relevant to both food intake and substance use. Preclinical studies demonstrate GLP-1R-mediated reduction in substance self-administration via reward pathway modulation in VTA, NAcc, and PFC. While this provides biological plausibility, observational human data cannot establish causality, and RCT evidence is needed.

Observational data suggest potential associations between GLP-1 RA use and reduced substance-related harms, but cannot establish causality due to confounding. Before clinical application, essential research includes: (1) completion of ongoing RCTs with addiction-specific outcomes, (2) safety and tolerability evaluation in actively substance-using populations, including assessment of nausea/vomiting risks and drug interactions with methadone, buprenorphine, and benzodiazepines, (3) adherence and implementation feasibility studies in populations with chaotic substance use, and (4) health economics modeling. Psychiatrists should monitor emerging trial results critically as this evidence base develops in the coming years.

To evaluate whether the pre-lithium workup in patients with Bipolar Affective Disorder (BPAD) initiated on lithium in Psychiatry in patient unit of Allied Hospital, Faisalabad adheres to the Maudsley prescribing guidelines in psychiatry.

This study was conducted in 2025 at a tertiary care hospital in Faisalabad, data was collected from files of 72 inpatients in psychiatry ward prescribed lithium, to check if adequate pre lithium workup was done for each patient as recommended by Maudsley prescribing guidelines. A baseline audit was followed by a faculty led presentation on guidelines, and a re audit 3 months later, in which data was observed from 86 patients files. Initial findings revealed unsatisfactory workup . Results were discussed in a departmental meeting, leading to targeted teaching session for all the residents. The reaudit showed significant improvement in workup practices prior to prescribing lithium as recommended

The initial audit revealed that only 50(69.4%) out of 72 patients had their LFTs done, 3 (4.2%) had TFTs, 14(19.4%) had ECG and None of the patients got their weight measured before prescribing lithium.

A reaudit done 3 months later showed results from 86 patients according to which there was much improvement in compliance with the guidelines as 74(86%) had their LFTs, 53 (61.6%) had TFTs, 58 (67.4%) had ECG and 33 (38.4%) had weight measured before prescribing lithium.

These findings indicate a positive staff response and significant progress in adhering to pre lithium workup guidelines

Lithium is the most effective mood stabiliser for the treatment and long-term prophylaxis of BPAD and helps in reducing relapse and suicide risk. Although it is very effective, lithium has a narrow therapeutic index and can cause range of adverse effects involving renal, thyroid, cardiovascular and metabolic systems. Therefore, it is essential to do baseline physical health assessment before initiating lithium therapy. It helps to identify pre-existing risk factors and ensures safe prescribing. Lithium can commonly cause hypothyroidism, renal impairment, weight gain and cardiac conduction abnormalities. The risk increases with longer treatment duration and cumulative exposure.

This audit demonstrated initially poor compliance with pre lithium workup as recommended by Maudsley prescribing guidelines. Rates of RFTs, TFTs, ECG and Weight measurement were very low which could have resulted in avoidable complications. Later intervention and reaudit showed much improved compliance with recommended standards. This highlights the importance of audit driven interventions leading to improvement in quality of care for patients in their best interest. Ongoing education, standardised pre-lithium checklists and regular re-auditing are recommended to ensure sustained compliance and further improvement in patient safety

Current dementia referral pathways within Mental Health of Learning Disability (MHLD) Team in Kent and Medway were analysed in order to understand existing practices while identifying opportunities for improvement. Objectives were: (1) to capture staff opinions on what MHLD should provide for people with intellectual disability (ID) and dementia, and (2) to analyse dementia-related referrals to East and West Kent MHLD over 12 months. Audit standards were drawn from NICE NG54, which advises referral of people with learning disabilities and suspected dementia to a specialist psychiatrist. We hypothesised that pathways would lack clarity.

We employed a mixed-methods research design. An anonymous survey was used to collect opinions from MHLD clinicians across Kent about referral practices, assessment responsibilities, prescribing, and post-diagnostic support. We conducted a retrospective evaluation of dementia-related referrals from January-December 2024 by reviewing referral meeting documents and electronic health records. We collected information on demographics, referral sources, outcomes, and follow-up details. Descriptive statistics and thematic analysis were used.

Eighteen staff responded. Most (83%) supported a formalised pathway, mentioning inconsistency in the current system. Views on assessment, diagnosis, prescribing, and follow-up were divided; joint working was favoured but resource limitations were noted. Confidence gaps in diagnosis and prescribing for ID were highlighted. Twenty-seven dementia-related referrals were identified (41% East, 59% West; mean age 55.7; 63% male; 59% with Down’s Syndrome). Overall, 48% were accepted, with marked variation (82% East vs. 25% West). Psychiatric input occurred in 84% of cases, and 77% were redirected to MAS or CLDT. No confirmed diagnoses were made at initial or three-month follow-up.

Our findings indicate differences in how dementia referrals for people with ID are managed across Kent and Medway. The staff supports the creation of a formalised pathway which would address inconsistencies and define roles among MHLD, MAS and CLDT and maintain compliance with NICE guidance. A standardised approach together with enhanced training resources could improve dementia care delivery to patients with ID.