Background Medical students experience disproportionately high rates of anxiety and depression, and treatment gaps may exist. To date, little is known about how these mental health outcomes have changed over time.Objective To examine recent trends in clinically significant anxiety, depression, suicidal ideation, and counselling service utilisation among US medical students.Methods We analysed five

BACKGROUND Improving preventative interventions for self-harm and suicide-related behaviour is a mental health policy priority. Existing evidence-based interventions can be lengthy, resource-heavy, difficult to access, and are not always acceptable or effective. Extending support through brief and remotely delivered interventions outside of traditional clinical services brings potential to expand access

BACKGROUND Repetitive transcranial magnetic stimulation (rTMS) of the left dorsolateral prefrontal cortex (DLPFC) is an effective non-pharmacological, non-invasive intervention for depression. However, the optimal strategy for localising the DLPFC treatment site on the patient's scalp is heavily disputed. Routine strategies were previously incrementally refined and compared in terms of anatomical accuracy

OBJECTIVE To assess the effectiveness of NHS Talking Therapies (NHSTT) service for working-age adults with mild to moderate depression or anxiety and to evaluate the impact of multiple physical long-term conditions (LTCs) on treatment outcomes. METHOD We have linked routinely collected data from the NHSTT services in South London (UK) with primary care data for aged 18-64 years who had accessed the

BACKGROUND With the increasing prevalence of climate-related disasters, psychological responses, including climate change anxiety and anticipatory climate disaster stress, have received heightened attention. OBJECTIVE We investigate the correlates of climate change anxiety and anticipatory climate disaster stress, as well as the nature of these psychological responses. METHODS At the start of the annual

BACKGROUND Anaemia during pregnancy is associated with maternal depressive symptoms during pregnancy and the postpartum period. However, the effect of anaemia development during pregnancy on maternal psychological health in non-anaemic women remains unclear. OBJECTIVE To investigate the effect of anaemia development during pregnancy on maternal psychological health during pregnancy and the postpartum

BACKGROUND Rates of common mental disorders (CMDs) including anxiety, depression and stress, treated in primary care have increased among young adults, but it is unclear if this reflects more help-seeking and/or an increase in symptoms, and if there are differences across sociodemographic groups. OBJECTIVE This study examined trends in primary care-recorded CMD and self-reported psychological distress

BACKGROUND We previously demonstrated that a large language model could estimate suicide risk using hospital discharge notes. OBJECTIVE With the emergence of reasoning models that can be run on consumer-grade hardware, we investigated whether these models can approximate the performance of much larger and costlier models. METHODS From 458 053 adults hospitalised at one of two academic medical centres

BACKGROUND Circadian disruption has been suggested to induce cognitive impairment and dementia. It remains unknown which brain structures are involved in the pathology. OBJECTIVE To investigate which specific brain structure alterations are associated with dementia and cognitive impairment induced by circadian disruption. METHODS Circadian disruption was represented by two accelerometer-derived circadian

BACKGROUND Acute mental health service use (AMHSU), that is, hospitalisations and emergency department (ED) visits for mental health, have been rising in the Canadian province of Ontario and globally; however, national-level estimates are not available. We examine trends and socioeconomic inequalities in AMHSU in the Canadian adult population between 2004 and 2019. METHODS Using the Canadian Community

BACKGROUND Existing health inequalities and the lack of timely and appropriate support have long been a reality for many ethnic minority individuals living with mental health conditions, even before the pandemic. Limited access to services and the absence of culturally or religiously embedded care have led to increased severity of mental health problems. OBJECTIVE To explore the complexity of interactions

OBJECTIVES This nationwide cohort study investigated the association between attention-deficit/hyperactivity disorder (ADHD) and various types of urticarial diseases. METHODS We conducted a population-based cohort study using data from Leumit Health Services (LHS), a health maintenance organisation in Israel. The study population consisted of all members of LHS between 1 January 2002 and 30 November

AIM The adoption of artificial intelligence (AI) tools is gaining traction in maternal mental health (MMH) research. Despite its growing usage, little is known about its prospects and challenges in low- and middle-income countries (LMICs). This study aims to systematically review articles on the role of AI in addressing MMH in LMICs. METHODS This systematic review adopts a patient and public involvement

OBJECTIVE To develop a clinician-guided, research-based guideline for adult outpatient psychotherapy for complex presentations of post-traumatic stress disorder (PTSD). METHODS We used state-of-the-art methods to develop clinical guideline recommendations and conduct systematic reviews with meta-analyses for five research questions: (Q1) When treating adults with PTSD, should trauma-focused psychotherapy

QUESTION This study investigated the methodological rigour of randomised controlled trials (RCTs) of mental health apps for depression and anxiety, and whether quality has improved over time. STUDY SELECTION AND ANALYSIS RCTs were drawn from the most recent meta-analysis of mental health apps for depression and anxiety symptoms. 20 indicators of study quality were coded, encompassing risk of bias,

BACKGROUND The prevalence of attention-deficit hyperactivity disorder (ADHD) drug treatment for youth and adults has been rising exponentially in Iceland over the past 15 years. The efficacy of ADHD drugs is not as strongly supported for adults as for children and adolescents, and adult use has been reported to increase the risk of psychosis or mania. OBJECTIVE To assess the absolute risk of hospitalisation

BACKGROUND Adolescence constitutes a critical window for preventing depression, but efforts have mostly targeted single risk factors. The Identifying Depression Early in Adolescence Risk Score (IDEA-RS) integrates easily obtainable sociodemographic variables and has been able to predict future depression across diverse populations. However, its performance within a prospective cohort remains untested

BACKGROUND Social environment characteristics, including social relationships and cultural milieus, may influence the occurrence, course and management of depression. Effective questionnaires are needed to measure these factors and improve disease management. OBJECTIVE We aimed to (1) evaluate the social environment, such as social isolation, social disability and social cohesion of depressed inpatients

BACKGROUND There have been few rigorous evaluations of population, multi-strategy, suicide prevention programmes, despite increasing global recognition that such approaches are needed to reduce suicide. OBJECTIVE To examine the effects of a multi-strategy suicide prevention model on age-standardised rates of hospital presenting self-harm and suicide after 24 months of implementation. METHODS A stepped-wedge

BACKGROUND The Hamilton Rating Scale for Depression (HRSD) and the Montgomery-Åsberg Depression Rating Scale (MADRS) are the two most common clinician-rated scales to quantify depression symptom change in repetitive transcranial magnetic stimulation (rTMS) trials. However, it is unclear how the values of one scale translate to the other. Being able to translate scores between these scales could allow

QUESTION Mental health complaints are increased in survivors of natural hazards and disaster responders. This meta-analysis assessed the efficacy of psychological and psychosocial interventions for the prevention of mental disorders after exposure to natural hazards. STUDY SELECTION AND ANALYSIS We searched Web of Science, PsycINFO and MEDLINE for peer-reviewed randomised controlled trials evaluating

BACKGROUND Psychotic disorders are known to exhibit heterogeneity with regards to illness course and prognosis, yet few studies have examined long-term healthcare use. OBJECTIVE To determine the prevalence and predictors of healthcare use for psychiatric disorders at 9 years after the first episode of psychosis (FEP). METHODS National registers were used to identify all Swedish residents aged 18-35

Internationally, capacity building for mental health implementation and translation research has lagged. A review of literature found initiatives since 2008 indicating limited dedicated attention to growing capabilities of early-to-mid-career mental health researchers, and little reporting of tailored career pathways and skills growth. Significant gaps in capacity building thus exist. This perspective

QUESTION What are the experiences and needs of parents of children and young people (CYP) aged 5-18 with diagnosed mental health difficulties, particularly in relation to the parents' own well-being? STUDY SELECTION AND ANALYSIS A systematic review with thematic meta-synthesis was conducted, including qualitative studies published in English. Seven databases were searched (MEDLINE, PsycINFO, CINAHL

BACKGROUND Rheumatoid arthritis (RA) and axial spondyloarthritis (axSpA) are autoimmune illnesses characterised by chronic inflammation demonstrating differential associations with psychiatric conditions. OBJECTIVE In this matched-cohort study, we aimed to investigate whether the associations between these inflammatory illnesses and mental disorders are predominantly the consequence of the burden of

QUESTION The Green Brain Capital Model emphasises the bidirectional relationship between brain health and the environment, making it an environmentally focused type of brain capital. This work represents the initial stage of conceptualising the Green Brain Capital Model, which is essential to avoid ambiguity and misinterpretation while developing a quantitative model. Ecological intelligence (EI) is

BACKGROUND Migraine is linked to increased suicidal behaviour, but its relationship with suicide mortality remains underexplored. In South Korea, suicide rates are among the highest in Organisation for Economic Co-operation and Development nations, particularly in young adults. OBJECTIVE To investigate the effect of migraine on suicide mortality in young Korean adults. METHODS Participants who underwent

BACKGROUND Psychological prevention programmes delivered in schools may reduce symptoms of depression. However, high-quality, large-scale trials are lacking. OBJECTIVE The aim was to examine whether a digital cognitive-behavioural programme ('SPARX'), delivered at scale in schools, would reduce depressive symptoms 12 months later. METHODS A cluster randomised controlled trial with parallel arms (intervention;

BACKGROUND Healthcare workers (HCWs) face substantial daily work-related pressures, leading to frequent reports of depression, anxiety and post-traumatic stress disorder (PTSD) symptoms. OBJECTIVE To compare the effects of Self-Help Plus in its digital version Doing What Matters in Times of Stress (DWM) to an equally structured activity in reducing anxiety and/or PTSD symptoms among HCWs. METHODS We

BACKGROUND The Warwick-Edinburgh Mental Wellbeing Scale (WEMWBS), a questionnaire designed for the assessment of mental well-being, is widely used in different countries and cultures worldwide. However, there is a lack of studies examining its metric performance and measurement invariance across countries. OBJECTIVE This study aims to examine the internal structure, reliability and cross-country validity

BACKGROUND Little is known about the impact of healthcare structural changes and socioeconomic indices, such as deprivation, mental health needs, and inequalities, on attention-deficit hyperactivity disorder (ADHD) medication prescribing across different regions in England. OBJECTIVE The objective was to examine trends in ADHD medication prescribing and explore their association with socioeconomic

BACKGROUND Trans, non-binary and gender-diverse (TGD) people experience poorer mental health relative to cisgender populations. However, we know little on how TGD mental health inequalities are changing over time. With newly available information on gender identity within Australia's largest longitudinal household survey, we aimed to provide the first nationally representative estimates of temporal

Most low- and middle-income countries (LMICs) have poor or non-existent mental healthcare. Many of LMIC countries allocate less than 1% of their health budgets to addressing mental illness, making large-scale public health interventions not a practical option, at least for the foreseeable future. Psychiatric services are limited to large urban centres, and mental health literacy is low. There is increasing

OBJECTIVE Agitation in the emergency department (ED) affects up to 2.6% of encounters, posing significant risks to patients and caregivers. This review investigates the impact of circadian rhythms on benzodiazepine (BZD) pharmacokinetics and pharmacodynamics, focusing on how dosing time influences outcomes in managing acute agitation. METHODS A comprehensive literature search was performed using PubMed

BACKGROUND Depression in older adults is often undertreated. A 2011 systematic review of treatments for treatment-resistant depression (TRD) in older adults identified one placebo-controlled randomised controlled trial (RCT). We aimed to update this review, synthesising evidence for the effectiveness of treatments for TRD in older people. METHODS We systematically searched electronic databases (PubMed

This editorial focuses on the seven studies published in the BMJ Mental Health topic collection Advances in Clinical Psychopharmacology in Children and Young People. Collectively, these articles provide evidence that informs key steps in the psychopharmacological management of children and adolescents with mental health or neurodevelopmental conditions. Papers in this collection contribute to strengthen

We argue that psychiatry has overlooked a significant modifiable risk factor for mental illness in female patients: cyclical symptoms associated with the menstrual cycle. Premenstrual dysphoric disorder has recently been included in the International Classification of Diseases-11, while there is growing evidence that menstrual cycle stage can impact mental health symptoms transdiagnostically and influence

BACKGROUND Suicidal thoughts and behaviours are common in people in prison and associated with poor health outcomes, including suicide, injury and repeat self-harm. OBJECTIVE To develop and validate a model to stratify risk of repeat suicidality up to 3 months in people in prison. METHODS In seven English prisons, we identified 754 people aged over 17 who had been placed on a suicide risk management

In the mental health research field, there is a need for effective and robust methodological approaches that are able to address complexity. In this article, we reassert the importance of mixed methods, an approach increasingly applied within mental health research, and examine the ongoing challenges in the field. We provide worked examples from our own research to demonstrate the diverse range of

BACKGROUND The subcallosal cingulate gyrus (SCG) is integral to cognitive function and mood regulation. Open-label SCG deep brain stimulation (DBS) studies demonstrate improvement or stabilisation of cognitive function in treatment-resistant depression (TRD). OBJECTIVE This randomised controlled study aims to evaluate the neuropsychological effects of SCG-DBS. METHODS 35 participants with TRD received

BACKGROUND Mood episodes and high suicide risk of bipolar disorder (BD) are thought to derive from amygdala-ventral prefrontal cortex emotion regulation brain circuitry dysfunction and resulting emotion dysregulation, making these potential intervention targets. OBJECTIVE To assess feasibility, acceptability, and preliminary efficacy in engaging the emotion regulation targets of two Brain Emotion Circuitry-targeted

AIM To identify sleep abnormalities in individuals at clinical high risk for psychosis (CHR-P) or with schizophrenia spectrum disorders (SSDs) compared with healthy controls (HCs) using wrist actigraphy, and to assess potential differences in the direction of effect with self-reported assessments of sleep. METHODS We conducted a systematic review of observational studies, with the search last updated

BACKGROUND Mood is known to change over seasons of the year, days of the week, and even over the course of the day (diurnally). But although broader mental health and well-being also vary over months and weeks, it is unclear whether there are diurnal changes in how people experience and report their mental health. OBJECTIVE To assess time-of-day association with depression, anxiety, well-being and

BACKGROUND The increasing prevalence of mental health disorders among adolescents highlights the importance of early identification and intervention. Artemis-A is a web-based application of computerised adaptive testing (CAT), originally developed for secondary schools, to quickly and efficiently assess students' mental health. Due to its speed, reliability and accessibility, it may be a valuable tool

BACKGROUND Evidence-based mental health requires patient-relevant outcome data, but many indicators lack clinical meaning and fail to consider youth perceptions. The minimally important change (MIC) indicator designates change as meaningful to patients, yet is rarely reported in youth mental health trials. OBJECTIVE This study aimed to establish MIC thresholds for two patient-reported outcome measures

BACKGROUND Depression alongside multiple long-term conditions (MLTCs) in older adults poses a critical public health challenge, worsening physical and mental health and increasing healthcare costs. COVID-19 restrictions further exacerbated these impacts. Behavioural activation (BA) shows promise as a remote intervention for depression during isolation, but its cost-effectiveness for depressed, socially

OBJECTIVES Should a young person receive psychotherapy or medication for their depression and on what evidence do we base this decision? In this paper, we test the factors across modalities that may influence comparability between medication and psychotherapy trials. METHODS We included 92 randomised controlled trials (RCTs) of psychotherapy and medication for child and adolescent depression (mean

BACKGROUND Obsessive-compulsive disorder (OCD) is associated with an increased risk of morbidity and mortality due to cardiometabolic disorders. Whether this association is driven by familial factors is unknown. This population-based family study explored the familial co-aggregation of OCD and cardiometabolic disorders. METHODS We identified 6 049 717 individuals born in Sweden between 1950 and 2008

BACKGROUND Traumatic brain injury (TBI) is associated with an increased risk of major depressive disorder (MDD) and post-traumatic stress disorder (PTSD). We aimed to identify predictors and develop models for the prediction of depression and PTSD symptoms at 6 months post-TBI. METHODS We analysed data from the Collaborative European NeuroTrauma Effectiveness Research in Traumatic Brain Injury study

Climate change poses enormous, rapidly increasing risks to human well-being that remain poorly appreciated. The growing understanding of this threat has generated a phenomenon often called 'eco-anxiety'. Eco-anxiety (and its synonyms) is best documented in the Global North, mostly among people who are better educated and whose reasons for concern are both altruistic and self-interested. However, the

QUESTION Evidence on the likelihood of receiving rapid tranquillisation (RT) across ethnic groups is mixed, with some studies suggesting that ethnic minorities are more likely to receive RT than others. We aimed to investigate the association between ethnicity and RT use in adult mental health inpatient settings and to explore explanations for RT use in relation to ethnicity. STUDY SELECTION AND ANALYSIS

BACKGROUND There is some evidence that perinatal anxiety (PNA) is associated with lower rates of infant vaccinations and decreased access to preventative infant healthcare, but results across studies have not been conclusive. OBJECTIVE To investigate the relationship between maternal PNA and infant primary care use. METHODS Cohort study of mother-infant pairs identified between 1998 and 2016 using

BACKGROUND Stressful life events (SLEs) are associated with increased risk of depression or anxiety. Coping mechanisms may moderate this relationship but little is known on this topic in young people or in Latin America. AIM To investigate whether coping strategies predict odds of depression and/or anxiety and moderate the relationship between SLEs and depression and/or anxiety in young people in Peru

QUESTION Cognitive-behavioural therapy (CBT) is frequently implemented for individuals with attention-deficit hyperactivity disorder (ADHD). It is still unknown which specific components are effective, because CBT is a complex intervention with several components. The objective of this review was to assess the efficacy of CBT components for ADHD. STUDY SELECTION AND ANALYSIS Building on definitions

Data sharing is a cornerstone of modern scientific research, playing a critical role in fostering greater collaboration, enhancing reproducibility, transparency and efficiency of scientific discoveries, and integrating diverse data sources. In circadian rhythm research, data sharing is particularly important due to the complexity and heterogeneity of the data, which includes molecular profiles, physiological

Systematic reviews and meta-analyses have become crucial for evidence-based decision-making in recent decades. However, it is common for the results of multiple reviews on the same topic to be inconsistent, and it is widely recognised that the results of the reviews are not always effectively communicated to healthcare professionals and the lay public. This manuscript proposes a strategy to summarise

BACKGROUND The link between cardiometabolic disease and mental illness has been well established but remains incompletely explained. One hypothesis suggests that circadian rhythm dysregulation links cardiometabolic disease and mental illnesses. BMAL1 is a circadian rhythm regulatory gene. Human genetic studies have implicated BMAL1 in depression, schizophrenia, bipolar disorder as well as body mass

QUESTION Collective evidence for the bidirectional association between depression and autoimmune diseases (ADs) is scarce, especially for subgroups of patients with specific ADs. We conducted a meta-analysis to determine the incidence rates and relative risks (RRs) of depression among patients with ADs, and vice versa. STUDY SELECTION AND ANALYSIS PubMed, Embase, Web of Science, Ovid, PsycNet and Cochrane

OBJECTIVE This paper investigates how state-of-the-art generative artificial intelligence (AI) image models represent common psychiatric diagnoses. We offer key lessons derived from these representations to inform clinicians, researchers, generative AI companies, policymakers and the public about the potential impacts of AI-generated imagery on mental health discourse. METHODS We prompted two generative

BACKGROUND A persecutory delusion (severe paranoia) occurs when a person believes that others are trying to harm them when they are not. It is often a central difficulty for patients diagnosed with schizophrenia. OBJECTIVE The objective is to identify potentially important research questions about severe paranoia. METHODS A priority-setting partnership exercise was conducted involving people with lived