Care (Education) and Treatment Reviews (C(E)TRs) are intended to reduce unnecessary psychiatric hospital admission and length of stay for people with intellectual disability and autistic people. The use and impact of C(E)TRs have not been systematically evaluated since their introduction in England in 2015. The aims of this study are to describe the demographic and clinical profiles of people who receive a community C(E)TR and to investigate their effects on admission, length of hospital stay and clinical and functional change.

We will conduct a retrospective cohort study using de-identified data from electronic health records derived from two large National Health Service mental health providers in London, England, including one replication site. Data will be extracted using the Clinical Record Interactive Search (CRIS) tool for all people with recorded intellectual disability and/or autism who received mental healthcare from 2015. We will identify community C(E)TR events using keyword searches. Community C(E)TRs will be examined in two ways: (1) In a community cohort, we will capture data in the 6-month periods before and after a community C(E)TR and compare this to a matched control group and (2) In a hospital cohort, we will compare groups who did and did not receive a community C(E)TR prior to their admission. We will describe the socio-demographic and clinical profiles of each group and their health service use, and compare C(E)TR and no C(E)TR groups using t-tests (or a non-parametric equivalent). The primary outcomes are admission to a psychiatric hospital (community cohort) and length of psychiatric hospital admission and clinical change (hospital cohort). Admission to psychiatric hospital will be estimated using propensity score weighting and difference-in-differences methods. Cox’s proportional hazard model will be used for length of hospital admission and repeated-measures analysis of variance (ANOVA) will be used to assess clinical change.

Use of CRIS to examine de-identified clinical data for research purposes has overarching ethical approval. This study has been granted local approval by the South London and Maudsley CRIS Oversight Committee. Findings will be disseminated in an open-access peer-reviewed academic publication, at conference presentations, and to service users and carers in accessible formats.

Shift work sleep disorder is a circadian rhythm sleep-wake disorder characterised by insomnia and/or excessive sleepiness associated with a shift work schedule that overlaps with habitual sleep time. This study aimed to assess the prevalence of shift work sleep disorders and associated factors among healthcare professionals working at Jimma University Medical Center, Southwest Ethiopia.

Institutional-based cross-sectional study.

Tertiary hospital in Southwest Ethiopia.

The data were collected using a self-administered questionnaire from health professionals recruited using a simple random sampling technique.

Shift work-sleep disorder was assessed by the International Classification of Sleep Disorders, the Insomnia Severity Index and/or the Epworth Sleepiness Scale. A logistic regression analysis was conducted to determine the association between the predictor and the outcome variable. The ORs and 95% CIs were determined. Variables with a p value

370 participants were involved in the study, yielding a response rate of 97.6%. The prevalence of shift work sleep disorder was 35.9% (n=133). Working in three shifts (Adjusted OR (AOR) 3.25, 95% CI=1.92 to 5.57), more than 11-night shifts per month (AOR 2.83, 95% CI=1.49 to 5.37), absence of nap (AOR 2, 95% CI=1.14 to 3.52), stress (AOR 4.4, 95% CI=2.36 to 8.2), fatigue (AOR 2.7, 95% CI=1.26 to 3.73), alcohol (AOR 3.9, 95% CI=1.79 to 8.47) and khat (AOR 4.40, 95% CI=1.76 to 10.96) use in the last 3 months was significantly associated with shift work sleep disorder.

One in three healthcare professionals working at Jimma University Medical Center had a sleep disorder related to shift work. Working in three shifts per day, having more than 11-night shifts per month, lack of naps, presence of stress, fatigue and substance use were found to be associated with shift work sleep disorder.

Parents of children with neurodevelopmental disorders often experience high levels of stress that impact their mental health, yet few interventions focus on their well-being. To address this gap, we developed a mental health intervention based on emotional intelligence (EI), designed for delivery in healthcare settings. We hypothesise that enhancing EI can reduce parenting stress and improve psychological well-being. This study aims to assess the effectiveness, cost-effectiveness and feasibility of this EI-based intervention in Bangladesh.

This hybrid type 1 effectiveness-implementation study will include a cluster randomised controlled trial, an implementation analysis and an economic evaluation. Eight child development centres will be randomly assigned in a 1:1 ratio to intervention and waitlist control groups. A total of 480 parents (mothers and fathers) will be recruited. The intervention consists of interactive sessions on EI skills, supported by personal diaries and a mobile app. Data will be collected at baseline and 12 weeks postintervention using validated tools to assess EI, parenting stress, psychological well-being and other mental health outcomes. Implementation will be evaluated using mixed methods to assess feasibility, acceptability and fidelity. Cost-effectiveness will be determined through a cost–utility analysis of direct and indirect costs.

Ethical approval was granted by the Institutional Review Board of Bangladesh Medical University (BSMMU/2022/10733). Written informed consent will be obtained at each stage of data collection and intervention. Findings will be disseminated through open-access publications, plain-language summaries, academic conferences, community workshops and policy briefs. Data will be shared in open-access platforms to inform mental health strategies in low-resource settings globally.

NCT06166550.

Multiple sclerosis (MS) is a common autoimmune illness that causes inflammation, demyelination and neurological damage. Symptom relief and immunotherapy are part of the treatment, but several healthcare barriers significantly influence outcomes and quality of life.

This study aimed to assess different aspects among patients with MS, such as their knowledge of the disease, access to care, medications’ beliefs and depression, and to evaluate any correlations between these variables and their impact on the presence of depression.

A cross-sectional study was conducted from May 2024 to October 2024 at Al-Basheer Hospital, King Abdullah University Hospital (KAUH), Princess Basma Teaching Hospital and the Multiple Sclerosis Society of Amman. 200 participants were recruited after confirming consent. Data were collected through face-to-face interviews using validated instruments, covering sociodemographics, beliefs about medicines, knowledge about MS, access to care and levels of depression.

This study involved 200 patients with MS with a median age of 36 years, mostly women (70.5%), non-smokers (65%) and insured (77.5%). The majority had high education (58%) but low income (67%), with a mean duration of MS disease of 7.8 years after diagnosis. The majority (79.5%) were unaware of their MS type. Beliefs about medications varied, with 22% accepting, 48.5% ambivalent, 14.5% sceptical and 15% indifferent. Disease knowledge was high, with patients recognising MS as an immune, non-contagious and non-curable disease that affects women more than men. Despite good access to care, a percentage of patients needed to travel long distances for care. Depression affected 58% of participants, and it was influenced by access to care, concerning beliefs, income and education. Other variables such as gender, health insurance, the duration of the disease and the necessity of medications had no significant influence.

In conclusion, patients with MS deal with various challenges, such as difficulties in accessing care, associated with psychological factors such as depression. Addressing these barriers by optimising patients' beliefs about medications, enhancing access to care and focusing on the level of knowledge of the disease is crucial for ensuring better and optimal treatment outcomes, as well as decreasing the risk of depression development.

Self-harm and suicide are common among prison inmates, but less is known about these phenomena in those with psychosis.

The aim of this study was to examine self-harm behaviour in New South Wales (NSW) prisons in Australia among inmates diagnosed with psychosis. This study also examined self-harm-related alerts applied by Corrective Services to assist staff with the management of the security and well-being of inmates.

A retrospective case-control data-linkage study was conducted using administrative data collections in NSW, Australia.

The study included all individuals diagnosed with psychosis and incarcerated between 2001 and 2020 in NSW as cases and an age and sex matched control group with no such diagnosis with a record of incarceration in the same time period.

The primary outcome measure was self-harm among the cases and controls. The secondary outcome measure was the application of alerts by Corrective Services in relation to self-harm incidents.

Multivariate regression analysis was used to examine predictors of self-harm in prison. Prisoners with psychosis (n=14 900) were more likely to self-harm than controls (n=2713), with 15.0% versus 3.6% engaging in self-harm (highest odds of self-harm observed in those with schizophrenia and related psychoses, aOR=4.84, 95% CI: 3.93 to 5.98). Those of Aboriginal heritage had an increased risk of self-harm (aOR=1.58, 95% CI: 1.43 to 1.75). Factors associated with a lower risk of self-harm were male sex and older age (≥25 years) at the time of their first incarceration. 35.6% of those released from prison with a prior psychosis diagnosis had at least one alert applied during incarceration compared with 10.1% of prisoners without a diagnosis of psychosis. Overall, 35 individuals with psychosis and 1 individual from the control group died while in prison between 2001 and 2020. 17 prison suicides were recorded from the study population; all occurred in the psychosis group.

Given the heightened risk of self-harm in those with histories of psychosis, consideration should be given to sharing mental health information between agencies to improve the care and management of this group during incarceration. Prison alerts may be a useful tool to help staff manage inmates’ well-being if used appropriately.

This study examined the mental health literacy of perinatal healthcare professionals in the United Arab Emirates (UAE) and analysed how their knowledge, attitudes and confidence impact their clinical practices in addressing perinatal mental health disorders.

A qualitative study with a descriptive phenomenological design. Data were collected via semi-structured individual interviews and focus group discussions. The data were analysed inductively using Braun and Clarke’s six-step thematic analysis.

The study was conducted in Abu Dhabi, Dubai and Al Ain in the UAE. Participants were recruited from various healthcare facilities and professional educational events.

The participants consisted of perinatal healthcare professionals from seven disciplines, including lactation consultants, midwives, nurses, obstetricians, paediatricians, family medicine practitioners and psychiatrists/psychologists. All participants were required to be actively involved in providing care to perinatal patients and to have a minimum of one year of clinical experience. The study included three focus group discussions and 28 semistructured individual interviews, culminating in a sample of 43 participants for analysis.

Three key themes emerged: (1) Knowledge and awareness, highlighting variable understanding of perinatal mental health and reliance on instinct over formal screening; (2) Navigating professional roles and realities, showing empathy and willingness to support patients, yet role ambiguity, low confidence and societal stigma influence perinatal healthcare professionals’ responses and care practices and (3) Strengthening support systems and resources, where participants called for improved training, clear policies and psychosocial resources to overcome institutional and educational gaps and to enhance perinatal mental healthcare and patient outcomes.

The study reveals gaps in mental health literacy and institutional support that hinder the delivery of effective perinatal mental healthcare. Strengthening provider training, implementing standardised screening and referral pathways, and promoting culturally sensitive, multidisciplinary approaches are essential. Such interventions can enhance early detection and improve outcomes for mothers and infants. Further research should focus on developing and evaluating the efficacy of such interventions to enhance early detection and improve outcomes for mothers and infants.

Severe mental disorders are associated with increased risk of metabolic dysfunction. Identifying those subgroups at higher risk may help to inform more effective early intervention. The objective of this study was to compare metabolic profiles across three proposed pathophysiological subtypes of common mood disorders (‘hyperarousal-anxious depression’, ‘circadian-bipolar spectrum’ and ‘neurodevelopmental-psychosis’).

751 young people (aged 16–25 years; mean age 19.67±2.69) were recruited from early intervention mental health services between 2004 and 2024 and assigned to two mood disorder subgroups (hyperarousal-anxious depression (n=656) and circadian-bipolar spectrum (n=95)). We conducted cross-sectional assessments and between-group comparisons of metabolic and immune risk factors. Immune-metabolic markers included body mass index (BMI), fasting glucose (FG), fasting insulin, Homeostasis Model Assessment-Insulin Resistance (HOMA2-IR), C reactive protein and blood lipids.

Individuals in the circadian-bipolar spectrum subgroup had significantly elevated FG (F=5.75, p=0.04), HOMA2-IR (F=4.86, p=0.03) and triglycerides (F=4.98, p=0.03) as compared with those in the hyperarousal-anxious depression subgroup. As the larger hyperarousal-anxious depression subgroup is the most generic type, and weight gain is also a characteristic of the circadian-bipolar subgroup, we then differentiated those with the hyperarousal-anxious subtype on the basis of low versus high BMI (2 vs ≥25 kg/m², respectively). The ‘circadian-bipolar’ group had higher FG, FI and HOMA2-IR than those in the hyperarousal-anxious-depression group with low BMI.

Circadian disturbance may be driving increased rates of metabolic dysfunction among youth with emerging mood disorders, while increased BMI also remains a key determinant. Implications for assessment and early interventions are discussed.

The COVID-19 pandemic led to major disruptions in society across many spheres, including healthcare, the economy and social behaviours. While early predictions warned of an increased risk of suicide during and after the COVID-19 pandemic, rates of suicide deaths remained stable or decreased over that period for most countries. In contrast, the prevalence of suicidal ideation doubled and suicide attempts slightly increased during the COVID-19 pandemic in the adult general population worldwide, accompanied by a higher prevalence of major depressive disorder and anxiety disorders. While these data can tell us what happened, they cannot tell us why. Qualitative suicide research seeks to understand experiences of individuals with suicide-related thoughts and behaviours, provides an in-depth exploration of their lives and interactions with others and centres their views and unique context. There is little qualitative research focusing on suicidality during the pandemic. This study will use a qualitative approach to explore the extent and impact of the COVID-19 pandemic on Canadians who experienced suicidality and review their experiences of accessing mental healthcare to identify key components in supporting safety and recovery.

This study will involve approximately 100 semistructured interviews with participants across four Canadian provinces and will explore experiences with suicide-related thoughts and behaviours during the COVID-19 pandemic. Transcripts will be analysed through qualitative analysis informed by constructivist grounded theory.

The study was approved by the Research Ethics Board of the Centre for Addiction and Mental Health, Toronto Academic Health Sciences Network (for JZ: CAMH REB No 104-2022). In addition to traditional peer-reviewed presentations and publications, a report will make study findings accessible to policy makers, media and the public.

Anxiety and depression are among the top contributors to disability in the Kingdom of Saudi Arabia (KSA), but little is known about their economic impact. This study estimates the economic burden of moderate to severe symptoms of anxiety and depression among adults in KSA.

A cross-sectional survey was administered via a web panel. Participants were asked to fill out the Patient Health Questionnaire-4 (PHQ-4) for themselves and on behalf of other household members to capture prevalence rates. Those who reported at least moderate symptoms of anxiety or depression filled out a longer survey with questions on healthcare utilisation and productivity losses due to symptoms. These responses were monetised using prevalence rates and population estimates to calculate per-person and total annual costs.

Prevalence estimates are based on responses from 1164 participants on behalf of 3202 Saudi adults. Of these, 269 individuals with symptoms completed the longer survey.

Prevalence of anxiety and depression; healthcare utilisation (medications, outpatient, inpatient) and productivity losses due to absenteeism and presenteeism.

In total, 26.2% reported at least moderate symptoms consistent with anxiety and/or depression. Among those with symptoms, direct healthcare costs due to anxiety and depression averaged Saudi riyal (SAR) 3431.95 per person annually. Indirect costs via absenteeism and presenteeism averaged SAR 9702.87 and SAR 24 577.28 per person assuming that anxiety and/or depression episodes last for 6 months. Summing up the healthcare costs and productivity losses yields a total annual economic burden of SAR 163.3 billion. Absenteeism accounts for 24.8% of this total (SAR 40.5 billion), presenteeism accounts for 62.8% (SAR 102.5 billion) and healthcare resource utilisation accounts for 12.4%(SAR 20.3 billion).

The overall prevalence of anxiety and depression in KSA is estimated at 26.2%. The economic burden associated with these symptoms amounts to SAR 163.3 billion or 4.1% of GDP. Absenteeism and presenteeism costs account for the vast majority of the total, but a large percentage (nearly 60%) also report emergency department visits and unplanned hospital admissions. Evidence-based interventions should be considered to address the health and economic burden of these conditions in KSA.

Children and adolescents in sub-Saharan Africa (SSA) experience exceptionally high levels of trauma, including experiencing multiple forms of abuse and witnessing violence. Exposure to such traumatic events may lead to the development of post-traumatic stress disorder (PTSD), or other health-related or behaviour-related harms. Untreated PTSD in adolescents results in significant impairments in their adaptive, social, emotional and academic functioning. To date, various intervention strategies have been developed internationally to reduce the severity of PTSD symptoms among children and adolescents. However, despite the documented mental health burden, there is limited evidence of culturally and contextually appropriate PTSD interventions in SSA. The objective of this scoping review is to investigate the evidence-based treatments available for adolescents diagnosed with PTSD in SAA. This investigation includes evaluating whether identified treatments were considered culturally and contextually appropriate.

This scoping review will follow the methodological framework proposed by Arksey and O’Malley. This framework outlines six essential stages for conducting scoping reviews: (1) Defining the research question, (2) Locating pertinent studies, (3) Study selection, (4) Charting the data, (5) Collating, summarising and reporting the results and (6) Consulting with stakeholders. Findings will be presented using the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews guidelines. Major databases, including PubMed (Medline), Scopus Academic Search Premier, Africa-Wide Information, Cumulative Index to Nursing and Allied Health Literature, Education Resources Information Centre, Healthsource: Nursing/Academic, PsycINFO, PsycARTICLES and SocINDEX will be searched.

This review will not involve the collection of primary data from human participants. While formal ethics approval is not required, permission to conduct the study has been obtained from the Human Research Ethics Committee of the Faculty of Health Sciences at the University of Cape Town. The results of the scoping review will be submitted to a relevant academic journal, including presentations at relevant conferences, to contribute to academic literature and inform future research.

Mentalising, the capacity to understand behaviour via underlying mental states, is a key construct in psychopathology. While self-report instruments are widely used to assess mentalising, significant questions about their psychometric properties persist and no systematic review has comprehensively evaluated them using standardised criteria. This systematic review, guided by the COnsensus-based Standards for the selection of health Measurement Instruments () methodology, aims to: (1) identify all available self-report mentalising measures for adults; (2) evaluate the methodological quality of their validation studies; (3) synthesise and grade the quality of evidence on their measurement properties and (4) provide evidence-based recommendations for their use in research and clinical practice.

Five electronic databases (SCOPUS, Web of Science, PsycINFO, PubMed, ProQuest) will be searched from their inception, supplemented by a search of grey literature and reference lists. We will include studies of any design that report on at least one measurement property of a self-report measure of mentalising in adults. Two reviewers will independently screen all records, extract relevant data and assess the methodological quality of included studies using the COSMIN Risk of Bias checklist. For each instrument, the evidence for each measurement property will be synthesised, and the overall quality of the evidence will be graded using a modified Grading of Recommendations Assessment, Development and Evaluation approach.

As this systematic review will synthesise data from previously published studies, it does not require formal ethical approval. The findings will be disseminated through a peer-reviewed, open-access publication and presentations at scientific conferences. The results will provide a comprehensive inventory of available measures and a rigorous evaluation of their psychometric quality, creating an evidence base to guide clinicians and researchers in selecting the most appropriate instruments for mentalising assessment.

CRD420251031469.

Psychiatric conditions require long-term maintenance, and people with mental illness are often involved in care provided by multiple service providers. At the same time, reports indicate that people with mental illness and comorbid physical health conditions often fail to get their needs met in current systems. For example, coordinated support within the mesosystem is rarely available, and mesosystem fragmentation often results in individual suffering as well as inefficient use of societal resources. Meanwhile, integrated services, where collaboration is important, have shown superior effectiveness compared with services and support delivered in parallel silos. This contradictory image needs further investigation, and there is a need for a better understanding of the dynamics and complexities of collaboration within the mesosystem.

This review aims to map the mesosystem for services and support for people with mental illnesses. The review will seek to answer questions such as who are the actors (formal and informal) in the mental health services and support mesosystem, and how are collaborations among actors organised and implemented? To synthesise qualitative, quantitative and mixed methods findings, it uses a systematic integrative methodology. Searches will be conducted in PubMed, PsycINFO, CINAHL and Web of Science between 17th June and 21st 2024. Data will be extracted and synthesised using Covidence software. Two blinded researchers will make determinations regarding the inclusion and exclusion of articles. The subsequent process of analysis will be jointly conducted by the whole research team. Preferred Reporting Items for Systematic Reviews and Meta-Analyses tools for quality assessments will be used.

Articles included in the review will be analysed through an ethical lens, making sure that ethical considerations have been made where applicable. The study will result in a scientific publication in a peer-reviewed journal.

The study is registered in PROSPERO, no CRD42024543891.

This study was designed to explore the potential categories and their characteristics of self-compassion in Chinese enterostomy patients and then to investigate related factors.

A cross-sectional study.

The research focused on enterostomy patients who were hospitalised in two tertiary hospitals in Yangzhou City, China, between Nov 2022 and Aug 2023.

222 adult enterostomy patients in China completed the questionnaires.

This study investigated scores from the Self-Compassion Scale, Perceived Stress Scale and the Social Support Rating Scale. Information on the patients included: age, gender, marital status, monthly household income, types of medical insurance, education level, place of residence, enterostomy complications, postoperative time and whether adjuvant chemotherapy was given.

Three profiles of self-compassion in enterostomy patients were identified: ‘low self-compassion group’ (class 1), ‘moderate self-compassion group’ (class 2) and ‘high self-compassion group’ (class 3), accounting for 40.5%, 28.0% and 31.5%, respectively. The multivariate logistic analysis showed adjuvant chemotherapy, social support (PP

There is significant heterogeneity in self-compassion among enterostomy patients, and nearly half of them belong to the ‘low self-compassion group’. Focused interventions are required for females, patients with permanent enterostomy, low educational level and undergoing adjuvant radiotherapy. The self-compassion ability of patients can be effectively improved by reducing perceived stress and enhancing social support. These findings provide a basis for constructing targeted intervention strategies.

Mental health issues such as depression and anxiety are highly and disproportionally prevalent among university students. Beyond the academic rigour, stressors imposed by a new environment result in them being vulnerable to the onset and manifestation of mental health symptomatology. Leveraging smartphones and wearables for digital phenotyping capabilities is an innovative approach for monitoring and intervening in the mental health conditions of university students. This provides a unique opportunity to collect and identify digital and behavioural biomarkers, subsequently enabling the development of predictive models to identify university students at risk.

This study—Brightline—will employ an observational study design over a 6-month period, recruiting 500 students from a major public university in Singapore. Passive data collection will occur continuously throughout the monitoring period through a wearable device (Fitbit Charge 6) and smartphone sensors via the Brightline app, which uses a digital phenotyping data collection platform. Active data collection will consist of self-report questionnaires to be completed at the beginning of the study and follow-up assessments at 1, 3 and 6 months after. The passive and active data collected will be analysed to identify the digital biomarkers associated with depression, anxiety, stress, loneliness and affect among university students. Predictive models of these mental health issues will also be developed.

This study was approved by the Nanyang Technological University Institutional Review Board (IRB-2023-894). Findings from this study will be published in peer-reviewed journals and presented at academic conferences.

NCT06770075.

Although poor mental health among young people has been increasing in the past decades, many young people are reluctant to use traditional mental healthcare. To cater to the needs of young people, various youth-friendly treatment options have been developed. These include the youth-friendly health service (YFHS) standards put forth by the WHO in 2012 and the integrated youth services (IYS) for mental health developed in certain countries globally. However, no synthesis of the effect of these services on youth mental health has been conducted. The aim of the proposed study is to conduct a systematic review of the effect of mental health treatments conducted within YFHS and IYS clinics. The primary research question is what effect mental health interventions given at ‘youth-friendly’ clinics for treating mental health, such as IYS and YFHS, have on the mental health and quality of life (QoL) of young people?

A preliminary search for other reviews on the topic was conducted during the first half of 2024, after which a protocol of the present study was registered in PROSPERO. In May 2024, a search was carried out in the PubMed, PsycINFO, CINAHL and Web of Science databases, which gave references for 12 738 papers to be screened for inclusion in the review, and a follow-up search was carried out in April 2025, yielding a further 2182 references. For inclusion, studies must have participants between 12 and 25 years of age; interventions be given at clinics designed to be ‘youth-friendly’ or given at an IYS; control condition, if any, consisting of standard care or waiting list; outcomes must be mental health symptomology or QoL. To be included, studies must be published from 2012 and onwards. Screening of titles and abstracts in the initial search was carried out independently by two reviewers. Screening of studies found in the follow-up search and in the reference lists of included articles will be carried out in the same way. Data analysis of the initial search was conducted in the latter half of 2024, while final data analysis including the results from the follow-up search is ongoing. The Cochrane risk of bias assessment tools will be used to assess bias of included articles, and certainty of the evidence will be evaluated according to the GRADE methodology. A meta-analysis of the results will be performed if a sufficient amount of homogenous data is found; otherwise, a synthesis without meta-analysis will be conducted.

The proposed review may form a valuable synthesis of the state of the art of treatment options catering to young people. Investigating the effectiveness of YFHS or IYS in treating young people’s mental health may inform future directions for development and research. The present study does not need ethical approval, since only previously published, ethically approved data are used in the current study. The findings of the study will be disseminated through submissions to peer-reviewed journals and international conferences, as well as disseminated within the Swedish YFHS community.

ID nr CRD42024528687.

The gig economy is a promising arena to reduce unemployment and provide other benefits such as the opportunity to earn supplemental income. Like all other forms of work, the gig space also presents occupational health issues for those working in it. This proposed review is aimed at identifying and describing the common occupational health outcomes reported within this workforce; second, to examine the risk factors that contribute to the development of these health issues; and third, to assess the interventions and support systems currently in place to promote the occupational health of gig workers.

A systematic review will be undertaken according to the recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Statement (2009). A search from 2015 to 2025 will be conducted on four global databases (Web of Science, SCOPUS, Academic Source Complete and Business Source Complete). Only records in English, full text and peer-reviewed journal articles will be included. Book chapters, thesis, reports and systematic reviews will be excluded. The Joanna Briggs Institute Critical Appraisal Tools will be used to assess the methodological rigour of various studies prior to inclusion for the final analysis. The extracted data will be synthesised using a narrative synthesis approach, integrating findings from both quantitative and qualitative studies.

This research is exempt from ethics approval because the work will be carried out on published documents. We will disseminate this protocol in a related peer-reviewed journal.

CRD420250654059.

Poststroke depression affects approximately 30% of stroke survivors and is linked to worse functional outcomes, cognitive decline, reduced quality of life and increased mortality. While early treatment of poststroke mental health conditions is critical, current pharmacological options offer limited efficacy. Music listening interventions are a promising, low-risk, accessible and affordable alternative that may enhance recovery through engagement of reward-related brain circuits. However, most music listening studies have focused on the acute stage of stroke, lack objective measures of music engagement and rarely assess underlying neural mechanisms. To address these gaps, we propose a feasibility study of a remotely delivered music-listening intervention for individuals with chronic stroke, incorporating objective tracking of music exposure and multimodal assessments of mental health, cognitive, neural and physiological changes.

We will conduct a parallel group randomised controlled feasibility trial enrolling 60 patients with chronic stroke from a well-characterised stroke registry in New York City. Participants will be randomised to either an intentional music listening (IML) group or an active control group that listens to audiobooks. The study includes a 4-week preintervention period during which no treatment is administered; this phase is designed to assess the stability of outcome measures. Following this, participants will engage in 1-hour daily listening sessions over a 4-week intervention period. All listening activity (ie, track identity, duration and engagement) will be continuously tracked using custom open-source software, providing a measure of treatment dose. Behavioural outcomes related to mental health will be assessed at baseline, preintervention, postintervention and 3-month follow-up. Multimodal biomarkers (functional and structural MRI, electrodermal activity and heart rate) will be collected preintervention and postintervention. The primary objective is to establish feasibility, defined by rates of retention and adherence, treatment fidelity, feasibility, acceptability and participant burden. Secondary outcomes include recruitment and randomisation rates. This trial will provide essential data to inform the design of future large-scale clinical studies of IML for poststroke mental health recovery.

The study was approved by New York University’s Institutional Review Board (FY2024-8826). All human participants will provide written informed consent prior to participation and will be adequately compensated for their time. Results will be reported in peer-reviewed journals.

NCT07127159.

This study aimed to assess the prevalence of depression and anxiety and to identify factors associated with these conditions among caregivers of children and adolescents with epilepsy attending the paediatric neurology clinic at Muhimbili National Hospital (MNH) in Tanzania.

A hospital-based cross-sectional study.

The paediatric neurology clinic of a national referral hospital in Dar es Salaam, Tanzania.

427 caregivers of children with epilepsy (CWE) were consecutively enrolled. Eligibility criteria included being 18 years or older and having provided care for the child for at least 6 months. Caregivers unable to read and write in Swahili or previously diagnosed with a mental illness before assuming the caregiving role were excluded.

Primary outcomes were the prevalence of depression (assessed with the Patient Health Questionnaire-9 (PHQ-9), cut-off ≥10), anxiety (assessed with the Generalised Anxiety Disorder-7 tool (GAD-7), cut-off ≥10), and their co-occurrence. Secondary outcomes were the factors associated with these conditions, analysed using logistic regression and reported as adjusted odds ratios (aORs).

Depression was observed in 74 (17.3%, 95% CI: 13.8 to 21.3) participants and anxiety was found in 74 caregivers (17.3%,95% CI: 14.1 to 20.8). 38 (9.0%, 95% CI: 6.3 to 11.7) participants had concurrent depression and anxiety. Factors associated with depression were having a child: less than 5 years old (adjusted OR (aOR)=6.56, p=0.012), epilepsy duration of more than 5 years (aOR=2.80, p=0.048), history of epilepsy-related injuries (aOR=2.64, p=0.015) and three or more admissions (aOR=2.56, p=0.046). Caregivers whose children had not started school or were in primary school had lower odds of depression compared with counterparts in secondary school (aOR=0.02, p=0.003) and (aOR=0.03, p=0.005), respectively. Caregivers' anxiety was associated with having a child with: another comorbidity (aOR=1.93, p=0.020), a history of epilepsy-related injuries (aOR=2.37, p=0.030), three or more admissions (aOR=2.98, p=0.015) and caregiver age between 41 to 50 years (aOR=3.06, p=0.042).

Depression and anxiety are prevalent among caregivers of CWE. The findings indicate a need for the integration of mental health services within paediatric neurology clinics to support caregiver well-being.

With the COVID-19 pandemic driving people into social isolation, causing a financial crisis and creating uncertainty, individuals were at an even greater risk of experiencing negative mental health outcomes. Individuals who identify as women living with diabetes mellitus (DM) of low socioeconomic status (SES) are potentially at increased risk of negative mental health outcomes secondary to health-related risks of COVID-19, as well as financial barriers to access to medications and diabetes-care supplies.

The objective of this scoping review is to investigate how the COVID-19 pandemic affected the mental health of those who identify as women living with DM of low SES including the consequences of public health measures put in place to stop the spread of the virus. The review aims to identify what is known about the impact of COVID-19 on this and identify potential areas for further investigation.

The scoping review protocol was developed with guidance from the framework created by Arksey and O’Malley and refinements from the Joanna Briggs Institute and Levac et al published studies employing experimental and correlational designs to collect quantitative and/or qualitative data will be considered. Search strategies were developed for the MEDLINE, Embase and PsycINFO databases to identify relevant sources. Article titles and abstracts will be screened for eligibility by two independent reviewers. Full-text review will be conducted by two reviewers with a third reviewer being included if disagreement must be resolved. Data extraction will be conducted by two reviewers, one extraction and one quality check, and a third will resolve conflict if necessary. Data will be synthesised and reported in a narrative structure that provides a thematic analysis of the currently available literature.

As this is a scoping review, there are no ethical approval requirements. There is to be a full publication of findings and analysis in a peer-reviewed journal.

In deprived urban areas of South America, young people face heightened risks of mental disorders. Research suggests an association exists between social media engagement (SME), depression and anxiety.

This study explored the associations of SME with symptoms of depression, anxiety and subjective quality of life among young people from South American deprived urban areas.

Our cross-sectional survey study used an adapted version of the Multidimensional Facebook Intensity Scale to categorise 2399 participants into four SME groups: low, moderate, high and very high. Symptoms of depression (Patient Health Questionnaire-8), anxiety (Generalised Anxiety Disorder-7) and quality of life (Manchester Short Assessment) were assessed and compared using F and Tukey tests.

Each step of increased SME was associated with more symptoms of depression and anxiety and poorer quality of life. Statistically significant differences were observed across all groups (p

The findings suggest an association exists between SME, increased mental distress and lower quality of life in young people from deprived South American urban areas. This influence seems to apply across the spectrum of engagement levels, not only to extremes. However, due to the cross-sectional nature of the study, causal relationships cannot be established.

SME should be explored in clinical settings, as lower levels are associated with lower symptom levels and better quality of life. Policies addressing youth SME should be developed and evaluated in the challenging contexts of deprived urban areas.