http://hdl.handle.net/20.500.12904/17286 2026-03-16T03:22:33Z http://hdl.handle.net/20.500.12904/20125 Real-world effectiveness of self-administered transcranial direct current stimulation (tDCS) for depression: a retrospective cohort study Mu, Mu; Banazadeh, Aria; Cauchi, Michael; Griffiths, Chris Background Flow FL-100 is a transcranial direct current stimulation (tDCS) device self-administered by users at home. The retrospective analysis examined real-world usage and effectiveness of Flow tDCS treatment using data from 14,726 users collected by Flow Neuroscience AB between 2020 and 2024. Methods Self-reported user background information and Montgomery-Åsberg Depression Rating Scale Self (MADRS-S) scores up to week 50 of the treatment were analysed. Effectiveness metrics (remission, response, and relapse rates) were assessed at pre-treatment baseline followed by week 3, 6, 10, 15, 20, and 50. Repeated-measures ANOVA, post-hoc and between-subject analysis were used to examine the change in MADRS-S over time and the influence of user background factors. Outcomes The reported mean MADRS-S score decreased from a moderate level before treatment to a mild level at week 10 and then plateaued thereafter. Response and remission rates increased between week 3 and week 10, then stabilised through to week 50. A repeated measures ANOVA and post-hoc test reveal statistically significant differences (p < 0.0001) in MADRS-S scores across multiple time points. Reduction in reported depressive symptoms was observed during the initial weeks of treatment, these levels were maintained throughout the subsequent weeks. User adherence and background factors were significantly associated (p ≤ 0.005) with changes in MADRS-S scores during the first 10 weeks of treatment. Interpretations Users of self-administered Flow tDCS treatment reported a rapid initial improvement and long-term reduction of depressive symptoms. Observed variability in adherence and response across diverse user groups suggests potential benefits from personalised treatment protocols and support. 2026-04-01T00:00:00Z http://hdl.handle.net/20.500.12904/20124 Lamotrigine-induced DRESS syndrome with myelosuppression in a patient with bipolar disorder: case report Kelbrick, Marlene; Mustafa, Feras Ali; Wilson, Helen; Nyadzayo, Lynn; Ibrahim, David; Paduret, Gabriela Lamotrigine-induced DRESS syndrome is a potentially fatal drug reaction with variable clinical presentation and complications requiring early recognition and rapid response. 2026-01-01T00:00:00Z http://hdl.handle.net/20.500.12904/20123 Community sentence with mental health treatment requirement (MHTR): an exploration of offenders’ engagement, experience, and outcomes Walker, Kate; Griffiths, Chris; Coelho, Liv The Mental Health Treatment Requirement (MHTR) is a sentencing option for offenders where mental health is linked to offending and is delivered by clinical psychologists. An interpretative phenomenological analysis of interviews with 14 MHTR service users explored factors promoting engagement and perceived change. Three superordinate themes were identified: experiences of safety, support, and personal fit facilitating engagement; mechanisms of change through developing tools, insight, and emotional regulation; and shifts in identity, relationships, and lifestyle. Findings highlight the importance of a strong therapeutic alliance, individualized and flexible delivery, and suggest MHTRs can improve mental health, self-worth, and reduce reoffending. 2026-01-01T00:00:00Z http://hdl.handle.net/20.500.12904/20118 The impact of the mental health treatment requirement (MHTR) service on psychological distress, mental health recovery-related quality of life, and shame of individuals convicted of a criminal offence Griffiths, Chris; Walker, Kate; Coelho, Liv; Pinto, Regina; Sarai, Jasmine; Andrew, Megan; Hopkins-Young, Olivia; Giddings, Laura; Jiang, Harmony; House, Elliott; Pereira Cunha, Maiara Background: The Mental Health Treatment Requirement (MHTR) is a court sentencing option for individuals convicted of a criminal offence when there is a link between their mental health and offending which requires community-based treatment. To improve mental health and reduce reoffending, the MHTR service seeks to understand service users’ needs and goals and provides appropriate psychological therapy and connection with supportive community services. Aims: This study investigated the impact of an MHTR service on service users’ psychological distress, mental health recovery-related quality of life, and shame. Methods: The study design was open-label and did not have a control. Measures used were Clinical Outcomes in Routine Evaluation (CORE-34), Recovering Quality of Life (ReQoL-20), and Experience of Shame Scale (ESS). Participants: Twenty-one MHTR service user participants, thirteen males (62%) and eight females (38%). The ages ranged from 19 to 66 years, with an average age of 37 years. Results: At the end of the MHTR the CORE-34 and ReQol-20 scores significantly improved, with large effect sizes; all four CORE-34 domains (including “risk”) significantly improved. There was a significant improvement in ESS overall score with a moderate effect size; all three ESS domains significantly improved. CORE-34 reliable improvement was 76% and ReQoL-20 reliable improvement was 57%. CORE-34 remission rate was 24%. Conclusions: Improvements on the ReQoL-20 indicate the positive impact of MHTR on the individual’s mental health recovery, real-world functioning, and quality of life. CORE-34 improvements indicate a positive impact on reducing psychological distress and risk, which is associated with reducing reoffending. Improvements on the ESS indicate the positive impact of MHTR on reducing shame-related distress which is associated with reduced self-criticism, anger, and antisocial traits. Further research required has been identified. Evidence indicates that MHTR is effective in meeting its goals and should be appropriately resourced to meet demands. 2025-08-01T00:00:00Z