Objectives: This systematic review aimed to explore the available support and identify the unique needs of young and young adult carers of individuals with dementia. Method: A systematic review following PRISMA guidelines was conducted. Electronic databases, including PubMed, Web of Science, PsycINFO, CINAHL, and Ovid, along with Google Scholar for grey literature, were searched. A narrative synthesis approach was used to analyse the findings of the included studies. The quality of the articles was assessed using the Mixed Methods Appraisal Tool (MMAT). Results: Seven studies met the predefined inclusion criteria and were included in the narrative synthesis. Findings revealed that young and young adult carers often lack knowledge of available support services and face challenges navigating the healthcare system. Caregiving responsibilities were found to hinder educational and career aspirations, leading to social isolation and strained relationships. The support received from family, friends, and teachers was often inconsistent and inadequate. A significant finding was the lack of differentiation between young and young adult carers in the existing research, despite their distinct social care support needs. Conclusion: The limited research highlights a critical gap in the literature regarding the support and needs of young and young adult carers of people with dementia. The lack of distinction between these two groups, who receive different social care support, emphasises the need for further research to better understand their unique experiences. There is an urgent need for targeted education and support programmes that address the distinct developmental needs and challenges of this population, promoting their well-being and safeguarding their personal and educational aspirations.

Background: A false division between mental and physical disorders is supported by dualism, contributing to mental health stigma. There is a widespread misconception about the prognosis and treatment options for psychiatric diseases. This is despite data supporting the effectiveness of psychiatric treatments for a variety of illnesses that have been proven by meta-analysis. In general, the efficacy of drugs used to treat physical problems and psychiatric disorders is comparable. Method(s): In this article, experts from a variety of fields-including psychiatry, primary care, and general medicine-highlight how the paradigms based on dualism play a crucial role in maintaining the myths regarding psychiatric disorders, particularly those that relate to their treatability in comparison to physical health conditions. Result(s): There are numerous similarities between mental and physical problems in terms of the causes and treatment. Healthcare, like other complex human systems, is rife with uncertainty. In actuality, the severity and treatability of both physical and mental diseases range widely. Treatment response varies from person to person. There are certain physical and mental health disorders that respond well to treatment, some that do not, and some for which there are currently no effective cures. Conclusion(s): We believe that dualism, which promotes the separation of mental and physical phenomena, is the core driving force behind these misconceptions. These fallacies, in our opinion, are primarily motivated by dualism, which advocates the division of mental from physical occurrences. Copyright © 2025 Latoo, Mistry, Alabdulla, Jan, Shariful Islam, Iqbal, et al.

Aim The current study explored the influence of therapists' self-reported attachment strategies on their therapeutic relationships with clients. Methods Twelve therapists working with individuals with complex trauma were interviewed and Thematic Analysis was used to generate themes from the data. Results Key findings identified a distinction between the therapeutic alliance and a secure attachment, based on the relationship's capacity to tolerate rupture. The study found that therapists' own attachment strategies affected empathy towards clients and how the underlying process may be related to identification, where over-identification was unhelpful. The study also identified, how therapists responded to client anger was related to their attachment strategies. Whilst avoidant/dismissive therapists were better able to contain client anger, this had the potential to impact upon attunement. Findings challenged the widely accepted view of therapists needing a secure attachment, rather warmth and proximity elicited negative responses from some clients. An unexpected finding was therapists' motivations and identified the therapeutic relationship as meeting the needs of some therapists. Conclusions Findings reinforce the premise of counselling psychology for reflective functioning and recommend that therapists acknowledge their own attachment strategies and wounds. A better understanding into these processes may enhance the therapeutic relationship and improve treatment outcome.

The COVID-19 pandemic negatively impacted the mental health of people with emotionally unstable personality disorder (EUPD), with reports of maladaptive coping mechanisms, reduced mental health support and quality of life. In this study, the authors examine the impact of COVID-19 lockdown and post-lockdown period on acute psychiatric admission rates in an NHS Trust in people diagnosed with EUPD. In addition, the authors analyse whether patient profiles and the seasonal pattern of admission were impacted by COVID-19 in this population. The study highlights the need for preventative clinical care pathways with increased access and service responsiveness, adjusted to fit local needs at times of confinement policies and additionally more research into seasonal patterns of admission in those with EUPD.

Background Transcranial magnetic stimulation may lead to short-term improvement in depression symptoms. Pilot work suggested that personalised magnetic resonance imaging connectivity-guided intermittent theta burst stimulation might lead to sustained improvement in depression symptoms in treatment-resistant depression. Objectives To determine the efficacy, acceptability, and cost-effectiveness of connectivity-guided intermittent theta burst stimulation over 8, 16 and 26 weeks on depression symptoms (Hamilton Rating Scale for Depression-17) compared with repetitive transcranial magnetic stimulation. To explore the mechanism of action of transcranial magnetic stimulation through effective and functional connectivity, and gamma-aminobutyric acid and glutamate+glutamine in the prefrontal cortex, subgenual anterior cingulate cortex and right anterior insula. Design A multicentre parallel group, double-blind, randomised controlled trial, to test the efficacy of connectivity-guided intermittent theta burst stimulation versus repetitive transcranial magnetic stimulation without connectivity guidance, in patients with moderate to severe treatment-resistant major depressive disorder (treatment-resistant depression). Setting Secondary care mental health services across five study sites. Participants Aged 18 years or over with major depressive disorder, Massachusetts General Hospital Treatment Resistant Depression staging score ≥ 2, and Hamilton Rating Scale for Depression-17 score ≥ 16. Exclusions: bipolar disorder, secondary depression, suicidality, current substance abuse or dependence, neurological conditions, prior brain surgery, major unstable medical illness, standard contraindications to magnetic resonance imaging, change in prescribed medication or benzodiazepines or hypnotics ≥ 5 mgdiazepam equivalents daily in 2 weeks before baseline. Trial interventions In total 3000 pulses were delivered in each 37.5-minute repetitive transcranial magnetic stimulation or connectivity-guided intermittent theta burst stimulation session for 20 sessions over 4–6 weeks. Personalised transcranial magnetic stimulation stimulation targets were identified from magnetic resonance imaging (F3 site for repetitive transcranial magnetic stimulation, maximum effective connectivity from right anterior insula to left dorsolateral prefrontal cortex for connectivity-guided intermittent theta burst stimulation) using neuronavigation to deliver transcranial magnetic stimulation. Main outcome measures The primary outcome measure was mean change in depression symptoms from baseline and at 8, 16 and 26 weeks using the Grid version of the Hamilton Rating Scale for Depression-17. Secondary outcomes were response, remission, sustained response, self-rated depression (Patient Health Questionnaire-9, Beck Depression Inventory-II), generalised anxiety-7, function (Work and Social Adjustment Scale), quality of life (Euroqol five-dimension five line), overall improvement (Euroqol five-dimension five-line scale), acceptability, with cognition (THINC-it battery), resting state functional magnetic resonance imaging and magnetic resonance spectroscopy (baseline and 16 weeks) and costs from health and society perspectives. Results A total of 255 participants were randomised (128 connectivity-guided intermittent theta burst stimulation, 127 repetitive transcranial magnetic stimulation). There were no significant differences between repetitive transcranial magnetic stimulation and connectivity-guided intermittent theta burst stimulation in the Hamilton Rating Scale for Depression-17 score [intention-to-treat adjusted mean −0.31 (95% confidence interval −1.87 to 1.24)] nor on any secondary outcome. Sustained response rates at 26 weeks were 22/127 (17.3%) repetitive transcranial magnetic stimulation, and 29/128 (22.7%) connectivity-guided intermittent theta burst stimulation. Connectivity-guided intermittent theta burst stimulation was dominant over repetitive transcranial magnetic stimulation in cost-effectiveness (0.009 greater quality-adjusted life-year gain and £180 greater cost saving to health services per individual), albeit overlapping 95% confidence interval between treatment groups demonstrates uncertainties. One serious adverse event in each group (mania, psychosis) was attributable to transcranial magnetic stimulation. Both treatments were equally acceptable. Clinical improvement was associated with measures of effective or functional connectivity between left dorsolateral prefrontal cortex and right anterior insula, subgenual anterior cingulate cortex and left dorsomedial prefrontal cortex, and spectroscopy baseline gamma-aminobutyric acid. Limitations Participants may have benefited from > 20 transcranial magnetic stimulation sessions. There was no sham control group. Conclusion Connectivity-guided intermittent TBS was not superior in efficacy to standard repetitive transcranial magnetic stimulation. Magnetic resonance imaging neuronavigation personalised repetitive transcranial magnetic stimulation or intermittent theta burst stimulation are acceptable methods to reduce depression symptoms over 26 weeks in treatment-resistant depression alongside other reasons for improvement. Study registration Current Controlled Trials ISRCTN19674644. Funding This award was funded by the National Institute for Health and Care Research (NIHR) Efficacy and Mechanism Evaluation (EME) programme (NIHR award ref: 16/44/22) and is published in full in Efficacy and Mechanism Evaluation; Vol. 12, No. 2. See the NIHR Funding and Awards website for further award information.

Background: People who experience severe mental illness (SMI) have a high prevalence of depression symptoms, which is linked to worse functioning and quality of life. Research evidence indicates that transcranial direct current stimulation (tDCS) can reduce symptoms of depression. Flow FL-100 is a transcranial direct current stimulation (tDCS) device self-administered by a patient at home in combination with a software application that delivered wellbeing behaviour therapy training. Purpose/Aim: This study investigates if Flow can be introduced to a Community Mental Health Team (CMHT) service and the impact of Flow in treating depression. The study addresses the questions: “what are the depression reliable improvement and remission rates?” and “can Flow significantly reduce depressive symptoms and improve real world functioning (everyday, social and occupational functioning) and health-related quality of life?”. Methods: An open-label patient cohort design with no control group. Pre-intervention and 6-week follow-up intervention assessments using the participant self-report measures: Patient Health Questionnaire (PHQ-9), Work and Social Adjustment Scale (WSAS), and EuroQol five-dimension (EQ-5D-5L). Participants were 31 CMHT patients, 15 males and 16 females, with an age range of 21 to 64 years, and average age of 42 years. Results: PHQ-9 reliable improvement and remission rates were 51.61% and 12.9%, respectively. PHQ-9 scores significantly improved, from 20.9 (SD 5.55) to 14.6 (SD 7.33) at 6 weeks, with large effect size. WSAS scores improved from 31.3 (SD 6.02) to 22.5 (SD 11.43) at 6 weeks, with large effect size. EQ-5D-5L results showed significant improvements in the health index score, and three EQ-5D-5L dimensions (“mobility”, “self-care”, and “pain”). Conclusion: Flow tDCS treatment was integrated into a CMHT service and was found to be beneficial in terms of improving functioning and quality of life and reducing depression symptoms. Flow FL100 tDCS and wellbeing behaviour therapy training could be offered through all CMHT services to people with SMI to treat depression, enable better functioning, and improve quality of life.

Background: Transcranial direct current stimulation (tDCS) has research evidence that it can reduce symptoms of depression. Flow FL-100 is a transcranial direct current stimulation (tDCS) device self-administered by a patient at home in combination with a software application that delivers wellbeing behaviour therapy training. Purpose/aim: The purpose of this study was to investigate if Flow can be introduced to a Crisis Resolution & Home Treatment (CRT) service and the impact of Flow in treating depression. The study addresses the questions: 1) “what are the depression reliable improvement and remission rates?” and 2) “can Flow significantly reduce depressive symptoms and improve real world functioning (every-day, social and occupational functioning) and health-related quality of life?”. Methods: An open-label patient cohort design with no control group. Pre-intervention and 6-week follow-up intervention assessments using the participant self-report measures: Patient Health Questionnaire (PHQ-9), Work and Social Adjustment Scale (WSAS), and EuroQol five-dimension (EQ-5D-5L). Participants were 49 CRT patients, 19 males and 30 females, with an age range of 20 to 66 years, and average age of 42 years. Results: PHQ-9 reliable improvement and remission rates were 57.1% and 14.3%. PHQ-9 scores significantly improved, from 23.1 (SD 3.44) to 14.8 (SD 6.82) at 6 weeks, with a large effect size. PHQ-9 suicide/self-harm related question significantly improved from 2.51 (SD 0.77) to 1.08 (SD 1.17), with a large effect size. WSAS scores significantly improved, from 33.6 (SD 5.22) to 21.9 (SD 10.82) at 6 weeks, with a large effect size. EQ-5D-5L results showed significant improvements in the health index score, global assessment of health EQ-VAS from 34.2 (22.26) to 51.6 (24.95), and three EQ-5D-5L dimensions (“self-care”, “usual activity”, and “anxiety/depression”). Conclusion: A CRT service effectively integrated Flow tDCS treatment. Flow was beneficial in terms of improving functioning and quality of life and reducing depression symptoms and thoughts of suicide/self-harm. Flow FL100 tDCS and wellbeing behaviour therapy training could be offered through all CRT services to treat depression, reduce thoughts of suicide/self-harm, enable better functioning, and improve quality of life.

Purpose The purpose of this paper is to examine the psychometric characteristics of male offenders who joined a democratic therapeutic community and their relationship to attrition. Design/methodology/approach Residents who left therapy prematurely during the assessment phase (N = 46) and residents who left therapy prematurely during core therapy (N = 202) were compared to residents who completed therapy (N = 52) on two psychometric measures: Raven’s Standard Progressive Matrices and The Blame Attribution Inventory. Findings A multinomial logistic regression analysis showed higher levels of external blame can predict attrition during therapy; those with higher levels of external attribution are significantly more likely to leave therapy prematurely, including both during the assessment phase and during core therapy. Raven's Standard Progressive Matrices score did not significantly predict whether an individual left therapy prematurely. Originality/value Support was found for existing research within the academic evidence base. The findings have both empirical and clinical utility, suggesting during the assessment phase of therapy, practitioners can identify residents that may require additional support to maintain engagement, minimising the potential for premature departure. The implications of the findings are discussed, with suggestions made for future research.

Background The current research builds on a previous review of the literature which explored sexuality during gender transition. There has been increased attention toward TGNC people across academic, political, and healthcare fields since the previous review, as well as shifts in language use and health interventions, justifying a need for more contemporary understandings. Aim The current systematic review explores the experience of sexuality during gender transition. Methods A meta-ethnography was conducted on 16 papers that focused specifically on TGNC people’s experiences of their sexualities. Results The main findings were the intersection of gender and sexuality; the importance of re-writing labels around sexuality, bodies and relationships; (re)negotiating changes in sexual, romantic and/or physical relationships due to transitioning; and changes in a sense of community and belonging. Discussion The results have implications for supporting TGNC people navigating their identities by recognizing the multiple and intersecting levels of influence within which they are situated.