Mental health issues are prevalent among children and young people (CYP) with chronic conditions like epilepsy, yet few access evidence-based psychological therapies. Evidence from the Mental Health Intervention for Children with Epilepsy (MICE) trial supports the effectiveness of a personalised modular psychological intervention, but cost-effectiveness is unknown.

To assess the cost-effectiveness of the MICE intervention compared with assessment-enhanced usual care at 12-months follow-up, taking a health and social care perspective.

We conducted a within-trial economic evaluation. Outcomes were the Strengths and Difficulties Questionnaire (SDQ; primary) and quality-adjusted life years (QALYs; secondary) for CYP, caregivers, and CYP and caregivers combined. Sensitivity analyses examined missing data and intervention-costing assumptions.

Cost-effectiveness results for the SDQ indicated that MICE had a higher probability of being cost-effective compared with control at a willingness to pay ≥£368 per unit improvement. For QALYs, MICE had a lower probability of being cost-effective for CYP compared with control (35 to 42%) across the £20 000–£30 000 per QALY threshold range. However, at the upper threshold this finding was reversed in sensitivity analyses with missing data imputed (45 to 58%) and with MICE costed at 75%, assuming the intervention partly substituted standard services (46 to 55%). Furthermore, MICE had a higher probability of being cost-effective for caregiver QALYs (52 to 63%) and combined CYP and caregiver QALYs (62 to 75%).

MICE appears to be cost-effective compared with assessment-enhanced usual care when considering QALYs for CYP and caregivers combined, though uncertainty exists across willingness-to-pay thresholds.

Eating disorders, particularly anorexia nervosa and bulimia nervosa, are significant global health challenges.

This study analyses historical trends and forecasts future patterns of eating disorders among young adults aged 15–29 years using machine learning techniques.

Global data on anorexia nervosa and bulimia nervosa from the Global Burden of Disease study 2021 spanning 1990 to 2021 were analysed, examining incidence, prevalence and disability-adjusted life years (DALYs) across age groups, sociodemographic index (SDI) levels and regions. Eight machine-learning models were employed to forecast trends from 2022 to 2050.

Bulimia nervosa showed more pronounced increases compared to anorexia nervosa across all metrics. The 15–19 age group had the highest incidence rates, while the 20–24 age group showed the highest prevalence and DALY rates. Low SDI regions experienced substantial increases, with bulimia nervosa prevalence rising by 179.05%. East Asia demonstrated the most significant rise in age-standardised rates. The Prophet model best forecast anorexia nervosa trends, while ARIMA performed best for bulimia nervosa. Projections indicate continued increases through 2050 for both disorders.

The global burden of eating disorders among young adults is projected to increase significantly by 2050, with bulimia nervosa showing more rapid growth than anorexia nervosa. Substantial variations exist across age groups, SDI levels and regions. These findings highlight the urgent need for enhanced prevention programmes targeting high-risk age groups, strengthened healthcare capacity in rapidly developing regions and evidence-based policy interventions to address the growing global burden of eating disorders.

Various key events characterise experiences in later life, such as retirement, bereavement, caregiving, developing long-term conditions and hospital admission. Given their potential to disrupt lives, such events may affect older people’s mental health, but research on the associations between such events and depression has produced inconsistent findings.

To investigate the impact of key events in later life on depression trajectories in a representative cohort of people aged 50–69 in England.

Our sample draws on 6890 respondents aged 50–69 in Wave 1 (2002/2003) of the English Longitudinal Study of Ageing, following them through to Wave 9 (2018/2019). We measured depression using the eight-item Center for Epidemiological Studies Depression scale. Later life events included retirement, spouse/partner death, becoming an unpaid caregiver, developing a limiting long-term illness and hospital admissions because of a fall or non-fall causes. Piecewise mixed-effects logistic regression models tested for changes in the trajectories of depression before and after each event.

Statistically significant improvements in the trajectory of depression were observed following spousal bereavement, one’s own retirement and hospital admission because of causes other than falls, with reductions in the odds of depression of 48% (odds ratio: 0.52 (95% CI: 0.44–0.61)), 15% (0.85 (0.78–0.92)) and 4% (0.96 (0.94–0.99)), respectively. No changes were associated with developing a limiting long-term illness, becoming an unpaid caregiver or following spousal retirement or a hospital admission because of a fall.

The findings highlight the relative resilience among older adults in England in terms of depression following key later life events. There is still a role to play in delivering mental health support for older people following such events, particularly by improving the identification of those at risk of certain events as part of a broader strategy of prevention. Findings also underscore the importance of partner/spousal circumstances on individual mental health.

To examine whether unconscious and systemic biases regarding ethnicity have an impact on equity of access to a national tic service for children and young people (CYP) at Great Ormond Street Hospital for Children, London, UK. We retrospectively reviewed triaged referrals over an 18-month period and examined differences in triage decision, re-referrals required before acceptance and symptom severity at initial assessment by clinician-perceived and self-assigned ethnicity.

There was no evidence of an unconscious bias within the triage process. CYP from racially minoritised ethnic backgrounds were underrepresented and presented with greater overall need at initial assessment.

Better recording of ethnicity is a requisite starting point for research. We encourage local services to audit ethnicity of the CYP they refer to national and specialist services. Findings call for greater awareness of challenges faced by patients from racially minoritised ethnic backgrounds.

Schizophrenia is associated with premature mortality, but most evidence comes from high-income regions.

This study aimed to estimate the excess mortality associated with schizophrenia in southern China.

We linked register data from a nationwide information system for psychosis to death registers. Individuals diagnosed with schizophrenia and residing in Guangzhou between 2014 and 2021 were included. Standardised mortality ratios (SMRs) were calculated to compare the mortality of people with schizophrenia with that of the general population. Life expectancy, potential years of life lost (PYLL) and years of life lost (YLL) were estimated for all-cause mortality and specific causes of death. Gender difference in these metrics was examined.

There were 3684 deaths (11.3%) during the study period. The leading causes of death were circulatory, neoplastic and respiratory diseases. The mortality rate among people with schizophrenia was twofold greater than in the general population, with a greater risk associated with unnatural causes than natural causes. The risk of mortality due to suicide was 15-fold higher than that of the general population. The life expectancy in schizophrenia was around 60 years, which is 21 years shorter than that for the general population. Schizophrenia was associated with substantial premature mortality burden, showing greater impact in men than women.

Schizophrenia is associated with increased premature mortality, reduced life expectancy and substantial PYLL. The enduring disparity in mortality underscores an imminent call for targeted interventions aimed at suicide prevention and enhancement of the physical well-being of people with schizophrenia.

The aim of this study is to determine the prevalence and type of mental disorders associated with pathological gambling/gambling disorder (GD) in the general population.

Systematic review and meta-analysis of adult population-based studies reporting on psychiatric comorbidity of GD according to International Classification of Diseases (ICD-10/ICD-11), Diagnostic and Statistical Manual of Mental Disorders (DSM-IV/DSM-5) criteria, or widely used assessment instruments. PubMed, Scopus, and Web of Science databases were searched for relevant studies in English. The study’s protocol was preregistered in PROSPERO (CRD42024574210).

Of 454 articles published between 1993 and 2024, 12 met the inclusion criteria. Most studies used DSM-IV or DSM-5 criteria (only two ICD-10 criteria), and were evenly distributed across Europe, North America, and Southeast Asia. The weighted average prevalence of any mental disorder in individuals with GD was 82.2%. High comorbidity rates were found for substance use disorders (SUDs) (34.2%), mood disorders (30.9%), and anxiety disorders (29.9%), followed by personality (14.3%) and psychotic (5.9%) disorders. Meta-analysis indicates that individuals with GD are 10.7 (95% confidence interval [CI]: 5.7;20.1) times more likely to develop any mental disorder than the general population. The odds ratio for mental disorders associated with GD were 5–12 times higher for nicotine dependence, drug use disorder, alcohol use disorder, and SUD, and 3–4 times higher for anxiety and mood disorders.

These findings add weight to the view that GD is associated with a significantly increased risk for addictive behaviors, mood, and anxiety disorders.