Suicide is a significant global public health problem, with a disproportionately large burden among youth in low- and middle-income countries (LMICs). Despite growing awareness of the problem, evidence-based interventions in these settings are scarce.

This systematic review aims to identify and synthesise the evidence-based literature on the effectiveness of psychosocial-interventions to prevent suicide among young people aged 10–24 years in LMICs to reduce the risk of suicide and improve their mental-wellbeing.

After registering protocol with the PROSPERO database of systematic reviews (CRD 420251016364), we searched electronic databases (e.g., PubMed, Medline, Cochrane Library, APA PsycINFO, Scopus, EMBASE, Web of Science and Google Scholar) for potential studies. We considered relevant literature in the English language and published from January 2000 to March 2025. Studies eligible for inclusion were psychosocial interventions compared with a control group, conducted on adolescents in LMICs, and with suicidal-ideation and suicide attempt as primary outcome. Reducing symptoms of anxiety and depression as well as improvements in quality of life were considered as secondary outcomes.

Among 1,223 identified studies, only four met the inclusion criteria. Despite the limited evidence base, all included trials reported reductions in suicidal ideation and improvements in emotional well-being, suggesting the potential effectiveness of culturally adapted psychosocial approaches. Estimated intervention effect sizes ranged from large to extremely large (Cohen’s d = 1.46, 2.08, 1.30 and 3.02, respectively), compared with small-to-moderate effect sizes from high-income countries (d ≈ 0.24 to 0.54). Secondary benefits were noted for hopelessness, depressive symptoms and quality of life. However, interpretation is limited by small samples and inconsistent methods, reducing comparability with high-income data.

The review highlights major gaps in youth suicide prevention within LMICs, emphasising the urgent need for contextually relevant, evidence-based psychosocial interventions and policy frameworks. Findings suggest moderate effectiveness of current interventions, underscoring the importance of culturally tailored implementation to enhance impact.

Peer-supported Open Dialogue (POD) integrates peer practitioners within mental health teams, fostering a collaborative, person-centred and social network approach to care. Although peer practitioners are increasingly involved in Open Dialogue, the role of peer practitioners within such teams remains underexplored.

This study aimed to explore (a) the experiences of peer practitioners working within Open Dialogue teams in the Open Dialogue: Development and Evaluation of a Social Intervention for Severe Mental Illness trial, and (b) the perspectives of non-peer Open Dialogue practitioners regarding peer involvement. Our further objectives were to understand the nature, degree and perceived impact of peer practitioner involvement in Open Dialogue.

A qualitative study was conducted using semi-structured interviews and joint interviews with peer practitioners (n = 9). Additionally, excerpts from 11 interviews and 4 focus groups (n = 18), in which non-peer practitioners discussed peer practitioners’ contributions in Open Dialogue, were analysed. Thematic analysis was employed to identify key themes.

Three themes were developed. The first focuses on the perceived influence of peer practitioners on Open Dialogue network meetings; the second explores the opportunities and challenges of working as a peer practitioner in Open Dialogue, while the third details the perceived impact of peer practitioners on team and organisational culture.

Open Dialogue’s emphasis on a flattened hierarchy facilitates the integration of peer practitioners, enabling them to contribute meaningfully to network meetings and team culture. Despite the overall positive experiences, peers still faced common challenges faced by those in other services, such as low pay and occasional instances of a compromised, flattened hierarchy.

To date, no research has explored the impact of the COVID-19 pandemic on psychotropic prescription patterns among young people in Japan, where lockdown measures were relatively less stringent.

This study aimed to investigate changes in the prescription patterns of psychotropic medications for Japanese young people before and after the COVID-19 pandemic, using the DeSC Database.

We conducted an interrupted time-series analysis, with data from February 2016 to November 2022, to assess the pandemic’s effects on psychotropic prescriptions for children, adolescents and young adults. The analysis included subgroups based on age (6–11, 12–17 and 18–22 years) and gender. The number of patients prescribed psychiatric drugs before and after the pandemic was analysed.

Among 93 385 individuals, psychotropic prescriptions – except anxiolytics – increased overall, although not uniformly across age and gender groups. Significant upward trends were observed in the prescription rates of antidepressants (from 2.53 (95% CI 2.21–2.84) to 6.47 (95% CI 5.89–7.05) patients per month), anxiolytics (from −1.83 (95% CI −2.52 to −1.13) to 7.37 (95% CI 6.06–8.67) per month) and hypnotics/sedatives (from −1.48 (95% CI 0.73–2.24) to 6.62 (95% CI 5.21–8.03) per month).

A persistent increase in psychotropic medication prescriptions was observed after the COVID-19 pandemic. Given the influence of age and gender, clinicians and society must prioritise the mental health needs of the female and adolescent populations. These findings may be generalisable to other countries that implemented less stringent lockdown measures.

Patients with psychiatric disorders are more likely to experience financial difficulties. Yet, there is limited knowledge about the longitudinal relationship between psychopathology in adolescence and debts or experienced financial scarcity in emerging adulthood.

We aimed to examine whether distinct types of psychological symptoms in mid-adolescence precede the occurrence of unsecured debts and experienced financial scarcity in emerging adulthood.

Data from a Dutch adolescent cohort (N = 659, 53.9% female) oversampled on the risk of psychopathology was used. Psychological symptoms were self-reported at baseline (mean age 14.80 years, s.d. = 0.79), using the Youth Self-Report and the Prodromal Questionnaire-16. At follow-up (mean age 17.95 years, s.d. = 0.80), adolescents reported presence of unsecured debts and completed the Psychological Inventory of Financial Scarcity. Logistic and linear regression analyses were applied, adjusting for the baseline characteristics of sex, age, ethnic background, parental psychopathology and household income as an indicator of family socioeconomic status.

More attention-deficit/hyperactivity problems (adjusted odds ratio 1.15, 95 CI% 1.04–1.27), oppositional defiant problems (adjusted odds ratio 1.17, 95 CI% 1.00–1.35) and psychotic experiences (adjusted odds ratio 1.10, 95 CI% 1.01–1.21) at age 15 years were associated with unsecured debts at age 18 years. Depressive, anxiety, somatic and conduct problems were not associated with later unsecured debts. Depressive, anxiety, attention-deficit/hyperactivity, oppositional defiant, conduct problems and psychotic experiences at age 15 years were associated with increased experienced financial scarcity at age 18 years.

Psychological symptoms during mid-adolescence precede both objective and subjective financial difficulties when entering adulthood. Integrating financial education into prevention efforts could potentially provide significant long-term benefits, particularly for those with mental health problems.

Some adolescents can achieve academic success and maintain well-being despite their engagement in video gaming. Social factors may play a role in their vulnerability to mental health problems.

This study examined the role of perceived peer support and childhood experiences of optimal parenting in the association between video-gaming duration and depressive symptoms in adolescents.

A sample of 1071 adolescents (mean age 13.62 years, s.d. = 0.95) completed a questionnaire on video-game usage. Their perceptions of parental care and support since childhood were assessed using the Parental Bonding Instrument, whereas their perceived peer friend support was assessed using the friend support subscale of the Multidimensional Scale of Perceived Social Support. Their depressive symptoms were measured using the depression subscale of the Depression Anxiety Stress Scales. Moderated mediation analysis was conducted to examine the associations of these variables. Family socioeconomic status and symptoms of attention-deficit hyperactivity disorder were included as covariates.

Longer durations of video gaming were associated with higher levels of depressive symptoms. The role of perceived peer support in this association was moderated by childhood experiences of optimal parenting. Specifically, the mediating role of perceived friend support was significant only for adolescents who lacked optimal parenting.

The relationship between frequent video gaming and depressive symptoms in adolescents is complex and may depend on the levels of peer and parental support. Lacking support from both parents and peers can increase adolescents’ risk of depression associated with frequent video gaming.

To date, little is known about the evidence of a potential risk of psychiatric adverse events following COVID-19 vaccination in large populations with adequate study design.

To investigate whether COVID-19 vaccination is associated with increased risk of psychiatric adverse events.

We used South Korea’s linkage database to obtain registry data and claims data from 2019 to 2021, and conducted a population-based self-controlled case series study including 11 751 806 individuals. Primary outcomes included anxiety/nervousness, mood disorders, perceptual disturbances/psychoses, aggression/behavioural disturbances, cognitive impairments and sleep disorders within 21 days of COVID-19 vaccination. Secondary outcomes were the stratified primary outcomes according to each individual’s psychiatric history. Conditional Poisson regression was used to estimate incidence rate ratios (IRR) and 95% confidence intervals.

COVID-19 vaccination did not increase the rate of anxiety and nervousness (adjusted IRR 0.95, 95% CI 0.95–0.96), mood disorders (adjusted IRR 0.75, 95% CI 0.75–0.76), perceptual disturbances and psychoses (adjusted IRR 0.72, 95% CI 0.70–0.74), aggression and behavioural disturbances (adjusted IRR 0.93, 95% CI 0.89–0.97), cognitive impairment (adjusted IRR 0.68, 95% CI 0.67–0.69) or sleep disorders (adjusted IRR 0.90, 95% CI 0.89–0.91). Secondary outcomes were consistent with the primary outcome, although the adjusted IRRs for anxiety and nervousness (adjusted IRR 1.17, 95% CI 1.15–1.18) and sleep disorders (adjusted IRR 1.07, 95% CI 1.06–1.09) were statistically significant in individuals with no history of psychiatric disorders. Sensitivity analyses showed consistent results with our main findings.

Our findings provide short-term safety profiles for COVID-19 vaccines regarding psychiatric adverse events. Continuous monitoring of anxiety/nervousness or sleep disorders after COVID-19 vaccination is required regardless of history of psychiatric comorbidities.

This concurrent, exploratory, mixed-methods process evaluation, embedded within a randomised controlled trial, investigates how the ‘active prevention in people at risk of dementia through lifestyle behaviour change and technology to build resilience’ (APPLE-Tree) secondary dementia prevention intervention might support behavioural and lifestyle goal attainment, through determining the contexts influencing engagement and testing intervention theoretical assumptions.

We aimed to investigate (a) intervention reach, dose and fidelity, (b) contexts influencing engagement and (c) alignment of findings with theoretical assumptions about how the intervention might have supported participants to meet personalised behavioural and lifestyle goals.

We measured intervention reach and dose. We selected interviewees for setting, gender and ethnic diversity from the 374 APPLE-Tree trial participants randomised to the intervention arm. We interviewed 25 intervention participants, 12 facilitators and 3 study partners. Additionally, we analysed 11 interviews previously conducted during or after intervention delivery for an ethnography, and 233 facilitator-completed participant goal records. We thematically analysed data, combining inductive/deductive approaches informed by the ‘capability, opportunity and motivation-behaviour’ (COM-B) behaviour change model. We video-recorded a randomly selected tenth of sessions and rated fidelity.

A total of 346 of 374 (92.5%) intervention arm participants received some intervention (reach), and 305 of 374 (81.6%) attended ≥5 main sessions (predefined as adhering: dose). According to facilitator records, participants met a mean of 5.1 of 7.5 (68.3%) goals set. We generated three themes around (a) building capability and motivation, (b) connecting with other participants and facilitators and (c) flexibility and a tailored approach.

The intervention supported behaviour change, through increasing knowledge and providing space to plan, implement and evaluate new strategies and make social connections. Feedback indicated that the intervention was flexible and inclusive of diverse preferences and needs.

Depression severity is a well-established risk factor for suicidal ideation, but the extent to which sociodemographic and employment-related factors contribute independently remains unclear.

Complete data from doctors (N = 4055) presenting to National Health Service Practitioner Health (NHS-PH) in 2022–2023 were used to test the hypothesis that depression severity is the largest determinant of suicide ideation risk (defined by Patient Health Questionnaire 9 (PHQ-9) question 9 score) among doctors.

Using PHQ-8 score (PHQ-9, excluding the item on suicide ideation) as a proxy for depression severity, the case–control discriminatory capacity of receiver operating characteristic curves (AUCs) were evaluated for (a) a univariable model studying modified PHQ-9 alone as the predictor of severe suicide ideation; and (b) a multivariable model integrating modified PHQ-9 and multiple sociodemographic and employment factors as the predictor of severe suicide ideation. Models were compared both descriptively and through a likelihood ratio test.

The univariable model using depression severity alone as the predictor of severe suicide ideation yielded an AUC of 0.921. The addition of sociodemographic and employment factors improved the fit significantly (likelihood ratio test with (χ2(14) = 50.26, P < 0.001), amended AUC 0.930). Having both a disability and a relationship status of ‘no partner’ was significantly independently associated with suicide ideation in the multivariable model.

In this national cohort of doctors, depression severity was strongly associated with suicidal ideation. However, disability and lack of a partner were also independently linked to increased risk, suggesting that suicidal ideation is not solely driven by symptom severity. Social and functional factors may help identify higher-risk individuals and inform targeted support.

First-episode psychosis (FEP) is a critical phase in psychotic disorders where early intervention significantly influences long-term outcomes. Catatonia, characterised by motor, behavioural, and psychological abnormalities, is an under-recognised aspect of FEP.

This study examines catatonia prevalence in affective and non-affective FEP, its role as a severity indicator across psychopathological domains, its correlations with other symptoms and its association with clinical syndromes.

A cross-sectional study was conducted with 58 FEP patients (38 females, 20 males) aged 15–55 years. Of those, 40 were antipsychotic-naive, and 18 had minimal prior antipsychotic exposure. Participants were recruited from acute psychiatric units. Catatonia was assessed using the Bush Francis Catatonia Rating Scale (BFCRS), while psychopathology was evaluated with the Positive and Negative Symptom Scale (PANSS), Calgary Depression Scale (CDS) and Young Mania Rating Scale (YMRS). Data analysis included descriptive statistics, t-tests, X2 tests, and multivariable regression using SPSS version 25 for Windows.

Catatonic signs were identified in 22.4% of cases based on the Bush Francis Catatonia Screening Instrument (BFCSI) criteria (BFCSI-positive group, defined as ≥2 signs present for over 24 h), indicating potential catatonia. Prevalence varied by criteria: 13.8% (DSM-IV), 10.3% (Fink and Taylor), 10.38% (ICD-11) and 8.6% (DSM-5). Catatonic patients had more years of education and significantly higher PANSS totals, Emsley negative, disorganised, excited, and anxiety scores. Catatonic signs moderately correlated with Emsley disorganised scores. Regression analysis identified PANSS total and Emsley domain scores as significant predictors of catatonia severity.

Catatonia is notably prevalent in FEP and associated with severe psychopathology, particularly in negative and disorganised domains. These findings underscore the importance of improving recognition of catatonia in early psychosis. Larger longitudinal studies are needed to confirm these findings and explore treatment implications.

Non-suicidal self-injury (NSSI) often emerges during adolescence and young adulthood. A prior open-label pilot study suggested that N-acetylcysteine (NAC) may reduce NSSI frequency in young individuals.

This study investigated potential NSSI-related biological markers for NAC in young adults with a history of NSSI using a placebo-controlled, randomised clinical trial of two NAC dosage regimens.

Forty-three individuals (assigned female at birth) aged 16–24 years and with a history of NSSI were randomly assigned to either low-dose NAC (3600 mg/day), high-dose NAC (5400 mg/day) or placebo treatment for 4 weeks. Participants underwent blood draws, magnetic resonance imaging with spectroscopy and clinical assessments before and after treatment. Primary outcomes included brain glutathione (GSH), blood reduced to oxidised GSH ratio and brain glutamate. Secondary outcomes included antioxidant protein levels, brain gamma-aminobutyric acid concentrations, functional connectivity (between amygdala and insula) and clinical outcomes. Pharmacokinetics, tolerability and correlations among measures were also explored.

For 39 participants who completed study assessments at follow-up, weekly NSSI and depression symptoms improved similarly across both treatment and placebo groups, with no significant group differences in primary or secondary outcomes at follow-up. Some significant correlations emerged.

The study did not support the proposed biological signatures of NAC in young adults with NSSI, although exploratory findings suggested potential biological correlates of clinical improvement. Further research is necessary to explore neurobiologically based treatments for young adults with NSSI.

Several independent reviews in the UK have recently investigated sustained, systemic failings by statutory services and government departments. These reviews document severe psychological impacts on people affected by these scandals, which have been exacerbated by miscarriages of justice, denials of accountability and lack of formal support. There is evidence that impacted people have significant, unmet mental health needs.

To explore the psychological support needs of people infected and affected by the infected blood scandal in England, their experiences of seeking support and how insights from this research could inform responses to people affected by similar failings, including the Hillsborough Disaster, Windrush Scandal and Post Office Horizon IT Scandal.

We used a qualitative design involving semi-structured interviews with infected and affected people in England and with mental health practitioners to explore experiences, psychological impacts and perspectives on existing support services. Our analysis was thematic, adopting an empathetic interpretive orientation toward participants’ experiences.

We identified significant unmet mental health needs among infected and affected people, including those who had been in contact with NHS or private psychological support services. Historically, infected and affected people have rarely accessed effective mental health support.

Insights from the Infected Blood Inquiry and the subsequent development of a bespoke psychological support service could inform the setting up of skilled, tailored psychological support for people affected by other severe, systemic state failings. This response could address complex, unmet mental health needs and increase understanding of the psychological impacts of scandals resulting from systemic, statutory failings.

The high comorbidity of substance use disorders (SUDs) among people with severe mental health conditions (MHCs) poses major challenges to providing effective care, particularly in low- and middle-income countries (LMICs), where treatment options are limited.

The aim of this scoping review was to produce an overview of the current evidence on psychosocial interventions for people with comorbid MHCs and SUDs in LMICs.

The following databases were searched from their inception to 23 July 2024: PubMed/Medline, Global Health, Embase, PsycINFO and Global Index Medicus. We also searched for grey literature, using Google Scholar, ProQuest and Clinicaltrials.gov. Reporting was according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) Checklist. Studies were eligible if they focused on any psychosocial intervention targeting substance use in people with severe MHCs from LMICs. Of the 6304 records screened by titles and abstracts, 138 full-text articles were assessed and included for data extraction.

Of the 6304 records screened by titles and abstracts, 138 full-text articles were assessed and 13 articles were included for data extraction. Many of the studies (n = 9) had a quasi-experimental design, and were from Latin America and South Asia. Four studies were randomised controlled trials. The primary outcomes examined were substance use abstinence, treatment engagement and retention, reduction in psychiatric symptoms, functioning and suicidal behaviours. Despite some heterogeneity in study designs, target populations and evaluated outcomes, interventions including various tobacco cessation programmes, screening and brief intervention with family support, and community-based programmes, have demonstrated positive outcomes in reducing tobacco, alcohol and khat use, respectively.

The review shows that there have been few initiatives to design and test psychosocial interventions for individuals with comorbid severe MHCs and SUDs in LMICs. There is a clear need to design and test feasible, acceptable, and effective interventions to address both severe MHCs and substance use when they co-occur.