PurposePost-COVID syndrome (PCS) also known as long COVID affects up to 66.5% of children and young people (CYP) following SARS-CoV-2 infection. Common symptoms include fatigue, headaches, anxiety, brain fog, breathlessness, and post-exertional symptom exacerbation, resulting in reduced school attendance and recreational participation. This study aimed to co-design an online group intervention to support psychological wellbeing, breathing retraining, symptom management, and peer connection during PCS recovery.MethodA co-design approach refined a 'journey-of-life' online intervention for adolescents with PCS and incorporated respiratory physiotherapy activities.ResultsSeven CYP provided feedback on the intervention structure, pacing, accessibility, and content. Participants valued the breathing retraining with narrative-based psychological approaches and highlighted the importance of peer connection, regular breaks, and accessible online resources to accommodate fatigue and cognitive symptoms. Feedback informed refinement of the intervention structure, physiotherapy activities, and supporting digital materials.ConclusionCo-design with CYP with lived experience of PCS supported the development of a patient-centred online intervention integrating psychological and physiotherapy approaches. The findings highlight the value of involving CYP in the development of interventions for complex long-term conditions and demonstrate the potential of accessible telehealth approaches to support recovery and wellbeing. Further evaluation of feasibility, acceptability, and clinical impact is warranted.

In this paper, we aim to provide a multidisciplinary and lived-experience-informed perspective on existing evidence for the utilisation of digital health interventions in schizophrenia care. We have integrated the findings from the most recent meta-analysis of digital health interventions for people with schizophrenia, and latest available evidence on the feasibility and efficacy of digital health interventions as a potential adjunct treatment. We found that there is growing evidence from randomised controlled trials on the efficacy of digital health interventions in improving specific aspects of psychotic symptoms, cognition and reducing the risk of relapse. To date, however, there have been no randomised controlled trials evaluating digital health interventions that target physical health comorbidity, although promising co-designed interventions are emerging. Overall, the quantity and quality of evidence regarding the efficacy of digital health interventions for schizophrenia care is rapidly increasing. Given the established acceptability and feasibility of such treatment approaches, along with potential benefits and low adverse risk profile, digital health interventions with established evidence of efficacy should be considered as an adjunctive part of core treatment and overall clinical care, with dedicated attention to ensuring their safety, accessibility and sustainable implementation. Further high-quality randomised controlled trials establishing the efficacy of digital health interventions targeting physical health aspects, and rigorous implementation studies informing optimal and sustainable integration within routine care in mental health services, are required. Integration of lived experience, clinician and lived experience (peer) support input across all stages of the research process, including subsequent implementation in real-life services, is needed to ensure high acceptability of these innovative, adjunctive treatment approaches for people with schizophrenia.

Polygenic scores (PGS) have been used to quantify genetic liability for psychiatric disorders, but it remains unclear how these scores are associated with age- and gender-specific risk of diagnosis.

To examine associations between disorder-specific PGS and age- and gender-specific risk of psychiatric diagnoses across major psychiatric disorders.

We conducted a population-based case-cohort study using the Danish iPSYCH2015 sample, including individuals born in Denmark between 1981 and 2008 and followed for psychiatric diagnoses from 1994 to 2015. Cases comprised individuals diagnosed with major depressive disorder (MDD; N = 30 905), schizophrenia spectrum disorders (SCZ; N = 12 703), bipolar disorder (N = 3169), attention-deficit hyperactivity disorder (N = 25 167) or autism spectrum disorder (ASD; N = 15 677), alongside a randomly sampled subcohort (N = 52 765). Disorder-specific PGS were the exposures. Gender- and age-specific hazard ratios for first hospital-based diagnoses were estimated using Cox proportional hazards models.

All PGS were associated with risk of all disorders regardless of age. For MDD, the highest association per 1 s.d. increase in PGS was observed at ages 17-19 (males: hazard ratio 1.56; 95% CI 1.45-1.69; females: hazard ratio 1.48; 95% CI 1.40-1.57). SCZ-PGS showed marked gender differences, with the strongest association with SCZ diagnosis at ages 20-22 years for males (hazard ratio 1.71; 95% CI 1.54-1.90) and 17-19 years for females (hazard ratio 1.29; 95% CI 1.16-1.44). ASD-PGS associations were strongest in males at ages 4-6 (hazard ratio 1.51; 95% CI 1.44-1.61) and 7-9 years (hazard ratio 1.55; 95% CI 1.47-1.65), and in females at ages 13-15 years (hazard ratio 1.60; 95% CI 1.41-1.82). Gender differences were evident across disorders. The PGS-schizophrenia association was stronger in males, whereas for childhood-onset disorders, associations were stronger in females but emerged at older ages.

Polygenic burden for psychiatric disorders tends to be more strongly associated with risk of diagnosis at younger ages, with gender-specific patterns. Future genetic research should consider both age at diagnosis and potential gender differences.

National implementation of early intervention in psychosis offers a lens on sustaining evidence-based mental health reform at scale. Experience from England and Ireland highlights tensions between fidelity and flexibility, the centrality of capacity and the need for system-level leadership to protect core mechanisms and prevent dilution during national roll-out.

Mental disorders are a leading cause of disease burden in 10-24-year-olds. In Australia, fragmentation within and across health, mental health and human services sectors contributes to gaps in service provision and increased disease burden. Comprehensive methodologies are needed to identify service gaps and inefficiencies to shape policy, optimise resource allocation and improve outcomes for young people.

To describe the design and methodology of a population-based data linkage study involving evaluation of health, mental health and human service use among young people in Victoria and identify subgroups experiencing unmet mental health needs.

The primary cohort comprises young people aged 12-25 years in the period between January 2018 and December 2025. For comparative purposes, children aged 5-11 years and adults aged 26-53 years are also included. We describe data sources, linkage methodology and planned analyses. Traditional statistical methods alongside contemporary machine learning and natural language processing techniques will be used.

The study will provide a comprehensive examination of the clinical characteristics of young people, their service use behaviour and typical pathways through care that cannot be gleaned from examining datasets in isolation. Ongoing consultation and engagement with young people and key stakeholders will inform interpretation, dissemination and translation of findings.

By integrating data across multiple service sectors, this study will generate novel evidence regarding pathways through care and unmet mental health needs among Victorian young people. Findings will inform mental health service reform and support improvements in healthcare delivery, service integration and outcomes for young people.

Sexual and gender minority (SGM) individuals experience substantial health inequalities, and clinical competence among healthcare providers is a key determinant of equitable care. The Lesbian, Gay, Bisexual and Transgender Development of Clinical Skills Scale (LGBT-DOCSS) is a validated instrument for assessing SGM-related clinical competence, but no Italian version has been available. This study aimed to translate, adapt, and validate the Italian LGBT-DOCSS among mental health professionals.

A cross-sectional online survey was administered to clinicians and trainees across Italy between June and December 2024. Psychometric analyses were conducted on 345 participants with complete data on all 18 items. Internal consistency, confirmatory factor analysis (CFA), Scalar multi-group CFA provided preliminary evidence consistent with measurement invariance across sexual orientation subgroups, and Spearman correlations with external measures of authoritarianism were examined.

The original three-factor structure (Clinical Preparedness, Attitudinal Awareness, Basic Knowledge) was replicated with good model fit (CFI = 0.967, TLI = 0.962, RMSEA = 0.058). Internal consistency was strong across all subscales (Cronbach's α ranging from .81 to .89; ordinal α ranging from .87 to .95). Scalar multi-group CFA supported measurement invariance across heterosexual and non-heterosexual subgroups (CFI = 0.944, RMSEA = 0.074), with non-heterosexual professionals demonstrating greater attitudinal affirmation and stronger awareness of SGM health disparities. Authoritarianism showed small-to-moderate associations with Basic Knowledge and Attitudinal Awareness. Significant differences by gender, sexual attraction and profession were observed, with nurses showing lower self-perceived SGM-related competence than other professional groups.

The Italian LGBT-DOCSS demonstrates strong psychometric properties and is a valid tool for assessing SGM-related clinical competence among Italian mental health professionals. It can support the identification of training needs and the development of targeted educational interventions to improve care for SGM individuals.

Responsive to local concerns about youth suicidality, we highlight an event hosted by a long-term community-engaged research partnership focused on upstream community interventions to promote youth mental wellness.

This workshop aimed to listen for direction from youth and community about the implications of research results, including their hopes and priorities.

Approximately 60 community members and youth participated in a half-day world café style event that was co-designed with youth and a community advisory council, using critically reflective dialogue.

Five priorities emerged, generating a robust agenda to guide a continuing program of responsive, community-engaged and youth-led research. Participants envisioned research serving to, in and of itself, promote resiliency among youth by virtue of its role in cultivating connection, belonging and positive social climates.

This half-day workshop provided a rapid, intensive platform for identifying community and youth priorities while strengthening connections among community partners.

Schizophrenia frequently follows a chronic relapsing-remitting course, comprising alternating episodes with and without psychotic symptoms (hereafter: psychosis and psychotic remission). One potential neurobiological correlate of this course is aberrant dopamine synthesis and storage (DSS) in the striatum, which can be estimated by the 18F-DOPA positron emission tomography (PET) outcome kicer. We conducted a longitudinal study of state-related kicer changes in striatal subregions in medicated patients with multiple-episode schizophrenia. We hypothesised that striatal DSS in patients with schizophrenia decreases from psychosis to psychotic remission, with higher striatal DSS during psychosis and lower striatal DSS during psychotic remission, compared to healthy subjects. Additionally, we explored whether striatal DSS is associated with psychotic relapse after remission. 18F-DOPA PET scans and clinical assessments were conducted in 28 patients with schizophrenia at two timepoints, first during psychosis and second during early-to-moderate psychotic remission (6 weeks to 12 months after the first timepoint, 189±80 days between-scan interval), as well as in 21 healthy controls, assessed twice in a comparable time interval. The averaged influx constant kicer of the striatal subregions nucleus accumbens, caudate and putamen was calculated as a proxy for DSS, using voxel-wise Gjedde-Patlak modelling with a cerebellar reference region. Mixed-effects models and post hoc analyses were used to test for longitudinal changes in kicer and cross-sectional group differences. An exploratory clinical follow-up 12 months after the second scan was conducted to assess psychotic relapse, and post hoc ANCOVAs were used to test for differences in kicer at each session between relapsing and non-relapsing patients. Patients' kicer changes from psychosis to psychotic remission in caudate and nucleus accumbens differed significantly from assessments in healthy controls at comparable time points, with a significant longitudinal decrease of caudate kicer in patients. Furthermore, kicer in both caudate and accumbens was significantly lower in patients during early-to-moderate psychotic remission compared to controls, but no significant group difference was observed during psychosis. At the exploratory clinical follow-up, 32% of patients had experienced a psychotic relapse; they showed higher caudate kicer compared to non-relapsing patients during psychosis, with no difference during psychotic remission. These findings provide evidence for longitudinal changes of striatal, particularly caudate, DSS from psychosis to psychotic remission in medicated, multiple-episode schizophrenia patients, with lower caudate DSS during early-to-moderate psychotic remission but no aberrance during psychosis. The data indicate aberrant, fluctuating striatal dopamine synthesis across disorder states in schizophrenia.

Major depressive disorder (MDD) impacts 300 million people globally, with most people being managed in primary care. Clinical response to antidepressant medications is highly variable. Pharmacogenomics (PGx) may improve prescribers' ability to match an antidepressant medication with patient phenotype, increasing the likelihood of a response.

This process evaluation aims to understand factors that impacted PGx intervention implementation in the PRESIDE Trial, conducted in general practices in Victoria, Australia.

Antidepressant prescribing data, evidence of intervention use and qualitative data from interviews with participants were included. Analysis and interpretation of the data were informed by the (UK) Medical Research Council's Framework for Developing and Evaluating Complex Interventions.

While clinicians and patients supported PGx informed antidepressant prescribing, documented uptake of the intervention was low, as were antidepressant medication initiations or changes in line with the PGx report. Participants reported a lack of clarity regarding follow-up processes post PGx report return. The impact of COVID-19 during trial implementation included delays to intervention delivery. The provision of mental health care in primary care settings was also impacted.

Future applications of PGx informed antidepressant prescribing would benefit from refined patient selection and ensuring PGx information is available when most useful.