Background: Maternal postpartum hospital readmissions represent profound implications for maternal health outcomes and potential gaps in quality of maternal care. Objective: This study aims to synthesise evidence on risk factors for maternal postpartum hospital readmissions within 42 days of discharge following birth hospitalisation. Methods: An electronic database search utilised CINAHL, EMBASE (Ovid), and MEDLINE for relevant studies published from 1 January 2010 to 30 June 2024. The studies that investigated the prevalence and risk factors for 42-day postpartum maternal readmission and reported risk estimates, published in English, were included. The risk of bias was assessed using the Newcastle-Ottawa Scale (NOS) for case-control studies and cohort studies. The PRISMA guidelines were followed in reporting this review. The review protocol was registered on PROSPERO (CRD42023442269). Results: A total of 7758 articles were retrieved, ultimately including 60 studies. The rate of maternal postpartum readmissions varied from 0.1236‱ to 26%. Significant risk factors were extracted and categorised into five groups: maternal demographic and socio-economic factors; behavioural and lifestyle factors; health institution structural factors; obstetric and delivery characteristics; as well as maternal morbidity The most frequently cited risk factors which contributed to maternal postpartum hospital readmissions were age, race/ethnicity, substance use, caesarean delivery, length of maternal hospital stay, premature birth, and all maternal morbidities, especially mental health disorders, severe maternal morbidity, and hypertensive disorders of pregnancy. Conclusions: This systematic review identified complex and diverse risk factors associated with maternal postpartum hospital readmissions within 42 days after discharge following birth hospitalisation. This helps our understanding of the risk factors and the strength of association with maternal postpartum hospital readmissions. Future research should develop a multidimensional risk assessment framework to guide clinical practice in adopting holistic individualised approaches for postpartum risk evaluation, thereby reducing readmission rates and improving maternal health outcomes.

Cardiovascular disease is the leading cause of death in women, yet prevention and management have historically relied on male-centered models. Sex and gender critically influence risk, clinical presentation, and outcomes. Depression, anxiety, and psychosocial stress, more prevalent in women, act as key amplifiers of cardiovascular risk. We conducted a clinically oriented narrative review based on a broad, non-systematic search of major databases, integrating evidence selected for relevance and methodological robustness to clarify biological and psychosocial mechanisms linking mental health and cardiovascular disease in women. Affective disorders and stress contribute to cardiovascular risk through interconnected pathways, including hormonal fluctuations, autonomic and neuroendocrine dysregulation, inflammation, endothelial dysfunction, and heightened platelet reactivity. These mechanisms interact with gender-related exposures such as caregiving burden, occupational stress, and interpersonal violence. Stress-related phenotypes, including mental stress, induced ischemia and takotsubo syndrome, exemplify the heart-brain axis and its clinical implications. Incorporating mental health into cardiovascular risk assessment is essential for precision prevention in women. A women-centered approach should include systematic psychosocial evaluation, multidisciplinary care, and tailored strategies to improve risk control, adherence, and outcomes.

Psychiatric illnesses and intellectual disabilities commonly occur in the criminal justice system and may impair an individual's ability to participate effectively in legal proceedings. Fitness to stand trial (FST) is an important safeguard for ensuring fair trial processes. This retrospective chart review examined the demographic, clinical, and legal profiles of 159 court-referred individuals assessed for FST at a major tertiary forensic psychiatry centre in New Delhi (India) between January 2017 and December 2022. Data on sociodemographic variables, ICD-10 diagnoses, current mental status, alleged offences, and FST outcomes were analysed using chi-square/Fisher's exact tests and multivariate logistic regression. The sample was predominantly male (81.1%) with a mean age of 37.9 years (SD 14.2). Psychotic disorders were the most frequent diagnosis (35.2%), followed by bipolar affective disorder and intellectual disability. Violent offences constituted 62.9% of alleged crimes. Overall, 54.7% were found fit to stand trial. Active psychiatric symptoms (adjusted OR 47.2, 95% CI 6.1-365.3) and organic mental disorder or intellectual disability (adjusted OR 22.5, 95% CI 4.8-105.6) independently predicted unfitness. Active psychopathology and cognitive impairment were the strongest determinants of unfitness, highlighting the need for structured assessment tools and restoration programmes under the Bharatiya Nagarik Suraksha Sanhita 2023.

ObjectiveTo examine the utility and limitations of remote supervision in a rural psychiatry training program through narrative review and dual reflective accounts.ConclusionsConsistent, well-structured remote supervision can nurture clinical expertise, ensure good clinical governance, improve patient safety, and promote graded trainee autonomy. Limitations can include reduced opportunity for direct observation, challenges processing complex relational dynamics, and heightened trainee isolation. Clear pedagogical structures, reliable technology, and a strong local multidisciplinary team are key to remote supervision providing effective containment and supporting progressive independence; and a hybrid model incorporating regular onsite and in-person contact deepens professional development and relational quality.

Real-world evidence on major depressive disorder (MDD) management in children and adolescents is limited in Japan. This study aimed to evaluate the antidepressant treatment persistence rate in this population.

This study evaluated the antidepressant treatment persistence in children and adolescents (aged 6-18 years) with MDD who had claims data from 6 months before to 1 year after the index date between 2012 and 2017 using a large-scale Japanese claims database. Treatment persistence was defined as the absence of a prescription gap beyond 30 days. Factors associated with it were examined using a Cox proportional hazards model (JMP ver.18).

In total, 1,582 patients on the index date were included. The treatment persistence rate for any antidepressant was 62.6% on the 30th postindex day, 46.1% on the 60th postindex day, 22.3% on the 180th postindex day, and 10.2% on the 365th postindex day. The most frequently prescribed initial antidepressant was sulpiride (30.0%). By drug class, selective serotonin reuptake inhibitors (SSRIs) were the most frequently prescribed (39.9%), followed by tricyclic or tetracyclic antidepressants (TCAs) (18.3%) and serotonin and norepinephrine reuptake inhibitors (SNRIs) (6.3%). The significant factors associated with treatment discontinuation with any antidepressant were treatment initiation with sulpiride, noradrenergic and specific serotonergic antidepressants, serotonin antagonist and reuptake inhibitors, or TCAs, as well as consultations with nonmental health specialists.

Antidepressant treatment persistence rates in children and adolescents with MDD were low. However, the rate varied depending on the first prescribed antidepressant and mental health specialist involvement. Relatively high persistence was observed among those prescribed SSRIs or SNRIs as their initial antidepressant treatment and those who received clinical interventions provided by mental health specialists. Given the claims data and no clinical severity measures, these findings should be interpreted with caution.

The impostor phenomenon (IP) is an individual's internal experience of intellectual phoniness, characterized by an inability to internalize success, leading to self-doubt and fear of being exposed as a fraud. We examined IP among Croatian and Bosnian- Herzegovinian undergraduate dental students.

A cross-sectional study (n = 679) was conducted at the School of Dental Medicine, University of Zagreb (n = 355), and the Faculty of Dentistry, University of Sarajevo (n = 324). We aimed to assess the risk associated with certain predictors, such as sociodemographic characteristics, substance use, quality of life, physical and mental health, social interactions, mental health issues, and academic and non-academic stressors, in relation to a clinically relevant level of impostorism measured by the Clance Impostor Phenomenon Scale (CIPS).

Dental schools in Sarajevo and Zagreb had similar average CIPS scores, 58.5 versus 58.7. Females had significantly higher average scores than males (Sarajevo: 60.1 vs. 53.7; Zagreb: 60.0 vs. 52.4). Every second student had a clinically relevant level of impostor feelings. Transitional years, 1st, 4th, and 6th, exhibited the highest average scores. Alcohol consumption, smoking, parental expectations, PHQ-9 scores, and lower quality of life increased risk, while social inclusion in the broader community reduced risk.

IP is highly prevalent and influenced by internal and external factors. This study was the first to examine IP among Croatian and Bosnian and Herzegovinian dental students. Dental schools should implement targeted interventions and psychological support into curricula to build student resilience.

Recent studies have focused on characterising the brain's intrinsic connectivity networks during fear learning, going beyond traditional brain activation analyses, to study the acquisition of fearful associations as a model for clinical anxiety onset.

Given the sharp increase in prevalence of affective disorders during puberty, a period marked by heightened affective sensitivity and fronto-amygdala circuitry development, the current study compares the connectivity within and between the salience network, executive control network and default mode network throughout fear learning, between young adults with and without mild mixed affective complaints. We hereby aim to identify potential neural targets for promising novel treatment options, such as functional magnetic resonance imaging (fMRI)-guided neurofeedback or transcranial magnetic stimulation.

Generalised psychophysiological interaction analysis was used to assess connectivity changes within and between the salience network, executive control network and default mode network during an fMRI fear-conditioning paradigm (habituation, early, mid and late acquisition phase). Results were compared between healthy controls (n = 44), spider phobics (n = 44) and a group with subclinical mixed psychopathology (n = 52; 21 males), all aged 16-25 years.

Task-induced changes in functional connectivity were specifically found in the default mode network (F(6, 792) = 4.170, p < 0.001). Overall, the default mode network showed less functional connectivity during conditioned threat stimulus than neutral 'safe' stimulus trials. Notably, a subset of connections within the default mode network of the subclinical mixed psychopathology group failed to differentiate between the stimuli (F(27, 377.39) = 2.01, false discovery rate-adjusted p-value = 0.014), which is in line with fear-conditioning research showing impaired (behavioural) stimuli differentiation in affective disorders.

Stimulus-specific temporal dynamics of the default mode network during fear learning differentiated young adults with and without mild psychopathology. These results add up to a growing body of research identifying deficient default mode network functionality in affective disorders.

The Health of the Nation Outcome Scales (HoNOS) are the most widely used psychiatric clinical outcomes tool in the UK. Nonetheless, HoNOS scores and their change during treatment for people with anorexia nervosa have not been investigated. We retrieved clinical data from the Clinical Records Interactive Search register from 234 with an anorexia nervosa or an eating disorder diagnosis, a body mass index (BMI) <18.5 kg/m² and with available HoNOS, BMI and C-reactive protein (CRP) data at admission.

From admission to discharge, patients showed a significant moderate improvement in HoNOS total score (mean±s.d.) from 14.30±6.23 to 10.11±4.81, and a significant moderate-to-large increase in BMI from 14.15±1.45 kg/m² to 16.22±2.56 kg/m². CRP levels >2 mg/L on admission were significantly associated with age, a personality disorder diagnosis, agitation and hallucinations in the HoNOS.

In-patient treatment for anorexia nervosa improves health and social functioning.

Peer-supported self-management at discharge from early intervention in psychosis services (EIPS) has received limited attention. The MyPREPED (My Personal Recovery Plan for Early Discharge) trial will evaluate a co-designed, digital and paper-based, peer-delivered recovery and self-management focused intervention, tailored for young people exiting EIPS.

This protocol describes a hybrid type 2 effectiveness-implementation trial designed to assess MyPREPED's impact, feasibility, real-world implementation and cost-utility.

This multi-site, mixed-method, two-arm (1:1), parallel-group, randomised controlled trial (MyPREPED versus treatment as usual) trial will be delivered across eight Australian EIPS that deliver ultra-high risk and/or first-episode psychosis streams, using a hybrid type 2 implementation-effectiveness design. Eligible participants are young people aged 16 years and over within 6 months of planned discharge from EIPS. Peer coaches will deliver up to ten sessions of using a self-management plan (modules: discharge, recovery, well-being, relapse prevention, goal-setting, service navigation). Co-primary outcomes include (a) mental health recovery (Recovery Assessment Scale - Domains and Stages; effectiveness outcome) and (b) feasibility (Feasibility of Implementation Measure; implementation outcome). Secondary outcomes assess broader effectiveness domains (mental health quality of life, clinical and functional outcomes) and other implementation outcomes. A cost-utility analysis will estimate incremental costs and quality-adjusted life-years associated with MyPREPED, alongside a secondary cost-effectiveness analysis. Analyses will follow intention-to-treat principles, using mixed-effects models.

This study will provide the first rigorous test of a co-designed, peer-delivered recovery and self-management focused intervention specifically targeting EIPS discharge.

Psychiatry on call occupies a distinct and formative space within mental health services, shaped by moments of uncertainty, responsibility, and relational decision-making. In Ireland, non-consultant hospital doctors continue to deliver the majority of out-of-hours emergency psychiatric care, often as the sole on-site psychiatric clinician, working across multiple settings and managing high levels of clinical and organisational risk. This paper situates contemporary psychiatry on call within its wider clinical, societal, and service context, drawing on the College of Psychiatrists of Ireland's 2025 position paper and emerging evidence on emergency mental health care. We argue that emergency psychiatry differs from other acute specialties, being characterised by distress rather than disease, uncertainty rather than diagnosis, and time-intensive relational work rather than protocol-driven intervention. Rising demand reflects broader systemic pressures, including unmet social need, reduced inpatient capacity, uneven crisis alternatives, and increasing regulatory burden. We examine the service-user experience of out-of-hours care, highlighting issues of environment, equity, trust, and safety, particularly for marginalised groups. While high-quality supervision and training remain essential, we contend that sustainable improvement requires system-level reform, including strengthened multidisciplinary crisis responses, clearer role delineation, and coordinated investment in and also beyond mental health services. Attending to psychiatry on call offers a critical lens through which to understand and improve emergency mental health care for both clinicians and service users.