Demand for recognition of the specialized knowledge and skills required of Infant and Early Childhood Mental Health (IECMH) practitioners, researchers, and policymakers resulted in the establishment of standardized professional credentials that document this expertise. However, to date, research on the influences and impacts of an Infant or Early Childhood Mental Health Endorsement on IECMH professionals is scarce. This descriptive, cross-sectional study aims to fill this gap by reporting quantitative findings from a voluntary online survey, the Perceptions of Endorsement Survey (PES), completed by a diverse group of 911 Endorsed professionals across the United States and Australia. The study by a U.S. research team explores how personal factors, professional supports, and perceived benefits influence the likelihood of continuing to participate in the Endorsement system and of recommending it to others (Attitudes towards Endorsement). Regression analyses revealed three factors that were significant predictors of positive Attitudes towards Endorsement: Confidence and Motivation, Endorsement-related Social Influences, and perceived Opportunities. Moreover, the combination of Endorsement-related Social Influences and Opportunities significantly and uniquely predicted positive Attitudes towards Endorsement above what these factors predicted individually. Discussion focuses on how individual-level demographic characteristics, occupational-level factors, social factors, and perceived benefits relate to Attitudes towards Endorsement.

People presenting to emergency departments with behaviours of concern is increasing, placing staff and patients at risk of psychological and physical harm. An electronic Behavioural Assessment Tool (EDBAT) was implemented across four emergency departments to guide nursing assessment and care of these patients. The aim of this study was to determine: 1) Characteristics of patients with an EDBAT completed; 2) the proportion of patients detained involuntarily with an EDBAT completed; and 3) facilitators and barriers to uptake of the EDBAT by emergency nurses.

A multi-method study design was used comprising two studies: a retrospective quantitative descriptive study and implementation survey.

There were 743 EDBATs completed over 3-months. Of the 724 patients involuntarily detained, 512 (70.7%) had an EDBAT completed. The survey was completed by 93 (33.2%) nurses. Twelve facilitators and eight barriers were identified. The EDBAT was considered easy to use (n = 73, 78.5%) and 81 nurses (87.1%) intended to continue using it. Inadequate nursing staff (n = 48, 51.6%), lack of time (n = 61, 65.6%) and "nil clinical space appropriate" hindered emergency nurses from using the EDBAT.

The EDBAT is a useful clinical aid. Adequately trained staff and resources are needed to achieve successful uptake in emergency nursing practice.

22q11.2 deletion syndrome (22q11.2DS) is an under-recognized multi-system genetic condition. There are limited data available on the delivery of care for adults with 22q11.2DS or the experience of patients and caregivers.

At a dedicated multidisciplinary clinic for adults with 22q11.2DS, we distributed anonymous online surveys to adults with 22q11.2DS and their caregivers. We compared the results to those from a similar survey conducted before establishing the dedicated clinic using descriptive statistics with Benjamini-Hochberg adjustment for multiple comparisons.

A total of 149 responses were received from 40 adult-22q-respondents and 109 caregiver-respondents, with survey completion rates of 87.5% and 89.9%, respectively. Compared to pre-clinic survey results, a significantly greater proportion of non-neutral respondents agreed that medical services were easy to access and well coordinated (89/118, 75.4% vs. 25/50, 50.0%; adjusted p = 0.012) and that appropriate transition services were provided (84/113, 74.3% vs. 15/49, 30.6%; adjusted p = 0.001). A majority reported that the clinic improved access to other services and professionals (112/120, 93.3%) and shared comprehensible information (124/124, 100.0%). Supports provided by the social worker and dietitian were valued. 75/108 (69.4%) of all non-neutral respondents noted that external providers lacked sufficient information about 22q11.2DS. As before, the top challenges noted by both patients and caregivers were neuropsychiatric conditions.

The results support the need for, and perceived value of, specialized clinics for adults with complex healthcare needs and their caregivers.

Differentiating bipolar disorder (BD) from major depressive disorder (MDD) during major depressive episodes remains a significant challenge. EDIT-B is an in vitro diagnostic test based on machine learning (ML) method integrating clinical metadata with adenosine-to-inosine (A-to-I) RNA editing signatures in eight genes (GAB2, IFNAR1, IL17RA, LYN, MDM2, PRKCB, PTPRC, ZNF267) to differentiate BD from MDD.

The objective of this study is to assess and confirm the diagnostic performance of EDIT-B in a new, independent, double-blind, external, multicentre European cohort.

We evaluated EDIT-B results across four European centres (Spain, France, Denmark) compared with physician diagnoses. Explainability and sensitivity analyses were performed to identify the primary drivers of the model.

In 393 patients with current major depressive episode (238 MDD; 155 BD), EDIT-B demonstrated robust performance: area under the curve-receiver operating characteristic of 0.873 (95% CI 0.837 to 0.909), sensitivity of 82.6% (95% CI 75.7% to 88.2%) and specificity of 80.3% (95% CI 74.6% to 85.1%). Performances were consistent across sites and all stratified patient subgroups, corroborating previous results. Explainability analysis pointed to RNA editing biomarkers as the most important variables for EDIT-B diagnosis.

This study confirms the diagnostic performances of EDIT-B showing that A-to-I RNA editing coupled with ML methods is a reliable approach to distinguish BD from MDD.

EDIT-B represents an innovative, reliable and complementary diagnostic tool supporting psychiatric practice and enhancing clinical outcomes with potential impact in reducing diagnostic delays, tailoring the therapeutic strategy and improving therapeutic alliances. These findings may represent a significant advance towards precision psychiatry, with potential to reduce misdiagnosis and inappropriate treatment.

NCT05603819.

Despite Nepali older adults reporting high levels of depressive symptoms, interventions have not been developed to support their mental health. This study examines what such interventions should include and the factors that attract or prevent participation.

A survey was used to collect qualitative data from 280 older adults aged 60 to 95 years (M = 69.6, SD = 8.05). Three open-ended questions inquired about the content of such interventions, and the factors that attract or prevent participation. These were analyzed using a content analysis approach.

Interventions for Nepali older adults should address physical and mental health, social connection, leisure, and spirituality. They should be delivered in comfortable, inclusive, and supportive settings. Participants would be attracted by ease of access, perceived relevance, apolitical content, and peer influence. Factors that would prevent participation include hostile environments, perceived irrelevance or politicization, cultural mismatch, inaccessibility, and personal constraints.

When designing interventions targeting Nepali older adults, consideration needs to be given to the content of the intervention, how it is delivered, and the factors that attract or prevent participation.

Nepali older adults need relational and cultural components in addition to specific foci to encourage their participation in mental health interventions.

Healthcare delivery now exceeds the cognitive and operational capacity of individual clinicians, making effective teams the core units of clinical performance. Professionalism serves as a stabilizing force within these systems. This review presents an evidence-based leadership framework for building and sustaining high-performing clinical teams through coordinated intelligence: the collective ability to rapidly integrate distributed expertise to improve patient outcomes. Clinical leadership therefore centers on creating teams capable of consistent collective excellence, grounded in individual accountability, shared responsibility, and internally sustained standards.

To examine the characteristics and needs of Spanish-speaking first-time mothers enrolled in the Nurse-Family Partnership (NFP) and to contextualize quantitative findings with observations from a bilingual nurse key informant regarding barriers, challenges, and service-access needs among Spanish-speaking clients.

A cross-sectional observational study combining quantitative data from mothers via retrospective chart review with qualitative insights from a single key informant interview with a Spanish-speaking nurse home visitor.

A Texas NFP program serving low-income, first-time mothers.

Quantitative data were collected from 305 first-time mothers enrolled in NFP, including 62 Spanish-speaking and 243 non-Spanish-speaking participants. Qualitative data were collected through a recorded 50-min semistructured interview in English with a bilingual NFP nurse who primarily serves Spanish-speaking mothers.

Quantitative data from routine NFP home visits were analyzed using descriptive statistics, chi-square tests, and independent-samples t tests to compare Spanish-speaking and non-Spanish-speaking participants. Measures included demographics, insurance type, health behaviors, depression, anxiety, intimate partner violence, and referrals to services. The nurse interview was analyzed using thematic analysis to contextualize the quantitative findings.

Quantitative analyses showed that Spanish-speaking participants differed from non-Spanish-speaking participants across several sociodemographic, insurance, health behavior, mental health, and referral outcomes. Spanish-speaking participants reported lower depression, anxiety, and intimate partner violence. The nurse interview generated four themes: complex systems navigation; trust building as the foundation for engagement; language, cultural, and structural barriers; and resilience-based nursing practice.

This study highlights the distinct needs and contextual challenges of Spanish-speaking first-time mothers enrolled in NFP and underscores the value of bilingual, culturally responsive, and relationship-centered home-visiting practices to support system navigation, client engagement, and access to maternal health and community resources.

Stepped care approaches can improve access to posttraumatic stress disorder (PTSD) treatments by matching clients to an intervention level that suits their needs. This randomized controlled non-inferiority trial evaluated the efficacy of an online stepped care approach for PTSD. The approach had two treatment steps: (1) This Way Up (TWU; an online self-guided therapy); and (2) cognitive processing therapy (CPT; standard format therapy), adopting pre-specified criteria for stepping up between treatment steps. Stepped care was evaluated compared to CPT delivered via telehealth among 84 adults with PTSD and subthreshold PTSD (86% female, 87% white, aged 18-79). Stepped care cost less than CPT in terms of clinician time (by 8-10%), but CPT had less dropout (26% versus 43%). Both groups demonstrated significant improvements in PTSD (CAPS-5: g = 1.19 to 2.09; PCL-5: g = 1.23 to 2.59), depression (DASS-21: g = 0.63 to 1.13), and quality of life (AQoL-8D: g = -0.46 to -1.02) over time (baseline, post-treatment, 3-month follow-up, 6-month follow-up), with no differential rates of change over time. Stepped care was non-inferior to CPT on the clinician-rated PTSD measure (at post-treatment) and for depression at all time points. Non-inferiority could not be established for the PCL-5 and quality of life measures, with outcomes favoring CPT. The stepped care approach was feasible, even among participants with high symptom severity and complexities. However, future research is needed to address attrition and improve outcomes compared to CPT, and to identify which clients would benefit from initially receiving low-intensity therapies.

Binge eating disorder (BED) is a prevalent public health concern associated with significant medical and psychosocial burden. To better understand the mechanisms underlying this concern, the present systematic review aimed to synthesize findings from resting-state and task-based functional magnetic resonance imaging (fMRI) studies of the neurobiology of BED. PubMed, MEDLINE, PsycInfo, Embase, and Web of Science were searched, the Joanna Briggs Institute Critical Appraisal Tools were used, and the PRISMA guidelines were followed. The review identified 24 studies, comprising approximately 1,689 non-independent participants from an estimated 17 unique cohorts. These included task-based fMRI studies (n = 14), resting-state fMRI studies (n = 6), and BED treatment-outcome fMRI studies (n = 4). Key findings of the review included: (i) differences in neural responsivity to palatable food cues involving reward- and salience-related circuitry (e.g., orbitofrontal cortex, ventral striatum, and insula), alongside reduced recruitment of inhibitory-control regions during cognitive-control tasks; (ii) evidence suggesting reward-related differences in BED may be more food-specific than generalized across reward types, although some findings indicate broader frontostriatal hyporesponsivity during monetary reward processing; and, (iii) findings indicating that BED may share neurobiological overlap with, but remain distinguishable from, obesity and bulimia nervosa. However, these findings/interpretations are preliminary, given limitations in the current evidence base, including small samples, methodological heterogeneity, and the underrepresentation of males. Future neuroimaging studies should prioritize large-scale, longitudinal, efforts that include more representative (e.g., greater inclusion of males) and developmental (e.g., more children and adolescents) samples and consider socioenvironmental contexts relevant to BED. Such efforts may help inform individual-level personalized interventions.

Post-traumatic stress disorder (PTSD) is a serious mental health condition. It may develop following exposure to an extremely threatening event. Military personnel face an increased likelihood of developing PTSD because they sometimes bring experiences of difficult events from before they joined the military and because they have higher odds of being exposed to potentially traumatic events during service. To support the mental health of military personnel, several psychological interventions have been developed to help them manage PTSD symptoms. Although there is a lot of research demonstrating how well these interventions work, we do not know how the different interventions (eg, trauma-informed therapy, cognitive-behavioural therapy) compare. Because many of these interventions include more than one type of treatment (eg, behavioural activation), we do not know which specific component works best.

To explore these questions, we will identify previous studies that have examined interventions for PTSD in military personnel. We will then use network meta-analysis methods to make comparisons between all interventions, including some that have never been compared against each other in previous studies, to identify the best treatments. We also aim to identify which individual components are effective, even when delivered in combination. We will work with people with lived experiences, researchers, and mental health professionals to guide the project stages. Overall, this project aims to improve outcomes for military and ex-military personnel with PTSD by (1) identifying effective treatments, (2) establishing the relevance and transferability of the findings to a wider audience and (3) offering suggestions that will have immediate implications for clinical practice.

No ethics approval is required as this study only involves a systematic review of published literature. The findings will be published in peer-reviewed journals and presented at relevant conferences.

CRD420251081519.