Inpatient treatment in psychiatry is important due to several reasons, including stigma, cost, family support, admission indication, as well as availability of beds and other resources. In our setting, limited bed availability and challenges in inpatient services hinder the delivery of quality patient care. Therefore, information on the awareness, functionality, and needs of the inpatient services at our centre is imperative. This study aims to explore the clinicodemographic profile of psychiatric inpatients and examine their association with the length of hospital stay.

This was a retrospective cohort study of all inpatients from June 2013 to May 2017. The clinicodemographic variables were recorded as per the developed proforma. We summarized the sociodemographic and other characteristics using median and proportions. To identify the factors with a significant impact on the length of stay, we performed multiple linear regression analyses.

Of 1085 psychiatric inpatient records available, 1034 were included. The median length of stay was 8 days (Interquartile Range, 5 to 12 days). The patients with psychotic disorders and those receiving electroconvulsive therapy were more likely to have a longer length of stay by 30% and 146%, respectively.

The overall length of stay was relatively short. However, the presence of psychotic disorders and the use of electroconvulsive therapy were associated with prolonged hospitalization.

Pediatric traumatic injury (PTI) is a leading cause of hospitalization and long-term morbidity among U.S. youth, with approximately 30% developing posttraumatic stress or depression. Despite clear mandates from the American College of Surgeons (ACS) for behavioral health screening and referral, few pediatric trauma centers have the infrastructure to deliver coordinated mental health care. The Trauma Resilience and Recovery Program (TRRP) is a stepped-care, technology-enhanced model designed to promote psychological recovery following injury. This study evaluates the effectiveness of TRRP and identifies factors influencing its integration within pediatric trauma settings.

This multi-site, Type I hybrid effectiveness-implementation trial will recruit 300 adolescents (ages 12-17) hospitalized for traumatic injury and their caregivers across three pediatric trauma centers. Participants are randomized to TRRP or Enhanced Usual Care (EUC). TRRP includes bedside psychoeducation, risk screening, a brief coping skills intervention, automated text-based symptom monitoring, 30-day follow-up screening, and referral to evidence-based mental health care as needed. Primary outcomes (PTSD, depression, quality of life) are assessed at baseline, 3, 6, and 12 months. Qualitative interviews with families and trauma personnel, guided by the Consolidated Framework for Implementation Research (CFIR), will explore barriers and facilitators to implementation. Quantitative data will be analyzed using mixed-effects models; qualitative data will undergo thematic analysis.

This study will provide critical evidence on the clinical effectiveness and real-world integration of TRRP for adolescent trauma survivors. Findings will inform a scalable roadmap for embedding evidence-based behavioral health care into pediatric trauma systems to improve recovery and long-term well-being.Clinicaltrials.gov idNCT05086757.

Irritable bowel syndrome (IBS) and inflammatory bowel disease (IBD) are common gastrointestinal (GI) disorders often linked with anxiety and depression. IBS is defined by recurrent abdominal pain and altered bowel habits without a detectable organic disease, whereas IBD involves chronic, relapsing intestinal inflammation. Bidirectional communication through the gut-brain axis, gut dysbiosis, neuroimmune interactions, and shared genetic susceptibility may underlie these associations. This study aims to quantify and compare the bidirectional associations between anxiety and IBS or IBD using a large, real-world multicenter dataset.

A retrospective cohort study was conducted using TriNetX, a global network of de-identified electronic health records from over 100 healthcare organizations. Adults diagnosed with anxiety disorders, IBS, and IBD between January 1, 2021, and January 1, 2024, were identified along with matched controls. Patients with prior psychiatric disorders, GI conditions, recent GI infections, or relevant medication use were excluded. Propensity score matching balanced cohorts by age, sex, race, ethnicity, smoking status, and history of depression. Outcomes included incident IBS or IBD following anxiety and incident anxiety following IBS or IBD assessed over a follow-up period of five years post-index. Risk ratios, risk differences, and odds ratios with 95% confidence intervals were calculated.

Among matched cohorts, 6,724 individuals (1.1%) with anxiety developed IBS compared with 2,457 (0.4%) in controls (RR 2.737, 95% CI 2.613-2.866; p < 0.001). For IBD, 1,412 patients (0.2%) with anxiety developed the condition versus 908 (0.2%) in controls (RR 1.555, 95% CI 1.431-1.690; p < 0.001). Reciprocally, 8,334 patients (6.6%) with IBS developed anxiety compared with 3,770 (3.0%) in controls (RR 2.211, 95% CI 2.129-2.295; p < 0.001). Among patients with IBD, 2,354 (2.6%) developed anxiety versus 2,383 (2.7%) in controls (RR 0.988, 95% CI 0.934-1.045; p = 0.669).

Anxiety and IBS exhibit strong bidirectional associations, whereas links between anxiety and IBD are weaker and inconsistent. These findings highlight the roles of the gut-brain axis and neuroimmune pathways in these conditions. Screening for psychiatric comorbidities and integrating GI and mental health care, including gut-brain-targeted interventions, may improve outcomes for patients suffering from these conditions.

Managing multiple health conditions can create a demanding workload, especially when capacity is limited. This can lead to disengagement and poor health outcomes. Our pilot trial explored the feasibility of care coordination using a minimally-disruptive medicine approach.

The setting was a community health service in rural Victoria, Australia. People with multimorbidity and complex life demands were linked to care coordinators who evaluated and addressed burden and capacity imbalance, informed by client priorities. Clinicians underwent training in capacity-burden assessment and participated in ongoing case conferencing. A mixed-methods evaluation was undertaken guided by Bowen's feasibility framework with treatment burden and quality of life as quantitative outcomes.

26 clients (mean age 66.5 years) engaged with 3 care coordinators. Clients reported high treatment burden with a mean of 11 chronic conditions each, dominated by mental health and chronic pain conditions. The program was highly acceptable to clients, who reported increased control over their health and life demands. Six-month outcomes showed a significant reduction in treatment burden level (MMTBQ) p=0.019, Phi=0.524 and improvement in quality-of-life scores (EQ-VAS) p=0.019. Clinicians valued the program and highlighted the importance of putting aside one's discipline lens and focusing on the client priorities, aided by the assessment tools and training.

A burden-capacity model of care coordination is feasible in the community health setting and may lead to reduced treatment burden. Barriers identified were related to community health funding and structures favouring single diseases and disciplinary boundaries, which may not reflect the lived experience of clients.

This study investigates the utilization of modern glucocorticoid medications (Acecort®, Alkindi®, Efmody®, Plenadren®) for congenital adrenal hyperplasia due to 21-hydroxylase deficiency, examining prescribing patterns, barriers to adoption, and geographical and temporal trends.

A two-part study was conducted: a retrospective analysis of treatment regimens from the International Congenital Adrenal Hyperplasia Registry across 46 centres in 20 countries (2017-2023), and a qualitative survey of 39 centres regarding barriers to prescribing modern medications. Patients included both paediatric and adult populations. Data analysed included regional prescription trends, timing of modern glucocorticoid adoption, and identified barriers.

From 2017-2023, 44 of 790 (5%) patients transitioned from traditional to modern glucocorticoid therapy, with the highest adoption in high-income Western European countries. Alkindi® was exclusively prescribed to patients under 8 years, while 97% of Efmody® users were 7 years or older. By 2023, modern glucocorticoid availability varied among centres: Alkindi® (54%), Efmody® (46%), Plenadren® (33%), and Acecort® (15%).

Adoption of modern glucocorticoid medications for congenital adrenal hyperplasia remains limited, with only approximately 5% of patients transitioning from traditional therapies. Significant barriers include legislative approval, supply chain challenges, and elevated costs.

This international study looked at how new medications for congenital adrenal hyperplasia are used globally. We found that despite increasing availability of new medications during the study time period, only a small number of patients (5%) switched to these newer treatments. This limited use is mainly due to high costs, problems with getting legal approval, and supply issues, highlighting unequal access to care worldwide.

Previous research has established that sex workers have specific health needs and face significant obstacles in meeting them. This study explored the experiences of sex workers in Flanders regarding their access to healthcare and sought to identify key barriers and facilitators. Following Belgium's decriminalisation of sex work in 2022, the study also aimed to explore how this policy change was reflected in sex workers' experiences and perceptions of healthcare access. In-depth semi-structured interviews (N = 10) were conducted with sex workers in Flanders: six women and four men aged between 24 and 64 years. Transcripts of interviews were analysed using thematic analysis. Four main themes were identified: (1) specific health complaints; (2) the role of decriminalisation; (3) remaining barriers to healthcare access; and (4) support and resources for sex workers. Barriers to healthcare access included stigma and discrimination; lack of knowledge and trust in healthcare providers; long waiting times; and reluctance to disclose their occupation. Culturally sensitive training for healthcare providers, expanding the services of sex workers' organisations, and ensuring that future research examines the long-term impact of decriminalisation with diverse populations such as migrant sex workers, are recommended.

To explore the experiences of mental health difficulties and access to mental health support among young people with cerebral palsy (CP).

We used a qualitative descriptive design. Participants were young people with CP aged 13 to 25 years and parents of children with CP (6-25 years). Nineteen semi-structured interviews were conducted. A narrative thematic analysis was conducted to identify themes related to their mental health experiences.

Four themes were identified from the data: (1) understanding manifestations of mental health, triggers, and the importance of early intervention; (2) structural and human challenges in accessing mental health services; (3) the interplay between mental health and personal, social, educational, and familial challenges; (4) navigating future aspirations and holistic mental health support.

People with CP face complex, interconnected challenges to their mental health, influenced by personal, family, social, and systemic factors. Mental health difficulties often go unrecognized or are inadequately addressed, highlighting the need for early identification, integrated service provision, and holistic, person-centred interventions that support young people and their families.

AimHealth service usage for eating disorders (EDs) has increased substantially; however, many tertiary hospitals lack resources for specialist ED services. Evidence-based guidelines outline ED management approaches for acute medical stabilisation in non-specialised services, including protocols for care across key disciplines (psychiatry, medicine and dietetics). The study aim was to evaluate collaboration of care within an Australian tertiary hospital following an eating disorder Inpatient Access and Treatment Pathway (IATP).MethodsThis retrospective cohort study reviewed 40 patients admitted with an ED diagnosis pre- (2019) and post- (2022) implementation of the IATP. The electronic medical record was utilised to gather patient demographics and health outcomes, and organisation of care (multidisciplinary team meetings, discharge planning).ResultsFollowing the implementation of the IATP, there was a 40% (p = .01) increase in appropriate discharge planning, classified as ED service referral or suitable community dietetic, medical and psychology follow-up. There was a significant increase in the Care Adherence Score (p = .004) which quantified organisation of care, utilising four key dichotomous variables. There was also a significant an increase in starting energy prescription (5900 KJ vs 4480 KJ, p = .046).ConclusionsA local IATP supported a significant increase in multidisciplinary collaboration and care adherence, appropriate discharge planning and starting energy provision.

People with psychotic disorders have greater mortality rates following cancer diagnosis, compared to people without psychotic disorders. Prior examinations of the effect of psychotic disorders on survival following cancer diagnosis mediated by stage at diagnosis and treatment disparities did not accommodate for multiple mediators and post-exposure confounding. The present study sought to estimate analogues of the natural indirect effects of having NAPD on mortality following cancer diagnosis, mediated through stage at diagnosis and time to treatment initiation.

We identified cases of cancer diagnosed between 1995 and 2019 among people with non-affective psychotic disorders (NAPD) and a comparison group without NAPD, constructed using Ontario health administrative data. Death from any cause was identified using register data. Inverse probability of treatment weighted Cox models were used to estimate the effect of NAPD on mortality following cancer diagnosis mediated by stage at diagnosis and time to treatment initiation, adjusting for relevant confounders.

The analytic sample included 3,643 people with NAPD and 15,174 people without NAPD who developed cancer. People with NAPD had a 66% greater adjusted hazard of all-cause mortality than people without NAPD (95%CI = 1.55,1.78). The HR estimate for the indirect effect mediated through stage at diagnosis was 1.09 (95%CI = 1.05,1.13) and HR estimate for the indirect effect mediated through time to treatment initiation was 1.00 (95%CI = 0.96,1.04).

Our findings suggest that a relatively small proportion of the effect of NAPD on mortality is mediated by stage at diagnosis, while time to treatment initiation does not mediate that effect. This excess risk is potentially mediated by other patient, provider, and system-related factors in cancer care.

To identify patient and intervention factors that moderate the effects of running on intervertebral disc health (IVD) in adults with non‑specific chronic low back pain.

Pre‑planned secondary analysis of a 12-week parallel-group (1:1) randomised controlled trial of 40 adults with non-specific CLBP (mean [SD] age: 33 [6] years, female: 50%). Participants were allocated to a digitally-delivered progressive run-walk interval exercise training program (3 days/week, 30 min/session) or waitlist control. Magnetic resonance imaging at baseline, six, and 12 weeks quantified primary outcome IVD composition as whole-disc T2 (ms) from T11/T12 to L5/S1. Moderators included baseline degeneration (Pfirrmann grade; aggregated Pfirrmann score), sex, body mass index, and intervention factors (cumulative running volume, mean speed, and dominant surface). Linear mixed models were fitted at the IVD level to estimate group-by-time effects within each moderator-defined subgroup (α = 0.05).

The highest aggregated Pfirrmann scores reflecting greater multi-level degeneration (estimated marginal mean net difference [95%CI]: 3.42 [0.22, 6.62] ms, P = 0.036), cumulative running volumes between 28.6 and 46.1 kms (4.80 [2.51, 7.10] ms, P < 0.001), mean running speeds between 10.5 and 11.7 km/h (2.46 [0.14, 4.79] ms, P = 0.038), and running on grass (2.93 [0.10, 5.76] ms, P = 0.043) positively moderated between-group IVD T2 changes.

In this pre-planned secondary analysis of a randomised control trial of a run-walk program, our data suggest running speed, volume and surface, as well as more multi-level IVD degeneration, may be associated with more favourable 12-week IVD T2 changes. Findings are hypothesis-generating and may inform future trials designed to optimise IVD health.