The Resilience Hub was established to support people in need of psychological/psychosocial support following the 2017 Manchester Arena terrorist attack.

To use mental health screening measures over 3 years following the Arena event to examine the variation in symptoms reported by adults registered with the Hub, and whether this was associated with treatment access characteristics.

Adults engaging with Hub services were separated into eight cohorts depending on when they registered post-incident. Participants completed screening measures for symptoms of trauma, depression, generalised anxiety and work/social functioning. Baseline and follow-up scores over 3 years were compared among the eight admission groups. All types of appointment were recorded in terms of the number of minutes of clinical ‘contact time’ involved, to explore associations with time taken to register.

Overall, baseline screening scores increased as time to register post-event increased. Over the 3 years of follow-up, a decrease in scores was observed for all 4 screening measures, indicating improvement in mental well-being. Those taking longer to register had higher follow-up scores. However, they showed a slightly stronger decrease in average change of score per follow-up month. Mean contact time per month was greater (apart from the 18-months admission group) in individuals delaying registration. Increased contact time was associated with decreased follow-up screening scores for depression and anxiety.

People who registered earlier were less symptomatic, suggesting there may be a potential beneficial impact of early engagement with support services following traumatic events. All who registered showed improvement in symptoms, including those delaying registration, with increased contact time being beneficial. This reinforces the benefits of encouraging early and sustained engagement with services as soon as possible post-incident.

Social function is increasingly demonstrated as a factor in risk, maintenance and outcome of eating disorders, but not emphasised in theoretical models of, and treatment approaches to, adolescent eating disorders.

To adapt Schmidt and Treasure’s cognitive interpersonal model of anorexia nervosa to incorporate developmental and transdiagnostic components.

Qualitative interviews with young people aged 12–16 years (inclusive), who are in contact with child and adolescent community eating disorders services, and their parents, subjected to thematic analysis.

Five key themes emerged that were mutually dependent on a sixth theme of emotion regulation and coping. These themes were: peer relationships, change and uncertainty, thinking styles, appearance and achievement-based values, and family relationships.

Peer relationships emerged as distinct from family relationships in this population, and a unifying theme was emotion regulation and coping. The framework could guide clinical assessment and the development or adaptation of interventions to address the themes identified. Research is needed to understand the role of the themes in treatment response and outcomes.

Attention-deficit/hyperactivity disorder (ADHD) is more commonly missed or diagnosed later in females than in males. One explanation is that diagnostic criteria have been informed by research primarily based on male samples and may not adequately capture the female presentation of ADHD.

This study used a qualitative approach to better understand female ADHD in childhood, from the perspective of young women and non-binary adults with ADHD.

Twelve young adults (10 women and 2 non-binary individuals assigned female at birth, aged 18–25 years) with ADHD were interviewed to describe their lived experiences of ADHD throughout childhood. Interviews were transcribed verbatim and qualitatively analysed using the framework method, a codebook approach to thematic analysis.

Participants reported experiencing a range of ADHD symptoms, some of which are not included in current diagnostic criteria. Four core themes were identified: (a) socially oriented and internalised symptoms, (b) social impacts, (c) masking and compensation and (d) the importance of context. Theme one describes how girls with ADHD may experience symptoms as more socially oriented (e.g. losing track of thoughts in a conversation), non-disruptive (e.g. doodling) and internalised (e.g. feeling frustrated) than those described by current diagnostic criteria. Theme two highlights the importance of social impacts of ADHD on friends, home and school. Theme three describes the desire to ‘fit in’ socially, behaviours and strategies used to mask symptoms and associated unfavourable consequences. Theme four highlights variability in symptoms across different environmental contexts.

This study suggests that the presentation of ADHD symptoms in girls may be socially oriented, internalised and especially influenced by the social context. Also, female ADHD symptoms may be less visible due to scaffolding, masking and context. Future research should consider whether current ADHD diagnostic criteria require adjustment, to aid earlier recognition and diagnosis of ADHD in children and young people, especially in females.

The risk factors for post-traumatic stress disorder (PTSD) in children and adolescents following mass violence incidents, such as terrorist attacks, remain incompletely understood. In the aftermath of the 14 July 2016, terrorist attack in Nice, France, a dedicated paediatric consultation centre was established at the Children’s University Hospital, the Nice Pediatric Psychotrauma Center (NPPC).

This 2-year longitudinal study aims to identify and understand the influence of pre-trauma, trauma-related and post-trauma risk factors associated with the development of PTSD in children and adolescents following the 2016 terrorist attack in Nice.

Participants under 18 years of age at the time of the attack were recruited from the NPPC over 2 years, between 21 November 2017 and 22 November 2019. Assessments included semi-structured diagnostic interviews with children and/or parents, standardised clinical questionnaires for both parents and children and cognitive tests exclusively for children.

Two hundred and seventy-one children (mean age 8.10 years; 48.7% female) directly impacted by the terrorist attack, were assessed. Pre-traumatic factors (age, gender assigned at birth and cognitive functioning) failed to predict PTSD. Two trauma-related factors, subjective fear intensity and lifetime number of traumatic events emerged as significant predictors. Concerning post-trauma factors, maternal symptoms (anxiety, depression and PTSD), child somatic symptoms and comorbid DSM-5 diagnoses played a crucial role in child PTSD. The final regression model demonstrated an 84% accuracy in predicting PTSD in children and adolescents (χ2[3] = 2.4, P < 0.001).

These findings highlight the importance of assessing specific risk factors for PTSD in children and adolescents to deliver specialised and targeted care to young people and their parents following a terrorist attack.

The British Paediatric Surveillance Unit of the UK Royal College of Paediatrics and Child Health contacts participating consultant paediatricians each month to survey whether particular rare conditions or events have been seen in their services. This national surveillance of rare paediatric events has allowed a large amount of research into multiple paediatric conditions. In 2009, the Royal College of Psychiatrists established a similar system – the Child and Adolescent Psychiatry Surveillance System (CAPSS) – to survey consultant psychiatrists in UK and Ireland. Since many conditions involve mental and physical health features, seven studies have been run using reporting to both systems, with simultaneous surveillance across both paediatricians and psychiatrists. Given the desire by policymakers, commissioners and clinicians for well-integrated physical and mental healthcare (‘joined-up working’), and if the surveillance systems were functioning well, the CAPSS Executive expected high rates of parallel reporting of individual patients to the two systems. The current study synthesises the rates of parallel reporting of cases to those two systems. We assimilate rates of parallel reporting across the seven studies using figures that have already been published, and by contacting contributing research groups directly where the relevant figures are not currently published. No new primary data were collected.

Of the 1211 confirmed cases, 47 (3.9%) were reported by both psychiatrists and paediatricians. No parallel reporting occurred in four of the seven studies.

Our findings raise questions about whether joined-up working in mental and physical healthcare is happening in practice. Research into challenges to obtaining comprehensive surveillance will help epidemiologists improve their use of surveillance and control for biases.

Current approaches to identifying individuals at risk for psychosis capture only a small proportion of future psychotic disorders. Recent Finnish research suggests a substantial proportion of individuals at risk of psychosis attend child and adolescent mental health services (CAMHS) earlier in life, creating important opportunities for prediction and prevention. To what extent this is true outside Finland is unknown.

To establish the proportion of psychotic and bipolar disorder diagnoses that occurred in individuals who had attended CAMHS in Wales, UK, and whether, within CAMHS, certain factors were associated with increased psychosis risk.

We examined healthcare contacts for individuals born between 1991 and 1998 (N = 348 226), followed to age 25–32. Using linked administrative healthcare records, we identified all psychotic and bipolar disorder diagnoses in the population, then determined the proportion of cases where the individual had attended CAMHS. Regression analyses examined associations between sociodemographic and clinical risk markers with psychotic and bipolar disorder outcomes.

Among individuals diagnosed with a psychotic or bipolar disorder, 44.78% had attended CAMHS (hazard ratio = 6.28, 95% CI = 5.92–6.65). Low birth weight (odds ratio = 1.33, 95% CI = 1.15–1.53), out-of-home care experience (odds ratio = 2.05, 95% CI = 1.77–2.38), in-patient CAMHS admission (odds ratio = 1.49, 95% CI = 1.29–1.72) and attending CAMHS in childhood (in addition to adolescence; odds ratio = 1.16, 95% CI = 1.02–1.30) were all within-CAMHS risk markers for psychotic and bipolar disorders.

A substantial proportion (45%) of future psychotic and bipolar disorder cases emerge in individuals who had attended CAMHS, demonstrating large-scale opportunities for early intervention and prevention within CAMHS.

In the past decade, no meta-analytical estimates of the prevalence of post-traumatic stress disorder (PTSD) among children and adolescents have been published, despite a host of new prevalence studies and updated DSM-5 criteria.

We set out to estimate the prevalence rates of PTSD in trauma-exposed children and adolescents on the basis of DSM-IV and DSM-5 criteria, and investigate differences in prevalence across trauma type, gender, time since exposure, type of informant and diagnostic measures.

Studies identified in a previous meta-analysis were combined with more recent studies retrieved in a new systematic literature search, resulting in a total of 95 studies describing 64 independent samples (n = 6745 for DSM-IV, n = 12 644 for DSM-5) over a 30-year period. Three-level random-effects models were used to estimate prevalence for DSM-IV and DSM-5 criteria separately, and for testing coded variables as moderators.

The DSM-IV meta-analysis estimated a PTSD prevalence of 20.3% (95% CI 14.9–26.2%) using 56 samples with age range 0–18 years, and revealed moderating effects of gender, trauma type and diagnostic interview type. The DSM-5 meta-analysis found an overall prevalence of 12.0% (95% CI 3.7–24.2%) using eight samples with age range 1–18 years. There was insufficient data for moderation analyses.

Although most trauma-exposed children and adolescents do not develop PTSD, a significant proportion (20% under DSM-IV criteria and 12% under DSM-5 criteria) do, particularly girls and individuals exposed to interpersonal trauma. These findings highlight the urgent need of continuous efforts in prevention, early trauma-related screening, and effective diagnostics and treatment to address the substantial burden of PTSD.

Suicide remains a major risk factor for individuals suffering from schizophrenia and its prodromal state (i.e., Ultra-High Risk for Psychosis). However, less is known about the prevalence of suicidal behaviour among the adolescent and youth UHR population, a demographic vulnerable to the psychosocial and environmental risk factors of suicide. This review aims to synthesise existing literature on the prevalence of suicidal ideation and behaviour in the adolescent and youth at Ultra-High Risk for Psychosis (UHR), and the associations between suicidal behaviour and its correlates.

The databases PsycINFO, PubMed, Embase, Cochrane Library, Web of Science, and Scopus were accessed up to July 2024. A meta-analysis of prevalence was subsequently performed for lifetime suicidal ideation, lifetime non-suicidal self-injury, lifetime suicidal attempt, and current suicidal ideation. A narrative review was also carried out for the correlates of suicidal behaviour amongst adolescents and youth in the UHR population.

Studies were included in this meta-analysis. Meta-analysis revealed a high prevalence of lifetime suicidal ideation (58%), lifetime non-suicidal self-injury (37%), lifetime suicidal attempt (25%), and current (2 week) suicidal ideation (56%). The narrative review revealed that a personal transition to psychosis and a positive family history of psychosis were associated with suicidal attempts, while depression was associated with both suicidal attempts and suicidal ideation.

The prevalence of suicidal ideation and behaviour among UHR adolescents and youth is high and comparable to that of the general UHR population. Existing measures that mitigate suicide risk in the general UHR population should be adopted for the youth context.

To review and explore the eating disorder admissions to an in-patient child and adolescent mental health hospital which had restarted taking such presentations. This was done by conducting three audits using RiO (an electronic patient records system) and including all young people with eating disorders or related difficulties admitted between 1 February 2019 and 30 June 2023. As part of this, relevant practice standards were identified using the baseline assessment tool in UK national guidelines.

The audits identified 46 completed admissions, detailing demographic information, nasogastric and restraint feeding, therapeutic interventions and medication, admission and discharge routes, length of admission and more.

The review highlighted the apparent overall success of a general admission unit in treating eating disorders and related difficulties and identified key areas of importance and development in terms of clinical practice.

National policy in England recommends that young people be admitted to mental health wards that are age-appropriate. Despite this, young people continue to be admitted to adult wards.

To explore the impact of young people’s admissions to adult wards, from the perspectives of young people, parents/carers and mental health professionals working in adult services.

Semi-structured interviews were conducted with 29 participants to explore experiences of receiving and delivering care in adult mental health wards. Participants were four young people (aged 16–17 years), four parents/carers and 21 mental health professionals from adult mental health services in England. Data were analysed using framework analysis.

Young people’s admissions to adult wards tend to occur out of hours, at a time of crisis and when no suitable adolescent bed is available. Admissions were conceptualised as a short-term safety measure rather than for any therapeutic input. Concerns were raised about safeguarding, limited treatment options and a lack of education provision for young people on adult wards. However, exceptionally, for older adolescents, an adult ward might be clinically or socially appropriate. Recommendations to reduce adult ward admissions included better integration of adolescent and adult services, having more flexible policies and increasing community provision.

Our findings emphasise the importance of young people being admitted to age-appropriate in-patient facilities. Earlier intervention and increased provision of specialist care in the community could prevent young people’s admissions to adult wards.

A youth mental health crisis is considered one of the great challenges of our time, and research and clinical services in child and adolescent psychiatry have become a priority for governments and funders. Academic leadership is needed to drive forward research. It is not clear how many senior academic leadership posts (professorships) there are in child and adolescent psychiatry, nor how this benchmarks against a similarly sized medical specialty.

This study aimed to determine the number of professorships in child and adolescent psychiatry in the UK and Ireland compared to a similarly sized specialty. A secondary aim was to identify the number of clinical trials registered for mental and behavioural disorders in children.

We identified registered specialists in child and adolescent psychiatry and a similarly sized specialty who held full professorships in medical schools. We searched the International Standard Randomised Controlled Trial Number (ISRCTN) and ClinicalTrials.gov for trials.

As of 23 March 2023, there were 1725 doctors on the General Medical Council's (GMC) specialist register in child and adolescent psychiatry. The closest specialty in terms of number of registered specialists was neurology (N = 1724). We identified 24 professors in child and adolescent psychiatry across the UK and Ireland, compared to 124 in neurology. For every intervention trial registered for mental and behavioural disorders in children, there were approximately ten trials registered for diseases of the nervous system.

Despite equivalent numbers of medical specialists in child and adolescent psychiatry and neurology, there is a striking disparity in the number of professorship appointments. While young peoples’ mental health has, ostensibly, become a priority for policy-makers and funders, this is not reflected in medical professorship appointments. The paucity of senior academic child and adolescent psychiatrists has real-world implications for training, research, innovation and service development in mental health services.