Under the Universal Health Care Act of the Philippines, all health technologies should undergo health technology assessment. This manuscript details the process of the development of the Philippine guidance document for the use of real-world evidence (RWE) in the clinical evaluation of health technologies.

This study consisted of two phases. Phase 1 was a comprehensive, systematic review of all available HTA methods guides and literature related to the use of RWE in the clinical evaluation of health technologies. Based on the results of the review, a draft HTA methods guide on the use of RWE was created. Phase 2 was a validation study by expert consultation through key informant interviews (KIIs), and pilot assessment of the methods guide.

Seventy-nine articles and nine guidance papers were included, with pertinent information extracted and organized into sections. The first draft covered definitions of RWE, guidance for RWE utilization, scoping and selecting RWE, critical appraisal, data extraction, and synthesis and analysis of RWE. Changes were made to this draft based on the KIIs and pilot assessment results to produce the final output of the methods guide.

This document describes the process of creating a Philippine guidance document that covers the definition of RWE and the appropriate methods for conducting systematic search, screening, critical appraisal, data extraction, data analysis, and synthesis of RWE.

With the increased prevalence of major depressive episodes with mixed features specifier (MDE-MFS), the pharmacological treatment for MDE-MFS has attracted great clinical attention. This study aimed to investigate the efficacy and safety of medication use for MDE-MFS.

Commonly used databases were searched for the meta-analysis. Primary efficacy outcomes included response rate and the change in the Young Mania Rating Scale scores; the primary safety outcome was the rate of treatment-emergent hypomania/mania. Effects were expressed as relative risk (RR) or standardized mean difference (SMD).

In patients with MDE-MFS, antipsychotics significantly improved depressive (RR = 1.46 [95% CI: 1.31, 1.61]) and manic (SMD = −0.35 [95% CI: −0.53, −0.17]) symptoms without increasing the risk of manic switch (RR = 0.91 [95% CI: 0.53, 1.55]). However, subgroup analysis of bipolar disorder (BD) patients with MDE-MFS indicated that antipsychotics had limited effects on manic symptoms. Mood stabilizers, especially valproate, demonstrated significant effects in BD patients with MDE-MFS by relieving depressive and manic symptoms. For MDE-MFS in patients with major depressive disorder, trazodone has shown potential effectiveness in retrospective studies, while the effectiveness of antidepressants on BD patients with MDE-MFS lacked evidence.

While antipsychotics are first options for MDE-MFS, their effect on manic symptoms in BD patients with MDE-MFS is still unclear. Mood stabilizers may also be considered, and the use of antidepressants remains a topic of controversy. Since our findings are mostly based on post-hoc analyses, the evidence remains preliminary, highlighting the need for further research to produce more conclusive evidence.

The diagnosis of an advanced life-threatening illness brings with it existential challenges that activate the attachment system and different attachment styles influence coping with advanced illness.

The objective of this work were (a) to analyze the influence of attachment styles of patients with advanced disease and their relatives on emotional distress and other psychological and existential aspects, and (b) to identify the most used assessment instruments to measure it, highlighting those with better psychometric properties in palliative care contexts.

Articles on attachment published from October 2005 to February 2025 using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guide (PRISMA) were identified by searching PubMed, PsycINFO, Google Scholar, SCOPUS, Dialnet, and the Web of Science databases.

Of 1847 studies identified, 24 were included (21 quantitative and 53 qualitative). Quality assessment revealed low risk of bias and high methodological quality. The main results indicated that a secure attachment style was associated with better coping, adaptation and adjustment strategies to the experience of illness, causing a buffering effect on suffering at the end of life. In contrast, patients with insecure attachment styles presented higher levels of emotional distress, demoralization, existential loneliness, death anxiety and showed a poorer psychological adaptation to cancer. Almost two-thirds of the studies (65.1%) used some version of Experiences in Close Relationships (ECR) scale.

The attachment theory appears to offer a valuable conceptual framework for understanding how individuals may respond to the emotional and relational demands associated with advanced illness and end-of-life care. Its contributions have been increasingly considered in literature addressing psychosocial adjustment and coping in palliative contexts

For the assessment of attachment styles in a palliative context, the most used instrument is the original ECR-M16 scale or its iderived versions.

Children in care who experience frequent placement changes face an increased risk of negative mental health outcomes. Emerging evidence suggests a bidirectional relationship, where placement instability can both predict and result from mental health difficulties. Understanding the strength and direction of this relationship is crucial for informing policy and practice, yet UK-based evidence remains unconsolidated.

To conduct the first systematic review and meta-analysis examining the relationship between placement instability and mental health in the UK care system.

This review was prospectively registered on the International Prospective Register of Systematic Reviews (PROSPERO; CRD42024493617). We searched five databases (up to August 2024) for peer-reviewed UK studies that included a care-experienced sample, measured placement (in)stability, measured mental health, and quantitatively examined the relationship between placement instability and mental health. A random-effects meta-analysis was conducted, and study quality was assessed using the Newcastle–Ottawa Scale.

Fifteen studies (N = 6905) were included, with twelve studies (n = 5536) contributing to the meta-analysis. Children with unstable placements were more than twice as likely to experience mental health difficulties compared to those with stable placements (odds ratio 2.07, 95% CI 1.65–2.59). However, evidence on the causal direction of this relationship was limited.

Placement instability doubles the risk of mental health difficulties for care-experienced children, who already face elevated rates of mental disorders. Further research is urgently needed to clarify the bidirectional nature of this relationship and guide targeted intervention. Meanwhile, policymakers should prioritise collaborations between mental health services and local authorities to prevent the cycle of instability and mental health deterioration.

Much work has been done on the role of trauma in obsessive–compulsive disorder (OCD), but the relationship between stressful life events (SLEs) and the onset of OCD remains poorly studied. This study aims to summarize the evidence about the association between SLEs and OCD development.

For this systematic review, we searched PubMed, Web of Science, Scopus, and PsycINFO databases for studies published from the database’s inception to December 12, 2024. We included studies investigating the prevalence of SLEs among individuals diagnosed with OCD compared to other psychiatric disorders or healthy controls.

Seven studies met the inclusion criteria and were incorporated. Two studies found that OCD patients suffered more SLEs than healthy controls in the year before the onset of OCD. Two of the included studies showed a higher occurrence of SLEs across the patients’ lifetime before the onset of OCD. Three studies were comparable and, therefore, meta-analyzable. Together, they revealed that SLEs in the year before the onset of OCD were associated with a small yet positive pooled effect size.

Our review suggests that SLEs may be highly represented among people with OCD both in the year preceding the disorder’s onset and throughout their lifetime.

Refugees and asylum seekers often experience trauma, leading to high rates of post-traumatic stress disorder (PTSD). However, the extent to which trauma and PTSD impacts social functioning, such as social relationships or engaging with community activities in new environments, remains unclear.

This systematic review aims to identify key areas of social functioning influenced by trauma and PTSD, with additional analyses stratified by trauma type.

A comprehensive search of five databases, grey literature sources, and reference lists was conducted in February 2025. Included papers explored the impact of trauma or PTSD on social functioning in adult displaced populations post-migration, within the last 30 years. Studies’ risk of bias was assessed using the Mixed Methods Appraisal Tool and the Authority, Accuracy, Coverage, Objectivity, Date, Significance checklist. Data were extracted on associations between trauma, PTSD and social functioning outcomes.

Of the studies, encompassing 15 394 participants, 38 met the inclusion criteria. Our analysis indicated that trauma and PTSD have an impact on multiple domains of social functioning, including post-migration living difficulties, everyday functioning, acculturation and integration, social relationships, and employment and education. War-related trauma predominantly affected psychosocial functioning and integration, whereas interpersonal trauma had a greater impact on social relationships. While most findings indicated a negative influence of trauma and PTSD on these areas, some evidence suggested the potential for post-traumatic growth.

The findings underscore the challenges displaced groups face, alongside the possibility of post-traumatic growth. Future research should focus on identifying factors that facilitate positive adaptation, informing interventions to support social integration in these vulnerable groups.

Depression is one of the most common mental diseases, leading to a decline in both psychiatric and physical functions. One non-pharmacological therapeutic strategy for the management of psychiatric disorders is music therapy.

To assess the clinical effectiveness of music therapy and its various subscales for managing depressive symptoms (primary outcome) and related problems (secondary outcome) in comparison with other conventional treatments.

A comprehensive search of MEDLINE, Embase, Cochrane Review, CINAHL, PsyInfo and KMbase was conducted to identify randomised controlled trials published up to 31 August 2023. Studies assessing the clinical effectiveness of music therapy for individuals with depression were included, and data on participants, music therapy and clinical measurement scores were extracted. This study was registered with PROSPERO (no. CRD42023466833).

Music therapy was significantly more effective than controls in reducing depressive symptoms (standardised mean difference (SMD) −0.97 [95% CI: −1.23 to −0.71], P < 0.01). This benefit was consistent regardless of music therapy types, delivery methods or provider professionalism. In addition, music therapy was significantly better than controls in improving quality of life (SMD 0.51 [95% CI: 0.19−0.83], P < 0.01) and sleep quality (SMD −0.61 [95% CI: −1.03 to −0.19], P < 0.01), although it showed only a non-significant trend towards reducing anxiety (SMD −0.98 [95% CI: −2.01 to 0.06], P = 0.06). The evidence level was very low due to high risk of bias, inconsistency due to high heterogeneity and imprecision.

Despite the very low evidence level, music therapy may be recommended with weak strength for patients with depression, considering the results of the meta-analysis and the high accessibility and broad applicability of music.

The National Institute for Health and Care Excellence (NICE) in England introduced early value assessments (EVAs) as an evidence-based method of accelerating access to promising health technologies that could address unmet needs and contribute to the National Health Service’s Long Term Plan. However, there are currently no published works considering differences and commonalities in methods used between Assessment Reports for EVAs.

This rapid scoping review included all completed EVAs published on the NICE website up to 23 July 2024. One reviewer screened potentially relevant records for eligibility, checked by a second reviewer. Pairs of independent reviewers extracted information on the methods used in included EVAs using a prepiloted form; these were checked for accuracy. Data were described in graphical or tabular format with an accompanying narrative summary.

In total, seventeen EVA Reports of sixteen EVAs were included in this scoping review. Five Reports did not specify how many reviewers undertook screening, whereas five did not report data extraction methods. Five EVAs planned to conduct meta-analyses, nine planned narrative syntheses, and seven planned narrative summaries. Eleven conceptual decision models were presented, with available evidence used to construct cost-utility analyses (N = 5); cost-effectiveness analyses (CEAs; N = 4); a mix of CEAs and cost-consequence analyses (CCA; N = 2); one CCA; and one cost-comparison.

Future EVA Reports should enhance the transparency of the methods used. Furthermore, EVAs could provide opportunities for the adoption of innovative methodological approaches and more flexible communication between EVA authors and key stakeholders, including patients and clinicians, companies, and NICE.

Major depressive disorder (MDD) is a significant public health concern, and current treatments often have limitations in effectiveness and adherence. Psilocybin, a psychedelic compound found in certain mushrooms, is being explored as a potential treatment for depression. It primarily acts through the serotonin 5-HT2A receptor but interacts with 5-HT1A and 5-HT2C receptors. Its precise mechanisms remain under investigation.

(1) To consolidate evidence on psilocybin’s efficacy and safety for depression and the role of 5HT2a, (2) to identify limitations in the literature, and (3) to highlight areas needing further research.

This systematic review follows PRISMA guidelines and analyses 22 studies, including randomised controlled trials (RCTs) and open-label studies. The studies cover various populations, including individuals with treatment-resistant depression, different dosing regimens, and adjunctive therapies.

Psilocybin therapy shows substantial and rapid antidepressant effects, often after one or two sessions with psychological support. Improvements are sustained for weeks or months in many cases. Psilocybin is generally well-tolerated, with mild adverse effects such as anxiety during administration and transient headaches, which are manageable in controlled settings.

Psilocybin demonstrates promise as a novel treatment for depression, especially for individuals unresponsive to conventional antidepressants. Further research is needed to refine dosing, explore long-term effects, and understand its mechanisms of action.

The symptoms of anxiety in the outbreak of COVID-19 were so severe that they entered the research literature as the term COVID-19 anxiety. This systematic review and meta-analysis study aimed to identify the variables related to COVID-19 anxiety and the effectiveness of psychological interventions on it.

In the present systematic review and meta-analysis, the literature was systematically searched in PubMed, Scopus, Web of Science, Science Direct, ISI, and Persian databases such as Noormags and SID on COVID-19 anxiety from January 2020 to April 2022. In the initial search, 105 articles were found. In the data correlation section, 13 studies for the fixed effects model were meta-analyzed. In the interventional section, 14 articles were selected. The systematic review data were extracted, and all statistical data were analyzed by CMA-2.

The results of the meta-analyses for psychopathological correlations with COVID-19 anxiety in 13 articles indicated the correlation between COVID-19 anxiety and other mental states and disorders (P = .0001/I2 = 97.27%). Other findings demonstrated the effect of psychological interventions on COVID-19 anxiety in 14 articles with high effectiveness of these treatments (P = .00/I2 = 85.67%).

It seems COVID-19 anxiety is affected by psychological variables. Hence, psychological interventions represent effective treatments for anxiety due to COVID-19.

The optimal duration for maintaining antidepressant treatment in individuals with obsessive-compulsive disorder (OCD) who achieve symptom stabilization remains unclear.

This systematic review and pairwise meta-analysis of double-blind randomized placebo-controlled trials (DBRPCTs) compared antidepressant maintenance and antidepressant discontinuation groups in terms of relapse rate at each DBRPCT study endpoint (primary outcome), OCD symptom improvement, all-cause discontinuation, and adverse event-related discontinuation. Furthermore, relapse rates at 4, 8, 12, 16, 20, and 24 weeks were compared between the groups. Risk ratios (RRs) with 95% confidence intervals (CIs) were calculated. The absolute risk reduction (ARR) and number needed to treat to benefit (NNTB) for relapse rates were also estimated.

Nine trials (n = 1084; mean age: 32.8 years; proportion of males: 53.3%) were included. The antidepressant maintenance group had lower relapse rates at each DBRPCT study endpoint (RR [95% CI] = 0.53 [0.42–0.68]; ARR = 21.0%; NNTB = 5) and lower all-cause and adverse event-related discontinuation rates than the antidepressant discontinuation group. The maintenance group also exhibited lower relapse rates at 4 weeks (RR [95% CI] = 0.47 [0.31–0.70]; ARR: not significant; NNTB: not significant), 8 weeks (0.42 [0.31–0.57]; 12.0%; 8), 12 weeks (0.43 [0.32–0.56]; 18.0%; 6), 16 weeks (0.41 [0.32–0.52]; 25.0%; 4), 20 weeks (0.43 [0.34–0.53]; 26.0%; 4), and 24 weeks (0.42 [0.33–0.52]; 27.0%; 4) than the discontinuation group. Moreover, the maintenance group outperformed the discontinuation group regarding OCD symptom improvement.

Individuals with OCD may benefit from continued antidepressant treatment, provided that it is well tolerated.