The Management and Supervision Tool (MaST) helps NHS mental health care professionals identify patients who are most likely to need psychiatric hospital admission or home treatment, due to severe mental illness, through a Risk of Crisis (RoC) algorithm driven by electronic health record (EHR) data analytics. We describe the derivation and validation of the MaST RoC algorithm, and its implementation to support preventative mental healthcare in the NHS.

The RoC algorithm was developed and evaluated with EHR data from six UK NHS trusts using Ordered Predictor List propensity scores informed by a priori weightings from pre-existing literature, as well as real-world evidence evaluating the associations of clinical risk factors with mental health crisis using NHS EHR data. Mental health crisis was defined as admission to a psychiatric hospital or acceptance to a community crisis service within a 28-day period. Predictor variables included age, gender, accommodation status, employment status, Mental Health Act (MHA) status (under section or Community Treatment Order), and previous mental health service contacts (including hospital admissions and crisis services). Data were analysed using Ordered Predictor List propensity scores. The algorithm was derived using structured EHR data from 2,620 patients in a single NHS trust and externally validated using data from 107,879 patients in five other NHS trusts. Qualitative and quantitative data on feasibility, acceptability and system efficiency impacts of MaST implementation were obtained through staff surveys and local audits.

The factors associated with greatest propensity for mental health crisis included recent previous crisis, multiple previous crises, higher number of mental health service contacts in recent weeks, MHA section, accommodation status and employment status. The RoC algorithm identified 64% and 80% crises in its top quintile. Sentiment analysis of staff surveys suggested that the use of MaST improved productivity by reducing time taken to access patient information to support caseload management that was previously difficult to obtain through manual review of EHRs. The systems efficiency audit revealed a reduction in duration of crisis and inpatient admissions following MaST implementation.

The MaST RoC algorithm supports the identification of people more likely to use crisis services in NHS mental health trusts, is feasible to implement, and improves systems efficiency. EHR-derived algorithms can support real-world clinical practice to improve outcomes in people receiving NHS mental healthcare.

Psychiatric illnesses are common among older adults and are associated with increased mortality and physical comorbidities. It is suggested that patients with frailty have a higher prevalence of depressive symptoms. (1) The eFI (electronic Frailty Index) is a tool used to assess the severity of frailty in elderly frail patients using a cumulative deficit model based on routine interactions with their GP.

Patients were selected for annual frailty assessments by searching the electronic clinical system (SystmOne) using the eFI tool. Patients were assessed using the Comprehensive Geriatric Assessment (CGA) framework. In addition, all patients were screened for coexisting anxiety and depression using the Patient Health Questionnaire (PHQ-9) and Generalized Anxiety Disorder (GAD-7) questionnaire.

Of the 118 patients who ranged from mild to severe frailty, we found there was a positive correlation of the frailty severity eFI scores with increased rates of anxiety and depression evidenced by higher scores on the PHQ-9 and GAD-7 scoring tools. We found a positive correlation of the eFI with the PHQ-9 depression scores of (r = 0.819 p < 0.001). Within the same data set, we found correlation coefficients of eFI and anxiety GAD-7 scores (r = 0.651 p < 0.001). Increasing frailty was found to be associated with a higher rate of depression and anxiety.

We found in this study higher (eFI) electronic frailty indices are associated with higher rates of anxiety and depression. We would recommend annual frailty assessments in patients with high electronic frailty indices and this should include screening for mental health deterioration. Early detection of deterioration will enable patient centered supportive measures and targeted treatment strategies. Health maintenance programs should ensure patient centered holistic assessment of both physical and mental health needs for early identification to avoid deterioration of both physical and mental health.

The incidence of depression has risen both nationally and internationally. The mainstay of management remains referral to IAPT and treatment with SSRI and SNRIs and the rates of prescribing are rising exponentially. During the COVID-19 pandemic, more people faced mental health challenges. In the last ten years, the incidence of SSRI prescribing rose from 6.8% to 100%. A known side effect of antidepressant medication is weight gain, dyslipidemia, increasing risk of impaired fasting glycaemia and diabetes. Our study was conducted to assess the actual risk incurred in our population from the point of starting therapy till date.

Patients were identified from the GP clinical system (SystmOne) to identify those with a current prescription of antidepressants and antipsychotics. A retrospective analysis of 591 patients' case records was undertaken. Body weight, BMI, fasting glucose, HbA1c, fasting lipids and Q risk were analysed at the time of prescription initiation, post treatment and any rise in cardiovascular risk over a period of years. The data were analysed to see the trajectory of deterioration in metabolic risk. All patients were assessed to ensure they had been signposted and referred to weight management services.

The data show a positive correlation between the onset of antidepressant and antipsychotic prescribing, worsening of BMI, increase of cardiovascular and metabolic risk. The data show an exponential rise in BMI and metabolic risk (cardiovascular Q risk, dyslipidemia, imparied fasting glycaemia, diabetes and ischaemic heart disease) for patients taking SSRI and SNRI within 12 months. This effect continues for the length of the prescribing interval. We also found that with the rise of BMI dose, escalation was common due to reduced effectiveness. The average rise in cardiovascular Q risk average was 14.05% over three years. Patients need careful counselling at the outset and need regular reassessment of metabolic risks at each medication review. Informed consent must be obtained - risks of SSRI, SNRI and antipsychotic risk should be stated.

A known iatrogenic risk of antidepressant medication is weight gain, dyslipidemia, increasing risk of impaired fasting glycaemia and diabetes. Careful counselling and metabolic risk assessment is required when initiating these medications. Throughout the length of prescribing patients need re-assessment of their cardiovascular and diabetes risk with timely referral to weight management services to counterbalance metabolic risks.

To study the impact of the lockdown (pandemic) in the mother's understanding of the child's disorder (ADHD) and the burden faced by her.

A mixed method design with a combination of a qualitative and quantitative approach. An in depth in-person semi structured interview with the participant mother was conducted as the qualitative part and the quantitative part of the study consisted of burden assessment by the Zarit Caregiver burden scale pre and post pandemic. The responses were transcribed and themes were identified

As far as understanding of the disorder was concerned, the major themes identified were “Knew about the child's problems from teachers but online schooling made me see the child's issues in person” and “Knew about the illness but more time led to more bonding and more understanding”. When questioned about the burden faced, the major themes that evolved were “Increased burden as I felt exhausted taking care of child 24/7” and “Increased burden as I felt angry and irritated with my child, the school and family”. The Zarit caregiver questionnaire revealed a statistically significant difference in the burden before and after pandemic with more number of mothers falling in the mild to moderate & severe category of burden after the commencement of the pandemic.

COVID-19 pandemic increased the caregiver burden for Indian mothers of children with ADHD. They understood a lot more about their child's disorders by spending more time and devised different ways and means of helping their child in academic and other areas.

1. 1. To determine the association between serum BDNF, serum MMP-9 and cognitive function test in BD-1 patients in remission and to compare with controls.

2. 2. To assess the current psychosocial functioning of BD-I patients in remission and their correlates.

Single center case control study.

Cases were BD-I patients in Remission (n = 60) and controls (n = 60) were age and gender matched healthy persons. The diagnosis of BD-1 was confirmed using Structured Clinical Interview For DSM-IV-Tr Axis I Disorders –Research Version along with clinical record. Age group between18–60 years, in remission for at least 2 months [scoring ≤ 8 on the Hamilton Depression Rating Scale, and ≤ 6 on Young Mania Rating Scale] were included. Those with significant head injury, neurological disorder, substance use disorder, Diabetes/Hypertension and premorbid IQ < 70 were excluded.

Control group were excluded if their first degree relative had any psychiatric illness as elicited using Family Interview for Genetic Studies scale (FIGS).

Cognitive functioning was assessed using Addenbrooke's Cognitive Examination version III (ACE-III) and Trail making test A and B (TMT A and TMT B). Current psychosocial functioning was assessed with Functioning assessment short test (FAST).

Five ml blood sample was taken for estimation of serum BDNF and MMP-9 levels by ELISA.

Chi-square test used to compare categorical variables. Mann-Whitney U test for continuous variables. Spearman's correlation - evaluate the relationship between scores on the cognitive function tests and serum levels of BDNF and MMP-9, within the group of patients with BD-I.

With regards to cognitive functioning, compared to controls, cases performed significantly poor in domains of Memory (Z = −3.435, p = 0.001), Processing speed (z=−2.667, p = 0.008), and Executive functioning (Z= −4.084, p = 0.000).

No statistical difference in levels of serum BDNF and MMP-9 between patients and controls were found.

While BDNF serum levels were not associated with cognitive or psychosocial functioning, there were significant relation between serum MMP-9 and the various domains of FAST scale and total FAST score (rho = 0.447, p < 0.001).

BD-I patients exhibited poor psychosocial functioning compared to controls even in euthymic state (U = 702.00, p < 0.000).

Patients with BD-I display poor performance in memory, executive function and psychosocial functioning even during euthymic state compared to controls.

Serum BDNF and MMP-9 levels comparable to the healthy controls during remission- pointing towards them as state markers rather than trait.

Need for routine evaluation of cognitive function during follow-up visits and focus on target deficits for rehabilitation for better recovery and improving the quality of life of BD patients.

Antipsychotic medications such as risperidone, olanzapine and aripiprazole are used to treat psychological and behavioural symptoms among dementia patients. Current evidence indicate prescription rates for antipsychotics vary and wider consensus to evaluate clinical epidemiological outcomes is limited. This study aims to investigate the potential impact of atypical antipsychotics on the mortality of patients with dementia.

A retrospective clinical cohort study was developed to review United Kingdom Clinical Record Interactive Search system based data between January 1, 2013 to December 31, 2017. A descriptive statistical method was used to analyse the data. Mini Mental State Examination (MMSE) scores were used to assess the severity and stage of disease progression. A study specific cox proportional hazards model was developed to evaluate the relationship between survival following diagnosis and other variables.

A total sample size of 1692 patients were identified using natural language processing of which, 587 were prescribed olanzapine, quetiapine, or risperidone (common group) whilst 893 (control group) were not prescribed any antipsychotics. Patients prescribed olanzapine and Risperidone showed similar risk of death [hazard ratio (HR) = 1.32; 95% confidence interval (CI): 1.08–1.60; P < 0.01], (HR = 1.35; 95%CI: 1.18–1.54; P < 0.001). Patients prescribed Quetiapine showed no significant association (HR = 1.09; 95%CI: 0.90–1.34; P = 0.38). Factors associated with a lower risk of death were elevated MMSE score at diagnosis (HR = 0.72; 95%CI: 0.62–0.83; P < 0.001) along with other demographic factors such as women (HR = 0.73; 95%CI: 0.64–0.82; P < 0.001) and being of a Caucasian British group (HR = 0.82; 95%CI: 0.72–0.94; P < 0.01).

A significant mortality risk was identified among those prescribed olanzapine and risperidone which contradicts previous findings although the study designs used were different. Comprehensive research should be conducted to better assess clinical epidemiological outcomes associated with diagnosis and therapies to improve clinical management of these patients.

To assess current diagnostic methods used in the United Kingdom which have led to successful diagnoses of PMDD (Premenstrual Dysphoric Disorder).

Women suffering from PMDD were recruited across the United Kingdom. Participants were interviewed using a semi-structured interview guide about their paths to diagnoses and the impact of receiving a misdiagnosis. Interviews were transcribed and thematically analysed to assess for overarching themes and similarities across participants. The Patient Health Questionnaire-9, Generalised Anxiety Disorder-7 survey, and Premenstrual Symptom Screening Tool were used to assess for each questionnaire's diagnostic ability.

Four women aged 30–50 years all identifying as PMDD patients were interviewed. All four participants received misdiagnoses of major depressive disorder and/or generalised anxiety disorder. The key to achieving a PMDD diagnosis for all four women was awareness of the cyclical nature of their symptoms. All three surveys failed to fulfill all the diagnostic criteria for PMDD, however the Premenstrual Symptom Screening Tool performed the best and elicited the greatest number of symptoms from the population sample.

This research showed the need for patient awareness of PMDD via research, or awareness of the relationship between symptoms and the menstrual cycle, to achieving a diagnosis and receiving adequate treatment. Specialist treatment was also imperative to achieving a formal diagnosis.

The aims were to determine and compare the prevalence of possible psychiatric disorders among Bangladeshi adults before and during lockdown. It was hypothesized that prevalence of possible psychiatric disorders would increase during the lockdown. In Bangladesh, lockdown was implemented in response to the COVID-19 pandemic resulting in conditions where those prone to developing psychiatric disorders were more vulnerable in an environment where the mental healthcare infrastructure is already lacking. Although many studies outlined the devastating impact on mental health that the lockdown measures created, this unique study specifically uses a World Health Organization developed research instrument for a lower-middle-income country.

This was a cross-sectional, descriptive, comparative study with one stage design to determine possible psychiatric cases. Initially, 603 adults were randomly contacted using Facebook messenger & groups and email. Questionnaires including the validated Self Reporting Questionnaire (SRQ)-20 in Bangla, for screening psychopathology of the cases, and a structured questionnaire containing socio-demographic and other related variables, were inputted into Google Forms and hyperlinks were distributed. Eventually, 570 participants, from 18 to 77 years, with Internet access, who completed the questionnaires, were included in the study through purposive and consecutive sampling. The SRQ variables were divided into four categories: (1) depressive/anxious; (2) somatic symptoms; (3) reduced vital energy; and (4) depressive thoughts. Using IBM SPSS Statistics, paired sample t-tests were used during data analysis.

The mean age of cases was 34.69 ± 13.02 years; male: female = 1.41:1. The prevalence of possible psychiatric disorders was 43.9% during lockdown compared to 23.3% before lockdown (t = 19.497, P = 0.000). Before lockdown, sex and employment status were significant factors for the SRQ positive cases. After lockdown, in the SRQ positive cases, sex, educational status, COVID-19 positive cases and death due to COVID-19 among family members were highly significant (p = 0.0001) factors. Somatic symptoms and depressive thoughts were approximately double in prevalence among the SRQ positive cases during lockdown compared to before lockdown.

There was a significant impact on mental health where a reduction in psychological and socioeconomic support occurred. These findings are in line with those in the literature where somatic symptoms have been identified as most commonly experienced during the pandemic. Increased depressive thoughts are associated with increased feelings of possible impending death and fear of an uncertain situation. Clearly, the mental health infrastructure of Bangladesh is in even greater need of rapid change to ensure resilience to the survivors of the lockdown.

Since the 1950's, there has been increasing interest in the potential of the psychedelic experience to generate an enhanced state of emotional well-being in those suffering from a range of mental disorders. Following the so-called ‘War on Drugs’, much of this research was curtailed until a new surge of interest resulting in a ‘psychedelic renaissance’. This has come at a time where powerful institutions, including the medical sphere, are being asked to address their oppressive and damaging pasts; these narratives bear particular relevance to psychedelic research given the widespread use of entheogenic plants as medicines and tools for spiritual healing amongst indigenous groups worldwide, and the political history of the War on Drugs. The aim of this study was to explore how those in the psychedelic community have come to understand what it means to ‘decolonise’ this space and to situate these conversations within existing literature.

Semi-structured interviews were conducted with 10 participants who were recruited using theoretical and snowball sampling. Data collection and analysis were carried out from a critical theoretical standpoint, further borrowing from aspects of constructivist grounded theory methodologies. This involved open coding of existing literature to devise an interview guide, followed by coding of interview transcripts to generate several key themes as they emerged from the primary data.

Analysis of the data generated 8 sub-themes, which were then combined to create the 4 main themes;

• • The Making of a ‘New’ Medicine

• • Scientism and Spirituality

• • Appreciation vs Appropriation

• • Beyond Decriminalisation

The study demonstrated the participants’ willingness to engage in a discussion which explored some uncomfortable truths regarding psychedelic research. There was a suggestion amongst some participants that the space can never be truly decolonised given the capitalist and neo-colonial manifestations within the current space. Future research should seek to facilitate more critical discussion of the epistemic, material, and geopolitical injustices which exist, and critical indigenous methodologies offer a meaningful way of understanding and undoing the hierarchical power structures currently at play.

Background: The impact of the pandemic and resultant restrictions on suicidal thoughts may vary across populations, geographical areas, between high and low socio-economic groups and vulnerable populations. Aim: To investigate the psychological impact of COVID-19 and resultant restrictions on suicidal thoughts in the United Kingdom.

The study group conducted a cross sectional survey using a questionnaire based on published approaches (Generalised Anxiety Disorder 7, Patient Health Questionnaire 9, Impact of Events Scale-Revised) to understand the psychological impact of COVID-19 and the resultant restrictions on suicidal thoughts. The study was conducted in 3 phases to capture the different phases of the pandemic restrictions:

• Phase 1: 1st May 2020 to 31st July 2020

• Phase 2: 12th November 2020 to 12th February 2021

• Phase 3: 1st July 2021 to 30th September 2021

Analysis strategy: Descriptive analysis and logistic regression is applied in this study.

The study recruited 29133 participants in phase 1; 83851 participants in phase 2 and 75204 participants in phase 3. The largest age group of participants was 45–64 years. About two thirds of respondents were female. Majority of participants were of White British ethnicity. 31% participants in phase 1, 30% in phase 2 and 19% in phase 3 reported suicidal thoughts.

The preliminary regression analysis indicates that younger and male participants reported more suicidal thoughts among other findings which will be reported in the presentation.

Limitations: The non-probability sample design and time limited surveys meant that longitudinal changes were not possible to elicit.

There is mixed evidence on whether rates of suicidal thoughts increased during the pandemic. The results of this study will add to the evidence base and influence future pandemic planning and efforts to developing resilience and good mental health in society.

This research assessed healthcare workers' vaccination practices for influenza, hepatitis, and pneumonia, as well as their desire to get COVID-19 vaccine when accessible, and investigated their 7C psychological antecedents (confidence, complacency, collective responsibility, compliance, calculation, constraints and conspiracy). Stress variables and vaccination intention for COVID-19 were also compared to see whether psychological stress had a meditative impact on the relationship.

An analytical cross-sectional survey was conducted among health care professionals including nurses and doctors of tertiary care hospitals of Rawalpindi. Data were collected from February to April 2021 to get the COVID-19 vaccination when it became available, and looked into their 7C mental forebears (confidence, complacency, collective responsibility, compliance, calculation, constraints and conspiracy). A total of 642 health care professionals voluntarily participated in our research. Demographic Details, questions like pneumonia vaccination, hepatitis vaccination, influenza vaccination and 7C questions were asked. Data were entered and analysed through SPSS 26.0 and Python. Correlation, linear and non linear regression, and mediation analysis were applied.

The immunization rates for influenza, hepatitis, and pneumonia vaccines, as well as the percentage of those who received COVID-19 vaccination, were 43.4%, 65.2%, 42.8%, and 39.7%, respectively. Hepatitis vaccination was significantly associated with the 7C model, influenza vaccination with conspiracy, whereas pneumonia was significantly associated with compliance. confidence (r = 0.11), complacency (r = −0.19), constraints (r = −0.20), calculation (r = 0.08), collective responsibility (r = 0.18), and compliance (r = 0.19) were significantly corelated with the COVID-19 Vaccine Intention. Contrary to direct effect, the indirect effect of patient contact frequency (β = −0.01, ρ<0.05) and terrified of contracting virus (β = −0.05, ρ<0.05) via psychological stress on COVID-19 Vaccination intention were significant depicting full mediation.

For herd immunity, the probability for COVID-19 vaccination uptake among healthcare professionals was less than optimal. The 7C structures may help predict immunization against influenza, hepatitis, and pneumonia, but not vaccination against COVID-19.

Carers of individuals presenting with complex behavioural and mental health needs report that service users may not receive the provision of care they require, particularly when presenting following suicide attempts and self-harm. Carers are an integral part of the care system and often feel ignored and marginalised by services; there is a lack of involvement of carers and paucity of their views of support needs to be explored. The aim of the study is to understand carers’ experiences of caring for service users with complex mental health needs who self-harm and/or attempt suicide, and the support received from mental health care services.

Ten carers of service users with complex mental health needs were interviewed about their views on the psychiatric admission, treatment and discharge process for the people they were caring for. Data were gathered during semi-structured, one-to-one interviews remotely over the phone or online platforms. Interviews were audio-recoded and transcribed verbatim. A transcript-based conceptual analysis was conducted to identify and explore emerging themes.

Carers identified both positive and negative aspects of the psychiatric admission and care within community settings. The following key themes emerged from the interviews: lack of control and information from mental health services, the importance of support from staff, or conversely its absence; concerns about service users’ vulnerability, negative staff attitudes and opportunities for involvement; negative experiences of generic psychiatric settings; positive experiences were encountered when there were supportive and caring staff, good information sharing and satisfactory discharge arrangements.

Important areas for service improvements are highlighted. Recommendations included: the need for support; information about suicidal behaviour and advice on managing further incidents at home; more support in coping with regular and escalating self-harming and suicidal behaviours, particularly, severe consequences of staff safeguarding errors and inappropriate discharge, and the importance of supportive and adept staff. These findings identify the need for tailored support for carers regarding the management of self-harm and suicidal behaviours in the community.

Individuals presenting with complex behavioural and mental health needs may not receive the provision of care needed. Those presenting with a more complex clinical presentation may have a history of self-harm and suicide attempts. A common risk factor for preceding suicide is previous self-harm, suicide attempts or discharge from inpatient units. Understanding the descriptive symptom domains for inpatients and those treated in the community and the relationship between them could inform suicide prevention. The aim of this study was to explore the extent of self-harm and suicidal behaviours in individuals with complex mental health needs across inpatient and community settings.

A cohort study design of in-depth written medical notes (n = 80) for people who were known to have complex mental health needs across inpatient and community settings. Data were extracted from medical records onto a coproduced questionnaire. As well as demographic data, information was collated about previous self-harm, suicide planning, suicide attempts, and support seeking regarding suicidal thoughts. The study will include a quantitative in-depth description and inferential analysis of the demographic clinical characteristics of the patient group.

Medical case notes were reviewed for 80 service users with complex mental health needs. Across both groups, approximately three-quarters of participants had previously self-harmed (76%), or planned suicide (n = 73%), and/or attempted suicide (63%). Self-harm (83% vs. 70%) and suicide attempts (72% vs. 65%) were more prevalent in the inpatient group compared to the community group. Social support was received more by community patients than inpatients (70% vs. 50%), even though inpatients were more likely to sough help when experiencing suicidal thoughts compared to people cared for in the community (38% vs. 30%). In both groups, there were often multiple suicide plans and attempts made over their timeline of contact with services.

Self-harm, suicide planning, and suicide attempts were prevalent for people treated across both inpatient and community settings. Self-harm and suicide planning was indicative of a later suicide attempt within both settings. In those experiencing suicidal thoughts, few had sought help, suggesting the importance in staff training to enable then to recognise and identify patterns of self-harming and suicidal behaviours in individuals with complex mental health needs. Social support needs for inpatients should be increased, particularly when they sought help for suicidal thoughts. This may help to reduce length of stays in hospital or future readmissions to hospital; thus, reducing the cost implications for the NHS mental health services.

Brazil is the eighth in number of suicides in the American continent, and 4th in the number of suicides in Latin America. From 2011–2016, there were 33,269 cases in women and 14,931 in men, with 24.1% and 17.2% in populations aged 10–19 years, respectively. Regarding self-harm, there were 116,113 cases (25.9%), and 60,098 cases (19.6%). And in both, the recurrence rate was high, with 25.3–33.1%. Properly employed, the Singular Therapeutic Project (STP) can prevent further events and even completed suicide. In this way, there is a reduction in stigma in this population and for family members, adequacy of mental health services, in addition to lower public spending on hospitalizations. We analysed the effectiveness of the STP in cases of suicide attempt and self-harm, in an outpatient setting, through the comparison of a group of patients with more adherence with the STP, in relation to the group with less adherence in a multidisciplinary context.

It was a retrospective cohort, with adolescents aged 12 to 18 years, from the south of Sao Jose do Rio Preto (Brazil), during the period of 2015–2019, with follow-up for more than 3 months.

To analyze the behavior of numerical variables, descriptive statistics, boxplot plots and the specific test for Kolmogorov-Smirnov will be considered. Comparisons of continuous variables between two independent groups will be performed using Student's t test or Mann-Whitney test; comparisons of categorical variables with Pearson's chi-square test or Fisher's exact test.

The study sample consisted of 88 patients, 79.5% of whom were girls, 1.1% were illiterate, 34.2% were referred from the health unit, 29.5% from the hospital emergency. Patients with new episodes of suicide attempts accounted for 14.7% (1 attempt −10.2%, 2–1.1%, 3–3.4%), and self-harm 23.8% (1–12.5%, 2–2.3%, 4–4.5%, 5–2.3%, 6–1.1%, 7–1.1%).

There was no statistical significance between the group with adherence to STP and without adherence in relation to new suicide attempts (p = 1.0) and recurrence of self-harm (p = 0.309). In addition, both outcomes were not statistically significant with sociodemographic data, psychoactive substance use, and negative life events.

The adolescents' adherence on STP was not associated in recurrence of suicide attempts and self-harm. We hypothesized that the sample size may have influenced the power of the statistical analysis. This pilot study is the first phase of the still ongoing study on all city.

With extensive evidence and track record on efficiency, third-wave psychotherapies, i.e. mindfulness-based interventions (MBIs), have gained popularity in the United Kingdom (UK) as the mainstream tool for mental health and well-being. During the COVID-19 pandemic, a lot of MBI training has shifted from physical meetings to online to improve access nationally. To date, there is limited data on the differences of online MBIs available in the UK. This web pages review is aimed to elucidate the available resources for online training on MBIs in the UK.

Google Search engine was used to identify web pages providing MBI training in the UK from February 2021 to March 2021. The search words used were “mindfulness”, “acceptance commitment therapy”, “dialectical behaviour therapy”, “DBT”, “Compassion focused therapy”, “CFT”, “England”, “Northern Ireland”, “Scotland”, “Wales”, and “United Kingdom”. The search word “ACT” was omitted due to a high number of irrelevant search results. Inclusion criteria were any web page providing mindfulness training in the English language, based in the UK. Exclusion criteria were web pages that were not from the UK with limited information and the web page was not about the provision of mindfulness training. Given the high number of web pages appearing in the Google Search for each of the localities, further search was stopped when all ten web pages that appeared on a Google search page were all excluded.

The total number of web pages returned from searches was 23,030,000 of which were 13.1 million for England, 2.89 million for Scotland, 3.09 million for Wales, 2.18 million for Northern Ireland, and 1,770,000 were unspecified. Only 165 web pages offering MBI training were included. Among those, 57% were for the general public while 30% had information for both professionals and the public. The majority of them, i.e. 65% offered online training courses when only 25% of them offered both online and face-to-face training. There were 25% of web pages offering free basic courses for the public. There was a similar split between the group, individual and mixed training.

There is a significant amount of MBI training resources available online for both public and professionals. One interesting finding is that a significant portion of them provide free basic training which is very encouraging and certainly has a positive impact on the accessibility of mindfulness education during the pandemic disruption.

Introduction: Mental health literacy (MHL) is defined as “one's knowledge and beliefs about mental disorders” (Nishida-Hikiji et al., 2021). Additionally, it includes the capability to recognise specific disorders, distinguish risk factors and causes, recognise self-treatments and available professional help, and it is an attitude that encourages recognition and appropriate help-seeking (Jorm et al., 1997). Background: In the UK mental health problems are one of the main public health issues as it affects one in four individuals. It specifically has a high prevalence among university students which is between the ages of 16–24 years (Kessler et al., 2005)

The study design used for this study was a systematic literature review in which data were collected from PubMed, EBSCO and ScienceDirect using specific keywords in the advanced search. The amount of papers found were 953 after abstract screening for keywords only 34 papers were left and then final abstract and full-text article screening for the inclusion and exclusion criteria was done leaving it with only 8 papers. A quality assessment was done for the eight papers using CASP tool for RCT papers and EPHH tool for cross-sectional papers.

The findings showed that there are different levels of MHL between university students depending on their gender, education year, faculty and ethnicity. It was also found that the professional help seeking behaviour is not significantly different between genders but there was a difference regarding those identifying themselves as bisexuals despite them having high MHL scores.

In conclusion the MHL of university students in the UK was found to be lower than those in Australia thus stating that more attention should be drawn to the issue and the need for easily accessible counselling services should be provided and promoted by universities. So that students can know about their existence and make good use of it whenever needed.

Medicine is an undoubtedly challenging degree but studying medicine during the COVID-19 pandemic has posed added challenges for medical students across the UK. With teaching being moved online, practical exams cancelled, and final year students being fast-tracked onto the NHS frontline, there has been a dramatic change in how traditional medicine is being taught- with a ‘hands-on’ approach being swapped for video calls and remote teaching. This study will highlight the impact of the COVID-19 pandemic on the mental health of medical students, how they have coped through what has been an unprecedented two years and what can be done to support them through their medical training.

A cross-sectional survey was performed on medical students at University College London. This involved a combination of face-to-face interviews and an online survey. They were asked about the impact on their overall mental well-being, as well as what the most challenging aspect of studying medicine during the pandemic was. They were also asked how optimistic they feel about their future in the medical profession. The data gathered were then analysed.

There were 30 responses, which were a combination of face to face and an online survey. Students unanimously agreed that the most challenging aspects were loneliness, lack of face-to-face teaching and minimal social interaction. 60% stated that their mental health has suffered significantly, and everyone felt that they have missed out on certain aspects of teaching during the pandemic, namely cadaveric dissections, time on wards and gaining vital communication skills. However, the benefits of online teaching included learning at their own pace and being able to take breaks to avoid burnout.

There are limited studies looking at the long-term effect of COVID-19 on medical students in the UK. This survey highlights the detrimental impact of the pandemic on medical training and the mental health of these students. To address the possibility of burnout before they start their medical career, more resources could be signposted by medical schools to students during this challenging time. As we are transitioning out of the pandemic, we should be mindful not to forget the cohort of students who studied medicine alone in their homes. Most importantly, we must ensure this generation of doctors is well supported as they begin to care for members of the public.

To explore the reasons for relapse after receiving in-patient detoxification and de-addiction treatment for alcohol dependence syndrome, through in-depth interviews and thematic analysis.

This study was conducted in a tertiary care teaching hospital in South India. After obtaining Institutional ethics committee approval, patients of 18 years and above, who were admitted for the management of alcohol withdrawal syndrome, were approached and informed consent was obtained. Patients were screened with Clinical Institutes Withdrawal Assessment-Alcohol Revised (CIWA-Ar) and 15 patients who scored less than 7, who did not have any severe medical or psychiatric illness, whose cognition was intact according to Hindi Mental Status Examination (HMSE) and those who had two de-addiction treatments in the past were recruited. In-depth interviews were conducted in Tamil, audio-recorded, and transcribed. A semi-structured guided interview format was used to gather their narratives. The transcripts were translated to English on the same day and a step-by-step thematic analysis recommended by Braun et al was followed. The interviews were conducted in a soundproof room ensuring privacy and confidentiality. The recorded audios and the transcripts were firewall protected. The transcripts were read multiple times to familiarize the investigators. By using a general inductive method the data were retrieved, coded, and systematically organized according to patterns and themes. Two investigators coded the transcripts separately and any conflict was resolved by discussion. Thematic saturation was attained with the 14th transcript but the coding was completed for all 15 manuscripts. The mean age of the participants was 26.4 years.

The analysis resulted in the identification of reasons attributed by the patients for resuming drinking after receiving in-patient detoxification and de-addiction treatment for 21 days. This 21 days deaddiction program comprises of detoxification, motivation enhancement therapy, group therapy, and family interventions. The reasons for relapse included peer pressure, confidence that they will not become dependent again, craving, stressors, and health issues such as pain and insomnia and to test whether the treatment works or not. Reasons for the delay in help-seeking were lack of motivation, poor social support, financial constraints, lack of hope in medical treatment, did not feel the necessity to take treatment, fear of whether the doctors would be upset for relapsing again and, the guilt of letting down the treatment team. The reasons why they finally came for treatment were having severe withdrawal symptoms, pressure from a family member or employee, guilt and a desire to change, and fear of dying.

This research provides avenues to understand patients’ perspectives on relapse of alcohol dependence. Understanding these would be beneficial in psychotherapy while managing relapses. It also helps us to reflect on our practice and to address these issues before discharging the patients to minimize the relapses.

This study aimed to determine the prevalence of problematic mobile phone use and its association with the chronotypes among the doctors of a medical college hospital in Puducherry, India. It also aimed to assess the feasibility of the University of Rochester Modified CAGE Questionnaire as a brief screening tool for problematic mobile phone use.

This cross-sectional study was conducted at a tertiary care teaching hospital in South India. After obtaining the Institutional ethics committee approval, doctors including consultants, higher trainees, core-trainees, and junior doctors working in various departments were approached and requested to participate in the study. Those who agreed were provided with the participant information sheet and written informed consent was obtained. Part-A of the questionnaire contained requests for personal and professional details and part B had the following questionnaires to assess problematic mobile phone use, chronotypes, phantom ringing and vibration and, sleep quality.

• • Problematic use of mobile phone scale (PUMP)

• • Reduced Morningness Eveningness Questionnaire (r MEQ)

• • Questionnaire for Phantom ringing and Phantom vibration

• • The Pittsburgh Sleep Quality Index (PSQI)

• • University of Rochester Modified CAGE Questionnaire

• • Data were analysed using IBM SPSS Statistics for Windows, Version 20.0 (IBM Corp., Armonk, NY, USA). Nonparametric tests were used as the data were skewed. The data were summarized by frequencies and percentages for categorical variables and median and interquartile range for continuous variables. The chi-square test was used to find the association between two categorical variables. Kruskal Wallis test was used to compare the chronotype with the continuous variables such as CAGE total, PUMP, and PSQ score. Correlation between different continuous variables was studied by using Spearman rank correlations. Kappa statistics were used to evaluate the concordance between PUMP and the University of Rochester Modified CAGE questionnaire.

Neither type (NT) was the most common chronotype (41.5%), followed by morning type (38%) and evening type (20%). Eight (5.6%) doctors had problematic mobile phone use, and 38(26.8%) had poor sleep quality. Evening chronotype (p-value- 0.002), being a female (p-value- 0.014), working in a clinical department (p-value 0.017) and experiencing phantom ringing (p-value- 0.001) had significant association with higher PUMP score. Even though females had a higher median PUMP score, problematic mobile phone use was more among males. University of Rochester Modified CAGE Questionnaire had a sensitivity of 81.73% (73–88.6%), and a specificity of 28.95% (15.4–45.9%).

Doctors should be aware of their mobile phone usage. This study has reiterated the predilection evening chronotype has for behavioral addictions and doctors of evening type should be extra cautious.

To assess the association between executive dysfunction and the severity of alcohol dependence, age at first drink, and the number of deaddiction treatments in the past (indicating current relapse).

This cross-sectional study was carried out in the in-patient unit of the Department of Psychiatry of a tertiary care teaching hospital in South India. Institutional Ethics committee approval was obtained. 43 Adult patients who were diagnosed with alcohol dependence syndrome according to the International Classification of Diseases (ICD-10), admitted for deaddiction treatment, whose withdrawal symptoms were adequately treated, and who did not have a severe mental or physical illness were included in the study. The hospital has the policy to offer 21 days of inpatient treatment which comprises of detoxification, motivation enhancement therapy, group therapy, and family interventions. Only those patients previously treated in the same hospital were considered to maintain, homogeneity. After briefing the patients about the procedure, a participant information sheet was provided and informed consent was obtained. A semi-structured proforma was used to collect the demographic details and information regarding alcohol consumption. AUDIT (Alcohol Use Disorder Identification Test) Questionnaire was used to assess the severity of alcohol dependence. After familiarising the participants with the study and the procedure, their executive function was assessed using Frontal Assessment Battery (FAB).

The mean age of the participants was 36(SD 7.8) years. The mean age of the first drink was 21 years (SD 6). The mean duration of alcohol dependence was 5.6(SD 3.6) years. The total number of de-addiction treatments was 2.2(SD 1.2). 58% at least had a middle school education, 30% were unemployed and 48.2% belonged to lower socioeconomic status. 72% were married and 60% had a family history of significant alcohol consumption. The average duration of total abstinence was 147.5(SD 74) days. 86% consumed spirits and 14% consumed arrack regularly. The mean score on the AUDIT scale was 26.8 (SD 7.3). The mean FAB score was 11.2(SD 4.2). 53.4% had a score of less than or equal to 12 indicating executive dysfunction. Age, (p-value-0.02) number of de-addiction treatments (p-value- 0.014) and the AUDIT score (p-value-0.04) had statistically significant negative correlation with the FAB score. Age had a positive correlation with the number of de-addiction treatments

There is a bidirectional relationship between alcohol use and executive dysfunction. By establishing a significant association between executive dysfunction and the number of de-addiction treatments indicating relapses, this study reiterates the importance of assessing executive dysfunction among this population, to prevent relapses. It can be used as a high-risk indicator for relapse and adequate preventive measures should be in place while treating these patients.