Among various factors that determine an individual's self-esteem, parenting styles play a very significant role in this regard. Certain parenting styles that are practiced around the globe include authoritarian, authoritative and permissive parenting. The study aimed to investigate the co-relation between parenting styles and self-esteem among medical students.

A cross-sectional study was conducted among the MBBS students of Rawalpindi Medical University, Rawalpindi from December 2020 to March 2021. 255 students took part in this study. An online survey was prepared by using Parental Authority Questionnaire-Short Version and Rosenberg Self-Esteem Scale and students were asked to fill it. Simple Random sampling technique was applied. SPSS version 26.0 was used to enter and analyze data. Pearson Correlation, Logistic regression and Hierarchal regression analysis were applied.

Out of 230, 60% of the sample population experienced authoritative, 29% experienced authoritarian whereas 11% experienced permissive style of parenting. Authoritative (r = 0.283, p < 0.001) and authoritarian (r = -0.227, p < 0.001) parenting styles were significantly correlated with self-esteem. Authoritarian parenting style (AOR = 2.20, 95% CI: 1.17, 4.14) was significantly associated with self-esteem of the participants compared to authoritative parenting style.

Results indicated that authoritative parenting was only parenting style that correlates positively with self-esteem which suggest authoritative parenting is the optimum parenting style in Pakistani culture.

COVID-19 imposed lockdowns have impacted the mental health of medical students worldwide. However, the relationship of social anxiety disorder with psychological distress during the pandemic has not been studied. The objective of this study was to assess the association of social anxiety disorder and physical activity with psychological distress in medical students during COVID-19 imposed lockdown.

256 medical students (M/F: 144/112) took part in this online cross-sectional survey conducted in September 2020 during a government imposed lockdown. Kessler-10 (K10) questionnaire, social interaction anxiety scale (SIAS) and international physical activity questionnaire (IPAQ) - short form were used to assess psychological distress, social anxiety and physical activity, respectively. Data were analysed using SPSS v25, with application of multivariate logistic regression to assess association of various factors with psychological distress.

Out of 256 medical students, 73 (28.5%) had severe psychological distress and 105 (41.0%) had mild to moderate distress. A logistic regression model to assess the effect of social anxiety disorder, level of physical activity and gender with the likelihood of having severe psychological distress was statistically significant (p < 0.001) with overall accuracy of 73.8%. The risk of developing severe psychological distress was higher among females [OR 2.13 (95% CI 1.17–3.87), p = 0.013] and those with social anxiety disorder [OR 4.56 (95% CI 2.27–9.16), p < 0.001]. Low physical activity was not a significant risk factor for psychological distress [OR 0.88 (95% CI 0.35–2.23), p = 0.794].

This study shows that COVID-19 imposed lockdown has adversely affected the mental health of medical students. Female students and those with social anxiety disorder are at more risk of developing severe psychological distress.

Patient and public involvement and engagement (PPIE) is recognised as an essential part of health research. It provides an opportunity for patients to shape health research and acquire research skills, in the inpatient mental health setting, PPIE may have additional value in providing meaningful activity and enhancing recovery, as defined using connectedness, hope, identity, meaning and empowerment (CHIME) principles. An eight -session PPIE programme (“Discovery Group”) was designed to support patient-led research in a secure mental health hospital. This feasibility study aims to evaluate the acceptability of the programme from the perspective of patients and identify potential outcomes.

A retrospective single-arm post-programme evaluation of Discovery Group was undertaken. Participants attended an evaluation workshop where they were interviewed individually to complete an acceptability questionnaire designed using the domains of the Theoretical Framework of Acceptability. Participants also completed an outcomes questionnaire, which included CHIME-based recovery items. Quantitative data were analysed descriptively. Direct content analysis was applied to qualitative data.

In our sample, eight participants attended at least one session of the discovery group with one patient attending all sessions. Most of the participants felt positive about taking part in the group and expressed interest in joining another group in future. All participants experienced some burden from the effort required during group sessions, but a low level of opportunity cost in terms of the extent to which they perceived they had to forfeit benefits to participate in the programme.Some described the group as effective in helping them learn about research. Of the five CHIME recovery domains, only connectedness was reported as a benefit of the group. The participants valued the opportunity to use their time.

Discovery Group is a novel intervention that offers high level, non-tokenistic PPIE suitable for use in secure mental health inpatient settings. It produces research of value to patients through a programme of high acceptability and provides them with potential benefits of recovery as well as research knowledge and skills, and an activity that alleviates boredom, enhances autonomy, breaks down some important power and paternalistic barriers that can be experienced by patients detained in secure mental health settings. Finally, a future evaluation study that involves patients during the design, implementation, evaluation and writing stages, aiming to measure the potential outcomes identified in the present study using pre- and post-testing with a control group would reliably demonstrate the effectiveness of the revised Discovery Group and ensure meaningful involvement with patients as co-researchers.

The dearth of emotional intelligence leads to medical students’ inability to handle the pressures of medical education, sub-sequently causing burnout and mental illnesses. Poor emotional intelligence in young doctors also begets increased mistrust from the public, lowering the quality of healthcare delivery. Emotional intelligence of Pakistani students, similar to global context, is impacted by a myriad of psycho-socio-economic factors. It is pertinent to find out the detrimental and/or protective factors, and design interventions to enhance emotional intelligence as a soft skill. With this aim in mind, we explored the relationship of emotional intelligence with adverse childhood experiences and prevalent mental illnesses (depression and anxiety) amongst the medical students of one of the most populous cities of Pakistan; Lahore.

A cross-sectional study was conducted including currently enrolled MBBS (Bachelor of Medicine and Surgery) students from first year to final year in 2 medical schools of Lahore. An online google form was constructed by combining Modified Adverse Childhood Experiences Score Scale (ACES), Brief Emotional Intelligence Scale (BEIS-10) and Hospital Depression and Anxiety Scale (HADS). Data were exported to SPSS version 25.0 for descriptive and analytical analysis. Pearson's chi-square analysis and logistic regression analysis were used to study the association between the outcome and dependent variables; Odd's ratio (OR) with 95% Confidence Intervals (CI) were calculated.

Participants (N = 324) belonging to two different medical colleges in Lahore, namely King Edward Medical College (public) and Shalamar Medical and Dental College (private), took part in the study.

Pearson's chi-square showed significant association of emotional intelligence with early private schooling (p = 0.029), nuclear family system (0.044) and the presence of symptoms of depression (0.005). The adjusted logistic regression model showed that people who studied in a private sector school (OR: 2.12, CI: 1.01–4.45) and people who lived in a nuclear family (OR: 2.02, CI: 1.00–4.08) had significantly twice the likelihood of having high emotional intelligence. Also noteworthy is that respondents who were depressed according to HADS showed significantly lower emotional intelligence (OR: 0.37, CI: 0.16–0.86)

Emotional intelligence is now being recognized as an important life skill for healthcare providers. Emotional intelligence of medical undergraduates is influenced by a number of factors such as early schooling, family's living situation, current mental health and adverse childhood experiences. More prospective researches should be conducted to evaluate these relationships. Carefully crafted interventions for improving emotional intelligence for medical students must be implied at an early level to achieve better outcomes from medical education.

The COVID-19 pandemic and the associated impact on the NHS led to particular challenges for Intellectual Disability (ID) inpatient hospitals across the country. The aim of this Research Project is to gather the experience of Inpatient staff in our local ID Hospital following the first wave of COVID-19 pandemic in July 2020.

We gathered data by means of survey from inpatient staff including ‘staff nurses’ and ‘health care support workers’ from 2 cute assessment and treatment units and 1 rehabilitation unit over the preceding 3 months. We obtained 15 responses. We gathered quantitative data via a questionnaire on the views of staff regarding the service provision for patients and staff during COVID-19. We also gathered qualitative data on learning points and how things would have been done differently in hindsight.

The responses were anonymised, directly transcribed, coded and grouped into themes. 67% of staff stated appropriate type and quantity of Personal Protective Equipment was available. 60% of staff stated it was ‘easy’ to access a General Practitioner for patient reviews. 60% of staff stated, there was a change in arrangements for Do Not Resuscitate/Escalation plans during COVID-19. 47% of staff stated there was availability of virtual or face-to-face clinical training support. 67% of staff did not take sickness leave due to symptoms or contact with a COVID-19 patient. 67% of staff did not receive or found it difficult to access a COVID-19 test. 47% of staff reported a negative impact of the pandemic on their physical and mental health well being. 13% of staff found the Counselling/emotional Support helpful.

Some of the key themes that emerged in the qualitative data analysis included the importance of being grateful for personal health and well being, move lives could be saved if earlier and more frequent testing was available during the first wave, delays in the arrival of PPE in the hospital and ideas to mitigate risk by designating members of staff to a fixed work area to reduce mixing.

A wide range of reflections, suggestions and feedback were obtained during the research project which will be helpful to plan and organise services moving forward should future waves of COVID-19 emerge.

To compare characteristics, presentation and treatment of care home patients referred to care home pathway team during three lockdowns.

Data were collected from referrals to G&W care home pathway team during lock downs:

First: 23rd March 2020 to 30th June 2020

Second: 5th November 2020 to 2nd December 2020

Third: 5th January 2021 to 8th March 2021

Variables collected included number of referrals, age, gender, type of care home, reason for referral, type of behavioural and psychological symptoms of dementia (BPSD), diagnosis, new diagnosis of dementia, comorbidity, type and professional to make initial contact, blood tests at point of referral, appointments, duration on caseload, type of interventions for BPSD, admission, and use of antipsychotics. They were analysed for statistical significance at p value <0.05.

There were 23, 21 and 34 referrals respectively in the three lockdowns, with significant reduction in the weekly average of referrals (1.6), and number of men (17.4%) referred in the first lockdown. Significantly greater proportion of referrals in first lockdown was for BPSD (65.2%), with aggression (40%) as most common BPSD. Alzheimer's dementia was commonest dementia (67%) across lockdowns with fewer new diagnosis (21.7%) made in first lockdown. There was lower rate of delirium (21.7%) in fist lockdown associated with fewer blood investigations (56.5%) at point of referral. Although there was no difference by type of professional, number of appointments, and discharges, duration on caseload (median 58.5 days) was significantly longer during first lockdown. There was access to medical, nursing, and psychological therapies input during all lockdowns. There was reduction in medication prescription including antipsychotics (33%), with no new antipsychotics commenced in all lockdowns.

Despite availability of mental health services, this study highlights reduction in access to mental health services as well as physical health investigations for elderly residents in care homes during the first lockdown.

This study analyses the progression of psychiatric symptoms over time of young people with special educational needs (SEN). The aims of this study were: 1) To examine whether the presence of psychiatric symptoms in earlier life are more likely to impact functional outcomes in later life in those with SEN; 2) Whether the presence of psychiatric symptoms in adolescence predicts functional outcomes in early adult life.

Data were obtained from the Edinburgh Study of Comorbidity (ESC) which was a longitudinal follow-up study of adolescents with SEN. This study had ethical approval from the Multicentre Research Ethics Committee for Scotland. It involved head teachers of 99 schools around Scotland identifying pupils aged 13–22 years whom they would estimate as functioning in the borderline to mild intellectual disability range (estimated IQ between 50–80) and were therefore receiving special educational assistance.

Adolescents with SEN were assessed with the Clinical Interview Schedule (CIS) to evaluate the presence of psychiatric symptoms. A total of 247 individuals with SEN were recruited to the study. They completed the CIS at baseline (T1), 1–2 years later (T2) and 6 years later (T3). At T3, the participants also completed the World Health Organisation Disability Assessment Schedule 2.0 (WHO-DAS) to measure the degree of functional impairment. Correlation statistical analyses were carried out to find whether there was a significant relationship between CIS and total WHO-DAS scores.

There was a statistically significant correlation between total WHO-DAS score with slowness and anxiety symptoms (p values 0.008 and 0.024 respectively) measured on the CIS at T1. None of the symptoms measured on CIS at T2 had a statistically significant correlation with total WHO-DAS score. With the symptoms that were significant, after application of a Bonferroni correction, none of the symptoms measured on CIS had a statistically significant correlation at any time point with total WHO-DAS score.

Our results show that there is some evidence that anxiety and slowness in adolescence are associated with greater functional impairment in young adulthood. However, further research is required to confirm this relationship. Our data highlight the potential value of identification and treatment of psychiatric symptoms in early adolescence.

The full impact of the ongoing COVID-19 pandemic is yet to be determined, but it is likely to have had a significant influence on the development of young people, especially those with mental health conditions such as Obsessive Compulsive Disorder (OCD). This study aims to investigate the change in symptoms and whether these were linked to COVID-19/lockdown, as well as the treatment and support received.

The Mood and Anxiety team for West Kent were contacted to request patients with a diagnosis of OCD. A total of 16 patients were included (12–18 years, 63% female), as they were known to services prior to March 2020. Data were retrospectively collected by searching electronic notes between September 2018 and October 2021 to identify patient demographics, OCD symptoms and severity (and whether this had been affected by COVID-19/lockdown), and if they were receiving medication and therapy. It was noted whether questionnaires had been completed, and how frequently patients were contacted by CAMHS.

75% of young people reported increasing OCD symptoms after March 2020. Of the patients who reported an increase in symptoms, nearly half (47%) explicitly attributed this to either the COVID-19 pandemic or lockdown. Prior to March 2020, 31% of patients were receiving medication for OCD, this increased to 69% of patients between March 2020 and September 2021. 31% of patients were undergoing therapy for OCD prior to March 2020, and over the following 18 months, 50% were receiving therapy, with the remainder of patients on the waiting list. The most common therapy was CBT. Prior to March 2020, 13% of patients had completed questionnaires relevant to OCD, which increased to 44% between March 2020-Septermber 2021. Patients were contacted more frequently via CAMHS post-March 2020 (62.5% vs 25%), but the method of contact switched to mainly remote methods.

Overall, there was an increase in OCD symptoms during the pandemic, with a proportion of patients identifying either COVID-19 or lockdown as contributing factors. The number of patients receiving both psychological and pharmacological therapy for OCD increased. There were low numbers of patients completing questionnaires for OCD, which would be a useful way to identify changes in symptoms across patients. Contact from mental health services increased during the pandemic, although this shifted to virtual formats. This suggests that CAMHS need to prepare for the possible increasing need for services due to the pandemic and provide support targeted to those with OCD.

KS is a congenital condition with 47, XXY chromosome karyotype. Due to a lack of understanding of the condition amongst healthcare providers, KS is grossly underdiagnosed, with most patients never receiving a diagnosis. Within this population, gender dysphoria is suggested to be of higher incidence than in the general population. To establish the validity of this claim and to improve care for patients with KS, particularly in the area of gender service provision, we need to identify whether there is a significant proportion of XXY individuals that experience gender dysphoria. The aim of our study is to determine whether UK patients with a diagnosis of KS are more predisposed to gender dissatisfaction.

A PRISMA literature review was conducted on the epidemiology, management, and treatment outcomes of KS patients with gender dysphoria. Based on the results of the literature review, we then conducted a cross-sectional survey of patients serviced by the Klinefelter Syndrome Association on gender satisfaction. The survey recorded 81 responses.

Of the entire study population, gender distribution was 65% male, 6% female, 4% non-binary, 2% gender fluid, 3% neither, 1% equally male and female, and 1% intersex. This contrasted with most patients’ assigned birth on their birth certificate, which was 92.5% male and 3.75% female. Most patients surveyed enjoyed living as the sex written on their birth certificate (61.64%), which seemed to correlate closely with the proportion of patients that identified as male (65%).

Literature Review: As a whole, KS patients documented in research presented to psychiatric and sexual health services during adulthood, requesting either sex reassignment surgery or changes to hormonal replacement therapy. The sparse amount of research over a long period of time has created a reliance on outdated research techniques. Patient Survey: Survey results show that there are a significant proportion of survey respondents that do not identify as male despite it being written on their birth certificate; however, the majority prefer to be identified as male. This suggests that certain individuals with KS are at higher risk of gender dissatisfaction and dysphoria. Importantly, these observations are not substantiated with clinical judgement of a psychiatrist/mental health worker, which should aim to be incorporated in future research. Additionally, longitudinal studies should aim to establish whether certain age groups would be more at risk of gender dissatisfaction and gender dysphoria or if trends change with age.

There is a developing body of research that suggests that there may be distinct categories of patients that can explain the relationship between psychosis and antisocial behaviours. Specifically, three pathways of offending, antisocial behaviour and psychosis have been described and there is an evolving empirical evidence base to suggest that these pathways are aetiologically distinct. Firstly, there is a pathway for early-start offenders, which have been identified as those with psychosis preceded by Conduct Disorder (SZ + CD). Secondly, a group that start to display antisocial behaviours in parallel to the onset of psychosis (SZ-AS). The third group involves those with a long history of a psychotic disorder and no history of antisocial behaviours, who will present to services following a first conviction for non-violent or violent crime (SZ). The authors hypothesise that each typology will utilise services differently throughout the clinical trajectory. This pilot study aimed to (i) examine the concurrent validity of the antisocial behaviour and psychosis typologies, and (ii) examine differences in the service utilisation patterns of patients between these groups.

The sample consisted of adult male patients admitted to low and medium secure forensic hospitals within the Northwest of England. A total of 90 patients were used.

A categorisation checklist was developed, and the typology of patients determined from data collected from electronic health records. Data were collected on patient demographics, psychiatric diagnosis, aetiological factors, and service utilisation. Two researchers reviewed the data and determined the typology. Statistical analysis aimed to assess the difference in aetiological variables between the typologies and examine the relationship with how each typology utilised services.

This study provided further evidence of distinguishing characteristics emphasising typology heterogeneity.

The CD-SZ group were more likely to have utilised mental health services <18 years (70%, p = 0.062), and to have used services preceding a diagnosis of psychosis (60%, p = 0.011). Following the onset of a psychotic disorder, the AS-SZ and SZ groups had a higher proportion that used general adult psychiatry services (p = 0.031), with CD-SZ coming in to contact with forensic psychiatry services and criminal justice services earlier and more frequently.

This study demonstrates that each typology has a different clinical trajectory through mental health services. This provides further empirical evidence towards different clinical typologies and trajectories of individuals with psychosis and anti-social behaviour. Understanding more about how these typologies utilise services will enable clinicians to introduce interventions help develop effective management plans that address the distinct characteristics of each typology of offender with psychosis.

Theory of mind (ToM) is the ability to represent one's own and other's mental state. Studies in bipolar affective disorder show mixed results possible due to confounding factors like intelligence, attention, phase of illness and current mood. Purpose of this study is to study ToM in remittent bipolar disorder patients and compare with normal controls to find if there are residual deficits during remission

40 bipolar patients in remission and 40 age and sex matched controls were recruited. Clinical remission for 3 months with YMRS <4 and HAM-D <7 was inclusion criteria. ToM was assessed by Faux Pas test. Data were analysed using SPSS-11.5 for Windows with parametric and non-parametric tests as indicated. Level of significance taken as p < 0.05 (two tailed).

Mean age of onset of illness in patient group was 23.8 years with duration of illness 11.3 years. Mean number of episodes 6.7 and duration of remission 4.15 months. ToM test result revealed deficit in recognizing social cues in faux pas test by bipolar patients as compared to normal controls. There was no difference between both groups in test result on control stories.

Results suggest that ToM deficits are present in bipolar disorder patients even during apparent clinical remission, indicating it may be a trait marker of the illness. There is no deficit in understanding a regular social context without faux pas. It also revealed that there is no correlation with ToM and duration of illness

Autism prevalence is currently estimated to be approximately 1%. Ascertaining autism prevalence within the Criminal Justice System (CJS) has implications for understanding clinical and forensic need, alongside facilitating autism-specific CJS responses. This review aims to systematically identify and synthesise studies that investigate autism prevalence within CJS cohorts, and CJS involvement in autistic cohorts.

A systematic review of published studies that investigated autism prevalence within the CJS. A systematic search of major online databases was conducted in November 2021, including the ancestry method/expert consultation. Studies were qualitatively analysed, with reporting quality appraised.

The search yielded 6491 articles. Following duplicate removal, 2942 articles remained for screening, of which 2857 did not meet inclusion criteria. Therefore, full texts of 85 articles were accessed, and 34 qualified for inclusion.

Prevalence rates of autism in the CJS were examined in 19 studies, 12 focused on forensic settings (e.g. secure psychiatric services/prisons/court), with 7 focused on forensic psychiatric assessment referrals. Prevalence rates of autistic people within the CJS reported by the included studies varied from 1–60%. This variation appeared related to factors such as the characteristics of the forensic setting/cohort, the method of autism screening/diagnosis), and whether participants had co-occurring intellectual disabilities.

Prevalence rates of CJS involvement in autistic populations were examined in 15 studies, with reported rates varying by 3–48%, with variation appearing related to a lack of cohesion in the definition of CJS involvement, with focus on variables including self-reported offending behaviour, police contact, or criminal convictions. These studies reported rates of offending by autistic people at a rate equivalent to, or lower than the general population/comparison sample.

Studies examining prevalence of CJS involvement among autistic people indicate a rate of offending at a lower, or equivalent level to the general population or comparison samples. However, studies examining prevalence of autistic people within CJS settings suggest they are over-represented. Possible explanations fall within three categories:

• • pre-sentencing CJS factors - e.g. autistic people being more likely to be caught for their criminal behaviour, to confess during police interviews, to enter a guilty plea, or to have difficulty advocating for their rights in court

• • autistic offender factors – whether autistic people who do engage in criminal behaviour, engage in behaviour of a higher severity, possibly reflecting high rates of comorbid mental disorder

• • post-sentencing CJS factors – whether autistic people who offend are sentenced more harshly, or the possibility that a lack of autism sensitive forensic rehabilitative programmes and risk assessments may contribute to longer stays within forensic settings.

Callous-unemotional (CU) trait is a characteristic of conduct disorder. As CU-like behaviours emerge from early childhood, this could potentially be predicted early on in life. There is debate in whether general or specifically fear expression processing was impaired in those with CU traits. No studies investigated subliminal emotion processing in those with CU traits. Hence, this study addressed two questions. Firstly, we investigated whether attention to general facial expression or fearful expression is related to future CU behaviours. Secondly, we examined whether subliminal emotion processing can predict CU behaviours alongside supraliminal emotion processing by comparing EEG data to CU behaviours.

We performed EEG on 7 months old infants using fearful and happy faces as stimuli to investigate whether attention bias to general facial expression or fearful expression is related to future CU behaviours through the Nc component (300–600ms). We also used both subliminal and supraliminal eliciting techniques to determine whether there are any differences in terms of prediction of CU behaviours. The ERP data were then compared with behavioural data, including aggression and empathy scores, collected when the participants reach 14 to 18 months old through the infant-toddler version of the Multidimensional Assessment of Preschool Disruptive Behavior (MAP-DB) and the infant empathy and prosocial behaviour (IEPB) questionnaires.

A total of 18 infant participants were included in our analyses. There is a significant interaction between emotion and empathy for the Nc component, but not aggression. Infants with low empathy paid less attention to fearful facial expressions compared to happy facial expressions while those with high empathy paid more attention to fearful facial expressions compared to happy facial expressions. Moreover, subliminal and supraliminal emotion processing had similar ERP eliciting ability.

Our study showed those with less empathy have a different pattern of attention bias to emotional expression and are less sensitive to fear emotion. Attention bias to emotional expression during infancy could be used to predict CU behaviours during toddlerhood. Being able to predict CU behaviours before their occurrence could help identify those in need of early intervention and help identify potential participants for longitudinal studies that could aid the development of interventions and understanding of CU behaviours. Furthermore, subliminal and supraliminal emotion processing has a similar predicting ability for CU behaviours. This is the first study that investigated subliminal emotion processing in infants with CU behaviours. Future studies would need to include a larger sample size to verify our findings.

The primary aims of our study is to gather ideas from young people about developing an intervention for children who first started using social media. Our study also aims to investigate whether different types of social media use are associated with impact of social media on emotions and self-esteem.

An anonymous questionnaire was distributed to young people (16–25 years old), who were UK residents, through word of mouth, social media and university newsletters. We assessed participants’ baseline characteristics, including types of social media use (active, active-passive and passive), impact of social media. We also explored young people's idea on developing a social media intervention, including how it should be delivered, topics that needs to be covered. Quantitative data were analysed using descriptive statistics and ordinal regression analysis.

90 young people completed the questionnaire. 37.8% of the participants started using social media before 13 years old. Analysis has shown that interacting with other users and creating social media content is associated with higher self-rated negative impact on self-esteem from social media, but there is no association between impact on self-esteem and reacting to other's social media content or browsing other's social media content. Types of social media use were not associated with a self-rated impact of social media on emotions. Regarding the co-development of an intervention for social media, young people believe the best ways to distribute information about social media is through an interactive session by professionals (36.7%) or teaching it in class (28.9%) while the least popular ways are poster/booklet (1.11%) and mobile phone app (1.11%). The majority of young people felt the following topics on social media to be useful to cover during interventions, including risks on social media (85.6%), emotional safety on social media (81.1%), social media hygiene (70.0%), coping strategies and finding help on social media (66.7%), communication on social media (58.9%).

Although types of social media use are not associated with impact on emotions from social media, those who create social media content are at higher risk of having more impact on self-esteem. Interventions should be developed to help protect or improve self-esteem while using social media. This could be done by focusing on different topics. Future interventions for young social media users should be interactive and led by experts. They should also start before children reaches the common legal age of social media use to make them more resilient to the digital world.

A. To investigate the nature of liaison psychiatry consultations for COVID-19 patients in a tertiary care hospital in India B. To assess pattern and prevalence of mental health disorders and management, in COVID-19 patients in a tertiary care hospital in India.

Retrospective chart-based study

Data from medical records of 1600 confirmed COVID-19 patients was studied and charts of 368 patients among that who, during their in-patient stay for COVID-19 treatment in Lourdes Hospital, Kochi (September 2020 - December 2021), received liaison psychiatry consultation was selected for retrospective analysis

Psychiatric consultations were sought for 23%(368) patients with COVID-19 (1600) during the study period. The most common symptoms of mental health problems for referral were sleep disturbance (74.9%), agitation/restlessness, increased tension (50.3%), depressive symptoms like low mood, loss of interest (11.1%) and psychotic symptoms like talking to self, hearing voices, suspiciousness (8%). Liaison psychiatry consultation was most sought-after for critically ill patients (69.2%), with disturbed behaviour as the most common presenting complaint. Psychiatric diagnoses included in the spectrum of delirium (39.3%), sleep disorders (33.3%), anxiety (15.5%), depression (7.1%) and psychosis (4.8%). In terms of psychiatric treatments, 95.9% of patients who received psychiatric consultation were treated with psychotropic medications, including non-benzodiazepine sedative-hypnotic agents (54.8%), anti-psychotic (26.2%), benzodiazepines (22.6%) and antidepressant (10.7%). The symptoms of 61% of patients had improved and they were prescribed medications to continue the treatment on discharge.

A significant proportion of hospitalized COVID-19 patients experienced mental health problems, especially patients in intensive care unit. Data that emerged from this study regarding pattern of mental illness and management options will serve as a template for psychiatrists to liaise with medical teams to treat future patients.

Mother and baby units (MBUs) are inpatient units where women with severe acute postpartum psychiatric problems can be cared for alongside their babies. This is currently considered to be gold-standard care, recognising the importance of early childhood bonding and family-centered care. Great Britain has spearheaded the development of the MBU, however the history of MBUs in the United Kingdom (UK) has never been published.

Through a narrative review of published and grey literature, we explore the development of the MBU in the UK, from its infancy to modern day.

We outline the history of the MBU model of care, from its early conception to current state. We also examine factors contributing towards the expansion of MBUs and more broadly, the expansion of perinatal mental health services throughout the UK. We also briefly describe the approach to MBUs worldwide, taking into consideration sociocultural differences and approaches to caring for the mother-baby dyad.

Since its conception, there has been considerable investment in and expansion of perinatal mental health services, both in community and inpatient settings. Sustained research and continued advocacy is required to expand provision of care.

The mortality gap between patients with serious mental illness (SMI) and without is around 15–20 years. This has multiple contributing factors including poor physical health, side effects of antipsychotic medications and sub-optimal medical management. Presented here is a detailed cross-sectional study of physical health measures in an in-patient rehabilitation population in Scotland. Results are compared to national averages and clinical guidelines with the aims to a) benchmark physical health in this population and b) where possible improve physical health.

Physical health data including observations, blood tests, and investigations was collected ahead of detailed structured interviews and physical exams performed by a post-foundation doctor. These results were compared to recommendations for physical health monitoring from numerous national and government guidelines (SIGN, NICE, Scottish Government, Maudsley). Data were collected in 4 domains, 1) Indicators of physical health, 2) Engagement with physical health, 3) Concordance with guidelines and 4) Outcomes of reviews.

Data were collected from 57 of all 62 in-patients. 34 reported being generally happy with their health vs 15 unhappy. 42% were obese (compared to 28% of the general population), 84% were smokers (vs 16% in the local population) 16% were hypertensive, 22% had raised HbA1c, 50% had raised cholesterol, 47% had QRISK >10%. 68% agreed to a full physical health review, 65% agreed to flu vaccination. Completed cancer screening uptake compared to the Scottish population was low; Cervical (30% vs 71%), Bowel (8% vs 59%), Breast (23% vs 72%), AAA (0% vs 84%). Patients were generally up to date in terms of recorded weight (100%), BP (98.2%), HR (98.2%) and lipids (89.4%), but not ECG's (61.4%) and Diabetes screening (59.6%). 17 referrals were made to medics/surgeons, 29 to MDT's, 24 medications started, 9 stopped and 27 changed, most commonly statins (12 patients), vitamin D (8 patients) and hypoglycemics (5 patients).

Cardiovascular disease indicators were notably raised, uptake of screening was very poor and there were areas where the service didn't meet national guidelines. The number of referrals and medication changes suggest an unmet need within such services. The findings, if generalisable across similar populations, suggest that more can be done to address ongoing poor physical health in populations with SMI and indeed patient readiness to comply with physical health screening. Screening for key physical health parameters needs to be augmented by working to engage patients and following up with management plans for abnormalities found.

Schizophrenia is a chronic brain disorder characterised by distortion of thoughts and perception. Several studies have shown a key role of the hippocampal formation in the pathophysiology of schizophrenia. Patients show impaired theta coherence between medial temporal lobe and medial prefrontal cortex (mPFC), and impairment of knowledge structuring and inferential processes. Both the hippocampal formation and mPFC contain hexadirectional modulation of activity, indicative of grid cell populations. Grid cells play an important role in mapping the environment and are believed to represent the transition structure between task states. With other cell populations in the hippocampal formation, they play a fundamental role in inference, episodic memory, and spatial navigation. Here, we investigate whether schizophrenia is associated with disrupted grid firing patterns.

To test this hypothesis, we asked 18 participants with diagnoses of schizophrenia and 26 controls (matched for age, sex and IQ) to perform a spatial memory task in magnetoencephalography (MEG), while navigating a virtual reality environment. We first analysed theta (4–10 Hz) power during movement onset compared to stationary periods. We then source-localised the signal and looked for the hexadirectional modulation of theta band oscillatory activity by heading direction during movement onset. We also controlled for other symmetries in theta frequencies (four, five, and eight fold) and hexadirectional modulation in other frequencies. The same participants performed an inference task outside MEG, which we used for correlation analysis.

The peak of theta power during movement onset was stronger in controls compared to patients (p < 0.05). In the control group, we found hexadirectional modulation of theta power by movement direction in the right entorhinal cortex (p < 0.005). This effect was absent in patients with a significant difference between groups (p < 0.05), suggesting that their entorhinal grid firing patterns may be disrupted. No other symmetry modulated theta power significantly in controls or patients, and hexadirectional modulation during movement onset was found only in theta frequencies in controls. Performance in the inference task was significantly impaired in schizophrenic patients, and spatial memory performance in both controls and patients was positively correlated with their performance in the inference task.

These results are consistent with the hypothesis that impairments in knowledge structuring and inference associated with schizophrenia may arise from disrupted grid firing patterns in entorhinal cortex. Although further work is needed to better understand the role of grid cells in health and disease, this work provides new insights into dysfunction of the hippocampal formation in schizophrenia.

Psychiatric disorders are associated with fatigue and with impairment to a range of cognitive domains, including executive functioning, learning, memory and complex attention. Similar impairments are seen in autonomic nervous system (ANS) dysfunction. The aetipathogenic significance of this for psychiatric disorders is unknown. The main aim of the cap-mem study was to characterize the relationships between ANS and cognitive function in a sample of none-clinical controls and people with mental health, neurodevelopmental and neurodegenerative disorders. The potentially confounding role of medication was included within this analysis.

The sample was recruited via secondary care mental health trusts. ANS function was assessed using self-report measures of ANS dysfunction symptoms (COMPASS-31) and fatigue (VAFS). Cognitive ability in various domains was measured using a validated, computerised assessment tool (THINC-IT). Psychiatric status and medication status were self-reported, and where possible, disorder severity measured using a rating scale (CGI-S).

Participants with depression had a significantly higher COMPASS-31 and VAFS scores (higher being more severe), with effect sizes being medium to large. Medication did not fully explain the associations observed. Overall, participants with mental health disorders, when compared to healthy controls, had significantly higher levels of cognitive impairment. Levels of ANS dysfunction significantly and positively correlated with cognitive impairment. The severity of the psychiatric disorder significantly correlated with both ANS dysfunction (p < 0.001) and cognitive impairment. These results were found across all cognitive tests (p < 0.05), other than reaction times in the N-back test, a measure of working memory.

Our results show significant association between ANS dysfunction, psychiatric disorders and cognitive impairments. This is consistent with previously published data. There is now a need to understand the underlying mechanisms and the directionality of the associations. If these mechanisms are shared and relate to autonomic dysfunction, targeted treatments addressing this directly could be helpful with mental health disorders and associated burdensome symptoms, such as cognitive impairments and fatigue. This study is part of a wider project assessing cognitive ability and autonomic functioning in psychiatric populations, and investigating treatments that directly address autonomic dysfunction in psychiatric samples, such as non-invasive transauricular vagus nerve stimulation (taVNS).

Introduction. Despite society's secularisation, as of 2019 only 38.4% of the population of England and Wales identified as “No Religion”. The integration of chaplaincy and spiritual care teams into health services varies widely and we undertook this qualitative research to better understand the spiritual needs on psychiatric wards.

Between October 2021 and January 2022, we carried out semi-structured interviews with 10 patients and 10 staff-members, convenience sampled from acute General Adult Wards. The interviews were approximately 10–15 minutes long, documented in shorthand, compiled, and analysed thematically.

Themes (P = patient, S = staff member)

1. Religion and belief, or lack of it, defies categorisation

P1 (36M) identified as Christian but didn't really believe, whilst S2 (Nurse Clinical Team Leader) professed no religion but prayed that her sister would be healed. P7 (59F) was brought up Christian but thought religion was a fantasy. P2(21M) identified as Wiccan but thought all religions hold truth.

2. An incarnational, embodied service

P9 (33F) wished chaplains wandered around the wards and S10 (F1 Junior Doctor) praised their presence in general hospitals. P1 wanted a “prayer circle” and S5 (Student Nurse) suggested weekly worship services.

3. Space to “be”

S10 liked an empty chapel to think in and P4 (29M) said he was Lacking space for reflection and meditation.

4. Unmet needs

P9 felt abandoned by God during the admission and her vicar had recently died. She wanted someone to sit, pray with her and point her to helpful scriptures but was not aware of the existence of chaplaincy. Of the patients, only P3 knew how to contact the service and S8 said it was rarely discussed by the MDT.

5. Caution, ignorance and suspicion

S1 and S8 said chaplaincy visits are sometimes distressing for patients preoccupied with devils and demons and P5 (26M) was worried they'd judge him.

6. Links with wider faith communities

P6 (46F) would like to attend church with her family, P4(29M) would like to know where he could go to worship and S2 was also curious of what's available outside hospital.

Discussion and clinical implications

Despite limitations of small size and recruitment bias, the themes emphasise the complexity of understanding someone's spirituality. It highlights a call for a more visible presence and thoughtful consideration of what a spiritual need is and how it can be met.

Ward visits should be prioritised, having recently been limited by COVID-19 restrictions. Patient information and staff education regarding chaplaincy and spiritual care is urgently needed on psychiatric inpatient wards.