BACKGROUND: Mental health crisis rates in the United Kingdom are on the rise. The emergence of community mental health models, such as Crisis Resolution Home Treatment Teams (CRHTTs), offers a vital pathway to provide intensive assessment and treatment to individuals in their homes, including psychological interventions. Previous qualitative literature has identified facilitators and barriers to the implementation of psychological interventions within CRHTT settings; however, a synthesis of this literature has not yet been conducted. To address this gap, a systematic review was undertaken with the aim of identifying the reported facilitators and barriers of implementing evidence-based psychological interventions in CRHTTs.
METHODS: A systematic review and narrative synthesis were conducted. Studies were included if they examined the implementation of evidence-based psychological interventions in a CRHTT setting. The study population had to be 18 and over and could include healthcare professionals working in CRHTTs, service users of CRHTTs, or family and carers of CRHTT service users. Studies of any formal research methodology were included. Four databases were searched (MEDLINE, CINAHL Plus, Embase and PsycINFO), along with Google Scholar, to identify eligible studies.
RESULTS: Six studies were identified, using mixed qualitative and quantitative methodologies, with the predominant focus being the exploration of stakeholder perspectives on care implementation within CRHTTs, encompassing aspects including but not restricted to psychological care implementation. The literature was deemed to be of moderate to high quality. Facilitators included adapting psychological therapies, prioritizing the therapeutic relationship, increasing psychological skills and training of CRHTT staff and psychologically informed CRHTT models. The barriers identified included a medical model bias within teams, resource constraints and elements pertaining to CRHTT services.
CONCLUSIONS: Further robust research in this area is imperative. We recommend that future research be implemented in the form of service evaluations and randomized controlled trials (RCTs) and that the principles of implementation science be used to assess and develop the evidence base for psychological intervention delivery in CRHTTs.

UNASSIGNED: Dysmenorrhoea affects many adolescents with significant impacts on education and well-being. In the UK, most of the adolescents who seek care (and many never do), will do so through general practice (primary care). Knowing how best to care for adolescents reporting menstrual pain is an area where UK general practitioners would like better guidance and resources.
UNASSIGNED: This mixed-methods narrative synthesis collates community and specialist evidence from 320 papers about adolescent dysmenorrhoea, with a UK general practice community health perspective.
UNASSIGNED: We report a narrative summary of symptoms, cause, consequences and treatments for adolescent dysmenorrhoea. We highlight areas of tension or conflicted evidence relevant to primary care alongside areas of uncertainty and research gaps identified through this synthesis with input from lived experience advisers.
UNASSIGNED: There is little evidence about primary care management of adolescent dysmenorrhoea or specific resources to support shared-decision making in general practice, although there are evidence-based treatments to offer. Primary care encounters also represent potential opportunities to consider whether the possibility of underlying or associated health conditions contributing to symptoms of dysmenorrhoea, but there is little epidemiological evidence about prevalence from within community health settings to inform this. The areas where there is little or uncertain evidence along the care journey for adolescent dysmenorrhoea, including at the interface between experience and expression of symptoms and potential underlying contributory causes warrant further exploration.
UNASSIGNED: https://www.crd.york.ac.uk/PROSPEROFILES/256458_STRATEGY_20210608.pdf, identifier (CRD42021256458).

BACKGROUND: Patients living with life-limiting illnesses other than cancer constitute the majority of patients in need of palliative care globally, yet most previous systematic reviews of the cost impact of palliative care have not exclusively focused on this population. Reviews that tangentially looked at non-cancer patients found inconclusive evidence. Randomised controlled trials (RCTs) are the gold standard for treatment efficacy, while total health care costs offer a comprehensive measure of resource use. In the sole review of RCTs for non-cancer patients, palliative care reduced hospitalisations and emergency department visits but its effect on total health care costs was not assessed. The aim of this study is to review RCTs to determine the difference in costs between a palliative care approach and usual care in adult non-cancer patients with a life-limiting illness.
METHODS: A systematic review using a narrative synthesis approach. The protocol was registered with PROSPERO prospectively (no. CRD42020191082). Eight databases were searched: Medline, CINAHL, EconLit, EMBASE, TRIP database, NHS Evidence, Cochrane Library, and Web of Science from inception to January 2023. Inclusion criteria were: English or German; randomised controlled trials (RCTs); adult non-cancer patients (> 18 years); palliative care provision; a comparator group of standard or usual care. Quality of studies was assessed using Drummond\'s checklist for assessing economic evaluations.
RESULTS: Seven RCTs were included and examined the following diseases: neurological (3), heart failure (2), AIDS (1) and mixed (1). The majority (6/7) were home-based interventions. All studies were either cost-saving (3/7) or cost-neutral (4/7); and four had improved outcomes for patients or carers and three no change in outcomes.
CONCLUSIONS: In a non-cancer population, this is the first systematic review of RCTs that has demonstrated a palliative care approach is cost-saving or at least cost-neutral. Cost savings are achieved without worsening outcomes for patients and carers. These findings lend support to calls to increase palliative care provision globally.

BACKGROUND: Employment provides economic security, a social network, and is important for self-identity. A review published by van der Noordt and colleagues in 2014 showed that employment was beneficial for depression and general mental health. However, an updated synthesis including research published in the last decade is lacking. In the planned review, we aim to update, critically assess, and synthesise the current evidence of the association between paid employment (excluding precarious employment) and common mental health outcomes (depression, anxiety, and psychological distress) among the working age population in the labour force.
METHODS: We will follow recommended guidelines for conducting and reporting systematic reviews. Four electronic databases (MEDLINE, Embase, APA PsycINFO, and Web of Science) will be searched from 2012, using appropriate MeSH terms and text words related to our inclusion criteria. We will screen the records against predefined eligibility criteria, first by title and abstract using the priority screening function in EPPI-Reviewer, before proceeding to full-text screening. Only studies investigating the longitudinal relationship between employment and common mental health outcomes will be included. We will search for grey literature in OpenAlex and conduct backward and forward citation searches of included studies. The methodological quality of the included studies will be assessed using the Cochrane risk-of-bias tool (RoB 2), Risk Of Bias In Non-randomised Studies of Interventions (ROBINS-I), or the Newcastle-Ottawa scale (NOS). We will conduct a narrative review and, if possible following pre-set criteria, conduct random-effects meta-analyses to estimate the pooled effect of employment on depression, anxiety, and psychological distress, across the included studies.
CONCLUSIONS: An updated review of the association between non-precarious employment and mental health outcomes is needed. In the planned review, we will assess the quality of the included studies and synthesise the results across studies to make them easily accessible to policy makers and researchers. The results from the review can be used to aid in policy decisions and guide future research priorities.
BACKGROUND: PROSPERO CRD42023405919.

OBJECTIVE: To systematically review evidence on the effect of fixed-ratio combinations on adherence in people with type 2 diabetes.
METHODS: Systematic searches were conducted using MEDLINE and EMBASE in March 2023. Standardised screening, data extraction and risk of bias assessment were conducted. All review procedures were conducted independently by two reviewers. Eligible studies assessed the effect of fixed-ratio combinations on adherence in people with type 2 diabetes. Narrative synthesis was conducted to analyse findings.
RESULTS: A total of 488 records were identified, of which 37 proceeded to full-text screening and 7 - each representing a unique study - were included in the systematic review. Among the included studies, 3 were randomised controlled trials and 4 were cohort studies. Following narrative synthesis, it was shown that fixed-ratio combinations improved patient satisfaction and treatment adherence.
CONCLUSIONS: Available evidence supports a benefit for fixed-ratio combinations on patient satisfaction and treatment adherence in people with type 2 diabetes.

BACKGROUND: Persistent Physical Symptoms (PPS) include symptoms such as chronic pain, and syndromes such as chronic fatigue. They are common, but are often inadequately managed, causing distress and higher costs for health care systems. A lack of teaching about PPS has been recognised as a contributing factor to poor management.
METHODS: The authors conducted a scoping review of the literature, including all studies published before 31 March 2023. Systematic methods were used to determine what teaching on PPS was taking place for medical undergraduates. Studies were restricted to publications in English and needed to include undergraduate medical students. Teaching about cancer pain was excluded. After descriptive data was extracted, a narrative synthesis was undertaken to analyse qualitative findings.
RESULTS: A total of 1116 studies were found, after exclusion, from 3 databases. A further 28 studies were found by searching the grey literature and by citation analysis. After screening for relevance, a total of 57 studies were included in the review. The most commonly taught condition was chronic non-cancer pain, but overall, there was a widespread lack of teaching and learning on PPS. Several factors contributed to this lack including: educators and learners viewing the topic as awkward, learners feeling that there was no science behind the symptoms, and the topic being overlooked in the taught curriculum. The gap between the taught curriculum and learners\' experiences in practice was addressed through informal sources and this risked stigmatising attitudes towards sufferers of PPS.
CONCLUSIONS: Faculties need to find ways to integrate more teaching on PPS and address the barriers outlined above. Teaching on chronic non-cancer pain, which is built on a science of symptoms, can be used as an exemplar for teaching on PPS more widely. Any future teaching interventions should be robustly evaluated to ensure improvements for learners and patients.

Gender identity is a multifaceted concept and is represented by a wide range of measures and constructs including both self-report and researcher observations of preferences and behaviours. However, despite their similar theoretical underpinning, gender identity measures are rarely found to correlate with one another, and contrasting patterns and trajectories are often found for each construct (Egan & Perry, Developmental Psychology, 37, 2001, 451). Therefore, this systematic review aimed to present a review of the longitudinal research evidence surrounding gender identity development in the absence of formal intervention. Using a systematic search strategy, 21 studies were identified. Narrative synthesis was used to synthesize the data collected in these studies and trajectories were explored for (1) self-identification measures of gender identity, (2) clothing preferences, (3) peer preferences, and (4) object/activity preferences. Overall, the results of this systematic review are consistent with wider research suggesting that distinct developmental patterns can be observed when using different constructs and measures of gender identity.

OBJECTIVE: Psychological and social status, and environmental context, may mediate the likelihood of experiencing overdose subsequent to illicit drug use. The aim of this systematic review was to identify and synthesise psychosocial factors associated with overdose among people who use drugs.
METHODS: This review was registered on Prospero (CRD42021242495). Systematic record searches were undertaken in databases of peer-reviewed literature (Medline, Embase, PsycINFO, and Cinahl) and grey literature sources (Google Scholar) for work published up to and including 14 February 2023. Reference lists of selected full-text papers were searched for additional records. Studies were eligible if they included people who use drugs with a focus on relationships between psychosocial factors and overdose subsequent to illicit drug use. Results were tabulated and narratively synthesised.
RESULTS: Twenty-six studies were included in the review, with 150,625 participants: of those 3,383-4072 (3%) experienced overdose. Twenty-one (81%) studies were conducted in North America and 23 (89%) reported polydrug use. Psychosocial factors associated with risk of overdose (n = 103) were identified and thematically organised into ten groups. These were: income; housing instability; incarceration; traumatic experiences; overdose risk perception and past experience; healthcare experiences; perception of own drug use and injecting skills; injecting setting; conditions with physical environment; and social network traits.
CONCLUSIONS: Global rates of overdose continue to increase, and many guidelines recommend psychosocial interventions for dependent drug use. The factors identified here provide useful targets for practitioners to focus on at the individual level, but many identified will require wider policy changes to affect positive change. Future research should seek to develop and trial interventions targeting factors identified, whilst advocacy for key policy reforms to reduce harm must continue.

UNASSIGNED: The aim of this systematic review was to synthesise research examining the relationship between autism and psychopathy to: (a) better understand the relationship between these two constructs, and (b) describe the clinical manifestation of the two when they co-occur. A systematic search of the literature returned 36 studies.
UNASSIGNED: Across all ages, autistic individuals and those with elevated autistic traits but no autistic diagnoses appeared to have increased callous and unemotional traits or psychopathy relative to the general population. Several studies evidenced that although both constructs are associated with empathetic dysfunction, the underlying mechanisms differ. In adults, psychopathy/psychopathic traits were associated with diminished affective empathy and intact cognitive empathy, whilst the opposite was seen autistic adults and those with elevated autistic traits. In children, those with autistic traits or a diagnosis of autism had diminished cognitive empathy, but not affective empathy, while the relationship between callous and unemotional traits/psychopathy and empathy amongst children was less clear. The co-occurrence of autism and psychopathy was seen to lead to additional empathic and cognitive impairment, but findings were mixed making it challenging to clearly describe the clinical manifestation.
UNASSIGNED: There remains a paucity of research investigating the interaction between autism and psychopathy and included studies were characterised by multiple measurement difficulties. Attention should be directed toward developing better methods for identifying psychopathic traits in autistic individuals to advance our understanding of the relationship between autism and psychopathy to allow for the development of appropriate care pathways for this population.
UNASSIGNED: https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=413672, identifier CRD42023413672.

OBJECTIVE: Realizing that a child has a lifelong developmental condition like Autism Spectrum Disorder (ASD) can create feelings of sadness and grief for the parents. It remains unclear, however, how parents deal with and understand these emotions. The purpose of this narrative review was to explore the grief process of parents of children with ASD.
METHODS: An analysis of the literature was conducted using the databases Psychinfo, Scopus, Web of Science, and PubMed. As part of our research, we also searched the grey literature (Google Scholar) and the thesis database (ProQuest) manually. Among the study criteria were (1) targeting direct informants as parents of children with ASD, (2) original and empirical research published in different English-language sources, (3) outcomes pertaining to grief experiences among parents, and/or processes involved in raising children with ASD, and (4) studies with qualitative data collection methods.
METHODS: Seven articles met the inclusion criteria and were included in this narrative analysis.
RESULTS: Our study\'s deductive content analysis revealed three primary themes: (i) manifestations of ambiguous loss, (ii) dealing with disenfranchised grief, and (iii) oscillation.
CONCLUSIONS: The results showed that ASD in children can cause parents to feel ambiguity and uncertainty, experience grief, and may result in the modification of expectations, emergent affective responses, and self-blame attributions. When confronted with difficulties arising from their child\'s condition, parents of children with ASD may undergo significant life changes and oscillate between various coping strategies.
CONCLUSIONS: The findings are expected to provide healthcare professionals, including nurses and front-line clinicians, with valuable information about the burden of grief experienced by parents of children with ASD so they can provide and validate the necessary support for them. Moreover, rigorous qualitative and quantitative studies are also required to support the claims made.