Childhood dementias are a group of rare, fatal neurodegenerative disorders, characterised by global cognitive decline, loss of previously acquired developmental skills and behaviours and psychological symptoms of dementia (BPSD). Batten disease, or neuronal ceroid lipofuscinosis, and Sanfilippo syndrome, or mucopolysaccharidosis type III, are two of the more common forms of childhood dementia disorders worldwide. While psychosocial interventions are the best available therapeutic approach for BPSD management in adult-onset dementia, there is very limited literature or clinical experience in the context of childhood dementia. To address this gap, we conducted a descriptive case analysis of BPSD profiles, associated contributing factors and targeted psychosocial interventions in two cases with childhood dementia disorders (Sanfilippo syndrome and CLN3 (juvenile onset) Batten disease) who were referred to Dementia Support Australia, a national dementia behaviour support service in Australia. Primary BPSD identified in these disorders included physical and verbal aggression and irritability/lability. In these cases, contributing factors to the development of BPSD were not monolithic, encompassing pain, caregiver\'s approach and over or under-stimulation. Improvement in BPSD were observed using the Neuropsychiatric Inventory-Quesionnaire and globally noted as per the qualitative feedback reported by family and caregivers. Person-centred, multimodal psychosocial interventions were recognised as effective therapies in resolving BPSD in these cases. In conclusion, the case studies described the nature and presentation of BPSD in two common forms of childhood dementia and demonstrated the potential benefits of person-centred psychosocial interventions (delivered through national dementia-specific support programs) in alleviating BPSD such as irritability and aggression in these disorders.

OBJECTIVE: There is a large treatment gap for mental health conditions in sub-Saharan Africa where most patients who receive any care do so from lay primary health care workers (PHCW). We sought to examine the experiences of PHCW who provide care for older people with depression in Nigerian primary health care (PHC) settings.
METHODS: Qualitative study design. A total of 24 PHCW participated. Using in-depth key informant interviews (KIIs), we explored the views of 15 PHCW selected from 10 rural and urban PHCs in South-Western Nigeria. An additional focus group discussion comprising nine participants was also conducted to discuss emerging themes from KIIs. Data were analysed using thematic analysis.
RESULTS: Three overall themes were identified: views about depression, treatment options, and community outreach implications. Participants perceived depression in older people as being characterised by a range of mood, behavioural, and cognitive symptoms which made clinical assessments particularly challenging. Common treatment options used by PHCW included general advice and counselling, as well as frequent need to prescribe mild analgesics, vitamins and occasional sedatives in line with patients\' expectations. Antidepressants were rarely used even though PHCW are authorised. While home visits are part of their expected work schedule, PHCW rarely implemented these due to non-availability of transport facilities. Mobile technology was identified as a possible way of overcoming this constraint to providing community based mental healthcare for older people.
CONCLUSIONS: PHCWs perceived that patients\' poor cognitive performance, expectations to prescribe sedatives, analgesics and vitamins, as well as non-existence of community-based services were existing barriers to providing evidenced based continued care for older people with depression in the study settings.

We address the unconsciously biased perception of psychiatric disorders, highlighting a hierarchical perspective that favours certain diagnoses over others. We aim to uncover reasons for these inequities, emphasising the need for a shift toward pathophysiology-based nomenclature that can promote equal support for each disorder, enhance treatment adherence and encourage open discussions.

Cognitive impairment associated with schizophrenia (CIAS) represents one of the core features of the disorder and has a significant impact on functional and rehabilitation outcomes of people living with schizophrenia spectrum disorders (SSD). The aim of this critical review is to highlight the most recent evidence on effective treatments available for CIAS, to discuss the current challenges in this field, and to present future perspectives that may help to overcome them. Concerning psychopharmacological approaches, among the most indicated strategies for the management and prevention of CIAS is to favor second-generation antipsychotic medications and avoid long-term and high-dose treatments with anticholinergic medications and benzodiazepines. Moreover, non-pharmacological approaches such as cognitive remediation and physical exercise-based programs represent evidence-based interventions in the treatment of CIAS that have shown reliable evidence of effectiveness on both cognitive and functional outcomes. These treatments, however, are still delivered to people accessing mental health services with a diagnosis of CIAS in an uneven manner, even in high-income countries. Academic and clinical partnership and collaboration, as well as advocacy from service users, families, carers, and stakeholders\' organizations could help to reduce the bench to bedside gap in the treatment of CIAS. Future perspectives include the development of novel pharmacological agents that could be effective in the treatment of CIAS, the implementation of novel technologies such as telemedicine and virtual reality in the delivery of evidence-based interventions to improve accessibility and engagement, and further research in the field of non-invasive brain stimulation.

BACKGROUND: Assessment tools for engagement in people with dementia often rely on self-reported measures which restricts their use in people with severe cognitive limitations. The Engagement of a Person with Dementia Scale (EPWDS) is a valid and reliable tool to assess behavioral and emotional expressions and responses of engagement in people with dementia through observation; however, the EPWDS is not yet available in the German language.
OBJECTIVE: 1) Translation and cross-culturally adaptation of the original English version of the EPWDS into the German language (EPWDS-GER) and 2) to gain insights into assessing data with the newly developed instrument.
METHODS: International recommendations were followed to cross-culturally adapt the English original version of the EPWDS into the German language in 5 steps: translation by three independent translators, synthesis, back translation, expert committee review (N = 10) and test of the prefinal version in nursing practice (N = 22) on a 5-point Likert scale to assess comprehensibility, practicability and suitability of the EPWDS-GER.
RESULTS: The EPWDS-GER achieved high ratings for the five subscales on ease of understanding, ease of answering and importance of single items for assessing engagement. Average agreement for all items ranged from 3.86 to 4.43 (SD = 0.68-1.29). Overall rating of EPWDS-GER resulted in a mean agreement of 4.18 (SD = 0.73) for suitability and of 4.09 (SD = 0.81) for practicability.
CONCLUSIONS: The EPWDS-GER is an easy to use tool for measuring behavioral and emotional expressions and responses of engagement of a person with dementia and can now be utilized in clinical practice and research.
UNASSIGNED: HINTERGRUND: Instrumente zur Bewertung der sozialen Beteiligung von Menschen mit Demenz beruhen oft auf Selbstauskünften, was ihre Verwendung bei Personen mit schwereren kognitiven Einschränkungen limitiert. Die Engagement of a Person with Dementia Scale (EPWDS) ist ein valides und zuverlässiges Instrument zur Bewertung von Reaktionen, Verhaltens- und Gefühlsäußerungen der Beteiligung bei Menschen mit Demenz durch Beobachtung. Allerdings ist die EPWDS noch nicht in deutscher Sprache verfügbar.
UNASSIGNED: 1) Übersetzung und kulturübergreifende Anpassung der englischen Originalversion in die deutsche Sprache (EPWDS-GER) und 2) Gewinnung von Erkenntnissen über die Datenerhebung mit der EPWDS-GER.
METHODS: Die Originalversion der EPWDS wurde gemäß internationaler Leitlinien in fünf Schritten in die deutsche Sprache übersetzt: Übersetzung durch drei unabhängige Personen, Synthese, Rückübersetzung, Überprüfung durch ein Expertenkomitee (N = 10) und Test der vorläufigen Version in der Pflegepraxis (N = 22), um Verständlichkeit, Eignung und Praktikabilität der EPWDS-GER auf einer 5‑stufigen Likert Skala zu beurteilen.
UNASSIGNED: Die EPWDS-GER erzielte hohe positive Bewertungen der Subskalen für leichte Verständlichkeit, leichte Beantwortung und gegebene Relevanz einzelner Items. Die mittlere Zustimmung für alle Items reichte von 3,86 bis 4,43 (SD = 0,68–1,29). Die Gesamtbewertung der EPWDS-GER erzielte eine hohe Zustimmung von durchschnittlich 4,18 (SD = 0,73) für Eignung und 4,09 (SD = 0.81) für Praxistauglichkeit.
CONCLUSIONS: Die EPWDS-GER ist ein einfach anzuwendendes Instrument zur Messung der Beteiligung von Menschen mit Demenz sowie ihrer Reaktionen. Die EPWDS-GER ist nun in der klinischen Praxis und in der Forschung verfügbar.

BACKGROUND: The effectiveness of psychosocial interventions for geriatric depression across different treatment settings, regions, and comorbidities in China remains unclear. Therefore, we systematically reviewed studies geared towards reducing geriatric depression in China.
METHODS: Nine databases in Chinese or English from database were searched from inception through January 2021. Randomized controlled trials investigating psychosocial interventions on older adults with depression in China were included. The primary outcome was post-intervention depression measured by self-report instruments. Random-effect model was used to pool the overall effect size Hedge\'s g.
RESULTS: In 99 studies with a total of 9369 older adults with depression, psychosocial interventions were effective compared with control conditions (Hedges\' g: -1·48 [95 % CI: -1·83 to -1·13]). Comorbidity with physical disease significantly affect the pooled effect size (without comorbidity: Hedges\' g = -1.19, 95 % CI: -1.42 to -0.95; with comorbidity: Hedges\' g = -2.06, 95 % CI: -2.97 to -1.14; p = 0.062), and heterogeneity was substantial (without comorbidity, I2 = 91·3 %, 95 % CI: 89·5 % to 92·7 %; with comorbidity, I2 = 94·3 %, 95 % CI: 93·1 % to 95·4 %). The quality of evidence according to the GRADE criteria was generally moderate.
CONCLUSIONS: Significant heterogeneity among the studies reviewed was unavoidable, and the possible publication bias could lead to overestimation of the result.
CONCLUSIONS: Psychosocial interventions are significantly effective for treating geriatric depression in China regardless of the setting, region, or therapeutic orientation. Policies should support the development and implementation of psychosocial interventions in China, especially in community settings, to reduce disease burden.

Drama therapy is a popular form of management in mental illness, as it reaches out beyond many other therapies. Few studies have examined both the advantages and disadvantages of this medium. This qualitative study examines both, and finds gains and hazards.

UNASSIGNED: Psychosocial intervention is imperative for treating alcohol use disorder (AUD), but there is no comprehensive evidence regarding its effectiveness. Therefore, this study aimed to determine the effectiveness of psychosocial interventions in treating AUD amongadolescents and young adults.
UNASSIGNED: In this systematic review and meta-analysis, articles were searched from EMBASE, PubMed, Medline, CINAHL, Web of Science, PsycINFO, and Scopus. Also, articles were retrieved from gray literature. The quality of articles has been assessed using the Cochrane risk of bias assessment.
UNASSIGNED: A total of 12 randomized controlled trials were included. Integrated family and CBT, CBT, guided self-change, and ecologically based family therapy had a mild effect in reducing alcohol use frequency. On the other hand, integrated motivational enhancement therapy and CBT (-0.71 [95% CI: -0.97, -0.45]) and common elements treatment approaches (4.5 [95% CI: 6.9, 2.2]) had the highest effect size for reducing alcohol use frequency and amount, respectively. In conclusion, most of the interventions had no significant effect on different drinking outcomes. Nonetheless, the effectiveness of combined interventions surpassed that of the single interventions. The effect of psychosocial interventions on abstinence was inconclusive. Therefore, future studies will explore alternative, newly emerged third-wave therapeutic approaches.
UNASSIGNED: PROSPERO, CRD42023435011, https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=435011.

BACKGROUND: Urbanisation is taking place worldwide and rates of mental illness are rising. There has been increasing interest in \'nature\' and how it may benefit mental health and well-being.
OBJECTIVE: To understand how the literature defines nature; what the characteristics of the nature intervention are; what mental health and well-being outcomes are being measured; and what the evidence shows, in regard to how nature affects the mental health and well-being of children and adolescents.
METHODS: A meta-review was conducted, searching three databases for relevant primary and secondary studies, using key search terms including \'nature\' and \'mental health\' and \'mental well-being\'. Inclusion criteria included published English-language studies on the child and adolescent population. Authors identified the highest quality evidence from studies meeting the inclusion criteria. Data were extracted and analysed using descriptive content analysis.
RESULTS: Sixteen systematic reviews, two scoping reviews and five good quality cohort studies were included. \'Nature\' was conceptualised along a continuum (the \'nature research framework\') into three categories: a human-designed environment with natural elements; a human-designed natural environment; and a natural environment. The nature \'intervention\' falls into three areas (the \'nature intervention framework\'): access, exposure and engagement with nature, with quantity and quality of nature relevant to all areas. Mental health and well-being outcomes fit along a continuum, with \'disorder\' at one end and \'well-being\' at the other. Nature appears to have a beneficial effect, but we cannot be certain of this.
CONCLUSIONS: Nature appears to have a beneficial effect on mental health and well-being of children and adolescents. Evidence is lacking on clinical populations, ethnically diverse populations and populations in low- and middle-income countries. Our results should be interpreted considering the limitations of the included studies and confidence in findings.

Borderline personality disorder and eating disorders frequently co-occur among youths. These disorders emerge in adolescence, during the critical developmental period of building an independent sense of self and the capacity to relate to one\'s community. Because of core differences in the development and psychopathology of borderline personality disorder and eating disorders, adjustments are required when treating these disorders when they co-occur. Few established treatment approaches can address these disorders simultaneously. Evidence-based psychotherapies for borderline personality disorder, such as dialectical behavior therapy and mentalization-based treatment, have been adapted to accommodate the shared vulnerabilities and features of the two disorders. However, these approaches are specialized, intensive, and lengthy and are therefore poorly suited to implementation in general psychiatric or primary health care, where most frontline mental health care is provided. Generalist approaches can fill this public health gap, guiding nonspecialists in structuring informed clinical management for these impairing and sometimes fatal disorders. In this overview, the authors describe the adjustment of good (or general) psychiatric management (GPM) for adolescents with borderline personality disorder to incorporate the prevailing best practices for eating disorder treatment. The adjusted treatment relies on interventions most clinicians already use (diagnostic disclosure, psychoeducation, focusing on life outside treatment, managing patients\' self-destructive behaviors, and conservative psychopharmacology with active management of comorbid conditions). Limitations of the adjusted treatment, as well as guidelines for referring patients to specialized and general medical treatments and for returning them to primary generalist psychiatric care, are discussed.