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Artificial intelligence in forensic mental health : a review of applications and implications
Get PDF© 2025 The Authors. Published by Elsevier Ltd. This is an open access article distributed under the terms of the Creative Commons CC-BY license, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
You are not required to obtain permission to reuse this article.This narrative review explores the transformative role of artificial intelligence (AI) in forensic mental health, focusing on its applications, benefits, limitations, and ethical considerations. AI's capabilities, particularly in areas such as risk assessment, mental health screening, behavioral analysis, and treatment recommendations, present promising advancements for accuracy, efficiency, and objectivity in forensic evaluations. Predictive models and natural language processing enhance the precision of high-stakes assessments, enabling early intervention and optimized resource allocation. However, AI's integration in forensic mental health also brings significant challenges, particularly regarding data quality, algorithmic bias, transparency, and legal accountability. Limited access to high-quality, representative data can hinder reliability, while biases within AI models risk perpetuating existing disparities. Ethical concerns surrounding data privacy and the "black box" nature of many AI algorithms underscore the need for transparency and accountability. The review highlights future directions for responsible AI use, including improving data standards, fostering interdisciplinary collaboration, and establishing robust regulatory frameworks to safeguard ethical and fair AI applications in forensic settings. Balancing technological innovation with ethical considerations and legal obligations is essential to ensure AI supports justice and upholds public trust. This review calls for ongoing research, policy development, and cautious implementation to harness AI's potential while protecting individuals' rights within the justice system.https://www.sciencedirect.com/science/article/pii/S1752928X2500096
Promoting the resilience of Iranian women through a narrative arts approach
No full textNo abstract availablehttps://journals.sagepub.com/doi/10.1177/1757913925133669
LAsting Symptoms after Oesophageal Resectional Surgery (LASORS): multicentre validation cohort study.
No full textBACKGROUND: Long-term symptom burden and health-related quality-of-life outcomes after curative oesophageal cancer treatment are poorly understood. Existing tools are cumbersome and do not address the post-treatment population specifically. The aim of this study was to validate the six-symptom LASORS tool for identifying patients after curative oesophageal cancer treatment with poor health-related quality of life and to assess its clinical utility. METHODS: Between 2015 and 2019, patients from 15 UK centres who underwent curative-intent oesophageal cancer treatment, and were disease-free at least 1 year after surgery, were invited to participate in the study and complete LASORS and European Organisation for Research and Treatment of Cancer QLQ-C30 and QLQ-OG25 questionnaires. Receiver operating characteristic curve analysis was used to examine the accuracy of the LASORS tool for identifying patients with poor health-related quality of life. RESULTS: A total of 263 patients completed the questionnaire. Four of the six LASORS symptoms were associated with poor health-related quality of life: reduced energy (OR 2.13 (95% c.i. 1.45 to 3.13)); low mood (OR 1.86 (95% c.i. 1.20 to 2.88)); diarrhoea more than three times a day unrelated to eating (OR 1.48 (95% c.i. 1.06 to 2.07)); and bloating or cramping after eating (OR 1.35 (95% c.i. 1.03 to 1.77)). The LASORS tool showed good diagnostic accuracy with an area under the receiver operating characteristic curve of 0.858 for identifying patients with poor health-related quality of life. CONCLUSION: The six-symptom LASORS tool generated a reliable model for identification of patients with poor health-related quality of life after curative treatment for oesophageal cancer. This is the first tool of its kind to be prospectively validated in the post-esophagectomy population. Clinical utility lies in identification of patients at risk of poor health-related quality of life, ease of use of the tool, and in planning survivorship services
Risk Factors of Mortality in Patients With Periprosthetic Fractures: An Experience of 100 Cases.
Get PDFOBJECTIVE: This study aims to determine the frequency and risk factors of mortality in patients with periprosthetic fractures. MATERIALS AND METHODS: A retrospective review was conducted on 100 patients with periprosthetic fractures around hip and knee replacements. Inclusion criteria were radiological evidence of fracture and age >65 years. Exclusions included prior surgically treated fractures, fractures due to malignancy, lost follow-up, or unavailable postoperative data. Patients were analyzed for postoperative fracture union, complications, and mobility status using clinical and radiographic data. Data were analyzed using R software version 4.3.3 (R Foundation for Statistical Computing, Vienna, Austria), employing chi-square and Mann-Whitney U tests for categorical and numerical data, respectively, with logistic regression to control for confounders. RESULTS: The mean time to operation was 3.25 ± 1.11 days. Among 100 patients, the mean age was 82.22 ± 6.90 years, with a slight male predominance n = 58 (58%). Hip fractures were more common (n = 73; 73%), with knee fractures comprising n = 27 (27%). Most patients were treated at district general hospitals (DGHs) (n = 86; 86%). Mortality within six months was n = 17 (17%). No significant gender differences in mortality were found (p = 0.3). Age >81 years was associated with higher mortality (p = 0.04). Nonoperative management was linked to higher mortality (p = 0.003). No significant differences were observed between hip and knee fracture mortality rates (p = 0.8) or across fracture complexity (p = 0.5). Multivariate analysis indicated higher mortality for nonoperated patients (OR: 0.18, p = 0.004). CONCLUSION: Age and operative management significantly impacted mortality in periprosthetic fractures. Older age (≥81 years) and nonoperative management were linked to higher mortality rates
Infant Parent Support (IPS) : a multidisciplinary intervention to improve the mental health of children with a social worker - a study protocol for a feasibility randomised controlled trial with embedded process evaluation
Get PDF© The Author(s) 2025. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which
permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the
original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or
other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line
to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory
regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this
licence, visit http://creativecommons.org/licenses/by/4.0/BACKGROUND: In many families where children have a social worker, parents have experienced challenges in their own childhoods or have neurodevelopmental conditions. These families often endure significant stress, which is frequently worsened by financial or housing challenges. This added pressure can strain relationships and increase the risk of child maltreatment, as well as contribute to mental health issues in children. Relationship-focused interventions show promise in preventing child maltreatment, although there are currently no interventions that simultaneously address neurodevelopmental conditions and the impact of poverty. We have co-produced, alongside parent experts-by-experience, local stakeholders, and infant mental health practitioners, a new service called Infant Parent Support (IPS). IPS will i) adopt a relationship-focused approach to comprehensive understanding of family functioning, ii) incorporate child and parent mental health and neurodevelopmental awareness, and iii) ensure a poverty aware approach throughout. The aim of this phase is to investigate the feasibility of a definitive Randomised Controlled Trial (RCT) of IPS compared with services-as-usual (SAU). METHODS: The study settings are social care services in two local authorities: Glasgow City Council (Scotland) and the London Borough of Bromley (England). Our target population is children on a 'child in need' plan (or the Scottish equivalent) and eligible participants are families where i) the infant(s) are aged 0-5 years and ii) the family has an allocated social worker plus a multi-agency support plan. Thirty participants will be identified by social workers and randomised to receive either IPS or SAU. Families randomised to IPS will receive an intensive multidisciplinary attachment-focused assessment that provides a foundation for relationship-focused interventions. IPS will incorporate child and parent mental health and neurodevelopmental awareness and ensure a poverty aware approach throughout. Families randomised to SAU will receive the assessment and support that social care services normally implement. We will utilise a pre-post and 3/6-month follow-up design with embedded mixed-method process evaluation and exploratory economic analysis. The primary objective is to assess if enough families can be recruited, randomised, and retained in the trial such that a full-scale RCT is likely to be feasible. The secondary objectives are to assess the acceptability and feasibility of the planned outcome measures and the IPS intervention to families and professionals. CONCLUSIONS: A service like IPS, that uses a relationship-focused approach to child and parent mental health, neurodevelopmental and money/housing problems, has never previously been tested. Therefore, there are several areas of uncertainty that need to be addressed before moving onto a definitive RCT. TRIAL REGISTRATION {2A AND 2B}: Registered in ClinicalTrials.gov Identifier: NCT06003582. Co-production and Feasibility RCT of Intervention to Improve the Mental Health of Children with a Social Worker. Registered 22/08/2023. https://classic. CLINICALTRIALS: gov/ct2/show/NCT06003582 .https://pilotfeasibilitystudies.biomedcentral.com/articles/10.1186/s40814-025-01616-
Impact of 'the Q word' on hospital speciality activity levels: a narrative systematic review.
Get PDFBACKGROUND: Healthcare professionals commonly believe that saying the word 'quiet' can jinx a shift and lead to increased workload or particularly unwell patients. A previous small integrative review found no effect but had some methodological limitations. This narrative systematic review aimed to synthesise the evidence from studies on the impact of saying 'quiet' on clinical workload measures. METHODS: A comprehensive search was carried out across multiple electronic databases for any studies performed in a human healthcare setting investigating the impact of the use of 'the Q word' (or variations thereof) on workload. Outcomes of interest were objective measures of workload, such as patient volume, admissions or tasks. RESULTS: Eight randomised controlled trials (RCTs) were included. Settings included EDs, specialised hospital units and clinical support services. Outcome measures varied between studies, so meta-analysis was not possible. Seven RCTs found no significant differences in objective workload measures between intervention groups where 'q****" was uttered and control groups where it was not. One RCT in orthopaedics reported an increase in overnight admissions when 'q****" was said but had significant methodological limitations. Two RCTs noted potential impacts on subjective perceptions of workload among believers. Limitations of included studies include small sample sizes, lack of blinding and inadequate control for confounders. DISCUSSION: The available evidence does not support the assertion that saying the word 'quiet' affects clinical workload metrics. Healthcare professionals should be encouraged to prioritise communication based on evidence rather than myth, and there is insufficient evidence that saying 'quiet' while on shift will bring negative consequences for themselves or colleagues
A systematic review of alexithymia in young people and their parents
No full textAims & hypothesis This systematic review is the first to investigate whether there is a correlation in levels of alexithymia in young people and their parents, with the hypothesis that there is a positive correlation. Background Alexithymia means “no words for feelings” and encompasses three components: difficulty identifying feelings (DIF11Difficulty Identifying Feelings.), difficulty describing feelings (DDF22Difficulty Describing Feelings.) and externally oriented thinking (EOT33Externally Oriented Thinking.). Alexithymia is common, affecting 9–17 % of men and 5–10 % of women. Alexithymic adults and children experience higher rates of mental illness. Evidence points to a multifactorial cause including neurobiological, genetic and environmental factors and experienced parenting style. Parental alexithymia has been linked with parental burnout and psychopathology in their children. Methods A systematic search was undertaken for studies presenting data that directly compared parent-child alexithymic characteristics/measures. Quantitative data were extracted, and a meta-analysis carried out to estimate the overall effect size of this correlation. Results Ten studies were included in the review, including seven in meta-analysis. There was a statistically significant weak mother-child correlation in the level of alexithymia for total scores (r = 0.24, p = 0.01) and subscale scores (DIF r = 0.18, p = 0.02; DDF r = 0.15, p = 0.04; EOT r = 0.12, p = 0.006). In relation to fathers, there was a statistically significant weak correlation with total score (r = 0.16, p = 0.01) but not subscale scores. Rates of alexithymia were much higher in young people with mental and physical health diagnoses (12–46 %), compared with non-clinical populations (9 %), in keeping with previous research. Conclusion Alexithymia is common in adolescents with mental and physical health diagnosis, and there is a small but consistent correlation in child-parent alexithymia, in keeping with the understanding of a multifactorial cause for alexithymia. Future research should consider family-based interventions for alexithymia.https://www.sciencedirect.com/science/article/pii/S016503272501297
CASE STUDY: THE USE OF SUBCUTANEOUS CLONIDINE FOR PAIN RELIEF IN COMPLEX CANCER PAIN.
Get PDFPain is a common symptom in the terminal phase of a cancer patient, and the World Cancer Declaration sets a target for universally available pain control by 2025. Cancer pain can be complex to manage due to the different pathological mechanisms occurring, particularly as it advances and is progressively resisting current analgesia. This case report focuses on the use of clonidine in the palliative care setting, where opioid and non-opioid approaches to analgesia have not controlled the intensifying pain. Sharing this study aims to further the experience base of its utility in complex cancer pain management. The α2A-adrenergic receptor agonist, clonidine, is increasingly being recognised as an effective adjuvant medication for pain and agitation in patients in end-of-life care. This is due to its anti-nociceptive properties and non-opioid action. Evidence of its use in a palliative setting, and relevant pharmacokinetic safety profile, is limited. However, a recent retrospective study in the UK has shown it to be a promising drug due to being well tolerated and its symptomatic benefits. Clonidine was titrated in response to reported and observed pain behaviours, to serve as an adjuvant to opioids. It was noted that there was a significant decrease in opioid usage in correlation with an increased dosage of clonidine. Despite the complicating factor of COVID-19, the patient reported a clinical benefit of clonidine in terms of their pain and comfort. Review of the patient’s integrated Palliative Care Outcome Scale indicated maintained scores with introduction of clonidine compared to prior use of opioids.https://spcare.bmj.com/content/15/Suppl_2/A70.2.inf
Mindfulness-Based cognitive therapy for Life (MBCT-L) versus stress reduction psychoeducation (SRP) for the improvement of mental well-being in health care and other public sector staff : protocol for the well at work randomized controlled trial
Get PDF©Elena Nixon, Shireen Patel, Priya Patel, James Roe, Neil Nixon, Tim Sweeney, Paul Bernard, Clara Strauss, Michael P Craven, Sam Malins, Rob Goodwin, Laurence Astill Wright, Boliang Guo, Richard Morriss. Originally published in JMIR Research Protocols (https://www.researchprotocols.org), 26.05.2025.
This is an open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR Research Protocols, is properly cited. The complete bibliographic information, a link to the original publication on https://www.researchprotocols.org, as well as this copyright and license information must be included.BACKGROUND: Mindfulness-based and stress reduction interventions have been recommended by the National Institute for Health and Care Excellence guidelines in England and Wales as effective preventive mental well-being interventions for health care and other public sector staff at risk of poor mental health. OBJECTIVE: This trial aims to assess the effectiveness of the increasingly implemented Mindfulness-Based Cognitive Therapy for Life (MBCT-L) intervention versus a routinely available Stress Reduction Psychoeducation (SRP) intervention in reducing perceived stress and improving other mental health and work-related outcomes in national health care and other public sector service employees. METHODS: The trial is a multisite, single-blind, parallel-group, 2-arm superiority randomized controlled trial. Recruitment, interventions, and assessments will be conducted remotely via online platforms. We will recruit 260 health care and other public sector staff into 26 intervention groups across the United Kingdom, with the intervention delivered through human resource staff well-being provision channels affiliated with participating National Health Service trusts. Participants will be randomly allocated in a 1:1 ratio to either MBCT-L or SRP. Primary and secondary outcomes will be collected at 6, 12, and 20 weeks after randomization. The primary outcome will be the change in scores on the Perceived Stress Scale-14 from baseline to 20 weeks after randomization. Demographic, intervention-related, and health economic data will also be collected. Secondary outcomes will involve assessments of well-being, mental health state, and work-related engagement and performance. Adverse events will be recorded. Data analysis will involve multilevel modeling, and it will be conducted on an intention-to-treat basis. A substudy will involve online semistructured interviews after 20 weeks of randomization with a subsample of participants (n=30, 12%). Transcribed data will be subjected to thematic analysis to elicit qualitative outcomes on perceived well-being and work-related changes after intervention as well as drivers and barriers to intervention uptake and acceptability. RESULTS: Recruitment of participants commenced on August 29, 2023. The target recruitment of 260 participants was reached on April 30, 2024. Follow-up outcome data collection was completed on September 30, 2024, and data analysis is underway. A total of 30 qualitative interviews have been conducted. CONCLUSIONS: Findings will inform future recommendations on intervention suitability and implementation for public care staff well-being. TRIAL REGISTRATION: International Standard Randomised Controlled Trial Number (ISRCTN) ISRCTN18049845; https://www.isrctn.com/ISRCTN18049845. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/67695.https://www.researchprotocols.org/2025/1/e6769
Violence reduction, revisiting a public health approach
No full textObjectives Propose and test an alternative method for identifying population targets for public health model derived violence reduction programmes. Study design Quantitative and qualitative focused on neighbourhoods in the 75th percentile of violence or higher, using Lower Super Output Areas (LSOAs) as the data collection/integration focus. Methods Cluster analysis to group similar LSOAs together. Significant factors in the regression analysis plus violence rates were entered into a k-means cluster analysis creating five groupings and a short list to include in the quantitative and qualitative arms. Results Local Government Area (LGA) or a city-wide perspective, masks locations with high violence rates and misses potential solutions. Crime and violence are more prevalent in areas with high deprivation, poor design of housing and space associated with isolation and fear. Less considered violence vectors were identified. Conclusions Deprivation was the strongest predictor of violence, but there are highly deprived areas that do not have high levels of violence and conversely high-violence neighbourhoods in non-deprived areas. A granular and dynamic understanding of these patterns should form the basis of future investment and intervention efforts.https://www.sciencedirect.com/science/article/pii/S003335062500317