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This article titled "Qualitative Research Part 3: Publication" from the Journal of Psychiatric and Mental Health Nursing provides guidelines for conducting and reporting qualitative research in the field of mental health nursing. It emphasizes the importance of following the research methodology and method meticulously. The article offers guidance on various aspects of publication, including title and authorship, the introduction/background section, and the method section. It also provides examples and suggestions for reporting findings, synthesizing results, and discussing the implications for mental health nursing practice. The document aims to improve researchers' chances of having their papers accepted by journals and offers a checklist of key points to consider before submitting a research paper. [Extracted from the article]

Indigenous peoples experience well documented health inequities compared to majority ethnic groups. More research into serious conditions like Bipolar Disorder (BD) is needed. A systematic review of published original research involving Indigenous peoples with BD was completed to identify areas of consistency, contradiction and gaps in available literature. Searches identified 396 studies, 25 met inclusion criteria. Six countries including New Zealand were represented. Studies commonly reported small numbers of Indigenous participants, for whom results were often incomplete. The design, population, and methods were also diverse, limiting the review synthesis. The only consistent finding in studies of similar methods suggested BD prevalence may be greater in Indigenous communities. Future research must be designed to inform knowledge about Indigenous peoples with BD, to identify their needs and experiences, and address any factors maintaining health inequities. Keywords: Bipolar Disorder, Systematic Review, Indigenous Populations, Introduction Recent publications identify pervasive inequities and barriers affecting the health of Indigenous peoples when compared to majority ethnic groups (Anderson et al., 2016; UN Permanent Forum on Indigenous Issues, [...]

Bipolar disorder (BD) is a serious mental health condition that is clinically complex to monitor and manage. While best practice guidelines exist, they vary internationally lacking consensus. Indigenous peoples, including Māori in New Zealand, experience higher community rates of BD. While New Zealand practice guidelines recommend providing culturally responsive care to Māori, studies show that Māori do not receive best practice. This qualitative study aimed to share the evidence about patterns of health service use and Māori patient experiences with focus group participants involved in the design and delivery of BD services, to discuss and develop guidelines for best practice for Māori with BD and address areas of unmet need. Three focus groups were conducted with 22 participants involved in the delivery of services to Māori with BD across three sites. Willing participants were sent background information and three focus group questions framed to elicit priority solutions to improve clinical, structural and organisational features of mental health service delivery for Māori patients with BD and their whānau (family). The nominal group technique was used to synthesise responses, and then develop a prioritised list of proposed solutions. Results identified system-level changes required at the clinical, structural and organisational levels of healthcare. Findings further evidence the need for healthcare reform in New Zealand, to be responsive to Māori with BD. [ABSTRACT FROM AUTHOR]

Introduction: Emotion processing is an essential part of interpersonal relationships and social interactions. Changes in emotion processing have been found in both mood disorders and in aging, however, the interaction between such factors has yet to be examined in detail. This is of interest due to the contrary nature of the changes observed in existing research - a negativity bias in mood disorders versus a positivity effect with aging. It is also unclear how changes in non-emotional cognitive function with aging and in mood disorders, interact with these biases. Methods and results: In individuals with mood disorders and in healthy control participants, we examined emotional processing and its relationship to age in detail. Data sets from two studies examining facial expression recognition were pooled. In one study, 98 currently depressed individuals (either unipolar or bipolar) were compared with 61 healthy control participants, and in the other, 100 people with bipolar disorder (in various mood states) were tested on the same facial expression recognition task. Repeated measures analysis of variance was used to examine the effects of age and mood disorder diagnosis alongside interactions between individual emotion, age, and mood disorder diagnosis. A positivity effect was associated with increasing age which was evident irrespective of the presence of mood disorder or current mood episode. Discussion: Results suggest a positivity effect occurring at a relatively early age but with no evidence of a bias toward negative emotions in mood disorder or specifically, in depressed episodes. The positivity effect in emotional processing in aging appears to occur even within people with mood disorders. Further research is needed to understand how this fits with negative biases seen in previous studies in mood disorders. [ABSTRACT FROM AUTHOR]

This perspective paper explores the choice of psychotherapy for psilocybin‐assisted psychotherapy for treatment‐resistant depression. There is evidence to support the use of some psychotherapies in treating 'treatment‐resistant' depression, and emerging evidence for the efficacy of psilocybin. The next step which is the focus of this paper is to identify psychotherapies that are both effective and congruent with the psilocybin experience. The evidence for the efficacy of the psychotherapies is drawn from a Cochrane review and the analysis of their congruence with the psilocybin experience is drawn from a qualitative meta‐synthesis of the experience of psilocybin. The paper will examine whether three one‐to‐one psychotherapies identified as effective in the treatment of treatment‐resistant depression are compatible with the psilocybin experience. Each psychotherapy will be examined in relation to its congruence with the qualitative evidence that suggests the choice of psychotherapy needs to give priority to the subjective experience, facilitate emotional processing, support connectedness with others, acceptance of the self as emotional and support change based on the person's insights into their relationships with others and the world in which they live. We conclude that interpersonal psychotherapy and intensive short‐term dynamic psychotherapy align with that experience, although others are currently being trialled. [ABSTRACT FROM AUTHOR]

Objective: To describe the perspectives of those with lived experience of stimulant use disorder on methamphetamine-related violence in psychiatric inpatient settings. Method: Eight adult psychiatric inpatients with stimulant use disorder were recruited. Semi-structured interviews were recorded, transcribed and analysed using thematic analysis. Results: Participants reported that traumatic experiences predisposed those using methamphetamine to violent behaviour. Participants were fearful of psychiatric hospitalisation because of loss of autonomy and stigma. Methamphetamine use was associated with mercurial intense emotions. Participants believed these factors led to violence during psychiatric admissions. Conclusions: People with stimulant use disorder have a sophisticated understanding of the complex causal pathways from methamphetamine use to violent behaviour. Their lived experience can make an important contribution to service development. [ABSTRACT FROM AUTHOR]

Background: There is evidence of Indigenous and ethnic minority inequities in the incidence and outcomes of early psychosis. Racism has been implicated as having an important role. Aim: To use Indigenous experiences to develop a more detailed understanding of how racism operates to impact early psychosis outcomes. Methods: Critical Race Theory informed the methodology used. Twenty-three Indigenous participants participated in four family focus group interviews and thirteen individual interviews, comprising of 9 Māori youth with early psychosis, 10 family members and 4 Māori mental health professionals. An analysis of the data was undertaken using deductive structural coding to identify descriptions of racism, followed by inductive descriptive and pattern coding. Results: Participant experiences revealed how racism operates as a socio-cultural phenomenon that interacts with institutional policy and culture across systems pertaining to social responsiveness, risk discourse, and mental health service structures. This is described across three major themes: 1) selective responses based on racial stereotypes, 2) race related risk assessment bias and 3) institutional racism in the mental health workforce. The impacts of racism were reported as inaction in the face of social need, increased use of coercive practices and an under resourced Indigenous mental health workforce. Conclusion: The study illustrated the inter-related nature of interpersonal, institutional and structural racism with examples of interpersonal racism in the form of negative stereotypes interacting with organizational, socio-cultural and political priorities. These findings indicate that organizational cultures may differentially impact Indigenous and minority people and that social responsiveness, risk discourse and the distribution of workforce expenditure are important targets for anti-racism efforts. [ABSTRACT FROM AUTHOR]

There is increasing clinical interest in the use of psilocybin. There is emerging evidence of the efficacy of psilocybin for the treatment of a range of clinical conditions. Mental health nurses have a unique set of skills for caring for people who are hallucinating. To expand these skills to meet the developing clinical interest in the therapeutic use of psilocybin, it is helpful to understand the experience from the perspective of the person being treated with psilocybin. A qualitative meta‐synthesis was conducted to examine how those with psilocybin described their experiences to identify whether its effects are similar across different health conditions. Ten studies were included in the review. The health conditions studied were cancer, depression, HIV, substance use disorder, smoking cessation and trauma. The synthesis of findings identified three themes that were common across the studies despite the health condition: acceptance, connection and transformation. The review provides helpful insights into how people experience psilocybin and its effects on their health condition. [ABSTRACT FROM AUTHOR]

While antidepressants may be effective in treating depression for some people, a third of people do not have an improvement in mood after a trial of two different antidepressants for an adequate duration. These people are diagnosed as having 'treatment‐resistant' depression which situates the problem as part of their biological or psychological makeup. We conducted a search of studies that examined this problem from the perspective of people whose depression did not improve on antidepressants. Nine studies were included in a qualitative meta‐synthesis that identified four themes across these studies: feeling trapped, disconnection, loss of self, and questioning. The participants experienced considerable distress associated with the constant presence of depression in their lives. While antidepressants may help some people, there is a need for more innovative approaches to the treatment of depression. There is a strong argument for trialling appropriate evidence‐based psychotherapy before a person is categorized as having treatment‐resistant depression. It is perhaps better to describe the issue as inadequate efficacy of antidepressants to situate the problem with the treatment provided rather than with the person. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject?: People with mood disorders often use substances.There are several clinician‐driven hypotheses explaining the relationship. What the paper adds to existing knowledge?: The paper draws together the existing research on the perceptions of those with lived experience of mood disorders on the reasons for using substances.The participants in the studies identified using substances to manage their mood when treatment to manage their mood was not effective or acceptable, and as an escape from trauma and hardship. What are the implications for practice?: Mental health nurses need an understanding of why people with mood disorders may use substances and the impact of this on their treatment.Mental health nurses need to provide trauma‐informed care that emphasizes harm reduction for those who have mood disorders and substance use. Introduction: Substance use is highly prevalent among people with mood disorders. Effective treatment for these people requires a better understanding of the relationship between both mood and substance use from the perspectives of those with lived experience. Question: What are the reasons those with lived experience of mood disorders give for substance use? Method: An integrative review was conducted. The Joanna Briggs Institute suite of critical appraisal tools was used to evaluate the quality of individual studies. Data relevant to the review question were extracted, and the results were synthesized into themes. Results: Eighteen papers met the eligibility criteria. Three themes were identified across the included studies: Managing my mood, More Effective than prescribed medication, and Escape from trauma and hardship. Discussion: This integrative review identified that people with a mood disorder who use substances described choosing to take substances to manage their mood, as an alternative to prescribed medications, and to cope with trauma and social hardships. Implications for Practice: Mental health nurses need to provide care that recognizes why people use substances. They need to understand these reasons to provide a harm reduction and trauma‐informed model of care. Evidence‐based non‐pharmacological interventions for mood disorders need to be available as an alternative to medications or as a supplement. [ABSTRACT FROM AUTHOR]

Background: There is evidence of disparities between non-Indigenous and Indigenous incidence of psychotic disorders. Despite these disparities being a clear signpost of the impact of structural racism, there remains a lack of evidence to target institutional factors. We aimed to investigate non-Indigenous and Indigenous differences in government service use prior to first episode diagnosis as a means of identifying points of intervention to improve institutional responses. Methods: We used a previously established national New Zealand cohort of 2385 13 to 25-year-old youth diagnosed with psychosis between 2009 and 2012 and a linked database of individual-level multiple government agency administration data, to investigate the differences in health, education, employment, child protection and criminal-justice service use between non-Indigenous (60%) and Indigenous youth (40%) in the year preceding first episode diagnosis. Further comparisons were made with the general population. Results: A high rate of health service contact did not differ between non-Indigenous and Indigenous youth (adjusted rate ratio 1.0, 95% confidence interval [0.9, 1.1]). Non-Indigenous youth had higher rates of educational enrolment (adjusted rate ratio 1.2, 95% confidence interval [1.1, 1.3]) and employment (adjusted rate ratio 1.2, 95% confidence interval [1.1, 1.3]) and were 40% less likely to have contact with child protection services (adjusted rate ratio 0.6, 95% confidence interval [0.5, 0.8]) and the criminal-justice system (adjusted rate ratio 0.6, 95% confidence interval [0.5, 0.7]). Both first episode cohorts had a higher risk of criminal justice contact compared to the general population, but the difference was greater for non-Indigenous youth (risk ratio 3.0, 95% confidence interval [2.7, 3.4] vs risk ratio 2.0, 95% confidence interval [1.8, 2.2]), explained by the lower background risk. Interpretation: The results indicate non-Indigenous privilege in multiple sectors prior to first episode diagnosis. Indigenous- based social disparities prior to first episode psychosis are likely to cause further inequities in recovery and will require a response of health, education, employment, justice and political systems. [ABSTRACT FROM AUTHOR]

Eating disorders (EDs) are serious mental health illnesses, yet there is a need to better understand the illness experience to improve treatment outcomes. Qualitative research, and narrative approaches in particular, can elicit life stories that allow for the whole illness journey to be explored. This study aimed to explore the experiences of women with a history of an ED, identifying the life events they perceived were relevant to the onset of their ED through to recovery. Interviews were conducted with 18 women with lived experience of an ED. Through structural narrative analysis, an overarching storyline of childhood loss contributing to a belief of conditional acceptance, fear of abandonment and struggle to seek emotional support due to the fear of being a burden was identified. Negative experiences with the health sector were common. These findings have implications for the way medical professionals respond to help seeking and deliver treatment. [ABSTRACT FROM AUTHOR]

Aims: The validity of diagnostic classification in early psychosis has important implications for early intervention; however, it is unknown if previously found disparities between Māori (Indigenous people of New Zealand) and non‐Māori in first episode diagnoses persist over time, or how these differences impact service use. Methods: We used anonymized routine mental health service data and a previously established cohort of over 2400 13–25‐year‐old youth diagnosed with FEP between 2009 and 2012, to explore differences in diagnostic stability of psychosis diagnoses, comorbid (non‐psychosis) diagnoses, and mental health service contacts between Māori and non‐Māori in the five‐year period following diagnosis. Results: Differences in schizophrenia and affective psychosis diagnoses between Māori and non‐Māori were maintained in the five‐year period, with Māori being more likely to be diagnosed with schizophrenia (51% vs. 35%), and non‐Māori with bipolar disorder (28% vs. 18%). Stability of diagnosis was similar (schizophrenia 75% Māori vs. 67% non‐Maori; bipolar disorder 55% Māori vs. 48% non‐Māori) and those with no stable diagnosis at FEP were most likely to move towards a schizophrenia disorder diagnosis in both groups. Māori had a lower rate of diagnosed co‐morbid affective and anxiety symptoms and higher rates of continued face to face contact and inpatient admission across all diagnoses. Conclusions: Indigenous differences in schizophrenia and affective psychosis diagnoses could be related to differential exposure to socio‐environmental risk or assessor bias. The lower rate of co‐morbid affective and anxiety disorders indicates a potential under‐appreciation of affective symptoms in Māori youth with first episode psychosis. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject?: Rates of antidepressant prescribing have been increasing.Antidepressants are not effective for many people. What the paper adds to existing knowledge?: Participants described how in order to receive help they had to engage with a medical pathway in which their experiences were constructed as arising from a biochemical deficit.Antidepressant prescribing was identified as being the only option available and was associated with stigma. What are the implications for practice?: Mental health nurses have a role to play in providing treatment options for those experiencing depression.Mental health nurses need to provide evidence‐based information about antidepressants support those experiencing depression to make informed choices. Introduction: There are increased prescribing rates of antidepressants associated with an increase in the diagnosis of depression. However, antidepressants are not effective for many people. There is a gap in the existing literature for a synthesis of the experiences of those with lived experience of antidepressant use to better understand their use and impact given their ubiquitous use in mental health, primary care and other secondary and tertiary care settings. Mental health nurses play direct or indirect roles in both advocating for antidepressant use and monitoring adherence. Aims: To identify how people prescribed antidepressants describe their experiences of the medication including its discontinuation? Method: A meta‐synthesis of qualitative studies examining patients' experiences of antidepressant medication. Ovid MEDLINE, EMBASE, PsychINFO and Cochrane Library databases were searched in May 2021. One reviewer screened titles and abstracts. Two reviewers independently reviewed the retrieved papers for eligibility and data extraction. The data synthesis was conducted using thematic analysis. Two reviewers independently conducted quality appraisals. Results: Twenty‐seven studies with a total of 2937 participants were identified for inclusion in this review. Four themes were identified across the studies: the only option available; stigma associated with 'biochemical deficit' not myself and the vicious cycle. Implications for practice: Those seeking treatment for depression need to be provided with treatment options and evidence‐based information about anti‐depressants to provide them with the opportunity to make informed choices. [ABSTRACT FROM AUTHOR]

This perspective paper aims to present a personal viewpoint on the impact of psychiatric discourse on the principles of recovery in mental health care. Mental health services espouse these principles, yet psychiatric discourse remains the dominant model. A critical analysis will examine how psychiatry maintains this dominance. The aim is to examine how psychiatric discourse constructs both the nature of mental distress and its treatment, and how it maintains its power as the dominant authority and its relationship to recovery principles. The paper concludes that psychiatric discourse is the antithesis of recovery principles and that its authority is perpetuated through co‐opting a medical explanatory model, claiming expertise in the ability to predict social risk, and maintaining a tightly controlled echo chamber. A way forward involves the dismantling of the hierarchical service delivery model based on psychiatric discourse and replacing it with a more horizontal service delivery model in which the lived experience of mental distress is central. Regular audit of services needs to prioritize recovery principles. The implications for mental health nursing are considered. [ABSTRACT FROM AUTHOR]

The long-term burden of symptoms is an important outcome in bipolar disorder (BD). A method which has minimal burden of assessment uses a retrospective interview, the Longitudinal Interval Follow-up Examination (LIFE), although this may be subject to problems with recall. This study examines the relationship between the retrospective LIFE scale and concurrently-rated mood rating scales in two clinical trials of 18 months of psychotherapy for patients with BD. The Montgomery-Asberg Depression Rating Scale (MADRS) and Young Mania Rating Scale (YMRS) were administered every eight to nine weeks and the LIFE was carried out every 6 months. Correlations between scores on mood rating scales and at equivalent times on the LIFE were examined, as well as of potential clinical moderators. There were significant correlations between LIFE depression ratings and concurrent MADRS score (r = 0.57) and between LIFE mania ratings and YMRS score (r = 0.40). In determining "mild depression" on the MADRS, a receiver operating characteristics (ROC) analysis showed an AUC of 0.78 for LIFE scores. Correlations, particularly for depression scores, were high even when the LIFE rating was several months before the interview, suggesting that the LIFE has validity in examining the burden of mood symptoms over time, with relatively little burden of assessment. Future research should examine the relationship between symptom burden and quality of life measured in this way. [ABSTRACT FROM AUTHOR]

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Objective: To examine the impact of a treatment package combining Interpersonal and Social Rhythm Therapy (IPSRT) and cognitive remediation (CR), vs IPSRT alone, on cognition, functioning, and mood disturbance outcomes in mood disorders. Methods: A pragmatic randomised controlled trial in adults with bipolar disorder (BD) or major depressive disorder (MDD), recently discharged from mental health services in Christchurch, New Zealand, with subjective cognitive difficulties. Individuals were randomised to a 12‐month course of IPSRT with CR (IPSRT‐CR), or without CR (IPSRT). In IPSRT‐CR, CR was incorporated into therapy sessions from approximately session 5 and continued for 12 sessions. The primary outcome was change in Global Cognition (baseline to 12 months). Results: Sixty‐eight individuals (BD n = 26, MDD n = 42; full/partial remission n = 39) were randomised to receive IPSRT‐CR or IPSRT (both n = 34). Across treatment arms, individuals received an average of 23 IPSRT sessions. Change in Global Cognition did not differ between arms from baseline to treatment‐end (12 months). Psychosocial functioning and longitudinal depression symptoms improved significantly more in the IPSRT compared with IPSRT‐CR arm over 12 months, and all measures of functioning and mood symptoms showed moderate effect size differences favouring IPSRT (0.41–0.60). At 18 months, small to moderate, non‐significant benefits (0.26–0.47) of IPSRT vs IPSRT‐CR were found on functioning and mood outcomes. Conclusions: Combining two psychological therapies to target symptomatic and cognitive/functional recovery may reduce the effect of IPSRT, which has implications for treatment planning in clinical practice and for CR trials in mood disorders. [ABSTRACT FROM AUTHOR]

Background: Studies typically report overall change in function when assessing bipolar disorder (BD) interventions, but individual domains are not analyzed. Which aspects of functioning are impacted is clearly important and may differ between treatments. Methods: Data were analyzed from two previous clinical trials of Interpersonal and Social Rhythm Therapy (IPSRT) for BD patients. Change in total and subscale scores on the Social Adjustment Scale Self-Report (SAS-SR) from 0 to 78 weeks, were analyzed. Results: 152 BD patients took part in randomized controlled trials of IPSRT (n = 38) vs. Specialist Supportive Care (SSC) (n = 43), and of IPSRT (n = 41) vs. treatment as usual (TAU) which was discharge to primary care (n = 30). IPSRT was superior to TAU on change in the social and leisure activities and extended family subscales, and SAS-SR total score over 18 months. Limitations: Studies were not designed to be pooled. Patients in study 1 were younger and symptomatic at baseline. Patients assigned to TAU were more likely to drop-out. Patients did not respond to subscales that were not personally applicable (work, marital, children). Conclusion: IPSRT had a positive impact on two SAS-SR subscales compared to TAU over 18 months. Other subscales were limited by the lack of respondents due to individual applicability. Different psychotherapy may have differential effects on different domains of function. Measures of function and research into functioning in BD should include domain-based measures, and report the numbers of participants who respond to questions in each domain. [ABSTRACT FROM AUTHOR]

Social distancing/lockdown policies during the coronavirus (COVID-19) pandemic may alter social rhythms of people through imposition of restrictions on normal daily activities. This may in turn challenge circadian function, particularly in people with mood disorders. Although objective data describing the relationship between circadian disturbances and mood disorders exist, data regarding the subjective experience of circadian challenge is sparse, and its association with mood symptoms is unclear. The present qualitative study was one component of a mixed-methods multi-national project, which took advantage of widespread disruption to daily routines due to Government COVID-related lockdowns during 2020. The Behavior Emotion and Timing during COVID-19 (BEATCOVID) survey study included three open questions generating qualitative data on participants' subjective experience of social disruption due to social distancing/lockdown policies, two of which asked about the barriers and opportunities for stabilizing routines. Responses were coded and analyzed using Thematic Analysis. A total of N = 997 participants responded to at least one of the free-text questions. Four themes were identified: 1) loss of daily timed activities, 2) role of social interaction, 3) altered time perception and 4) disruption to motivation and associated psychological effects. Themes were organized into a provisional heuristic map, generating hypotheses for future research centered on the new concept of 'psychological drift.' [ABSTRACT FROM AUTHOR]

Accessible summary: What is known on the subject?: Aggression and violence are persistent problems in psychiatric inpatient units.Violence preventive factors have been identified from both staff's and patients' perspectives.Violent and aggressive inpatient incidents have not been adequately explained in research and reviews to date. What this paper adds to existing knowledge?: This review is novel in that it provides a comparison of patients' and staff's perspectives and identified that these differ and were influenced by factors attributable to the inpatient culture.The one contributory factor both agreed upon was the role of staff's interpersonal skills in either exacerbating or de‐escalating aggression and violence.The inpatient culture was found to engender differing perceptions of most contributory factors to violence and aggression. What are the implications for practice?: While staff's interpersonal skills were identified as a primary influence on whether their interaction with patients contributed to aggression and violence, this was shaped by the inpatient environment's culture.Patient‐centred interactional skills need to focus on the patients' needs for respect and active participation rather than engendering feelings of disrespect or coercion.Patient‐centred communication skills that demonstrate an understanding of the patient's experience in the inpatient environment need to be core skills for mental health nurses. Introduction: High rates of aggression and violence are a persistent problem in inpatient mental health environments. A comparison of staff's and patients' perceptions of the causes may provide novel insights. Aim: This review aimed to compare patients' and staff's perspectives on the causes of aggression and violence in inpatient environments. Method: An integrative review of the literature was conducted with a search of Ovid (Medline, Embase, PsycINFO) databases and manual searching. Results: Thirty articles met criteria for inclusion. Interactions prior to aggressive or violent incidents were characterized by patients as disrespectful and coercive, and by staff as indicative of the patient's mental state or personality. Both groups identified the importance of patient‐centred communication skills. Discussion: The review identified that patients and staff have differing perspectives on the causes of violence and aggression. There was an interactional dynamic between staff and patients that was shaped by the culture of the inpatient setting. Implications for Practice: Understanding how the inpatient culture plays a role in shaping a dynamic between patients and staff and developing communication skills that acknowledge this may help reduce violence and aggression in inpatient settings. [ABSTRACT FROM AUTHOR]

Objectives: Research suggests that patients with co-morbid bipolar disorder (BD) and substance use disorder (SUD) have a poorer illness course and clinical outcome. The evidence is limited as SUD patients are often excluded from BD studies. In particular, evidence regarding long term outcomes from studies using psychotherapies as an adjunctive treatment is limited. We therefore examined data from two studies of Interpersonal Social Rhythm Therapy (IPSRT) for BD to determine whether lifetime or current SUD affected outcomes. Methods: Data were analyzed from two previous clinical trials of IPSRT for BD patients. Change in scores on the Social Adjustment Scale (SAS) from 0 to 78 weeks and cumulative mood scores from 0 to 78 weeks, measured using the Life Interval Follow-Up Evaluation (LIFE), were analyzed. Results: Of 122 patients (non-SUD n = 67, lifetime SUD but no current n = 43, current SUD n = 12), 79 received IPSRT and 43 received a comparison therapy—specialist supportive care—over 18 months. Lifetime SUD had a significant negative effect on change in SAS score but not LIFE score. There was no effect of current SUD on either change in score. Secondary analysis showed no correlation between symptom count and change in SAS total score or LIFE score. Conclusion: Current SUD has no impact on mood or functional outcomes, however, current SUD numbers were small, limiting conclusions. Lifetime SUD appears to be associated with impaired functional outcomes from psychotherapy. There is limited research on co-morbid BD and SUD patients undergoing psychotherapy. [ABSTRACT FROM AUTHOR]

Accessible summary: What is known on the subject?: There is evidence that the LGBT communities experience greater health disparities, particularly in relation to their mental health needs.The LGBT communities are often faced with stigma and discrimination within mental health services. What the paper adds to existing knowledge?: People within the LGBT communities have identified that their experiences of mental health services reinforce stigma and lack an understanding of their specific needs.Their needs can be addressed by mental health services that challenge heteronormative assumptions and promote self‐acceptance and equity. What are the implications for practice?: The existing heteronormative culture in mental health nursing practice needs to be challenged.Practice needs to demonstrate self-awareness of personal and societal LGBT biases, prejudices, and stigma.Practice needs to demonstrate knowledge of important LGBT health care and psychosocial issues.Practice needs to reflect LGBT clinical skills grounded in professional ethics, guidelines, and standards of care. Introduction: The lesbian, gay, bisexual and transgender (LGBT) communities are a minority population that experience a range of health disparities, including mental health. Because these groups have higher rates of mental disorder than the general population it is, therefore, pertinent to identify their specific mental health needs and their experiences when accessing mental health care. Aim: To identify the mental health needs of the LGBT communities and their experiences of accessing mental health care. Methods: An integrative review of qualitative studies was conducted. Results: A total of fourteen studies were selected for this review. The studies identified that participants' experiences of accessing mental health care were related to (a) experiencing stigma and (b) staff's lack of knowledge and understanding of LGBT people's needs. They identified a need for mental health care that promotes the principles of equity, inclusion and respect for diversity. Discussion: The LGBT communities while not a homogenous group, face unique challenges when dealing with their mental health needs. Services that promote health equity and self‐acceptance are important for this group. Implications for practice: It is vital that mental health nursing education incorporate models that promote equity, inclusion and respect for diversity regarding this group of people. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to examine participants' experiences of interpersonal and social rhythm therapy, with or without cognitive remediation, and the impact of this intervention on their functioning. Methods: This qualitative study drew data from follow- up interviews of 20 participants who completed the 12-month intervention as part of a randomized controlled trial. The qualitative data were collected through semistructured interviews and were analyzed with thematic analysis. Results: The 20 participants (11 men, 9 women, ages 22-55, median age=32) reported that interpersonal and social rhythm therapy (content and process) as an adjunct to medication, alone or in combination with cognitive remediation, was effective in improving their functioning. They described these improvements as facilitated by a new sense of control and confidence, ability to focus, new communication and problem-solving skills, and better daily routines. Conclusions: Participants with recurrent mood disorders described improved functioning related to therapies that formulate their mood disorder in terms of a model, such as interpersonal and social rhythm therapy with or without cognitive remediation, that provides an understandable and evidence-based rationale, facilitates a sense of control and confidence by supporting the person in undertaking practical routines that can be integrated into daily life, focuses on communication and problem-solving skills, and engenders a sense of hope by working with the person to develop self-management strategies relevant to their specific symptom experiences and the life they choose to live. [ABSTRACT FROM AUTHOR]