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Aims and method With increasing recognition of the prevalence and impact of perinatal mental health (PMH) disorders comes a responsibility to ensure that tomorrow's doctors can support families during the perinatal period. Online surveys seeking information about the inclusion of PMH education in undergraduate curricula were sent to psychiatry curriculum leads and student psychiatry societies from each university medical school in the UK between April and September 2021. Results Responses were received from 32/35 (91.4%) medical schools. Two-thirds reported specific inclusion of PMH content in the core curriculum, typically integrated into general adult psychiatry or obstetric teaching. Students at the remaining schools were all likely to be examined on the topic or see perinatal cases during at least one clinical attachment. Clinical implications PMH education offers an opportunity for collaboration between psychiatry and other disciplines. Future work looking at educational case examples with objective outcomes would be valuable.

Aims and methodThis study aimed to explore factors that positively influence UK medical students’ interest in psychiatry. Delegates and committee members of the National Student Psychiatry Conference 2018 were invited to participate in individual semi-structured interviews. Nine interviews were conducted. Qualitative data were analysed using thematic analysis.Results:Four core themes emerged: psychiatry education and exposure, role of a psychiatrist, fitting in, and factors external to medical school. All students had some degree of interest in mental health before medical school, but placement and extra-curricular factors were strongly influential.ImplicationsInterest in psychiatry may be promoted by facilitating student exposure to enthusiastic psychiatrists and psychiatry subspecialties, encouraging extra-curricular activities and identifying early those with pre-existing interest in mental health on admission to medical school. Aspects of psychiatry that should be promoted include the potential to make a positive difference to patients’ lives and the teamworking elements of the specialty.

BackgroundExisting evidence suggests that some individuals from ethnic minority backgrounds are at increased risk of suicide compared to their majority ethnic counterparts, whereas others are at decreased risk. We aimed to estimate the absolute and relative risk of suicide in individuals from ethnic minority backgrounds globally.MethodsDatabases (Medline, Embase, and PsycInfo) were searched for epidemiological studies between 01/01/2000 and 3/07/2020, which provided data on absolute and relative rates of suicide amongst ethnic minority groups. Studies reporting on clinical or specific populations were excluded. Pairs of reviewers independently screened titles, abstracts, and full texts. We used random effects meta-analysis to estimate overall, sex, location, migrant status, and ancestral origin, stratified pooled estimates for absolute and rate ratios. PROSPERO registration: CRD42020197940.FindingsA total of 128 studies were included with 6,026,103 suicide deaths in individuals from an ethnic minority background across 31 countries. Using data from 42 moderate-high quality studies, we estimated a pooled suicide rate of 12·1 per 100,000 (95% CIs 8·4–17·6) in people from ethnic minority backgrounds with a broad range of estimates (1·2–139·7 per 100,000). There was weak statistical evidence from 51 moderate-high quality studies that individuals from ethnic minority groups were more likely to die by suicide (RR 1·3 95% CIs 0·9–1·7) with again a broad range amongst studies (RR 0·2–18·5). In our sub-group analysis we only found evidence of elevated risk for indigenous populations (RR: 2·8 95% CIs 1·9–4·0; pooled rate: 23·2 per 100,000 95% CIs 14·7–36·6). There was very substantial heterogeneity (I2 > 98%) between studies for all pooled estimates.InterpretationThe homogeneous grouping of individuals from ethnic minority backgrounds is inappropriate. To support suicide prevention in marginalised groups, further exploration of important contextual differences in risk is required. It is possible that some ethnic minority groups (for example those from indigenous backgrounds) have higher rates of suicide than majority populations.FundingNo specific funding was provided to conduct this research. DK is funded by Wellcome Trust and Elizabeth Blackwell Institute Bristol. Matthew Spittal is a recipient of an Australian Research Council Future Fellowship (project number FT180100075) funded by the Australian Government. Rebecca Musgrove is funded by the NIHR Greater Manchester Patient Safety Translational Research Centre (PSTRC-2016-003).

In recent years, there has been a substantial increase in the diagnosis of attention deficit hyperactivity disorder (ADHD) in children. Without appropriate management of symptoms and care, ADHD has been associated with a variety of negative child and adult outcomes. Environmental and familial factors that may contribute to three different pediatric referral types (academic, behavioural, and attentional) associated with ADHD were examined in the current study. In total, data from 477 families who were interviewed as a part of the intake process to a pediatric clinic were included in this study. Data for the current study was extracted from the intake questionnaires and included information on family history of mental health issues, socioeconomic status, and family relationships. The sample included children between the ages of three and 17 and mostly comprised males (n = 340). A frequency analysis of the data demonstrated relatively high rates of mental health issues within families (61.4%); almost half of the mothers reported some post-secondary education (46.1%) and most reported having normal relationships with their children (mothers, 78%; fathers, 62.9%). Finally, three stepwise regression analyses were conducted to predict referral type. All three regressions yielded significant models. Fifteen percent of the variability of the academic referral type was predicted by being male, age at the time of referral, mother's education level, and mother's learning. The behavioural referral types were predicted by a family history of depression, being male, mother-child relationship, and age at the time of referral; these accounted for 23% of the variance. Attentional referral type was predicted only by mother-child relationship that captured 6% of the variance. Overall, this study describes a population of parents of children with academic, behavioural, and attention-related referrals to pediatrics. Results indicate that mothers have a profound influence on their child's referral types, something that may transfer into later diagnosis and perhaps prognosis. Clinicians and researchers alike should focus their efforts toward developing integrative service assessment and treatment approaches that include important people in the child's life. The implementation of Community Social Pediatrics (a streamlined, inclusive approach to care) should be considered in urban centres like this one, where referrals like this are prevalent.

Traditional tall fescue cultivar, Kentucky 31, possesses a wild-type endophyte strain that produces several bioactive compounds including the ergot alkaloid, ergovaline, known to cause cattle toxicity and effects on insects. Novel cultivars, BarOptima PLUS E34, Jesup MaxQ, and Texoma MaxQ II, possess different endophyte strains that do not have negative effects on cattle but still protect from insect grazing. Our study investigated if different cultivars have different effects on insect dung decomposers such as dung beetles and determined if ergovaline could be detected in cow dung. Ergovaline at 0.04 and 0.27 μg/g was detected only from Kentucky 31 dung samples from 2017 and 2018 collections, respectively. From the 2017 dung collection, we tested Onthophagus taurus oviposition substrate preferences for each cultivar versus dung from uninfected pasture and also larval survival and development for each dung-type. From the 2018 dung collection, O. taurus and Digitonthophagus gazella oviposition substrate preferences, larval survival and development were tested for Texoma MaxQ II versus Kentucky 31 dung-types. Among the four cultivars, for making brood-balls O. taurus preferred dung from Texoma MaxQ II while dung from Kentucky 31 and BarOptima PLUS E34 were avoided. Both beetle species preferred dung from Texoma MaxQ II versus Kentucky 31 pasture. Larval survival was not affected by dung-type with the 2017 samples. However, with the 2018 samples both beetle species had reduced larval survival on Kentucky 31 than on Texoma MaxQ II brood-balls. Development time for O. taurus was shorter for larvae from Texoma MaxQ II versus Kentucky 31 or uninfected dung brood-balls. Adult mass was not affected in the 2017 collection but was reduced in 2018 Kentucky 31 samples when compared with Texoma MaxQ II. Finally, dung beetles can differentiate dung from pastures with different tall fescue cultivars. Novel cultivar, Texoma MaxQ II, provides more benefits for dung beetles. Pasture renovations with Texoma MaxQ II may improve pasture ecology by enhancing dung beetle populations.

This study aims to investigate the characteristics and mental health status of pregnant women with disordered personality traits. A cross-sectional study of a stratified sample of 545 women attending antenatal booking at a South London maternity service was conducted. Disordered personality traits were assessed using the Standardised Assessment of Personality-Abbreviated Scale (SAPAS). Mental disorders were assessed using the Structured Clinical Interview DSM-IV (SCID). Logistic regression was used to model associations, adjusting for confounders. Complete SAPAS data were collected for over 99% of women (n = 541). The weighted prevalence of elevated disordered personality traits (SAPAS ≥ 3) was 16.2% (95% CI 12.6–20.5). Women with elevated disordered personality traits were younger, less likely to live alone and more likely to report living in insecure accommodation. Among women with elevated disordered personality traits, the most common mental disorders were anxiety disorders (31.4%) and depressive disorders (17.6%). Each extra item endorsed on the SAPAS was associated with an 82% higher odds of meeting criteria for an Axis I mental disorder (adjusted OR 1.82 (1.42–2.33); p

BACKGROUND: Consultant pediatricians are commonly asked to see children regarding behavior and the potential of a diagnosis of ADHD. If left untreated and children unsupported over the long-term, the overall prognosis is poor, especially in terms of academic achievement and social functioning. Social inequities can create significant barriers to accessing timely and appropriate assessment and care (e.g., difficulty making appointments due to inconsistent contact information; decreased access to transportation to and from appointments). Adverse childhood experiences (ACEs) (exposure to mental illness, addiction and violence in the home to name a few) can influence child behaviour and function, complicating accurate diagnosis and effective treatment. There is evidence that children who are exposed to addiction, mental illness and violence will suffer long-term negative health outcomes and have increased rates of ADHD diagnosis. OBJECTIVES: This study aims to describe the family history and social conditions of children receiving behaviour-related referrals in a consultant pediatric clinic of five pediatricians in a catchment area of approximately 300,000 people, one urban city and including several rural communities. This area reports one of the highest child poverty rates in Canada. Family history of mental illness, learning, addiction, and anger issues, parental education level and employment status, and child demographics will be reported. By better understanding the needs of our referral base, we can make interventions to decrease barriers to care and match care plans to patient needs. DESIGN/METHODS: Data was collected via phone intake interviews of children being referred to pediatricians for behaviour-related referrals. Interview questions pertained to the child’s medical, academic and family history and other factors. Descriptive statistics were conducted to look at the frequency of potential risk factors that may impact children referred for behavioural assessments in terms of access to care, accurate diagnosis and treatment. These were referenced against the ACE score screening questionnaire. RESULTS: The sample was composed of 483 families, where the referred child was most often male (70.8%). Results indicate that a family history of mental illness (including, but not limited to: anxiety, depression, manic depression, schizophrenia, and bipolar disorder) was common among these families at 69.8%, and that 37.7% of families had at least one parent who reported a learning issue. Also common was a family history of addiction (43.5%) and anger issues (36%). Only 12.5% of mothers and 17.1% of fathers reported not having a high school education. CONCLUSION: This study demonstrates that many of the children being referred for behavioral referrals are at high-risk for ACEs such as exposure to mental illness, physical or emotional abuse, and addiction in the home. It is important to know these risk factors to inform the approach and considerations of diagnosis, treatment interventions and how to involve the family in a community centred, needs-based approach.