Early reports suggest that lockdown measures associated with the COVID-19 pandemic (e.g., social distancing) are having adverse consequences for people’s mental health, including increases in maladaptive eating habits and body dissatisfaction. Certain groups, such as those with pre-existing mental health difficulties, may be especially at risk. The current study explored perceived changes in eating, exercise, and body image during lockdown within the United Kingdom, using an online survey (n = 264). There were large individual differences in perceived changes in eating, exercise, and body image in this period. Women were more likely than men to report increasing struggles with regulating eating, preoccupation with food and worsening body image. Those with a current/past diagnosis of eating disorders reported significantly greater difficulties in regulating eating, increased preoccupation with food, exercise thoughts and behaviours and concern about appearance, even when compared to those with other mental health and developmental disorders. Ongoing research to explore individual differences in the trajectories of change in eating, exercise and body image as lockdown measures ease will be important for understanding the full psychological impact of this pandemic and improve service and public health planning going forward.

COVID-19 may have substantial impact on the mental health at a population level, but also has the potential to significantly affect those with pre-existing mental health difficulties such as eating disorders. This qualitative study explores the impact of COVID-19 and associated public health measures on adults with eating disorders within the UK. We conducted 10 in depth interviews with adults (24-38 years) with a self-reported eating disorder during lockdown. Data were analysed using an inductive thematic analysis approach. We identified core themes related to social restrictions (social isolation, changes in accountability to others, and increased responsibility for self and others), functional restrictions (lack of routine and structure, a need to intentionally plan activity, a desire for secrecy particularly around food shopping) and restrictions in access to mental health services. Overall, the impact of the lockdown was experienced as a catalyst for either increased disordered eating behaviours or for a drive for recovery, depending on individual circumstances going into these restrictions. This study is the first in depth interview approach with adults with mixed eating disorder presentations in the UK during COVID-19. Findings have important implications for post lockdown intervention care and practice.

Background Mentalization Based Therapy (MBT) has yielded promising outcomes for reducing self-harm, although to date only one study has reported MBT’s effectiveness for adolescents (Rossouw and Fonagy, J Am Acad Child Adolesc Psychiatry 51:1304–1313, 2012) wherein the treatment protocol consisted of an intensive programme of individual and family therapy. We sought to investigate an adaptation of the adult MBT introductory manual in a group format for adolescents. Methods The present study is a randomised controlled single blind feasibility trial that aims to (1) adapt the original explicit MBT introductory group manual for an adolescent population (MBT-Ai) and to (2) assess the feasibility of a trial of MBT-Ai through examination of consent rates, attendance, attrition and self-harm. Repeated measures ANOVAs were conducted to examine change over time in independent and dependent variables between groups, and multi level models (MLM) were conducted to examine key predictors in relation to change over time with self-report self-harm and emergency department presentation for harm as the primary outcome variables. Results Fifty-three young people consented to participate and were randomised to MBT-Ai + TAU or TAU alone. Five participants withdrew from the trial. Trial procedures seemed appropriate and safe, with acceptable group attendance. Self-reported self-harm and emergency department presentation for self-harm significantly decreased over time in both groups, though there were no between group differences. Social anxiety, emotion regulation, and borderline traits also significantly decreased over time in both groups. Mentalization emerged as a significant predictor of change over time in self reported self harm and hospital presentation for self-harm. Conclusions It was feasible to carry out an RCT of MBT-Ai for adolescents already attending NHS CAMHS who have recently self-harmed. Our data gave signals that suggested a relatively brief group-based MBT-Ai intervention may be a promising intervention with potential for service implementation. Future research should consider the appropriate format, dosage and intensity of MBT for the adolescent population. Trial registration NCT02771691 ; Trial Registration Date: 25/04/2016.

Victimization by peers and siblings is associated with poorer mental health outcomes in adolescence. What is less clear is whether mental health outcomes improve if victimization experiences cease (e.g., being victimized in primary school but not secondary school). This study aims to explore how changes in victimization experiences are associated with changes in mental health outcomes in early adolescence. Data are from 13,912 participants in the Millennium Cohort Study (MCS), a nationally representative cohort of individuals born in the UK. Self-reported victimization by peers and siblings, as well as mental health outcomes (depressive symptoms, life satisfaction, self-esteem, and body image), were collected at age 11 and age 14. Victimization at either time point was associated with poorer mental health across the range of outcomes, with effects largest for those who were consistently victimized. Those who reported increasing victimization had greater deterioration in their mental health compared with their peers who were never victimized. Conversely, children whose victimization decreased showed similar mental health development over this period as those who were never victimized. There was a cumulative effect of victimization by peers and siblings, with effect sizes generally larger for experiences with peers. Victimization in adolescence is associated with enduring reductions in mental health. Nonetheless, the promising outcomes associated with reductions in victimization suggest the potential for bullying interventions in schools to limit the deterioration in mental health in victimized groups.

Adopted children and adolescents are at an increased risk of experiencing emotional, behavioural and relational difficulties compared to their non-adopted peers. This systematic review aimed to establish the effectiveness of interventions with adoptive parents on adopted children and adolescents' psychological well-being, behavioural functioning and parent-child relationship. A systematic search was performed adhering to Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA), including studies that assessed the effects of interventions with adoptive parents on adopted child and adolescent outcomes. Electronic databases, key journals, grey literature sources, reference and citation lists were searched and published authors in the field were contacted; 19 papers describing 15 interventions were included. The findings from this review provide preliminary support for the use of interventions with adoptive parents for improving adopted children's emotional and behavioural outcomes. However, overall, the studies were found to have a high risk of bias, and the significant heterogeneity across the studies limits the conclusions that can be drawn. Further research is required to provide conclusive recommendations regarding the effectiveness of interventions with adoptive parents on the outcomes of adopted children.

Background Interpersonal psychotherapy for adolescents (IPT‐A) is a manualised, time‐limited intervention for young people with depression. This systematic review aimed to determine the effectiveness of IPT‐A for treating adolescent depression. Method A systematic search of relevant electronic databases and study reference lists was conducted. Any study investigating the effectiveness of IPT‐A in 12‐ to 20‐year‐olds with a depressive disorder was eligible. Synthesis was via narrative summary and meta‐analysis. Results Twenty studies were identified (10 randomised trials and 10 open trials/case studies), many of which had small sample sizes and were of varying quality. Following IPT‐A, participants experienced large improvements in depression symptoms (d = −1.48, p < .0001, k = 17), interpersonal difficulties with a medium effect (d = −0.68, p < .001, k = 8) and in general functioning with a very large effect (d = 2.85, p < .001, k = 8). When compared against control interventions, IPT‐A was more effective than non‐CBT active controls in reducing depression symptoms (d = −0.64, p < .001, k = 5) and was no different from CBT (d = 0.05, p = .88, k = 2). There was no difference between IPT‐A and active control interventions in reducing interpersonal difficulties (d = −0.26, p = .25, k = 5). Conclusions Interpersonal psychotherapy for adolescents is an effective intervention for adolescent depression, improving a range of relevant outcomes. IPT‐A is consistently superior to less structured interventions and performs similarly to CBT. However, these conclusions are cautious, as they are based on a small number of controlled studies, with minor adaptations to the standard IPT‐A protocol, and/or were conducted by the intervention developers. Further robust RCTs are therefore required. The lack of superiority in IPT‐A for improving interpersonal difficulties highlights a need for studies to explore the underpinning mechanisms of change.

The CHI-ESQ was posted out to 825 young people/families open to a CAMHS clinician in May 2009. This list was generated from the administrative database (PIMS) and

Background: To present clinical outcome data of the Adolescent Mentalization-based Integrative Treatment (AMBIT)-trained NHS Lothian Tier 4 child and adolescent mental health service in the context of service utilization and engagement. Method: Data were obtained for a 2-year period that included details of all face-to-face contacts between young people and clinicians along with routinely collected clinical outcomes data relating to anxiety, depression, symptoms of psychosis and quality of life. Results: Improvements were observed in quality of life, symptoms and distress across the course of the intervention. Overall attendance rates were high (80%). Relative to those who were better engaged, the less well-engaged group received the same number of appointments but spent longer in the service (v 2 (1) = 5.26, p = .022), had more professionals involved in their care (v 2 (1) = 4.91, p = .027) and showed a nonsignificant trend to more inpatient admissions. Later engagement was not associated with distress or symptoms at entry into the service with the exception of negative symptoms in the Early Psychosis Support Service cohort. Age and two quality of life factors were associated with later engagement (p < .05). Conclusions: Our AMBIT-trained Tier 4 CAMH service demonstrates change over the course of intervention consistent with the service model's theoretical expectations. Engagement with the service may be associated more with factors related to social circumstance and functioning than with key symptoms and distress. Less well-engaged young people utilize increased service resource. AMBIT's mentalizing focus may improve service provision for young people who are poorly engaged with mental health services. Key Practitioner Message• Locally developed practice-based evidence can be used to illustrate clinical change over the course of Tier 4 CAMHS interventions.• Service engagement may be associated with baseline variables relating to social context and functioning rather than emotional distress and symptoms.• Failure to successfully engage young people may result in increased service utilization. • Adolescent Mentalization-based Integrative Treatment (AMBIT) provides a theoretical and pragmatic service model which may improve service engagement for hard-to-reach young people.