A previously fit and well 37-year-old male healthcare worker presented with confusion, psychotic symptoms and a suicide attempt in the context of a new COVID-19 diagnosis. Following surgical interventions and an extended admission to the intensive care unit, he made a good recovery in terms of both his physical and mental health. A number of factors likely contributed to his presentation, including SARS-CoV-2 infection, severe insomnia, worry, healthcare worker-related stress, and the unique social and psychological stressors associated with the COVID-19 pandemic. This case highlights the need to further characterise the specific psychiatric sequelae of COVID-19 in community settings, and should remind general medical clinicians to be mindful of comorbid psychiatric symptoms when assessing patients with newly diagnosed COVID-19.

The recovery teaching program was associated with increased knowledge of recovery principles and more positive attitudes toward mental illness. Psychiatric clinical placements for medical students should include an explicit recovery focus.

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This is the first case series of adults with ASD presenting with challenging behaviour who have been treated with aripiprazole. While the results are promising, controlled trials are required to confirm the findings.

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Symptom onset in a youth FEP sample frequently occurs before age 18 years. Certain illness characteristics differed across the age categories, such as greater negative symptoms and cannabis abuse in the youth sample. Overall, the findings support the provision of adequate strategies for management of negative symptom deficits and substance abuse across all ages in FEP.

If you would like to write for this, or any other Emerald publication, then please use our Emerald for Authors service information about how to choose which publication to write for and submission guidelines are available for all. Please visit www.emeraldinsight.com/ authors for more information. About Emerald www.emeraldinsight.comEmerald is a global publisher linking research and practice to the benefit of society. The company manages a portfolio of more than 290 journals and over 2,350 books and book series volumes, as well as providing an extensive range of online products and additional customer resources and services.Emerald is both COUNTER 4 and TRANSFER compliant. The organization is a partner of the Committee on Publication Ethics (COPE) and also works with Portico and the LOCKSS initiative for digital archive preservation. AbstractPurpose -Autism spectrum disorder (ASD) has been studied as a neurodevelopmental disorder since Leo Kanner's early observations of abnormal head circumference in autistic children. In the past few years, there has been much progress made in elucidating the anatomical and functional abnormalities in ASD. This paper aims to summarise the extant research.Design/methodology/approach -This paper provides a summary of relevant research findings in the neuroimaging of autism for the past 12 month period. Papers were identified using the Medline search terms: autism; ASD (functional); magnetic resonance imaging (MRI); neuroimaging; diffusion tensor imaging (DTI); and endophenotype.Findings -Relatively recent techniques such as functional MRI and DTI have furthered the initial work derived from early histological and structural imaging studies. Even newer techniques, such as DTI tractography and support vector machine analysis, and other computer-based learning methods have allowed us to move beyond regional variations in grey and white matter volume and study ASD as a disorder of connectivity, and of regional cerebral function and neural circuitry. Brain regions and neural circuits that are implicated in the core symptoms of ASD (deficits in social reciprocity, language and communication, and restricted and stereotyped interests) have been repeatedly shown to be abnormal in those individuals.Originality/value -This paper aims to provide a background for clinicians to the current research and focuses on developments in the field of neuroimaging of ASD from the past year, which have generated further insights into the neurobiology of ASD.

Background Although mental ill-health is more prevalent among people from lower socioeconomic groups, digital mental well-being innovations are often developed for people from higher socioeconomic groups, who already have resources to maintain good mental and physical health. To decrease health inequalities and ensure that available solutions are appealing and accessible to people with fewer resources, new approaches should be explored. We developed the app Wakey!, which focused on creating engaging mental health content that is accessible, particularly among lower socioeconomic groups in the United Kingdom. Objective The aim of this study is to assess engagement with the app, investigate initial effectiveness data for 6 well-being outcomes, and explore participants’ subjective experiences of using Wakey! Methods The app Wakey! was publicly launched on January 20, 2020, and was free to download from Apple Store and Google Play. The app provided its users with entertaining and educational content related to mental well-being. Concurrently, a single-arm mixed methods feasibility trial was carried out from January to April 2020 among people who had downloaded the app and created an account. The primary outcome was engagement, which was collected passively from data logs. Secondary outcome measures were 6 well-being outcomes collected from self-report questionnaires. Individual interviews with 19 app users were carried out in April 2020. Results In total, 5413 people fit the inclusion criteria and were included in the final sample—65.62% (3520/5364) women, 61.07% (3286/5381) aged between 25 and 44 years, 61.61% (2902/4710) in employment, 8.92% (420/4710) belonging to the lower socioeconomic group, and 8.09% (438/5413) were engaged users. There was no evidence of a difference in engagement regarding sociodemographic and socioeconomic characteristics. There was evidence that users with a higher average daily sleep score, who joined the study more recently, who had higher baseline self-report of sleep quality, and who found episodes more entertaining were more likely to be engaged users. Among 230 users who provided follow-up data, there was evidence of improvements on four of the six well-being outcomes: life satisfaction (P<.001), feeling that life is worthwhile (P=.01), ease of getting up in the morning (P<.001), and self-efficacy (P=.04). The app and its content were well received by those who were interviewed, and several people perceived a positive change in their mental well-being. Conclusions This study shows that the app Wakey! could potentially be engaging across different socioeconomic groups, and there is an indication that it could positively impact the mental well-being of those engaged with the app. However, this study was a pragmatic trial with a limited sample, and the selection bias was present in the qualitative and quantitative study. Further work is needed to make any generalizable conclusions. Trial Registration ClinicalTrials.gov NCT04287296; https://clinicaltrials.gov/ct2/show/NCT04287296