Background Evidence suggests that Spouses of Persons with Schizophrenia (SPwS) are susceptible to higher levels of caregiver burden, mental health problems, and poor psychosocial well-being compared to the general population. The current review aimed to synthesize available evidence on the mental health, psychosocial well-being, and factors associated with the well-being of spouses of persons with schizophrenia. Methodology A comprehensive literature search was conducted across six electronic databases. Studies published in English between 2000 and 2025 that met the inclusion and exclusion criteria were considered for the review. Screening, data extraction, and quality appraisal were conducted independently by the reviewers. The JBI Checklist for Analytical Cross-sectional Studies was used to appraise quality. Findings were synthesized narratively. Results From 1809, 23 studies, comprising 4116 participants from six countries, were included. The review identified moderate-to-severe levels of caregiver burden, high levels of psychological distress, and a higher prevalence of mental health problems among SPwS. Various patient and caregiver-related factors were strongly associated with higher burden and poorer mental health. Conclusions The findings highlight the need for routine assessment of spousal well-being and for the development of simple, culturally appropriate interventions for both patients and their spousal caregivers.
Objective Disturbances in the experience of time are common across psychiatric disorders but rarely treated as a primary dimension of clinical formulation. This paper proposes that temporal organisation is a clinically meaningful cross-diagnostic dimension and advances a typology of four configurations: collapsed, deferred, rigid and fragmented time . The central hypothesis, a contemporary elaboration of Freud’s Nachträglichkeit , is that coherent experience depends on regulating temporal delay, and that failures of this regulation are clinically distinguishable. Four de-identified cases from specialist psychiatric work with New South Wales Police Force personnel illustrate the typology. Conclusions Despite overlapping symptom profiles (intrusions, avoidance, fatigue, occupational impairment), the cases showed distinct temporal organisations: collapse of past–present differentiation; prolonged incomplete integration; over-structured temporal control with conditional fragmentation under load; and discontinuous autobiographical continuity with dissociative features. Treatment priorities differed accordingly. The framework is a clinical heuristic rather than a diagnostic system; the cases are illustrative and drawn from a single occupational context, and the companion Temporal Architecture Assessment has not yet been validated. It directs clinicians to the temporal question most relevant to intervention: not only what symptoms are present, but how the patient inhabits time.
The recent unauthorised access by AI agents of Australian Medicare Statistics is alarming. This unauthorised access attack, or “hack,” has occurred in the context of similar hacks on Hugging Face and RubyGems by swarms of AI agents acting together. AI agentic hacks represent a substantial cyber security threat, both for large and small organisations, and for sensitive data, such as in healthcare records. We provide a succinct update on these events and basic advice on defending healthcare data against hacks by AI agents.
ObjectiveTo argue that current evidence does not justify privileging Jesudason et al.'s attention-economy account of rising adult attention deficit/hyperactivity disorder (ADHD) diagnoses over plausible alternatives, including delayed recognition, historical underdiagnosis and misdiagnosis, and exclusionary diagnostic practices.ConclusionsJesudason et al. appropriately caution against simplistic diagnosis, performance-enhancing stimulant use, and uncritical medicalisation. However, adult diagnosis is not equivalent to adult onset, and increased treatment uptake or prescribing does not establish increased underlying prevalence. Associations between digital use and ADHD characteristics do not resolve causality or directionality. Digital environments may amplify or unmask longstanding ADHD-related difficulties without causing ADHD, while problematic digital use may reflect ADHD-related vulnerabilities. Rising adult diagnoses may also represent diagnostic correction among women, people assigned female at birth, racialised communities, Indigenous and First Nations peoples, and culturally minoritised groups historically missed, misdiagnosed, or routed into punitive frameworks. A balanced account must reject both over-medicalisation and exclusionary diagnostic gatekeeping.
Objective Medical students’ entry and adaptation to the health system represents a unique psychological challenge. To operate successfully within a hospital’s institutional culture, they must learn its unspoken rules and their place in its hierarchy. Such a transition is complicated by anxieties inherent to being in the hospital, a place where disease can end in death rather than discharge. In defence against these anxieties, medical students deploy a range of individually and institutionally preferred defence mechanisms. This article will provide a psychoanalytical account of these defences and consider their implications for medical education and patient care. Conclusions Whilst fending off anxiety, defence mechanisms may also impede delivery of patient-centred care. Insiders like medical students and educators must convert this insight into strategies that circumvent destructive defences and their distortion of patient-doctor relationships. Healthcare’s inevitable anxieties can be defended against in more constructive and creative ways that enhance the quality of care. The choice to take or resist such a creative path carries major implications for healthcare in Australia and elsewhere.
