BACKGROUND:Evidence is lacking on whether support and education programs, facilitated by mobile technology, benefit people with stroke. AIMS:The primary aim was to determine the effectiveness of a co-designed, eHealth self-management intervention for reducing unplanned hospital presentations. METHODS:Prospective, multicenter randomized controlled trial with blinded outcome assessment and intention-to-treat analysis. Randomization (1:1, stratified by age and level of disability at baseline) within 2 weeks of hospital discharge. Participants aged ⩾18 years with modified Rankin Scale (mRS) score 0-4 were recruited from 11 Australian hospitals. To maintain blinding, all participants co-developed three to five self-management goals with a trained clinician-researcher, using a standardized approach. Following randomization, participants were allocated to receive personalized, goal-centered electronic messages (intervention) or administrative messages (active control) over 12 weeks via text or email. The groups were not informed about the number of messages they would receive and were unaware that only the intervention group had their messages tailored to their goals. The primary outcome was unplanned hospital presentations (emergency department/admission) within 90 days post-randomization. Secondary outcomes included goal attainment, self-efficacy, and various health outcomes. We used generalized mixed-effects regression model with a logistic link for categorical outcomes and Cohen's d (0.2 considered small effect, 0.5 moderate-1.0 large) to assess within-group change. RESULTS:The trial was impacted by COVID-19 and ceased with 556/890 planned participants; 465 were randomized (n = 234 control, n = 231 experimental), a median of 10 days post-discharge (median age 67.2 years, 67.1% male, median 3 goals/participant). Primary outcome assessments for 222 control and 218 experimental participants showed no between-group differences for unplanned hospital presentations (odds ratio (OR): 1.32; 95% confidence interval (CI): 0.52-3.34). Compared to controls at 90 days, a larger proportion of the experimental group had >3 unmet needs and slight to severe disability (both <8% difference). Both groups showed non-significant improvements in goal attainment at 90 days post-randomization; overall attainment was stronger among intervention participants (within-group change Cohen's d intervention 0.76 vs 0.61). CONCLUSION:We found no evidence that tailored, electronic messaging over 12 weeks, in addition to structured goal-setting reduced unplanned hospital presentations. Future research is needed to understand the role of disability and unmet needs, and factors that influence goal attainment. TRIAL REGISTRATION:ACTRN12618001468213, U1111-1206-7237.

Background Anxiety disorders and treatment-resistant major depressive disorder (TRD) are often comorbid. Studies suggest ketamine has anxiolytic and antidepressant properties. Aims To investigate if subcutaneous racemic ketamine, delivered twice weekly for 4 weeks, reduces anxiety in people with TRD. Method The Ketamine for Adult Depression Study was a multisite 4-week randomised, double-blind, active (midazolam)-controlled trial. The study initially used fixed low dose ketamine (0.5 mg/kg, cohort 1), before protocol revision to flexible, response-guided dosing (0.5–0.9 mg/kg, cohort 2). This secondary analysis assessed anxiety using the Hamilton Anxiety (HAM-A) scale (primary measure) and ‘inner tension’ item 3 of the Montgomery–Åsberg Depression Rating Scale (MADRS), at baseline, 4 weeks (end treatment) and 4 weeks after treatment end. Analyses of change in anxiety between ketamine and midazolam groups included all participants who received at least one treatment (n = 174), with a mixed effects repeated measures model used to assess the primary anxiety measure. The trial was registered at www.anzctr.org.au (ACTRN12616001096448). Results In cohort 1 (n = 68) the reduction in HAM-A score was not statistically significant: −1.4 (95% CI [−8.6, 3.2], P = 0.37), whereas a significant reduction was seen for cohort 2 (n = 106) of −4.0 (95% CI [−10.6, −1.9], P = 0.0058), favouring ketamine over midazolam. These effects were mediated by total MADRS and were not maintained at 4 weeks after treatment end. MADRS item 3 was also significantly reduced in cohort 2 (P = 0.026) but not cohort 1 (P = 0.96). Conclusion Ketamine reduces anxiety in people with TRD when administered subcutaneously in adequate doses.

BACKGROUND:Longer-term outcome and safety data of repeated subcutaneous racemic ketamine for treatment-resistant depression (TRD) is lacking, as is knowledge of the impact of prior ketamine treatment on subsequent response. AIMS:To evaluate the effectiveness and safety of a 4-week course of subcutaneous racemic ketamine over 6 months and investigate whether prior ketamine treatment influences treatment response. METHOD:An open label extension (OLE) of a randomised controlled trial (RCT) was conducted at seven mood disorder centres in Australasia, enrolling consenting trial participants who had a Montgomery-Åsberg Depression Rating Scale (MADRS) score of ≥20 at post-trial assessment. Participants initially received twice-weekly 0.5 mg/kg subcutaneous racemic ketamine (fixed regimen) for 4 weeks. Dosing was revised after a Data Safety Monitoring Board recommendation, to a 'flexible regimen' (0.5-0.9 mg/kg with response-guided increments). Depression and safety outcomes were assessed throughout treatment, and 4 weeks and 6 months later. RESULTS:130 RCT participants entered the OLE phase of whom 32 underwent the fixed OLE regimen and 98 the flexible regimen. At treatment end, 30% (36/116) had responded (MADRS reduction ≥50%), and 4 weeks later 17% (19/110) were 'responders'. Over 50% experienced <25% MADRS reduction. There was no difference in depression response at any time point between regimens. Those treated with ketamine during the RCT showed a transient reduced response after first OLE treatment but at no other assessment point. There were no reports of suicide or suicidal behaviour requiring admission and only expected side-effects observed. CONCLUSIONS:In a highly treatment-resistant sample, a 4-week course of subcutaneous racemic ketamine produced short-term clinical benefit in a minority of participants, with response rates declining substantially after treatment cessation, and no unexpected safety concerns. Exploratory subgroup analyses showed no association between prior RCT ketamine exposure and OLE outcomes. TRIAL REGISTRATION:ACTRN12616001096448 at www.anzctr.org.au.

Background Common mental disorders (CMDs) and psychological distress contribute substantially to morbidity among adolescents in India yet help-seeking remains limited. Understanding determinants of help-seeking behaviour is essential to designing context-specific, adolescent-friendly mental health interventions. Methods This systematic review was conducted following MOOSE guidelines and reported in line with PRISMA 2020 framework. Searches across PubMed, EMBASE, PsycINFO, and CINAHL identified studies published between January 2010 and April 2025. Eligible studies included qualitative, quantitative, and mixed-methods research conducted among adolescents aged 10–19 years in India that examined barriers or facilitators to help-seeking for CMDs, psychological distress, self-harm, or substance misuse. Data were synthesised narratively using an integrative thematic approach. Results Twenty-six studies (reported in 27 articles) met inclusion criteria. Most were school-based; only a small number of studies were conducted exclusively in urban slum settings. Across study types, stigma (self, public and structural) emerged as the most pervasive barrier to seeking care. Low mental health literacy among adolescents, parents, and teachers further delayed help-seeking. Additional barriers included negative or distrustful experiences with healthcare providers, concerns regarding confidentiality, academic pressures, and socioeconomic constraints. Facilitators included supportive peers and families, positive relationships with counsellors, psychoeducation delivered through school- or community-based programmes, and involvement of trained lay counsellors. Technology-enabled approaches showed promise but faced acceptability challenges within families. Conclusion Help-seeking among adolescents in India is shaped by multilayered individual, social, and structural barriers, with stigma and low mental health literacy at the core. Youth-centred interventions that promote literacy, reduce stigma, strengthen social support networks, and increase acceptability of services are crucial. Evidence gaps are substantial for adolescents in vulnerable contexts, particularly those living in urban slums.

In brief:Pregnancy complications such as hypertensive disorders, gestational diabetes mellitus, and anaemia may increase the risk of postpartum mental disorders, especially depression; however, the evidence for anxiety and posttraumatic stress disorder is limited. Women with medical complications in pregnancy should be considered at high risk for mental disorders and receive appropriate and timely screening and follow-up. Abstract:Mental health is a crucial aspect of overall well-being. The postpartum period is a vulnerable time for women's mental health, with poor mental health potentially impacting the long-term health of mothers and their children. Common postpartum mental disorders include depression, anxiety, and posttraumatic stress disorder (PTSD). Medical complications during pregnancy, such as hypertensive disorders of pregnancy (HDP), gestational diabetes mellitus (GDM), and anaemia, are prevalent and can make pregnancy, childbirth, and the postpartum periods particularly challenging, sometimes resulting in life-threatening situations for the mother and/or her baby. It is therefore plausible that women who experience a pregnancy complication may be at increased risk of also experiencing a postpartum mental health disorder. Published research indicates that HDP, GDM, and gestational anaemia may increase the risk of postpartum depression (PPD). There may be associations between a higher risk of anxiety and PTSD, but the evidence is unclear or under-researched. Postpartum mental health care is often neglected following medically complicated pregnancies, with a focus primarily on physical recovery. There are limited global guidelines addressing mental health care for mothers and their children, but growing recognition of the connection between medical complications and postpartum mental health has led to the development of some follow-up guidelines. Research is necessary to better understand postpartum mental health in women with medical complications during pregnancy. Until more is known, all pregnant women with medical complications should be considered at high risk for postpartum mental disorders and receive appropriate follow-up care.

Introduction Cardiac rehabilitation is known to reduce morbidity and improve quality of life in people living with heart disease, however, adherence, access and completion of these programmes is suboptimal. Peer support may offer an opportunity to close this service gap. The aim of the study is to determine whether the effectiveness of a digital peer support programme for people living with heart disease is effective in improving social connectedness, clinical and patient-reported outcomes and experience measures.Methods and analysis Heart2Heart is a community-based randomised controlled trial with 6 months follow-up for the primary outcome and 6 and 12 months for secondary outcomes. Approximately 752 adults with a diagnosis of heart disease in the past 12 months will be recruited from the general community and Australian cardiac rehabilitation programmes. Control group will participate in usual care, while intervention group will have access to a 6 months intervention that enables peer support via an interactive mobile application, in addition to usual care. The intervention includes online discussion groups, access to resources and facilitated conversations with health professionals. Primary outcome is social connectedness at 6 months follow-up. Secondary outcomes (6 and 12 months) will be all-cause/cardiovascular disease hospital admissions, all-cause mortality, lifestyle (sufficiently physically active, not smoking, sufficient fruit and vegetable consumption), proportion taking prescribed medications and health service utilisation (medical appointments, cardiac rehabilitation, participation in any other in-person peer support activities). Patient-reported outcome and experience measures including self-efficacy, quality of life, satisfaction and programme engagement will be analysed at 6 months. Process measures will include application analytics, barriers and facilitators to engagement with the intervention from participant’s perspective. An intention-to-treat analysis will be used.Ethics and dissemination Ethical clearance was obtained from Western Sydney Local Health District Ethics Committee. Heart2Heart has potential to improve social connectedness and provide a valuable addition to traditional cardiac rehabilitation.Trial registration number ACTRN12624000386538.

BACKGROUND:Observational studies have shown that selective serotonin reuptake inhibitors are associated with an increased risk of bone fractures, but the association can be confounded by indication and other sources of systematic bias that can be minimized in randomized controlled trials (RCTs). AIM:Our aim was to report the rate, site, context, and predictors of fractures after stroke, and whether the fractures modified the effect of fluoxetine on modified Rankin scale (mRS) at 6 months in an individual patient data meta-analysis of 5907 patients enrolled in three RCTs of fluoxetine (20 mg for 6 months) for stroke recovery. METHODS:We classified fractures by treatment allocation, site (and thus likelihood of osteoporosis), and context, then performed multivariable analyses to explore the independent predictors of fractures. We explored whether the trend toward a poorer mRS at 6 months was explained by a fracture excess. Risk of bias was assessed using GRADE. RESULTS:Among 5907 patients randomized at a mean of 6.6 days (SD 3.6) post-stroke onset and followed for 6 months, the number of fractures at 6 months was 93 (3.15%) in the fluoxetine group versus 41 (1.39%) in the control group (difference 1.76, 95% CI 0.10-2.51). However, 128 patients with fractures were suitable for further analyses. Of these, 102 (80%) were in sites typically affected by osteoporosis; 115 (90%) were associated with falls and 1 (1%) with a seizure. Independent fracture risk factors were female sex (hazard ratio (HR) 1.96; 95% CI 1.37-2.81, p = 0.0002), age > 70 years (HR 2.30, 95% CI 1.52-3.49, p < 0.001), previous fractures (HR 0.63 for no previous fractures, 95% CI 0.42-0.94, p = 0.0227), and randomized treatment (fluoxetine) (HR 2.39; 95% CI 1.64-3.49, p < 0.001). The common odds ratio for the effect of fluoxetine on mRS at 6 months was unchanged after excluding fracture patients. Risk of bias was high for imprecision. CONCLUSION:Fractures were more common in the fluoxetine group but the absolute risk of fractures was small and risk estimates were imprecise. Most fractures occurred with a fall, and in osteoporotic locations. Fractures did not modify the effect of fluoxetine on functional outcome.

ObjectiveTo explore post-stroke body image experience and enhance understanding of its impacts on wellbeing and recovery.DesignCross-sectional qualitative semi-structured interview study with an interpretative phenomenological approach.SettingInterviews conducted in participants' homes, using video-calls, telephone or in-person.ParticipantsPeople treated for acute stroke at two UK hospitals were identified at six months post-stroke and purposively sampled for diversity. Participants were 22 adults (55% male), on average 6.3 months post-stroke and aged 48 to 82 years (median 66 years).ResultsTwo main themes were identified: (1) 'Body now perceived as an 'obstacle' to normality', comprising three subthemes around altered trust in the body, outward presentation of body image and the likening of body image to that of an older person and; (2) 'Responses to a new body image experience', comprising five subthemes around the importance of body image, societal pressures, acceptance/adjustment to a changed body image and positivity through experiencing improvements towards a perceived 'normal' body image.ConclusionsRegaining perceived pre-stroke 'normal' body image and ability to adjust to a new one is reported as important in recovery. We have demonstrated negative changes in body image experience, and it is possible this is a normal part of post-stroke adjustment. Further research is required to determine whether body image experience can be positively influenced by brief interventions such as guided self-help or psychological support to ensure that they do not persist long term.

INTRODUCTION:Traditional medicines are used to meet a variety of health needs by people across India, but few data exist for their use by those affected by stroke. We aimed to assess the prevalence, costs, and drivers of traditional medicines used by patients with stroke and in relation to defined sociodemographic characteristics. METHODS:This study presents a post hoc analysis of the Family-led Rehabilitation after Stroke in India (ATTEND), a multicentre, prospective, randomised, open blinded endpoint (PROBE) trial conducted at 14 hospitals in India. Data were obtained on the use of non-modern medical treatments and associated financial implications. Multivariable logistic regression was used to identify the predictors of traditional medicine use and reported as adjusted odds ratio (aOR) and 95% confidence intervals (CIs). Financial impacts and their 95% uncertainty intervals were estimated for all new stroke cases in 2022 (80 INR = 1 USD). RESULTS:Of 1,250 randomised participants, 968 had sufficient data for analysis (age 57.7 [±13.6] years). The overall prevalence of traditional medicine use was 21.1%. Lower use of traditional medicine was associated with high school/college education (aOR: 0.55, 95% CI: 0.30, 0.98) and mild neurological severity (National Institutes of Health Stroke Scale [NIHSS] score <5; aOR: 0.32; 95% CI: 0.14, 0.72). There was no significant association with age (aOR: 1.76; 95% CI: 0.85, 3.64), unemployment (aOR: 2.16, 95% CI: 0.99, 4.74), pre-stroke dependency (aOR: 1.96, 95% CI: 0.46, 8.36), and living accommodation (aOR: 1.13, 95% CI: 0.53, 2.41). We calculated that traditional medicine costs USD 67 million annually: a higher cost burden among men (USD 36 million) compared to women (USD 31 million; 80 INR = 1 USD). CONCLUSIONS:Our study indicates that 1 in five patients used traditional medicine following acute stroke in India, with significant financial bearings on individuals and their families. There is greater use in those with more severe strokes and with lower education. More evidence is required on the efficacy of traditional medicines and their role in the healthcare system.

Living evidence involves continuous evidence surveillance to incorporate new relevant evidence into systematic reviews and clinical practice guideline recommendations as soon as it becomes available. Thus, living evidence may improve the timeliness of recommendation updates and reduce the knowledge-to-practice gap. When considering a living evidence model, several processes and practical aspects need to be explored. Some of these include identifying the need for a living evidence model, funding, governance structure, time, team skills and capabilities, frequency of updates, approval and endorsement, and publication and dissemination.

BackgroundYoung adults with stroke have distinct professional and social roles making them vulnerable to symptoms of post-stroke depression (PSD) and post-stroke anxiety (PSA). Prior reviews have examined the prevalence of anxiety and depression in stroke populations. However, there are a lack of studies that have focused on these conditions in young adults.ObjectiveWe performed a systematic review and meta-analysis of observational studies that reported on symptoms of PSD, PSA and comorbid PSD/PSA in young adults aged 18 to 55 years of age.MethodsMEDLINE, EMBASE, SCOPUS and PsycINFO were searched for studies reporting the prevalence of symptoms of PSD and/or PSA in young adults with stroke from inception until June 23, 2023. We included studies that evaluated depression and/or anxiety symptoms with screening tools or interviews following ischemic or hemorrhagic stroke. Validated methods were employed to evaluate risk of bias.Results4,748 patients from twenty eligible studies were included. Among them, 2,420 were also evaluated for symptoms of PSA while 847 participants were evaluated for both PSD and PSA symptoms. Sixteen studies were included in the random effects meta-analysis for PSD symptoms, with a pooled prevalence of 31% (95% CI 24-38%). Pooled PSA symptom prevalence was 39% (95% CI 30-48%) and comorbid PSD with PSA symptom prevalence was 25% (95% CI 12-39%). Varying definitions of ‘young adult’, combinations of stroke subtypes, and methods to assess PSD and PSA contributed to high heterogeneity amongst studies.ConclusionsWe identified high heterogeneity in studies investigating the prevalence of symptoms of PSD and PSA in young adults, emphasizing the importance of standardized approaches in future research to gain insight into the outcomes and prognosis of PSD and PSA symptoms following stroke in young adults. Larger longitudinal epidemiological studies as well as studies on tailored interventions are required to address the mental health needs of this important population.FundingNone.

Here, we report on an acoustoelectric slab waveguide heterostructure for phonon amplification using a thin Al0.58Sc0.42N film grown directly on a 4H-SiC substrate with an ultra-thin In0.53Ga0.47As epitaxial film heterogeneously integrated onto the surface of the Al0.58Sc0.42N. The aluminum scandium nitride film grown directly on silicon carbide enables a thin (∼850 nm thick) piezoelectric film to be deposited on a thermally conductive bulk substrate (370 W/m K for 4H-SiC); the high thermal conductivity of the substrate, large mobility of the semiconductor (∼7000 cm2/V s), and low carrier concentration (∼5 × 1015 cm−3) yield low self-heating. A Sezawa mode with optimal overlap between the peak of its evanescent electric field and the semiconductor charge carriers is supported. The high velocity of the heterostructure materials allows us to operate the Sezawa mode amplifier at 3.05 GHz, demonstrating a gain of 500 dB/cm (40 dB in 800 μm). Additionally, a terminal end-to-end radio frequency gain of 7.7 dB and a nonreciprocal transmission of 52.6 dB are achieved with a dissipated DC power of 2.3 mW. The power added efficiency and acoustic noise figure are also characterized.

The cognitive profile of ketamine for treatment-resistant depression (TRD) remains uncertain, particularly with repeated doses, up-titrated for clinical response. Here we report results from the Ketamine for Adult Depression Study (KADS).

BACKGROUND:Three large randomized controlled trials of fluoxetine for stroke recovery have been performed. We performed an individual patient data meta-analysis (IPDM) on the combined data. METHODS:Fixed effects meta-analyses were performed on the combined data set, for the primary outcome (modified Rankin scale (mRS) at 6 months), and secondary outcomes common to the individual trials. As a sensitivity analysis, summary statistics from each trial were created and combined. FINDINGS:The three trials recruited a combined total of 5907 people (mean age 69.5 years (SD 12.3), 2256 (38%) females, 2-15 days post-stroke) from Australia, New Zealand, United Kingdom, Sweden, and Vietnam; and randomized them to fluoxetine 20 mg daily or matching placebo for 6 months. Data on 5833 (98.75%) were available at 6 months. The adjusted ordinal comparison of mRS was similar in the two groups (common OR 0.96, 95% CI 0.87 to 1.05, p = 0.37). There were no statistically significant interactions between the minimization variables (baseline probability of being alive and independent at 6 months, time to treatment, motor deficit, or aphasia) and pre-specified subgroups (including age, pathological type, inability to assess mood, proxy or patient consent, baseline depression, country). Fluoxetine increased seizure risk (2.64% vs 1.8%, p = 0.03), falls with injury (6.26% vs 4.51%, p = 0.03), fractures (3.15% vs 1.39%, p < 0.0001) and hyponatremia (1.22% vs 0.61%, p = 0.01) but reduced new depression (10.05% vs 13.42%, p < 0.0001). At 12 months, there was no difference in adjusted mRS (n = 5760; common OR 0.98, 95% CI 0.89 to 1.07). Sensitivity analyses gave the same results. INTERPRETATION:Fluoxetine 20 mg daily for 6 months did not improve functional recovery. It increased seizures, falls with injury, and bone fractures but reduced depression frequency at 6 months.

Background Unplanned hospital presentations may occur post-stroke due to inadequate preparation for transitioning from hospital to home. The Re covery-focused C ommunity support to A void readmissions and improve P articipation after S troke (ReCAPS) trial was designed to test the effectiveness of receiving a 12-week, self-management intervention, comprising personalised goal setting with a clinician and aligned educational/motivational electronic messages. Primary outcome is as follows: self-reported unplanned hospital presentations (emergency department/admission) within 90-day post-randomisation. We present the statistical analysis plan for this trial. Methods/design Participants are randomised 1:1 in variable block sizes, with stratification balancing by age and level of baseline disability. The sample size was 890 participants, calculated to detect a 10% absolute reduction in the proportion of participants reporting unplanned hospital presentations/admissions, with 80% power and 5% significance level (two sided). Recruitment will end in December 2023 when funding is expended, and the sample size achieved will be used. Logistic regression, adjusted for the stratification variables, will be used to determine the effectiveness of the intervention on the primary outcome. Secondary outcomes will be evaluated using appropriate regression models. The primary outcome analysis will be based on intention to treat. A p -value ≤ 0.05 will indicate statistical significance. An independent Data Safety and Monitoring Committee has routinely reviewed the progress and safety of the trial. Conclusions This statistical analysis plan ensures transparency in reporting the trial outcomes. ReCAPS trial will provide novel evidence on the effectiveness of a digital health support package post-stroke. Trial registration ClinicalTrials.gov ACTRN12618001468213. Registered on August 31, 2018. SAP version 1.13 (October 12 2023) Protocol version 1.12 (October 12, 2022) SAP revisions Nil

OBJECTIVE:To determine the psychometric properties of an Aboriginal and Torres Strait Islander-developed depressive symptom screening scale. DESIGN:Prospective diagnostic accuracy study. SETTING:Ten primary health care services or residential alcohol and other drug rehabilitation services in Australia that predominantly serve Aboriginal and Torres Strait Islander peoples. PARTICIPANTS:500 adults (18 years or older) who identified as Aboriginal and/or Torres Strait Islander and were able to communicate sufficiently to respond to questionnaire and interview questions. Recruitment occurred between 25 March 2015 and 2 November 2016. MAIN OUTCOME MEASURE:Criterion validity of seven Aboriginal and Torres Strait Islander-developed items, using the adapted Patient Health Questionnaire 9 (aPHQ-9) and depression module of the Mini International Neuropsychiatric Interview (MINI) 6.0.0 as the criterion standards. RESULTS:The seven-item scale had good internal consistency (α = 0.83) and correlated highly with the aPHQ-9 (ρ = 0.76). All items were significantly associated with diagnosis of a current major depressive episode. Discriminant function and decision tree analysis identified three items forming a summed scale that classified 85% of participants correctly. These three items showed equivalent sensitivity and specificity to the aPHQ-9 when compared with the MINI-identified diagnosis of a current major depressive episode. CONCLUSION:Three items developed by and for Aboriginal and Torres Strait Islander people may provide effective, efficient and culturally appropriate screening for depression in Aboriginal and Torres Strait Islander health care contexts.

Background: Postpartum mental illnesses and hypertensive disorders of pregnancy (HDP) are both common, and both associated with adverse maternal and child health outcomes. However, the relationship between them is unclear. This study aimed to investigate prevalence and symptom severity of depression, anxiety, and post-traumatic stress disorder (PTSD) 2-years postpartum in women with normal blood pressure (NBP) during pregnancy versus preeclampsia or gestational hypertension (GH). Methods: Two-years follow-up of the prospective Postpartum, Physiology, Psychology and Paediatric (P4) Cohort Study was conducted in metropolitan Australia. Prevalence and symptom severity of depression (Edinburgh Postnatal Depression Scale, EPDS > 12), anxiety (7-item Generalized Anxiety Disorder scale, GAD-7 >= 10) and PTSD (Posttraumatic stress Diagnostic Scale, PDS/PDS-5) were measured and calculated for women with NBP, preeclampsia and GH. Results: Among 365 participants (NBP: n = 271, preeclampsia: n = 75, GH: n = 19), 2-years postpartum depression prevalence was 3.9% (95% CI 2.3-6.4%): 4.4% after NBP, and 2.7% after preeclampsia (p = 0.53). Anxiety prevalence was higher after GH than NBP (15.8% versus 3.3%, p = 0.02). Prevalence of any mental illness (depression/anxiety/PTSD) was 5.9% (95% CI 3.8-8.8%); 5.6% after NBP, 4.1% after PE, and 15.8% after GH (p = 0.15). Although PTSD prevalence was low (1.4%), and similar between groups (p = 0.97), around 3 times more women after PE (8.1%), compared to NBP (2.5%), recalled childbirth as traumatic (p = 0.003). Conclusions: Preeclampsia, although associated with persistent perceptions of traumatic childbirth, did not alter the risk of mental illnesses at 2-years postpartum. GH (albeit in a small subgroup) was associated with increased anxiety scores. Larger, multicentre studies are required to clarify relationships between HDP and postpartum mental illness.