IntroductionAttention deficit hyperactivity disorder (ADHD) is one of the most common neurodevelopmental paediatric disorders and persists into adulthood, although it is frequently underdiagnosed and underrecognized in adult populations. In this context, the prevalence of pharmacologically treated individuals diagnosed with ADHD represents an important quality indicator for ADHD management.AimTo estimate the pooled prevalence of pharmacologically treated individuals with ADHD in different age groups in Europe and worldwide.MethodsA comprehensive search of PubMed/MEDLINE was conducted to identify relevant articles published up to October 4, 2024. The present systematic review and meta-analysis examined ADHD prevalence using clinically confirmed diagnoses and treatment data from official records. The exclusion criteria included studies that lacked clinical confirmation of ADHD and/or relied exclusively on parental reports for diagnostic or medication information. The prevalence of pharmacologically treated individuals with ADHD was calculated as a percentage, with a 95% confidence interval (CI). A meta-analysis was performed in R using a random-effects model. Heterogeneity was calculated using I². Prediction intervals were additionally computed to reflect the expected range of prevalence in future studies. Risk of bias was assessed for all included studies using a standardized, previously published methodology. The study was prospectively registered in PROSPERO (CRD42020200220) and adhered to the PRISMA guidelines for systematic review and meta-analysis (2020).ResultsThe systematic review identified 13 studies (12 studies included in the meta-analysis) with substantial variation in age-specific reporting. The pooled prevalence of pharmacologically treated ADHD was 73.4% (95% CI: 63.4–81.5), with extremely high between-study heterogeneity and wide 95% prediction interval (29.6%–94.5%), reflecting substantial variation across settings. The pooled prevalence estimate should be interpreted with caution due to substantial between-study heterogeneity and is not intended for direct clinical inference. Geographic analyses revealed no significant variation across countries. Sex-stratified analyses showed no significant difference between males and females, although point estimates were slightly higher in males.ConclusionThe prevalence of pharmacological treatment among individuals with ADHD appears to vary across age groups and settings Overall, findings indicate substantial variation in pharmacological treatment of ADHD by age, with consistently high heterogeneity limiting the precision of pooled estimates.Systematic review registrationhttps://www.crd.york.ac.uk/PROSPERO/, identifier CRD42020200220.
Birmingham trusts launch InterSystems shared patient portal
Birmingham and Solihull Mental Health and Birmingham Community Healthcare NHS Foundation Trusts have launched a shared patient portal.
Loneliness From the Digital Mental Health Practitioners’ Perspective: Thematic Analysis of Semistructured Interviews
Background: Loneliness is a prevalent concern across the United Kingdom. While validated scales exist to quantify the severity of loneliness across populations, there remains a gap in understanding how loneliness manifests and is addressed within therapeutic practice. Given the associated stigma surrounding loneliness, practitioner perspectives offer crucial insights into how clients express loneliness within digital therapeutic environments. These insights can inform more nuanced conceptualizations of loneliness. Objective: This study aimed to gather the practitioners’ perspectives on loneliness within a digital therapeutic context and were defined as follows: (1) understand how practitioners identify loneliness concerns, (2) identify how loneliness is elicited in digital mental health interventions, and (3) identify co-occurring themes (such as grief, shame, and social disconnection) that signal loneliness concerns in client communications within digital therapeutic environments. Methods: Semistructured interviews were conducted with 9 practitioners. Participants included specialists in grief counseling, lesbian, gay, bisexual, transgender, and queer or questioning plus support; and digital mental health therapists. Interview transcripts were analyzed using thematic analysis, using an inductive, data-driven approach to allow themes to emerge from participant accounts rather than fitting data to preexisting theoretical frameworks. Results: The following four themes were identified: (1) Conceptualizing Loneliness: practitioners distinguished between social contact and meaningful connection; (2) Contextual Causes: loneliness emerged from life transitions, stigmatized identities, and resource reduction (eg, youth services closures and social support); (3) Expressions and Language: clients rarely expressed loneliness directly, instead using proxy terms, with disclosure patterns varying by age; and (4) Mental Health Co-occurrence: severe mental health conditions created bidirectional cycles of loneliness, exacerbated by symptoms of mental health difficulties. Practitioners reported that many clients experienced loneliness concerns, yet direct disclosure was absent across all participants’ experiences. Conclusions: Practitioners identified multiple stigmatizing experiences as contextual drivers of loneliness, particularly demonstrating how loneliness emerges not only from individual experiences but from broader patterns of social exclusion and marginalization. For therapeutic practice, these insights suggest that practitioners can use awareness of stigmatizing experiences as potential indicators when assessing loneliness risk. The presence of contextual patterns was consistent across practitioners’ experiences, providing a foundation for developing more targeted interventions to address both the emotional experience of loneliness and the underlying social drivers.
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Exercise interventions are most consistently supported for depressive disorders: an umbrella review of diagnosed depressive and anxiety disorders
BackgroundExercise is increasingly discussed as part of lifestyle-based and multimodal care for mood and anxiety disorders, but review-level evidence often mixes formally diagnosed clinical populations with symptom-defined or medically mixed samples.MethodsWe conducted an umbrella review of systematic reviews, meta-analyses, and network meta-analyses of structured exercise interventions for adults with depressive or anxiety disorders. Six databases were searched from inception to 1 March 2026. Primary outcomes were depressive and anxiety symptom severity, remission, and response; secondary outcomes were acceptability and tolerability. Review quality was appraised with AMSTAR 2, and primary-study overlap was quantified with corrected covered area (CCA), including overall and symptom-cluster analyses. The synthesis was designed to summarize review-level credibility and clinical interpretability rather than to generate a second-order pooled efficacy estimate.ResultsNine reviews met eligibility criteria; four supplied directly extractable primary overall review-level estimates for core psychiatric symptom outcomes. AMSTAR 2 appraisal rated one review as high, three as low, and five as critically low. Recalculated overall overlap was slight (112 primary-study occurrences, 89 unique primary studies; CCA = 3.23%), although cluster-level analyses identified localized redundancy, particularly within anxiety-disorder-specific reviews. In major depressive disorder, one clinically focused review reported a large reduction in depressive symptoms for aerobic exercise versus non-exercise comparators (Hedges’ g = -0.79, 95% CI -1.00 to -0.57; I² = 21%). Across diagnosed depressive and/or anxiety disorders, broader review-level estimates also favored exercise for depressive symptoms (SMD = -0.97, 95% CI -1.28 to -0.66) and anxiety symptoms (SMD = -0.66, 95% CI -1.09 to -0.23), but heterogeneity was high. Anxiety-disorder-specific evidence was less secure: the primary DSM-IV anxiety-disorder pooled estimate showed no clear benefit over selected controls (SMD = 0.02, 95% CI -0.20 to 0.24). Acceptability estimates were close to null, and adverse-event reporting was too sparse to support confident safety conclusions.ConclusionExercise is best supported as an adjunctive, patient-centered component of care for depressive disorders. Anxiety-disorder-specific efficacy remains uncertain when comparator rigor, diagnostic heterogeneity, and localized overlap are considered, and safety reporting needs substantial improvement.Systematic Review Registrationhttps://www.crd.york.ac.uk/PROSPERO/, identifier CRD420261364264.
Prediction of Clinically Significant Depressive Symptoms at 2-Year Follow-Up in Older Adults: Machine Learning Study Using the English Longitudinal Study of Ageing
Background: Depression in older adults is often underdiagnosed due to atypical symptom presentation and generational stigma, leading to delayed intervention. Early identification of individuals at risk of developing elevated depressive symptoms is therefore critical, but traditional approaches show limited predictive accuracy. To date, no study has applied machine learning (ML) models to predict clinically significant depressive symptoms at 2-year follow-up in older adults in the United Kingdom using data from the English Longitudinal Study of Ageing (ELSA). Moreover, the impact of encoding strategies for categorical health care variables has not been examined. Objective: This study aimed to develop and evaluate ML models to predict the clinically significant depressive symptoms at 2-year follow-up in older adults using ELSA data. We further compared ordinal and one-hot encoding strategies across different ML architectures and identified key predictors of depressive symptoms at follow-up. Methods: Data were drawn from 4 consecutive waves of ELSA, including participants aged ≥50 years without significant depressive symptoms at the baseline wave (waves 6‐9). Clinically significant depressive symptoms were defined as 8-item Center for Epidemiologic Studies Depression Scale (CES-D 8) scores of ≥4 at the subsequent wave (waves 7‐10). Over 120 features spanning sociodemographic, psychological, and health-related domains were analyzed. Eight ML models were applied, including tree-based ensembles, deep learning architectures for tabular data, distance-based methods, probabilistic methods, and linear methods. Model performance was assessed using the area under the receiver operating characteristic curve (AUROC) and -score. Model interpretability was examined using Shapley additive explanations (SHAP). Sensitivity analyses assessed the robustness of results across alternative CES-D 8 thresholds (≥3, ≥4, and ≥5) and encoding strategies. Results: Across waves, the best-performing models achieved mean AUROC scores of 0.72‐0.73, with a peak of 0.75 in the highest-performing wave. Ordinal encoding consistently outperformed one-hot encoding across all ML models, yielding improvements in AUROCs and -scores, with the greatest increase in tree-based methods. SHAP consistently identified loneliness, sleep disturbances, and low social engagement as strong predictors of elevated depressive symptoms at follow-up. Sensitivity analyses across CES-D 8 thresholds demonstrated robust feature importance, with AUROCs ranging from 0.67 to 0.82. Traditional ML models (random forest, extreme gradient boosting, and support vector machines) generally achieved higher performance than the deep learning models for this task. Conclusions: Our findings demonstrate the feasibility of predicting clinically significant depressive symptoms at 2-year follow-up in UK older adults, with moderate accuracy. Ordinal encoding demonstrates superior performance for health care datasets with inherently ordered categorical features. The identification of consistent risk factors highlights opportunities for developing targeted clinical screening tools and preventive interventions. This study provides new evidence on depressive symptom prediction in the UK context, leveraging longitudinal data from ELSA, and contributes to advancing digital mental health research for aging populations.
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A Recap of the Inaugural Youth Mental Health Hub at SXSW London
In early June, SXSW London returned for its second year, gathering thousands of creatives, enthusiasts, entrepreneurs, and investors into the city to celebrate film, music, tech, and culture. As part of this year’s festival, the Child Mind Institute, in partnership with Wellcome, proudly presented the inaugural Youth Mental Health Hub – a week of programming dedicated to advancing solutions to one of the defining challenges of our time: the global youth mental health crisis. Through six thought-provoking sessions, leaders in clinical care, science, technology, policy, and media came together to explore how to strengthen prevention, improve early identification, reduce stigma, and build systems that meet young people where they are.
Here’s a look back at the inspiring conversations that took place throughout the week.
Beyond the Average: Understanding Vulnerability in the Digital Childhood Era
As artificial intelligence rapidly transforms the experience of childhood, experts explored how AI can both support and challenge young people’s mental health. The panelists discussed when and under what conditions young people may be most vulnerable as well as what systems we need to support them.
Moderator
Gary Wilson, Director of Research, Huo Family Foundation
Speakers
Catherine Sebastian, PhD, Head of Evidence for Mental Health, Wellcome
John Pickavance, PhD, Principal Data Scientist, Born in Bradford
Georgia Turner, Postdoctoral Research Associate, University of Cambridge
Michael Milham, MD, PhD, Chief Science Officer, Child Mind Institute
AI Is Already Shaping Childhood. Who Is Shaping AI? Balancing Innovation, Evidence, and Safety in Youth Mental Health
Youth are experiencing the impacts of AI earlier and more intensely than any previous generation has. This session explored the role of public leadership in anticipating harm before it becomes systemic — establishing guardrails, fostering digital resilience, and ensuring that innovation advances hand in hand with youth mental health and well-being.
Moderator
Sarah Aguiar-Borges, PhD, University of Cambridge
Speakers
Julia Gillard, former Prime Minister of Australia; Chair, Wellcome
Kanishka Narayan, UK Minister for AI and Online Safety
Giovanni Salum, MD, PhD, SVP, Global Programs, Child Mind Institute.
Youth Mental Health After Conflict: Healing, Resilience, and Rebuilding Systems
Experts shared insights on the unique mental health challenges facing children affected by war, displacement, and humanitarian crises. This session explored how societies can implement youth-centered systems grounded in prevention and use early identification to position youth mental health as a cornerstone of long-term recovery and resilience.
Moderator
Krupa Padhy, BBC Radio 4
Speakers
Dr. Mark Jordans, professor, Centre for Global Mental Health, King’s College London; Director of Research & Development, War Child
Emma Ferguson, mental health policy and advocacy specialist, UNICEF
Mohamed Ali, Director, Iftin Global
Dyslexia: Changing the Story
In a timely discussion, experts explored how dyslexia is currently understood in society, challenging current language and misperceptions that can impact a child’s confidence and mental health. Through a blend of personal experience and clinical expertise, the conversation focused on the need for evidence-based support and strengths-based approaches to help children and their families thrive.
Moderator
Kate Griggs, Founder, Made By Dyslexia
Speakers
Maggie Aderin, PhD, space scientist & educator; dyslexia advocate
Harold S. Koplewicz, MD, President and Medical Director, Child Mind Institute
Connection Continuum: Preventing Suicide and Combating Loneliness
Suicide is one of the leading causes of death among young people globally. This session gathered community, clinical, and digital leaders to explore what a more connected system of support looks like in practice. The panelists also discussed the important of recognizing warning signs, expanding access to evidence-based care, and prioritizing early intervention to help prevent youth suicide.
Moderator
Krupa Padhy, BBC Radio 4
Speakers
Victoria Hornby, CEO, Mental Health Innovations
Dean Perryman, Empty Chairs
Michael Milham, MD, PhD, Chief Science Officer, Child Mind Institute
Does Mental Health Science Funding Need a New Paradigm in the Age of AI?
With technology evolving faster than the science designed to understand it, experts examined how research, philanthropy, and clinical leaders can work together to build the evidence, safeguards, and infrastructure needed to protect children’s mental health in the digital age.
Moderator
Chelsea Clinton, Vice Chair, Clinton Global Initiative
Speakers
Miranda Wolpert, Director of Mental Health, Wellcome
Margaret Laws, President & CEO, HopeLab
Daria Bukhman, Co-Founder and Chair, Bukhman Philanthropies
Harold S. Koplewicz, MD, President & Medical Director, Child Mind Institute
The post A Recap of the Inaugural Youth Mental Health Hub at SXSW London appeared first on Child Mind Institute.
Boys, Masculinity, and the Looksmaxxing Trend
By now, you’ve probably heard of the term looksmaxxing. Think pieces about the trend have popped up all over the internet. And in a recent episode of Saturday Night Live, comedians poked fun at lookmaxxing influencers obsessed with having the perfect male physique.
While this new social media craze may seem silly, it’s impacting more boys than you might think. In a study conducted last year that surveyed over 3,000 young men (ages 16–25) from the United States, United Kingdom, and Australia, nearly two-thirds of participants were regularly engaging with masculinity influencers.
Teen boys are being encouraged to change the way they look in order to fit a certain standard of attraction. The growing amount of looksmaxxing content they see online can have real effects on their self-esteem and mental health.
What is looksmaxxing?
Looksmaxxing originated nearly a decade ago in incel forums where men blamed their lack of romantic partners on the belief that female sexual selection is primarily based on physical qualities. So men who aren’t born with traits desirable to women are doomed to fail romantically. While traditional incels wallow in this fate, looksmaxxers seek to enhance their appearance to become more attractive. Their community claims that there is a universal standard for what the ideal man (and woman) should look like.
This is determined by a rating system called the PSL scale — the name being an amalgamation of three prominent misogynistic incel forums of the 2010s. There are many factors that go into the scaling, such as eye shape, jaw size, nose angle, and body fat percentage. Along this scale, you can land in four categories: subhuman, normie, Chadlite, and Chad (the ultimate catch).
During the pandemic, looksmaxxing went mainstream, merging with “manosphere” content on social media platforms like TikTok and Instagram. The trend became less about the ability to attract women and more of a competition among boys and men as they engaged in mog-offs — online contests where people have their faces analyzed and compared by facial recognition software to determine who’s better looking.
Self-improvement practices have gained popularity among boys. Some are considered to be softmaxxing, like developing skincare routines or eating high-protein diets, and others to be hardmaxxing, like using growth hormones or getting cosmetic surgery.
Prominent young influencers like Clavicular represent the extreme side of looksmaxxing. He practices bonesmashing (using a hammer on facial bones to try to form more angular features), injects himself with testosterone, and takes meth to maintain a low body fat percentage while still having a muscular physique.
Looksmaxxing and new beauty standards
The rise of looksmaxxing seems to have a caused a ripple effect among teen boys. While the ideal look has centered on big muscles and washboard abs for decades, there’s now an added pressure on facial beauty that’s typically been reserved for girls.
“With some of the teen boys I work with, most of whom already have self-esteem issues, I think there is a lot more concern about how they look,” observes Alnardo Martinez, LMHC, director of the Pediatric OCD Intensive Program and a mental health counselor at the Child Mind Institute. “They want to have the strong jaw, really big muscles, clear skin, and a perfect haircut.”
However, Martinez notes that it sometimes take a while for boys to admit that they feel this pressure. They may insist that they don’t really care about that stuff. “But then, maybe a few months later, it comes out that there is a lot of comparison. They’re spending a lot of time in front of the mirror or in the bathroom trying to create this perfect image,” he observes.
What teen boys think about looksmaxxing and self-improvement
We talked to young men who were critical of Clavicular and the impact looksmaxxing can have on teens but were positive about engaging in some form of physical self-improvement.
Wyatt, now 19, remembers comparing his jawline to his peers’ when he was in 7th grade. “I just felt like they had really sharp jawlines. And I was just like, ‘Oh, I want to get closer to that.’” He would also come across TikToks advertising rubber chewing blocks and chin exercises meant to strengthen the jawline.
And so, Wyatt began to do jaw exercises he’d found online, reciting the alphabet while stretching out the muscles. “I would go through my Zoom classes throughout the day and then after that was done, I’d just go into the bathroom and go through the whole exercise. It would take like an hour sometimes,” he recalls. “It turned into more like a self-care, self-improvement session. I would do that every day after my classes. I didn’t feel like I was done with school until I finished my jawline routine.” He took photos to document his progress.
Wyatt feels like the routine had a positive effect, because he was able to see an improvement. “I felt more satisfied with myself, a little more confident.”
Lev, now 19, remembers wanting to have some control over his body when going through puberty in high school. “Puberty is not a straightforward process. It’s not all peaches and cream. Your body changes, and it can be uncomfortable,” he explains. “But with lifting and strength training, it was very exciting to see this, you know, man energy that came out of it. I wanted to harness that and really take it by the reins. Have some agency as a man.”
And while he rejects the extreme parts of looksmaxxing, Lev does regularly practice self-improvement through weight lifting, skin care routines, and taking GLP-1 weight loss medication.
How looksmaxxing can impact boys’ mental health
Since looksmaxxing places such a strong emphasis on achieving a very specific look, clinicians are concerned about its influence on teens. “Self-esteem is pretty fragile during puberty,” Martinez says. “There’s already a ton of comparison and perceived flaws that teens don’t love about themselves.”
These insecurities can be exacerbated by the type of content teens engage with online, Martinez explains. Along with ChatGPT bots specifically designed to judge aesthetics, Reddit threads such as r/Mewing and websites like Looksmaxxing Forum encourage boys to post pictures of their faces and bodies to get rated by their peers. Boys as young as 13 visit these forums, posting pictures and asking for tips on how to improve their looks.
“These are generally places where people are already pretty harsh and critical. These boys are receiving a lot more ‘confirmation’ around the perceived things that are wrong with them or that they need to change,” Martinez says. “And it just feeds into the already present negative self-image and self-talk.”
He explains that this type of social media engagement can also compound underlying mental health issues like depression and social anxiety. “They might be less likely to go out and talk to people because they’re thinking, ‘Everyone is going to see this one thing that everyone else has told me is wrong with me. So now I can’t go out,’”he says.
Martinez is also concerned that online content can negatively affect teens with body dysmorphic disorder (BDD). “If they think they have a big nose, for example, they might go on these Reddits and ask, ‘What does my nose look like? Is it too big?’ There are trolls out there. Someone is going to say yes and then that’s going to make the BDD symptoms even worse.”
When behaviors might be concerning
In some ways, teen boys taking part in more self-improvement practices could be seen as a good thing. They’re exercising, taking care of their skin, and eating more balanced diets. The issues begin when these types of practices turn into obsession. And given the underlying ideology of looksmaxxing and the nature of social media, things can become unhealthy.
According to Martinez, there are some changes in behavior to look out for that indicate you might want to step in.
One clear change, he says, is a noticeable shift in the amount of time they’re spending on grooming themselves. “Maybe they were someone who would typically just get up and run out the door without washing their face,” he says. “But now they’re spending a lot more time in the bathroom and asking a lot of questions about how they look.”
Another warning sign can be a big change in personality. “Irritability is a big one that we’ll see a lot,” he says. “They’re unhappy with how they look, so this increases a general level of irritation.”
These behaviors paired with an unusual uptick in time spent on social media, Martinez explains, can be a sign that something’s wrong and support is needed.
How to support your child
If you’re worried that your child might be engaging in looksmaxxing-related behaviors to an unhealthy degree, says Martinez, there are a few things you can do:
- Open communication. Martinez suggests approaching your child with curiosity. “You could start the conversation by saying something like, ‘So have you heard about this? What do you think about it? Have you ever had any thoughts yourself about how you look or desires to change your body or face?’ And then give them some space to be open and vulnerable about it. Validate their experience.”
- Find out where your child is getting their information. “Read it together, talk about it, and see what your child thinks about it,” Martinez advises. “And if it’s promoting something dangerous, then you can talk to them about how those practices can be harmful and what could actually happen if they do some of those things.”
- Encourage male role models. “There’s a patient I work with now who doesn’t have a present dad,” Martinez explains. “His mom tries to talk to him about things like body image, but he feels like she doesn’t understand and can’t relate. So having someone that he can talk to and be open about this stuff with, especially someone who can also share their own struggles, can be really helpful.”
- Seek help from a mental health professional. This is especially important if you find out that your child has been engaging in extreme forms of looksmaxxing such as bonesmashing or starvemaxxing. Martinez recommends looking for a clinician who specializes in body image or body dysmorphic disorder.
A lot of parenting comes down to open communication around what your kids are seeing and what they’re feeling. We all have things about our bodies that we might not like and wish we could change, says Martinez, and it can help to normalize those feelings. “And then you can discuss how they can make changes in healthy ways,” he suggests. “Go over what’s a realistic change and what’s a dangerous change.”
The post Boys, Masculinity, and the Looksmaxxing Trend appeared first on Child Mind Institute.
The effect of weather on unscheduled healthcare utilisation for mental health conditions in England, 2014–2022
BackgroundWeather conditions have been linked to adverse mental health outcomes, and rising concern about climate change has increased interest in these associations. However, most existing research focuses on extreme weather events, such as heatwaves, or on acute clinical outcomes, such as suicide. Evidence is more limited regarding population-level variations in mental health–related healthcare utilisation across the full range of daily weather conditions.ObjectiveTo examine associations between daily weather conditions and unscheduled mental health–related healthcare contacts in England using large-scale national surveillance data.MethodsWe conducted a retrospective observational study across nine English regions from 1 January 2014 to 31 December 2022. Outcomes were daily counts of unscheduled mental health–related contacts to emergency departments (EDs), general practice out-of-hours (GP OOH) services, and the NHS 111 telephone advice line. Weather exposures included mean daily temperature (°C), hours of full sunshine, and total daily rainfall (mm). Associations were estimated using distributed lag non-linear models at regional level and combined through two-stage multivariate meta-analysis. Models were adjusted for seasonality, long-term trends, day of week, public holidays, and population size.ResultsMental health–related unscheduled healthcare contacts showed modest but consistent associations with temperature and sunshine. Across services, relative risks (demand) increased with rising temperatures up to around 18 °C and were higher on days with fewer hours of sunshine. Sunshine demonstrated the clearest pattern, with increased utilisation on low-sunshine days across all healthcare settings. Rainfall was not consistently associated with healthcare contacts. Age-stratified analyses showed a U-shaped relationship between temperature and ED attendances among adults aged over 64 years, with higher utilisation during both colder and warmer conditions. Overall variations in daily healthcare demand were modest, typically within ±10–20% of baseline levels.ConclusionIn England, short-term variations in temperature and sunshine are associated with changes in unscheduled mental health–related healthcare utilisation, whereas rainfall shows little consistent effect. Although effect sizes were modest, these findings highlight the role of everyday weather conditions in influencing mental health–related healthcare demand and may support planning and preparedness efforts for mental health services under current and future climate conditions.
Perspectives on Continuous Glucose Monitoring Among Adults with Type 2 Diabetes in the United Kingdom: Cross-Sectional Survey
<strong>Background:</strong> Type 2 diabetes (T2D) is one of the most common noncommunicable diseases, requiring ongoing lifestyle changes and continuous glucose management through medication, diet, and physical activity. Traditional self-monitoring of blood glucose can be burdensome, especially with frequent finger pricks. As continuous glucose monitoring (CGM) becomes more affordable and accessible, it offers benefits such as increased glucose awareness, behavioral modifications, and reduced anxiety. However, challenges remain, including cost, discomfort, skin reactions, and privacy concerns. In the United Kingdom, perceptions of CGM among people with T2D, including both users and nonusers, are not well understood, limiting insight into factors influencing adoption and sustained use. <strong>Objective:</strong> This study aims to explore how adults with T2D perceive the benefits and challenges of using CGM, including both current users and nonusers. <strong>Methods:</strong> This study used a cross-sectional, online survey using YouGov’s nationally representative panel to explore experiences of CGM among adults with T2D in the United Kingdom. A total of 531 participants were recruited from November to December 2024. Thematic analysis of responses to 2 open-ended questions identified key perceived benefits and challenges associated with CGM use. <strong>Results:</strong> A total of 531 adults with T2D completed the YouGov online survey. Over half were male (297/531, 55.9%) and aged 65 years and older (281/531, 52.9%). Two-thirds (347/531, 65.3%) had lived with T2D for more than 5 years, and 9.6% (51/531) use or had previously used a CGM. Overall, 50.8% (270/531) responded to at least one free-text question, with 49% (260/531) commenting on benefits and 33.1% (176/531) on challenges. Thematic analysis identified five key benefit themes: (1) reduced monitoring burden, described as eliminating frequent finger prick testing and simplifying daily routines; (2) lifestyle feedback, enabling participants to better understand how diet and physical activity influence glucose levels; (3) greater control, by supporting more informed decision-making and increasing confidence in self-management; (4) feeling safer, through alerts for hypo- and hyperglycemia; and (5) sharing data with clinicians, which facilitated communication and more collaborative care. The main challenges were (1) access barriers, including restrictive eligibility criteria and the high cost of self-funding; (2) device issues, such as discomfort, inconvenience, and practical difficulties wearing the sensor; (3) technology reliance, with concerns about depending on devices rather than listening to bodily cues; (4) emotional strain, including anxiety, over-monitoring, and increased preoccupation with glucose levels; and (5) data concerns, particularly regarding accuracy, interpretation, and privacy. <strong>Conclusions:</strong> Adults with T2D, including both users and nonusers, described CGM as a practical and empowering tool that improves understanding, safety, and collaboration with health care providers. Nevertheless, access barriers, usability issues, and emotional and data-related burdens remain major obstacles to equitable adoption. Addressing these through improved affordability, digital literacy support, and customized clinical guidance may support ongoing and inclusive CGM use in routine care.
Heat waves mess with your brain. Scientists are trying to figure out why.
It’s been hot in London this week. Really hot. A dangerous heat wave has hit Western Europe. Yesterday, the UK recorded its highest ever June temperature at 36.1 °C (about 97 °F). But as the weather app on my phone confirmed, it felt like 39 °C.
It’s frightening that we are seeing such temperatures in the UK in June. According to the Met Office, the country’s national weather and climate service, June temperatures peaked at an average 19 °C (66 °F) in England between 1991 and 2020. Across Europe, the heat wave is likely to cause thousands of deaths. There will be other awful consequences for agriculture, infrastructure, and the health system.
But this week I want to look at what the heat does to our minds and brains. Personally, I’ve found it almost impossible to think straight. The heat is distracting and my mind is foggy. I dread to think about the conditions of people who work outdoors, in even hotter regions.
It’s not just exhaustion and confusion. The effects of heat on the brain can be deadly. And researchers are still trying to figure out why.
Studies have confirmed that as temperatures rise, people seem to get more irritable and more violent. Most of these studies are based on associations, though. It’s difficult to directly study how a heat wave might affect our thinking, says Catherine Thompson, a cognitive psychologist at Liverpool Hope University.
She has been studying the effects of extreme heat on firefighters instead. It’s easier to measure people’s cognitive skills before and after they undergo scheduled training that involves entering a burning building.
It’s early days, but the team found that firefighters found it harder to focus and control their attention immediately after heat exposure—something people in heat waves can empathize with, I’m sure.
The firefighters’ skills returned to normal after 20 minutes or so of cooling down. But they’d experienced just 15 minutes of intense heat exposure. Thompson doesn’t know what the effects of living through a days-long heat wave might be—or how long they’ll last. Figuring that out might involve shipping cognitive test kits to thousands of people during the few days’ notice of an impending heat wave. “My guess [is] that no one’s done it because it’s just so difficult to do,” says Thompson.
Still, researchers can learn about some of the impacts of heat waves through studies after the fact. And those studies suggest that the heat seems to have more disastrous outcomes for people with mental-health disorders.
Those outcomes become apparent when temperatures rise above what is considered typical for a given region. “There seems to be a correlation where the hotter it gets, especially during the hottest times of the year, the worse the mental-health outcomes,” says Joshua Wortzel, who directs the Heat-Mind Lab at Hartford HealthCare in Connecticut.
In a study published in 2023, Emma Lawrence at the University of Oxford, who studies the effect of climate change on mental health, and her colleagues reviewed the evidence linking mental-health outcomes to ambient outdoor temperatures. They found that during heat waves, there was a 9.7% increase in the rate of hospital admissions for people with such conditions.
“People who live with mental-health conditions are among the most susceptible to the physical impacts of heat,” says Lawrence. People with schizophrenia were found to have been three times more likely to die during the record-breaking heat wave that affected Canada in 2021, for example.
In order to protect people, we need a better understanding of the mechanisms underlying these effects. After all, a lot of things change when it’s very, very hot. Some people may end up stuck indoors, avoiding outdoor play and exercise, and it can be difficult to get a good night of sleep, for example. Sleep, socializing, and exercise are all really important for our mental health.
But whether unusual heat does something specific to our brains is, as Wortzel puts it, “the million-dollar question.”
Research in lab animals suggests that excessive heat can alter the way chemical signals work in our brain. The levels of neurotransmitters like serotonin, for example, seem to increase when rats and mice are exposed to high temperatures, according to multiple studies. The heat may also interfere with the way networks in our brains communicate with each other. It might affect the way oxygen reaches our brain cells.
“There are so many biological reasons why brains may be negatively affected by heat,” says Wortzel.
Emerging research suggests that for whatever reason, children and young people are among the most vulnerable. In research published earlier this week, Wortzel and his colleagues saw a 2.97% increase in the suicide rate among people in the US aged 15 to 24 for every 1 °C increase in average monthly temperature. That’s more than double the increase seen in people over the age of 24 (which is concerning in its own right).
Other work hints that heat exposure might have long-term consequences for children’s brain development. Babies who were exposed to either extreme heat or cold appeared to have altered white matter by the time they were nine to 12 years old—although it’s not clear how these impacts might affect an individual child.
“It seems that extreme temperature exposure for very young children may affect their brain development,” says Lawrence, who spoke to me from Oxford. She was meant to be in London for Climate Action Week, but her event, which focused on extreme heat, ended up being canceled … owing to the extreme heat.
We are living through the effects of climate change. And that brings a new urgency to the question of how heat affects our brains. Children born in 2020 are predicted to experience around seven times the number of heat waves their grandparents did, says Lawrance. “[We] need to be serious about adapting to a warming world.”
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