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All Outputs (102)

Opportunities and challenges to delivering a trial for depressive symptoms in primary care during the COVID-19 pandemic: insights from the Alpha-Stim-D randomised controlled trial (2025)
Journal Article
Patel, S., Patel, P., Boutry, C., Guo, B., Butler, D., Higton, F., McNaughton, R., Briley, P. M., Griffiths, C., Nixon, N., Prasad, V., Sayal, K., Smart, D., Zafar, A., Kai, J., & Morriss, R. (2025). Opportunities and challenges to delivering a trial for depressive symptoms in primary care during the COVID-19 pandemic: insights from the Alpha-Stim-D randomised controlled trial. Trials, 26(1), Article 62. https://doi.org/10.1186/s13063-025-08772-3

Background
Randomised controlled trials (RCTs) are widely regarded as the most powerful research design for evidence-based practice. However, recruiting to RCTs can be challenging resulting in heightened costs and delays in research completion and i... Read More about Opportunities and challenges to delivering a trial for depressive symptoms in primary care during the COVID-19 pandemic: insights from the Alpha-Stim-D randomised controlled trial.

An item-level systematic review of the presentation of ADHD in females (2025)
Journal Article
Williams, T., Horstmann, L., Kayani, L., Lim, A. X. H., Russell, A., Ford, T., John, A., Sayal, K., Thapar, A., Langley, K., & Martin, J. (2025). An item-level systematic review of the presentation of ADHD in females. Neuroscience and Biobehavioral Reviews, 171, Article 106064. https://doi.org/10.1016/j.neubiorev.2025.106064

Previous studies examining sex differences in attention deficit hyperactivity disorder (ADHD) have primarily examined total or subscale scores. This systematic review aimed to examine which symptoms contribute to the female presentation of ADHD at an... Read More about An item-level systematic review of the presentation of ADHD in females.

Barriers and Facilitators to using Standardised Diagnostic Assessments in Child and Adolescent Mental Health Services: a qualitative process evaluation of the STADIA trial (2025)
Journal Article
Thomson, L., Newman, K., Ewart, C., Bhardwaj, A., Dubicka, B., Marshall, T., Gledhill, J., Lang, A., Sprange, K., & Sayal, K. (in press). Barriers and Facilitators to using Standardised Diagnostic Assessments in Child and Adolescent Mental Health Services: a qualitative process evaluation of the STADIA trial. European Child and Adolescent Psychiatry,

Background: The STADIA trial aimed to assess the effectiveness of a standardised diagnostic assessment tool (Development and Wellbeing Assessment, DAWBA) in aiding clinician-made diagnosis decisions in Child and Adolescent Mental Health Services (CAM... Read More about Barriers and Facilitators to using Standardised Diagnostic Assessments in Child and Adolescent Mental Health Services: a qualitative process evaluation of the STADIA trial.

The clinical and cost effectiveness of a STAndardised DIagnostic Assessment for children and adolescents with emotional difficulties (STADIA); multi- centre randomised controlled trial (2025)
Journal Article
Sayal, K., Wyatt, L., Partlett, C., Ewart, C., Bhardwaj, A., Dubicka, B., Marshall, T., Gledhill, J., Lang, A., Sprange, K., Thomson, L., Moody, S., Holt, G., Bould, H., Upton, C., Keane, M., Cox, E., James, M., & Montgomery, A. (in press). The clinical and cost effectiveness of a STAndardised DIagnostic Assessment for children and adolescents with emotional difficulties (STADIA); multi- centre randomised controlled trial. Journal of Child Psychology and Psychiatry, https://doi.org/10.1111/jcpp.14090

Background

Standardised Diagnostic Assessment tools, such as the Development and Well-Being Assessment (DAWBA), may aid detection and diagnosis of emotional disorders but there is limited real-world evidence of their clinical or cost effectiveness... Read More about The clinical and cost effectiveness of a STAndardised DIagnostic Assessment for children and adolescents with emotional difficulties (STADIA); multi- centre randomised controlled trial.

Investigating the reasons behind a later or missed diagnosis of attention-deficit/hyperactivity disorder in young people: A population cohort study (2024)
Journal Article
Barclay, I., Sayal, K., Ford, T., John, A., Taylor, M. J., Thapar, A., Langley, K., & Martin, J. (in press). Investigating the reasons behind a later or missed diagnosis of attention-deficit/hyperactivity disorder in young people: A population cohort study. JCPP Advances, https://doi.org/10.1002/jcv2.12301

Background
Attention Deficit Hyperactivity Disorder (ADHD) is a common neurodevelopmental condition, more often diagnosed in males. In many individuals, particularly females, ADHD is diagnosed later or missed, the reasons for this are not fully unde... Read More about Investigating the reasons behind a later or missed diagnosis of attention-deficit/hyperactivity disorder in young people: A population cohort study.

Impact of young people’s admissions to adult mental health wards in England: a national qualitative study (2024)
Journal Article
Burn, A.-M., Holland, J., Roe, J., Hopkin, E., Wild, L., Fisher, M., Ford, T., Nazir, S., Dubicka, B., James, A., Tuomainen, H., Fung, N., Wagner, A., Morriss, R., & Sayal, K. (in press). Impact of young people’s admissions to adult mental health wards in England: a national qualitative study. BJPsych Open,

Background: National policy in England recommends that young people be admitted to mental health wards that are age-appropriate. Despite this, young people continue to be admitted to adult wards.

Aims: To explore the impact of young people’s admi... Read More about Impact of young people’s admissions to adult mental health wards in England: a national qualitative study.

Experiences of the COVID-19 pandemic on child and adolescent psychiatric wards: multi-methods investigation (2024)
Journal Article
Holland, J., Da-Silva-Ellimah, M., Roe, J., Morriss, R., & Sayal, K. (2024). Experiences of the COVID-19 pandemic on child and adolescent psychiatric wards: multi-methods investigation. BJPsych Open, 10(6), Article e197. https://doi.org/10.1192/bjo.2024.783

Background
Child and Adolescent Mental Health Services (CAMHS) inpatient beds are unevenly spread throughout England. Where demand outstrips bed availability, young people may be admitted at-distance or to adult psychiatric wards. The COVID-19 pande... Read More about Experiences of the COVID-19 pandemic on child and adolescent psychiatric wards: multi-methods investigation.

Exploring the Unmet Needs of Teachers of Young Children with ADHD Symptoms: A Qualitative Study (2024)
Journal Article
Aldabbagh, R., Daley, D., Sayal, K., & Glazebrook, C. (2024). Exploring the Unmet Needs of Teachers of Young Children with ADHD Symptoms: A Qualitative Study. Children, 11(9), Article 1053. https://doi.org/10.3390/children11091053

Background/Objectives: Children with Attention and Hyperactivity Deficit Disorder (ADHD) and those at risk of ADHD typically exhibit challenging behaviours that may disrupt the classroom environment and be frustrating for teachers. This study aimed t... Read More about Exploring the Unmet Needs of Teachers of Young Children with ADHD Symptoms: A Qualitative Study.

Snakes and Ladders: The experience of being referred to and seen by Child and Adolescent Mental Health Services (2024)
Journal Article
Newman, K. L., Sayal, K., Ewart, C., Lang, A., Bhardwaj, A., Dubicka, B., Marshall, T., & Thomson, L. (2024). Snakes and Ladders: The experience of being referred to and seen by Child and Adolescent Mental Health Services. SSM - Mental Health, 6, Article 100343. https://doi.org/10.1016/j.ssmmh.2024.100343

Background: Referral processes in Child and Adolescent Mental Health Services (CAMHS) have been reported as stressful and inadequate by young people and parents/carers, who struggle during waiting periods for the referral outcome decision. The Covid1... Read More about Snakes and Ladders: The experience of being referred to and seen by Child and Adolescent Mental Health Services.

Sex differences in attention‐deficit hyperactivity disorder diagnosis and clinical care: a national study of population healthcare records in Wales (2024)
Journal Article
Martin, J., Langley, K., Cooper, M., Rouquette, O. Y., John, A., Sayal, K., Ford, T., & Thapar, A. (2024). Sex differences in attention‐deficit hyperactivity disorder diagnosis and clinical care: a national study of population healthcare records in Wales. Journal of Child Psychology and Psychiatry, https://doi.org/10.1111/jcpp.13987

Background
Population-based studies have observed sex biases in the diagnosis and treatment of attention-deficit hyperactivity disorder (ADHD). Females are less likely to be diagnosed or prescribed ADHD medication. This study uses national healthcar... Read More about Sex differences in attention‐deficit hyperactivity disorder diagnosis and clinical care: a national study of population healthcare records in Wales.

The impacts associated with having ADHD: an umbrella review (2024)
Journal Article
French, B., Nalbant, G., Wright, H., Sayal, K., Daley, D., Groom, M. J., Cassidy, S., & Hall, C. L. (2024). The impacts associated with having ADHD: an umbrella review. Frontiers in Psychiatry, 15, Article 1343314. https://doi.org/10.3389/fpsyt.2024.1343314

Introduction: Attention Deficit Hyperactivity Disorder (ADHD) affects up to 5% of the population and is characterised by symptoms of impulsivity, hyperactivity and inattention. These symptoms are significantly impairing and carry additional risks for... Read More about The impacts associated with having ADHD: an umbrella review.

Systematic review and meta-analysis:relative age in attention-deficit/ hyperactivity disorder and autism spectrum disorder (2024)
Journal Article
Frisira, E., Holland, J., & Sayal, K. (2024). Systematic review and meta-analysis:relative age in attention-deficit/ hyperactivity disorder and autism spectrum disorder. European Child and Adolescent Psychiatry, https://doi.org/10.1007/s00787-024-02459-x

Youngest students in their class, with birthdates just before the school entry cut-off date, are overrepresented among children receiving an Attention-Deficit/Hyperactivity Disorder (ADHD) diagnosis or medication for this. This is known as the relati... Read More about Systematic review and meta-analysis:relative age in attention-deficit/ hyperactivity disorder and autism spectrum disorder.

Precision computerised cognitive behavioural therapy (cCBT) for adolescents with depression: a pilot and feasibility randomised controlled trial protocol for SPARX-UK (2024)
Journal Article
Khan, K., Hall, C. L., Babbage, C., Dodzo, S., Greenhalgh, C., Lucassen, M., Merry, S., Sayal, K., Sprange, K., Stasiak, K., Tench, C. R., Townsend, E., Stallard, P., & Hollis, C. (2024). Precision computerised cognitive behavioural therapy (cCBT) for adolescents with depression: a pilot and feasibility randomised controlled trial protocol for SPARX-UK. Pilot and Feasibility Studies, 10(1), Article 53. https://doi.org/10.1186/s40814-024-01475-7

Background : A serious game called SPARX (Smart, Positive, Active, Realistic, X-factor thoughts), originally developed in New Zealand and incorporating cognitive behavioural therapy (CBT) principles, has been shown to help reduce symptoms of depressi... Read More about Precision computerised cognitive behavioural therapy (cCBT) for adolescents with depression: a pilot and feasibility randomised controlled trial protocol for SPARX-UK.

The impact of the COVID-19 pandemic on children and adolescent mental health inpatient service use in England: An interrupted time-series analysis of national patient records (2024)
Journal Article
Tsiachristas, A., Holland, J., Guo, B., Chitsabesan, P., Sayal, K., & Pari, A. A. A. (2024). The impact of the COVID-19 pandemic on children and adolescent mental health inpatient service use in England: An interrupted time-series analysis of national patient records. BJPsych Open, 10(2), Article e69. https://doi.org/10.1192/bjo.2024.9

Background:

During the initial phases of the COVID 19 pandemic children and young people (CYP) faced significant restrictions. The virus and mitigation approaches significantly impacted how health services could function, and be safely delivered.... Read More about The impact of the COVID-19 pandemic on children and adolescent mental health inpatient service use in England: An interrupted time-series analysis of national patient records.

Experiences and impact of psychiatric inpatient admissions far away from home: a qualitative study with young people, parents/carers and healthcare professionals (2024)
Journal Article
Roe, J., Holland, J., Burn, A.-M., Hopkin, E., Wild, L., Fisher, M., Nazir, S., Ford, T., Dubicka, B., James, A., Tuomainen, H., Fung, N., Horton, K., Wagner, A. P., Morriss, R., & Sayal, K. (2024). Experiences and impact of psychiatric inpatient admissions far away from home: a qualitative study with young people, parents/carers and healthcare professionals. BMJ Mental Health, 27(1), Article e300991. https://doi.org/10.1136/bmjment-2024-300991

Background: There are significant clinical, policy and societal concerns about the impact on young people (YP), from admission to psychiatric wards far from home. However, research evidence is scarce.
Aims: To investigate the impact of at-distance... Read More about Experiences and impact of psychiatric inpatient admissions far away from home: a qualitative study with young people, parents/carers and healthcare professionals.

Waiting-list interventions for children and young people using child and adolescent mental health services: a systematic review (2024)
Journal Article
Valentine, A. Z., Hall, S. S., Sayal, K., & Hall, C. L. (2024). Waiting-list interventions for children and young people using child and adolescent mental health services: a systematic review. BMJ Mental Health, 27(1), 1-6. https://doi.org/10.1136/bmjment-2023-300844

Question Children and young people experience delays in assessment and/or treatment within mental health services. The objective of this systematic review, funded by the Emerging Minds Network, was to explore the current evidence base for mental heal... Read More about Waiting-list interventions for children and young people using child and adolescent mental health services: a systematic review.

'Far Away from Home': adolescent inpatient admissions far from home, out of area or to adult wards: a national surveillance study. (2023)
Journal Article
Holland, J., Roe, J., Guo, B., Dasilva-Ellimah, M., Burn, A.-M., Dubicka, B., Ford, T., Wagner, A. P., Nazir, S., James, A., Morriss, R., & Sayal, K. (2023). 'Far Away from Home': adolescent inpatient admissions far from home, out of area or to adult wards: a national surveillance study. BMJ Mental Health, 26(1), Article e300843. https://doi.org/10.1136/bmjment-2023-300843

Background The increasing prevalence and acuity of mental disorders among children and adolescents have placed pressure on services, including inpatient care, and resulted in young people being admitted at-distance or to adult wards. Little empirical... Read More about 'Far Away from Home': adolescent inpatient admissions far from home, out of area or to adult wards: a national surveillance study..

Use of healthcare services before diagnosis of attention-deficit/hyperactivity disorder: a population-based matched case-control study (2023)
Journal Article
Prasad, V., Rezel-Potts, E., White, P., Downs, J., Boddy, N., Sayal, K., & Sonuga-Barke, E. (2024). Use of healthcare services before diagnosis of attention-deficit/hyperactivity disorder: a population-based matched case-control study. Archives of Disease in Childhood, 109, Article 46-51. https://doi.org/10.1136/archdischild-2023-325637

Objective: To compare use of healthcare services and reasons for attendance by children and young people (CYP) with attention-deficit/hyperactivity disorder (ADHD) versus non-ADHD controls. Design: Population-based matched case-control study. Setting... Read More about Use of healthcare services before diagnosis of attention-deficit/hyperactivity disorder: a population-based matched case-control study.

Association between relative age at school and persistence of ADHD in prospective studies: an individual participant data meta-analysis (2023)
Journal Article
Gosling, C. J., & Sayal, K. (2023). Association between relative age at school and persistence of ADHD in prospective studies: an individual participant data meta-analysis. Lancet Psychiatry, 10(12), 922-933. https://doi.org/10.1016/S2215-0366%2823%2900272-9

Background: The youngest children in a school class are more likely than the oldest to be diagnosed with ADHD, but this relative age effect is less frequent in older than in younger school-grade children. However, no study has explored the associatio... Read More about Association between relative age at school and persistence of ADHD in prospective studies: an individual participant data meta-analysis.