Clinical and cost effectiveness of a standardised diagnostic assessment for children and adolescents with emotional difficulties: the STADIA multi-centre RCT
(2025)
Journal Article
Sayal, K., Wyatt, L., Thomson, L., Holt, G., Ewart, C., Bhardwaj, A., Dubicka, B., Marshall, T., Gledhill, J., Lang, A., Sprange, K., Partlett, C., Newman, K., Moody, S., Bould, H., Upton, C., Keane, M., Cox, E., James, M., & Montgomery, A. (in press). Clinical and cost effectiveness of a standardised diagnostic assessment for children and adolescents with emotional difficulties: the STADIA multi-centre RCT. Health Technology Assessment,
All Outputs (105)
Post-intervention neuroimaging effects of psychosocial interventions aimed at promoting resilience in children and adolescents under psychological stress: A systematic review (2025)
Journal Article
Jawahar, N., Jawahar, B., Sayal, K., & Auer, D. P. (2025). Post-intervention neuroimaging effects of psychosocial interventions aimed at promoting resilience in children and adolescents under psychological stress: A systematic review. Neuroscience and Biobehavioral Reviews, 174, Article 106196. https://doi.org/10.1016/j.neubiorev.2025.106196Childhood and adolescence are neurodevelopmentally critical periods, during which psychological adversity can increase the risk of subsequent mental health difficulties. However, the increased neuroplasticity during this window also confers potential... Read More about Post-intervention neuroimaging effects of psychosocial interventions aimed at promoting resilience in children and adolescents under psychological stress: A systematic review.
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. (2025). 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, https://doi.org/10.1007/s00787-025-02678-wBackground: 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.
Impact of young people’s admissions to adult mental health wards in England: a national qualitative study (2025)
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. (2025). Impact of young people’s admissions to adult mental health wards in England: a national qualitative study. BJPsych Open, 11(2), Article e53. https://doi.org/10.1192/bjo.2024.850Background
Decision-making capacity (DMC) is key to capacity-based mental health laws. In 2017, Norway introduced a lack of DMC as an additional criterion for involuntary care and treatment to strengthen patient autonomy and reduce involuntary care.... Read More about Impact of young people’s admissions to adult mental health wards in England: a national qualitative study.
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/s13063-025-08772-3Background: 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.2025.106064Previous 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.
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. (2025). 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, 66(6), 805-820. https://doi.org/10.1111/jcpp.14090Background
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/jcv2.12301Background
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.
The Impact of Child and Adolescent Inpatient Psychiatric Admissions Out-of-Area or to Adult Wards: A Systematic Review (2024)
Journal Article
Holland, J., Lewis, L., Wreford, A., Singh-Lalli, H., Roe, J., & Sayal, K. (2024). The Impact of Child and Adolescent Inpatient Psychiatric Admissions Out-of-Area or to Adult Wards: A Systematic Review. British Journal of Hospital Medicine, 85(12), 1-20. https://doi.org/10.12968/hmed.2024.0466Aims/Background
Child and adolescent psychiatric inpatient admissions out-of-area or to adult wards are frequently discussed in the national media. No previous systematic reviews have investigated the impact of such admissions.
Methods
Sy... Read More about The Impact of Child and Adolescent Inpatient Psychiatric Admissions Out-of-Area or to Adult Wards: A Systematic Review.
Quantitative and Qualitative Outcomes of Non-Violent Resistance (NVR) Interventions for Children and Adolescents with Emotional and Behavioural Difficulties and their Caregivers – A Systematic Review (2024)
Journal Article
Awoyemi, B., May, L., David, R., Majumder, P., & Sayal, K. (in press). Quantitative and Qualitative Outcomes of Non-Violent Resistance (NVR) Interventions for Children and Adolescents with Emotional and Behavioural Difficulties and their Caregivers – A Systematic Review. Adoption and Fostering,
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.2024.783Background
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/children11091053Background/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.2024.100343Background: 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.13987Background
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.2024.1343314Introduction: 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. (2025). Systematic review and meta-analysis:relative age in attention-deficit/ hyperactivity disorder and autism spectrum disorder. European Child and Adolescent Psychiatry, 34, 381-401. https://doi.org/10.1007/s00787-024-02459-xYoungest 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/s40814-024-01475-7Background : 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.2024.9Background:
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.
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-2023-300844Question 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.
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-2024-300991Background: 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.