Objective: While psychological trauma in people with epilepsy (PWE) is a major issue, there is limited research on the interactions between such trauma and epilepsy. Therefore, our primary aim is to describe types and timing of potentially psychologically traumatic experiences (PPTE) in relation to epilepsy onset. Our secondary objective is to evaluate the impact of the timing of the PPTE on patients' psychiatric and neurological profiles.Methods: We conducted an observational study involving 182 PWE, excluding patients with comorbid functional/dissociative seizures. All participants underwent a comprehensive psychiatric evaluation, including biographical, neurological, psychiatric, and traumatic data collection through a semi-structured clinical interview and standardized scales. We compared the neurological and psychiatric characteristics of three groups of patients: those without PPTE, those with PPTE occurring before the onset of epilepsy, and those with PPTE occurring after the onset of their epilepsy.Results: Sixty-one patients (33.5%) reported having experienced PPTE before the onset of epilepsy, 65 patients (35.7%) reported having experienced PPTE after the onset of their epilepsy, and 56 patients (30.8%) had no history of PPTE neither before nor after the onset of epilepsy. The 'before' group had a significantly higher prevalence of epilepsy localized in the temporal lobe (p = .043). The 'after' group showed significantly more general psychiatric symptoms (p = .026), as well as more postictal mood and anxiety symptoms (p = .014). Additionally, the 'before' group reported a higher number of past traumatic experiences, with childhood traumatic experiences being more prevalent. According to our multinomial logistic regression model, higher temporal localization (p = .028) and fewer febrile seizures (p = .030) were significant predictors for the 'before' group.Significance: This study highlights the potential impact of the timing of PPTE on patients' psychiatric and neurological profiles. It underscores the importance of systematically assessing psychiatric and posttraumatic comorbidities in PWE. The role of trauma in temporal epilepsy requires further investigation.

Background: Black, Indigenous, People of Color (BIPOC) first responders in Canada report experiencing racism and an increased risk of trauma-related mental health symptoms.Objective: Using a BIPOC first responder sample in Canada, the present study examined subgroups of BIPOC first responders based on the frequency of different types of racist events, and their relations with mental health symptoms (posttraumatic stress disorder [PTSD] symptom clusters of intrusion, avoidance, negative alterations in cognitions and mood [NACM], and alterations in arousal and reactivity [AAR]; depression severity; anxiety severity).Method: The sample included 196 BIPOC first responders who reported more than one traumatic experience (Mage = 35.30; 71.4% men).Results: Latent profile analyses indicated a best-fitting 3-profile solution: Low (Profile 1), Moderate (Profile 2), and High (Profile 3) Frequency of Racist Events. Multinomial logistic regression indicated that BIPOC first responders reporting more frequent racist events endorsed greater depression severity, anxiety severity, and PTSD's NACM symptom severity.Conclusions: Findings improve our understanding of subgroups of BIPOC first responders based on the frequency and types of racist events they experience. Results highlight the need to incorporate assessments of racism-related experiences into therapeutic work, and to target depression, anxiety, and NACM symptoms among those who encounter more racist events.

Rates of mental health disorders are rising among adolescents and young adults. Therefore, scalable methods for preventing psychopathology in these age groups are needed. As repetitive negative thinking (RNT) is a risk factor for depression and anxiety disorders, targeting RNT via smartphone app promises to be an effective, scalable strategy. The current three-arm, parallel group, randomized controlled trial tested whether a self-help app designed to reduce RNT decreased psychopathological symptoms and RNT in adolescents and young adults at risk for mental disorders.

A sample of 16-22-year-olds with elevated levels of RNT (N = 365) were randomly allocated to either use a one of two self-help apps designed to reduce RNT for 6 weeks or to a waitlist. The full RNT-focused intervention app encompassed a variety of RNT-reducing strategies, whereas the concreteness training app focused on one of these strategies, namely, concrete thinking.

The apps did not decrease depressive symptoms, anxiety symptoms and RNT relative to the waitlist. However, exploratory analyses using a minimum dose criterion showed that participants who used the full-RNT-focused intervention app more often, reported greater baseline to follow-up decreases in depressive symptoms compared to waitlist.

Include decreased power due to slightly more dropout than expected and limited generalizability due to the mostly female and highly educated sample.

RNT-focused prevention via a self-help app did not decrease depression and anxiety, presumably due to too little engagement with the app content provided.

Discharge from psychiatric treatment has been established as an emotionally intense and vulnerable time for patients; however, to date no studies have investigated symptoms directly preceding discharge and the impact on post-discharge outcomes. Our primary aim was to assess the prevalence of elevations in depression and anxiety symptoms prior to discharge from a partial hospitalization program (PHP). Our secondary aim was to assess whether these pre-discharge elevations predict post-discharge outcomes. We analyzed daily depression and anxiety symptom severity from 4211 patients attending a PHP. Two subsamples (n = 113 and n = 70) completed post-discharge outcome measures of symptom severity, well-being, and/or functional impairment at two-weeks, one-month, and three-months post-discharge. Approximately two-thirds of patients demonstrated a significant increase in depression (p < .001) and anxiety (p < .001) symptom severity prior to discharge. These pre-discharge elevations did not significantly predict post-discharge measures when controlling for symptom severity at discharge. Our results suggest patients experience an increase in symptom severity preceding discharge, even after improvement; however, these elevations do not provide additional prognostic information. Clinicians may consider sharing these results with patients to normalize the experience of symptom elevation prior to discharge and highlight that it is not a prognostic indicator.

The identification of low breastfeeding self-efficacy allows for tailored interventions to increase the rate of exclusive breastfeeding among women in accordance with WHO recommendations. While breastfeeding self-efficacy can be measured using the widely accepted Breastfeeding Self-Efficacy Scale-Short Form (BSES-SF), the construct and predictive validity of a translated German version have not been sufficiently demonstrated. The present study aimed to assess the psychometric properties of an alternative German translation of the BSES-SF.

The BSES-SF was administered to mothers at three months (N = 143) and six months (N = 115) postpartum. In addition, exclusive breastfeeding duration and related constructs were assessed.

Excellent internal consistency (Cronbach's α = 0.91) was shown. A good model fit was achieved in the confirmatory factor analysis only when error covariances were considered (CFI = 0.95, SRMR = 0.057, RMSEA = 0.074), raising concerns about a unidimensional structure in the translated version. Construct and divergent validity were supported by significant correlations with self-esteem and social support, and negative correlations with depression, stress, and general anxiety. Importantly, predictive validity was confirmed. Furthermore, breastfeeding self-efficacy at three months postpartum was significantly correlated with exclusive breastfeeding duration at six months (r = 0.312).

This study ensures the construct validity of the German BSES-SF and confirms its predictive validity for the first time. The German translation enables midwives and healthcare professionals in German-speaking countries to identify mothers in need of breastfeeding support up to three months postpartum. Targeted interventions can be tailored based on the overall BSES-SF score or specific item responses, contributing to improved breastfeeding outcomes.

OCD symptoms are well documented in anorexia nervosa (AN) and to a lesser extent in bulimia nervosa (BN), yet remain virtually unstudied in binge-eating disorder (BED).

In this cross-sectional observational study, 5927 participants with lifetime eating disorders (EDs) (i.e., past or current) were categorized into five groups based on their diagnostic histories: AN only (n = 2330), BN only (n = 740), BED only (n = 665), AN and another ED diagnosis (AN Mixed) (n = 1293), and BN and BED (BN-BED) (n = 899). Obsessive-Compulsive Inventory-12 scores were compared across these groups and with OCD (n = 1040), anxiety-related disorders (ANX) (n = 423), and non-clinical community (NCC) (n = 1194) cohorts.

OCD symptoms were common among individuals with lifetime AN, BN, BED, and multiple EDs, with obsessing being the most prevalent dimension, followed by ordering, checking, and washing. The obsessing scale, which captures general intrusive thoughts rather than traditional OCD obsessions, was notably high. ED groups generally scored higher on the OCI-12 subscales than the ANX and NCC cohorts but lower than the OCD cohort, although ordering severity was higher in some ED groups. Positive correlations were found between ED symptoms and OCI-12 subscales, and gender-diverse individuals and men had greater OCD symptoms than women.

Clinicians should be vigilant for OCD symptoms in individuals with AN, BN, and BED. These findings call for research on the mechanisms linking EDs and OCD symptoms and support integrated treatment approaches for both conditions.

People with chronic illnesses are vulnerable to stress and psychopathology during population-level disasters, as a subset of individuals with disabilities. We aimed to examine the relationships between chronic illness, cumulative and specific stressors, and probable depression, probable anxiety, and post-traumatic stress in an under-resourced urban population in New York City during the COVID-19 pandemic. Using cross-sectional survey data collected in April 2020, we utilized bivariate chi-square analyses and multivariable logistic regression models to estimate differences in and adjusted odds of stressor endorsement and diagnostic prevalence between people with and without chronic illness. We also assessed effect modification of the relationship between stressor exposure and psychopathology by chronic illness status. Compared to people without chronic illness, those who reported having a chronic illness experienced increased odds of probable depression, probable anxiety, and post-traumatic stress. They were also more likely to report high cumulative COVID-19-related stress exposure, death of someone close to them due to coronavirus or COVID-19, family problems, feeling alone, supply shortages, and financial problems. Chronic illness was found to be an effect modifier in the relationship between the death of someone close due to coronavirus or COVID-19 and probable depression and between household job loss and probable anxiety.

Public safety personnel (PSP) are frequently exposed to psychologically traumatic events. The exposures potentiate posttraumatic stress injuries (PTSIs), including posttraumatic stress disorder (PTSD). The Royal Canadian Mounted Police (RCMP) Protocol was designed to mitigate PTSIs using ongoing monitoring and PSP-delivered Emotional Resilience Skills Training (ERST) based on the Unified Protocol for the Transdiagnostic Treatment of Emotional Disorders. The current study pilot-tested ERST effectiveness among diverse PSP.

A 16-month longitudinal design engaged serving PSP (n = 119; 34 % female; firefighters, municipal police, paramedics, public safety communicators) who completed PSP-delivered ERST. Participants were assessed for symptoms of PTSIs, including but not limited to PTSD, at pre- and post-training, and 1-year follow-up using self-report measures and clinical interviews.

There were reductions in self-report and clinical diagnostic interview positive screens for PTSD and other PTSI from pre- to post-training (ps < 0.05), with mental health sustained or improved at 1-year follow-up. Improvements were observed among firefighters (Cohen's d = 0.40 to 0.71), police (Cohen's d = 0.28 to 0.38), paramedics (Cohen's d = 0.20 to 0.56), and communicators (Cohen's d = 0.05 to 0.14).

Ongoing monitoring and PSP-delivered ERST, can produce small to large mental health improvements among diverse PSP, or mitigate PSP mental health challenges, with variations influenced by pre-training factors and organizational supports. ERST replication and extension research appears warranted.

Hypotheses Registration: aspredicted.org, #90136. Registered 7 March 2022 - Prospectively registered.

ClinicalTrials.gov, NCT05530642.

Differences in symptoms of depression and anxiety by race/ethnicity and socioeconomic status (SES) among a diverse cohort of young adults during the COVID-19 pandemic (Spring 2020-Fall 2021) have not been examined.

We analyzed four waves of biannual, panel data from n = 2629 emerging adults (16-25 years old) from the Texas Adolescent Tobacco and Marketing Surveillance study (TATAMS). We conducted a series of mixed effects ordinal logistic regression models to compare the independent and joint effects of race/ethnicity and SES on symptoms of (a) depression and (b) anxiety, adjusting for sex, cohort, and time.

Symptoms of depression (aOR range: 1.54 - 2.19; 95% CI: 1.02 - 3.08) and anxiety (aOR range: 1.64 - 2.19; 95% CI: 1.22 - 2.79) were elevated among low SES young adults, across all racial/ethnic groups. Across SES groups, symptoms of depression were lower among non-Hispanic Blacks compared to non-Hispanic Whites (aOR range: 0.33 - 0.41; 95% CI: 0.18 - 0.62) and Hispanics /Latinos (aOR range: 0.33 - 0.38; 95% CI: 0.20 - 0.57); similarly, symptoms of anxiety were lower among non-Hispanic Blacks compared to non-Hispanic Whites (aOR range: 0.44; 95% CI: 25 - 0.77) and Hispanics/Latinos (aOR range: 0.47 - 0.56; 95% CI: 0.29 - 0.83). No significant interaction (joint effect) was observed between SES and race/ethnicity during this period.

Low SES was persistently related to poor mental health. Lower odds of symptoms of anxiety and depression among non-Hispanic Black young adults may reflect the 'mental health paradox'. Overall, mental health policies should prioritize lower SES young adults regardless of race and ethnicity.

Manual pressure techniques are commonly employed as a therapeutic approach for individuals experiencing musculoskeletal pain. The painful nature of these techniques suggests that a central mechanism known as conditioned pain modulation (CPM) might play a role.

This study tested whether a painful manual pressure technique (MPT) reduces pain sensitivity partly by eliciting a CPM effect.

This crossover study examined 3 different conditioning stimuli: (1) a cold pressor test (CPT) with the contralateral hand submerged in a cold water bath, (2) painful MPT, and (3) sham-MPT on suboccipital muscles. We measured their effect on pain sensitivity using pressure pain thresholds at 3 locations: locally (suboccipital muscles), regionally (trapezius muscle), and remotely (tibialis anterior muscle).

In 63 healthy participants, no significant differences were found between the painful MPT and CPT on the pressure pain thresholds at all test locations: locally, -11 kPa (95% CI: 3 to -25); regionally, -15 kPa (95% CI: 10 to -39); and remotely, -24 kPa (95% CI: 55 to -7). Manual pressure technique compared to sham-MPT showed significant differences in the suboccipital muscles, -20.04 kPa (95% CI: -6.45 to -34.63) and the trapezius muscle, -38.24 (95% CI: -13.97 to -62.5) but no significant difference at the tibialis anterior muscle, -17.5 kPa (95% CI: 13.9 to -48.91).

Painful MPTs applied at the suboccipital muscles reduce pain sensitivity at all sites, similar to the CPT, indicating CPM activation. Central pain inhibition might contribute to the effect of painful MPT in healthy people.

Past research suggests that offline and online social capital are empirically linked to adolescent psychological adjustment. However, little is known regarding the implications of distinctive combinations of social capital for adolescent internalizing symptoms. The present study aimed to examine adolescent social capital patterns and their associations with internalizing symptoms by using latent profile analysis. A cross-sectional web-based survey was conducted among 1595 Chinese adolescents (mean age = 14.30 years, 50.7% male). All adolescents completed self-report questionnaires on their perceived offline and online social capital, depressive symptoms and anxiety symptoms. Latent profile analysis revealed four profiles of social capital: (1) Low Social Capital, (2) Moderate Social Capital, (3) High Social Capital, and (4) Only High Offline Social Capital. Further, analysis of covariance demonstrated that the Only High Offline Social Capital profile had significantly fewer internalizing symptoms than other three profiles. No statistical differences of internalizing symptoms were found between the other three profiles, except that the Moderate Social Capital profile showed fewer anxiety symptoms than the Low Social Capital profile. These findings suggest that more social capital does not equal to better mental health status. The social capital profiles and their associations with adolescent internalizing symptoms may provide practitioners with meaningful implications regarding the role of offline and online social capital in adolescent psychological adjustment.

Many patients experience a reduced quality of life for months after heart surgery. Besides medical factors, psychological factors such as preoperative expectations influence the recovery process. The ValvEx study investigated whether an expectation-focused preoperative intervention before heart valve surgery would (i) improve the postoperative recovery process by reducing illness-related disability and ii) impact secondary outcomes such as increased positive realistic expectations, and reduce preoperative anxiety.

N = 89 patients undergoing heart valve surgery were randomized into 1 of 2 groups after a baseline assessment: Standard medical care (SOC) vs SOC plus psychological expectation-focused intervention (EXPECT) on the day of hospital admission. Further assessments were conducted on the evening before surgery, 4 to 6 days and 3 months after surgery. The primary outcome was illness-related disability. Constrained longitudinal data analyses were conducted to analyze the intervention effects, while the need for information was considered as a potential moderator.

No general effects were observed for the EXPECT intervention over time regarding the primary outcome illness-related disability (Pain Disability Index, PDI) and the secondary outcomes (P ≥ .167). The intervention effects were moderated by the individual need for information: Patients with a higher need for information who received the EXPECT intervention were less anxious on the evening before surgery (P = .020, d = 0.314) and less restricted in their quality of life 4 to 6 days after surgery compared to patients who received SOC (P = .005, d = 0.464).

The ValvEx study is the first multicentre study investigating the expectation-optimizing preoperative intervention in heart valve patients. The implementation of the EXPECT intervention seemed to optimize outcomes after heart valve surgery for certain patients, such as patients with a high need for information. It is possible that there were no direct effects of the EXPECT intervention because the intervention dose was too low. These preliminary findings need to be corroborated by larger multicenter trials. Trial registration The study was preregistered at ClinicalTrials (identifier: NCT04502121, https://clinicaltrials.gov/study/NCT04502121).

Psychedelic-assisted therapy is increasingly applied within mental health treatment.

This study focused on factors moderating changes in the acute and long-term effects of an individual psilocybin-assisted program on depression, anxiety, PTSD and personality structures by including demographic factors, subjective experience and degree of mystical type experiences during the dosing, as well as emotional breakthrough and personal growth after the program.

At baseline, 1 week and 3 months after the psilocybin program participants completed the Generalized Anxiety Disorder Assessment (GAD-7), Patient Health Questionnaire (PHQ-9), PTSD Checklist for DSM-5 (PCL-5) and NEO Five-Factor Inventory-3 (NEO-FFI-3). In addition, after the dosing the Mystical Experiences Questionnaire (MEQ-30), Posttraumatic Growth Inventory (PTGI) and Emotional Breakthrough Inventory (EBI) were administered. Moderation effects were established using linear mixed-model analysis.

A single high dose of psilocybin in combination with therapy was found to lower symptoms of anxiety, depression, PTSD and neuroticism over a period of 3-months. Scores on openness and conscientiousness increased after the treatment only. Participants reported mystical type experiences, emotional breakthrough and personal growth. These subjective experiences together with demographic factors were moderating the observed positive changes.

Findings indicate that individual psilocybin-assisted therapy has the potential for beneficial effects on mood and personality characteristics. Moreover, the study highlights the importance of subjective experiences and demographic factors in moderating this effect. This study adds to the ongoing research on psilocybin-assisted therapy by investigating contributing factors for optimizing this evolving type of therapy.

Chronic anxiety is commonly associated with poor sleep patterns, which may contribute to an increased risk of cardiovascular disease (CVD) through mechanisms like oxidative stress, vascular dysfunction, and poor blood pressure control. As sleep disturbances, particularly poor sleep quality and/or regularity, have been independently linked to CVD development, this study explored whether sleep quality/regularity in young adults with chronic anxiety is associated with early indicators of CVD risk, specifically oxidative stress, vascular function, and blood pressure control. Twenty-eight young (24 ± 4 yr) participants with a prior clinical diagnosis of generalized anxiety disorder (GAD) or elevated GAD symptoms (GAD-7 > 10) had their sleep quality [total sleep time (TST) and sleep efficiency (SE)] and regularity [via TST/SE standard deviations (SD)] assessed for seven consecutive days. Various precursors to CVD development such as oxidative stress, brachial artery function, microvascular function, and blood pressure control [exercise pressor responses and cardiovagal baroreflex sensitivity (cBRS)] were also evaluated. Pearson's correlations were used to determine potential relationships between sleep quality/regularity and CVD precursors. Both sleep irregularity variables [SE-SD (r = 0.61; P < 0.01) and TST-SD (r = 0.39; P = 0.04)], but neither of the sleep quality variables, were positively correlated with oxidative stress. TST-SD alone was significantly associated with lower brachial artery function (r = -0.44; P = 0.02) and cBRS (r = 0.43; P = 0.02), with TST-SD median splits further highlighting these differences. The study found that irregular TST in individuals with chronic anxiety was significantly associated with higher oxidative stress, lower brachial artery function, and blunted blood pressure control (lower cBRS), key precursors of CVD.NEW & NOTEWORTHY This study examined the relationship between sleep irregularity and early cardiovascular disease (CVD) precursors in young adults with chronic anxiety. Key findings revealed that irregular total sleep time, rather than overall sleep quality, was significantly associated with greater oxidative stress, lower brachial artery function, and diminished blood pressure control. These results suggest that sleep irregularity in individuals with chronic anxiety may play a critical role in the development of CVD in this population.

The Patient Health Questionnaire (PHQ-9) and the Generalized Anxiety Disorder scale (GAD-7) are widely used symptom-based instruments for screening depression and anxiety. However, their validation in Chinese children and adolescents remains insufficient. We aim to investigate the performance and optimal cut-offs of PHQ-9 and GAD-7 in Chinese children and adolescents in screening clinical depression and anxiety, and to discuss the influencing factors of the cut-offs.

The study subjects were chosen from 3 sites of the Mental Health Survey for Children and Adolescents in Yunnan (MHSCAY), a total of 2,237 participants who had been screened positive by self-administered questionnaire and further diagnosed by using the gold standard were included in the final analysis. The Receiver Operating Characteristic (ROC) curves were used to determine the discriminative ability of the two instruments, measured by using the area under curve (AUC). The optimal cut-offs of the two instruments were determined by the maximum Youden's index. A series of stratified analyses were performed to discover the best cut-offs for children and adolescents of different characteristics. Logistic regression models were adopted to evaluate the influence of self-harm (SH) on identified optimal cut-offs.

We found the performance was generally poor for both the PHQ-9 and GAD-7 in screening clinical depression and anxiety in our study sample, with the AUCs ranged only between 0.622-0.712. When using the two instruments for diagnosis purpose, 11 was the optimal cut-off for both clinical depression and anxiety (AUC for PHQ-9: 0.664, AUC for GAD-7: 0.669). For study subjects of different age, gender, race, and left-behind status, discordant cut-offs were identified. SH also showed conspicuous influence on the optimal cut-offs of PHQ-9 and GAD-7, and the combination of SH information can increase screening accuracy of PHQ-9 in some subgroups.

Both the PHQ-9 and GAD-7 showed poor performance in screening clinical depression and anxiety in our study sample. This crucial finding suggests that, despite the wide use of the two scales, they might be fundamentally inadequate for depression and anxiety screening in Chinese children and adolescents. Other screening tools of higher accuracy should be developed and used in this age group.

Air pollutants and meteorological conditions have shown significant adverse effects on human health; however, their impact on mental health remains inconclusive and underexplored. Thus, this study aimed to investigate the association between long-term exposure to air pollutants (PM2.5 and PM10), meteorological factors, and depression and anxiety.

We selected 10,076 participants aged 15-49 from the Nepal Demographic and Health Survey (NDHS) 2022, who had lived in their current domiciles for over five years. The Patient Health Questionnaire-9 (PHQ-9) and the Generalized Anxiety Disorder (GAD-7) scale were used to quantify the presence of depression and anxiety. The mean levels of air pollutants (PM2.5 and PM10), temperature, and relative humidity between August 2021 and July 2022 were obtained from the national air quality monitoring center and the meteorological department. Adjusted linear and polynomial logistic regression models were used to estimate the risk of depression and anxiety.

The prevalence of depression and anxiety among participants was 3.8% and 16.9%, respectively. Increased PM2.5 and PM10 concentrations were significantly associated with increased PHQ-9 (PM2.5: β, 0.015; PM10: β, 0.011) and GAD-7 (PM2.5: β, 0.024; PM10: β, 0.011) scores. Exposure to higher PM2.5 and PM10 concentrations increased the risk of depression {OR, 95% CI (PM2.5: 1.05, 1.03-1.08); (PM10: 1.04, 1.01-1.05)} and anxiety {OR, 95% CI (PM2.5: 1.06, 1.04-1.10); (PM10: 1.03, 1.01-1.04)}, whereas higher temperatures and higher humidity showed a protective effect (p < 0.05).

This study demonstrates the substantial impact of air pollutants and meteorological factors on mental health status. Findings suggest that exposure to air pollutants may serve as an independent risk factor for depression and anxiety. Therefore, further robust investigations including large epidemiological cohorts and longitudinal observational studies are needed to elucidate these associations.

Not applicable.

Simpler and more feasible light therapy protocols, and objective indicators for assessing its effectiveness is lacking. We aimed to evaluate the efficacy of light therapy on subthreshold depression (SD) among college students and explore facial expressions as an objective biomarker across different treatment groups.

From September 13, 2021, to January 4, 2022, college students with SD were recruited from a university in Hubei Province, randomly assigned to Bright Light Therapy (BLT) group (10,000 lx), Dim Light Therapy (DLT) group (200 lx), or Waiting List Control (WLC) group (no intervention). Self-reported questionnaire and facial expressions were assessed for all participants before and after intervention. Repeated measures ANOVA and logistic regression were conducted to compare baseline and post-intervention differences among three groups.

135 participants were enrolled and 121 participants completed the study. Depression symptom and sleep quality scores significantly decreased in both BLT and DLT groups (P < 0.001), while no significant changes were observed in WLC group. BLT (OR, 4.50; 95 % CI, 1.11-18.27; P = 0.035) and DLT group (OR, 4.17; 95 % CI, 1.04-16.79; P = 0.045) had higher efficacy rates than WLC group. For facial expressions, DLT group showed significant increases in two happy-related facial action units (AU) including AU14 values (positive, negative and neutral stimuli) and AU26 values (neutral and negative stimuli). BLT group showed a significant decrease in fear-related AU20 values under negative stimuli (P < 0.001).

Light therapy improves depressive symptoms and sleep quality in individuals with SD, and facial expressions can serve as an objective biomarker to support its effectiveness.

Sexual orientation (SO) microaggressions contribute to mental health issues among sexual minorities. Microaffirmations may mitigate these effects, with internalized heterosexism and SO concealment proposed as mediators. A community sample of 307 Thai sexual minorities completed measures assessing SO microaggressions, microaffirmations, internalized heterosexism, SO concealment, and mental health concerns. Serial mediation analysis using Hayes' PROCESS macro model 6 tested indirect effects through proposed mediators. Conditional process analysis using PROCESS model 85 examined the moderating role of microaffirmations. These models tested hypothesized moderated serial mediation relationships among study variables. SO microaggressions had a total effect on mental health concerns, directly and indirectly through increased SO concealment. The internalized heterosexism → SO concealment sequence mediated this relationship. Microaffirmations moderated the direct microaggressions-mental health link, reducing this association at higher levels of microaffirmations. The full model accounted for 31.6% of the variance (R2 = 0.316) in mental health concerns. The Johnson-Neyman technique identified 0.613 as the microaffirmations value above which the effect of SO microaggressions on mental health was no longer significant. Findings elucidate mechanisms linking SO microaggressions to mental health issues and microaffirmations' protective role among Thai sexual minorities. These results could inform efforts to mitigate minority stress impacts.

Adolescents with depression are at heightened risk of suicide, with a distinct sex difference in suicidal behaviour observed. This study explores the sex-specific factors influencing suicide attempts among Chinese adolescents with depression.

Data were collected from 2343 depressed adolescents across 14 hospitals in 9 provinces through self-report questionnaires. The survey was conducted between December 2020 and December 2023. Thirty-six potential risk factors were selected from validated measures of psychological, sociodemographic, and social stress domains. The dataset was split by sex, and SMOTE was applied to address class imbalance. Logistic regression, elastic net regression, random forest, XGBoost, and neural networks were used to model the data, evaluated by accuracy, precision, recall, and F1 score. The optimal model was employed for SHapley Additive exPlanations (SHAP) analysis to identify key factors influencing suicide attempts.

The Random Forest model exhibited the best performance for both sexes (AUC: females 0.720, males 0.736). Non-suicidal self-injury and depression were significant predictors for both sexes. Among females, factors like difficulty identifying emotions and physical abuse had a stronger impact, while resilience and hopelessness were more predictive for males.

The study highlights sex differences in suicide attempt predictors, emphasizing the need for sex-specific prevention strategies.

To examine differences in post-injury needs in traumatic brain injury (TBI) care partners with and without a pre-injury psychiatric history (PH+ vs. PH-).

A multi-site, prospective, observational cohort study.

Community.

258 care partners for persons with TBI meeting these criteria: ≥18 years old; non-paid caregiver; TBI care recipient criteria: ≥ 16 years old at time of injury, TBI requiring inpatient rehabilitation; acute hospitalization/admission at TBIMS-approved inpatient rehabilitation site.

Not applicable, Main Outcome Measures: Family Needs Questionnaire-Revised (FNQ-R) assessed proportion of emotional (ES), instrumental (IS), professional (PS), and community (CS) support needs met at 6-months post-injury.

Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder-7 (GAD-7) assessed care partner depression and anxiety at 6, 12, and 24-months post-injury.

At 6-months post-injury, care partners reported more met needs for community support relative to instrumental support needs (Estimates; 95% CI: 7.30; 3.91-10.69, p<.001). PH+ care partners did not differ from PH- care partners in the percentage of met needs across any need category. Number of psychiatric diagnoses (0 vs. 1 vs. 2 vs. 3+) was not associated with differences in met needs. PH+ care partners endorsed more depression and anxiety symptoms than PH- care partners from 6 to 24-months post-injury (Estimates; 95% CI: depression: 3.78; 2.55-5.00 p<.001; anxiety: 2.91; 1.58-4.24, p<.001).

PH+ TBI care partners do not appear have differing needs than PH- care partners at 6 months post-injury, but do experience persistent emotional distress. Evaluating care partners' psychiatric history is warranted to identify caregivers vulnerable to developing post-TBI emotional distress.

Dyadic coping (DC) considers the perception of both the individual and their partner's coping behavior and influences various health outcomes. Given the paucity of research investigating the course of DC after a cancer diagnosis, we explored longitudinal data to find statistically distinct trajectories of DC and to characterize and predict those based on medical, psychological and sociodemographic characteristics.

In this prospective, multicenter study, we assessed patients with primary solid tumors at four measurement points using validated self-report questionnaires: first within 8 weeks of diagnosis, then at 6-month intervals. We measured DC using the Dyadic Coping Inventory (DCI). Clusters were identified via a feature-based clustering approach, characterized with t-tests and chi-squared tests and predicted with multinomial logistic regression.

We analyzed data from 418 patients in a partnership (mean age 61 years, 55.3% men, 84.8% married). Most prevalent cancers were prostate cancer (25.6%), skin cancer (17.5%) and breast cancer (16.3%). One cluster (33.5%) reported a stable high trajectory of coping behavior, indicating good coping behavior. It had the following characteristics: male (62.9%), regularly employed (57.9%), prostate cancer (34.3%) and childless (27.1%). The remaining sample contained a cluster with increasing coping behavior (34.7%) and another with decreasing coping behavior (31.8%). Lack of regular employment, having children and generalized anxiety are significantly associated with worsening coping behavior. This study is one of the first to examine DC trajectories in a large sample of cancer patients in the early phase after diagnosis. It is essential to understand markers such as psychological stress or family and work-related issues to optimize clinical and psycho-oncological outcomes and facilitate the support or maintenance of couple-related disease management in the long term.

This study aimed to develop and validate an instrument to assess dentists' adherence to infection control protocols and explore psychological factors related to infectious diseases in dental practice.

The instrument was developed through phases including context validity, face and semantic analysis, exploratory factor analysis (EFA), and confirmatory factor analysis (CFA). Internal consistency was evaluated using McDonald's Omega coefficient (ω) and Cronbach's Alpha (α).

A total of 405 individuals completed the instrument. EFA (n = 135) revealed a four-factor structure (Work Environmental Protection, Disinfection, Team Training, and Fear and Anxiety) with 23 items with factor loadings above 0.60. The Kaiser-Meyer-Olkin (KMO) value was 0.803, and Bartlett's test of sphericity was significant (χ2: 2501.136, df:253.000, p < 0.001). CFA (n = 270) confirmed an acceptable model fit: χ2/df: 1.75; Comparative Fit Index (CFI): 0.997; Tucker-Lewis Index (TLI): 0.996; Standardized Root Mean Square Residual (SRMR): 0.079; Root Mean Square Error of Approximation (RMSEA): 0.053, supporting the four-factor structure from the EFA. Reliability analysis demonstrated strong internal consistency across all factors (ω and α ≥ 0.70).

The developed instrument exhibited appropriate validity, reliability, and internal consistency, providing a suitable tool to evaluate infection control adherence and psychological aspects among dentists facing infectious diseases.

There is a high, unmet sleep need in young people with mental health difficulties. We took a whole-system approach to improving access to sleep support across a youth mental health system (14-25 years).

We used the Exploration, Preparation, Implementation and Sustainment (EPIS) framework to develop an implementation programme (The Better Sleep Programme) incorporating two levels of training: (i) therapeutic practitioners received training and supervision in CBT for insomnia (CBTi) adapted for young people with mental health difficulties, (ii) non-therapeutic practitioners received knowledge and skills workshops. Implementation and clinical outcome measures were collected.

Implementation outcomes of acceptability, adoption, appropriateness, accessibility and fidelity were considered for the programme and CBTi intervention within it. Clinical outcomes for the CBTi intervention covered sleep, wellbeing and personal goals and were evaluated using a pre-post comparison within-subject design.

High levels of attendance and uptake were seen for CBTi training (210 therapeutic practitioners from 18 services) and workshops (270 attendees from 29 services). Five of the six core service areas trained were routinely offering the CBTi intervention. Significant improvements were seen across all clinical outcome measures (n = 83, p ≤ 0.001 to p ≤ 0.05) with moderate to large effect sizes observed across measures of sleep (d = 0.61-1.35), mental health (d = 0.57-1.26) and personal goals (d = 1.77).

This centrally-funded, system-wide implementation programme shows significant promise as a means of improving sleep in young people with mental health difficulties. High uptake with encouraging clinical outcomes was seen across services. Further evaluation is required to establish sustainability and generalizability.

Pregnant women frequently experience psychological issues such as depression, anxiety, and excessive fear of childbirth. Non-pharmacological approaches for improving the mental health of pregnant women are increasingly needed in public health.

Mindfulness-based interventions are among the most promising approaches to improving mental health.

This study aimed to 1) develop a short online Japanese version of the mindfulness-based childbirth and parenting programme, and 2) investigate its effectiveness in improving mental health after intervention and birth.

A pre- and post-test study was conducted in Japan from February to October 2021 on a single group of 37 healthy pregnant women (16-34 gestational weeks). The four-week online mindfulness-based childbirth and parenting programme included psychoeducation based on mindfulness practices and the physiological processes of pregnancy and childbirth. Participants self-reported their evaluations of mindfulness, self-esteem, subjective happiness, sense of coherence, depression, stress, anxiety, and fear of childbirth before and after the programme (response rate: 97.4 %). The pre- and post-intervention responses were compared using a paired t-test.

The results showed a significant reduction in perceived stress and fear of childbirth and an increase in mindfulness, self-esteem, and subjective happiness. No significant effects were observed in this low-risk population with regard to perinatal depression, anxiety, or sense of coherence.

The newly developed condensed version of the mindfulness-based childbirth and parenting programme significantly improved maternal mental health. Further studies are required to clarify its effectiveness in larger and more diverse samples of pregnant women.

Mental health comorbidities are highly prevalent and problematic in epilepsy, making it important for neurologists to be equipped to manage their patients' mental health concerns. This article explores the paradigm shift toward integrated mental health care approaches, aiming to educate early-career neurologists on their role within epilepsy care. We focus on depression and anxiety, how they present in epilepsy, and the role of integrated mental health care in managing these comorbidities. Key areas include the neurologist's role in identifying mental health issues through patient discussions and screening tools, and the basics of neurologist-led management. This covers the selection and adjustment of antiseizure medications and the use of psychopharmacology. Additionally, we emphasize the importance of providing psychoeducation and promoting healthy lifestyle choices that support mental well-being. Finally, we discuss the neurologist's role in facilitating referrals to mental health specialists, including information about the role of psychological interventions and psychiatry. This article aims to provide foundational knowledge to encourage early-career neurologists to actively engage in integrated mental health care approaches with their patients. This care can be flexible in how it incorporates different modalities and is tailored to local resources. It does not have to be extensive but should be meaningful enough to identify mental health concerns and facilitate patient access to appropriate resources and care.

Depression is underdiagnosed in chronic limb-threatening ischemia (CLTI) patients, and its impact on outcomes is unclear. This study aims to evaluate a CLTI-specific questionnaire designed to detect depression and anxiety, as well as to quantify its impact on early outcomes.

A serial cross-sectional study was conducted over two four-month periods: Block I, which retrospectively examined depression prevalence based on medical records, and Block II, which prospectively assessed depression using a CLTI-specific questionnaire. Patients were followed for six months to assess early outcomes. Data on demographics, comorbidities, Wound, Ischemia, foot Infection (WIfI) grades, perioperative and six-month limb salvage, and survival were collected and analyzed.

We evaluated 101 CLTI patients (58 in Block I; 43 in Block II; median age 68 years [IQR 62-74]; 67 [66.3%] male). In Block I, 20.7% had a prior depression diagnosis; in Block II, 23.3% (p=0.76). The CLTI-specific questionnaire in Block II showed a median depression score of 22 (IQR 19-33), identifying 32.6% with moderate/severe depression and 11.9% more patients compared to chart review alone. Active smoking (Hazard Ratio [HR] 5.16, 95% Confidence Interval [CI] 1.9-14.1) and WIfI clinical stage 4 (HR 4.69, 95% CI 1.39-15.75) were significantly associated with depression. At six months, patients with depression had higher rates of major amputation (18.2% vs. 4.0%; p=0.02) and mortality (27.3% vs. 6.3%; p<0.01).

The overall prevalence of depression in CLTI patients is 32.6%. Our novel CLTI-specific questionnaire detects 12% more cases of moderate/severe depression compared to chart review alone. Depression was linked to higher six-month mortality, though confounders like smoking and WIfI stage 4 may contribute. Identifying and treating depression in high-risk CLTI patients could improve outcomes.

This cross-sectional study investigated mental health conditions, physical functioning, and health-related quality of life (HRQOL) in adults with short-statured skeletal dysplasia conditions across three centres; in New York, Newcastle-upon-Tyne and Norway.

Questionnaires were sent to patients registered at the centres or distributed to adults attending clinics. The questionnaires included demographics, medical history, depression (PHQ-8), anxiety (GAD-7), pain catastrophizing, activities of daily living (HAQ), and HRQOL (SF 36/RAND-36 and PROMIS-29).

Of the 142 participants, 62 (44%) had achondroplasia (n = 59) or hypochondroplasia (n = 3), and 80 (56%) had other skeletal dysplasia conditions (OSD), the largest groups being multiple epiphyseal dysplasia (n = 14), diastrophic dysplasia (n = 9), spondyloepiphyseal dysplasia congenita (n = 9) and pseudoachondroplasia (n = 8). Mean age was 41 (range 18-80) years. A prior psychiatric diagnosis was reported by 36%. Clinically significant symptoms of depression (PHQ-8 score ≥ 10) and anxiety (GAD-7 score ≥ 10) were reported by 23% and 13%. Almost all (99%) reported pain, while 9% had clinically significant levels of pain catastrophizing. For daily activities, the most affected domains were activities, reach and walking. The prevalence of current depression and anxiety symptoms was considerably higher in the study population than in the general US population. Participants with OSD reported more psychiatric diagnoses, depression and anxiety symptoms, more pain and challenges in performing daily activities, and lower HRQOL compared to participants with achondroplasia/hypochondroplasia.

Adults with skeletal dysplasia appear to have an increased risk for mental health issues and reduced physical functioning, which may impact HRQOL. These findings underscore the importance of including a formal assessment of mental health, pain and daily activities as part of regular medical follow-up across the lifespan in these patients.

Social media use in younger people has shown mixed associations with mental health. We hypothesized that communication types during social media use might alter the relationship between problematic social media use (PSMU) and anxiety over time. We aimed to identify how four dimensions of communication influence the link between PSMU and anxiety.

We recruited a cohort of undergraduate students aged 18-26 to participate in daily surveys over two weeks using a diary method to assess daily social media use, PSMU, anxiety symptoms, and the four dimensions of communication: Consumption, Broadness, Online Exclusivity, and Parasociality. Lagged logistic regression models with generalized estimating equations evaluated the influence of daily PSMU and communication type on subsequent anxiety levels.

Out of 79 participants, 1009 daily records were analyzed. PSMU positively correlated with anxiety (Kendall rank correlation τ = 0.30). Interaction analysis indicated that levels of parasociality and consumption moderated the association between PSMU components and anxiety outcomes. In young adults with high levels of consumption or parasociality, a 1-standard-deviation rise in PSMU's social conflict component led to an 11 %-13 % increase in next-day anxiety scores. This association was absent for those with low to moderate levels of parasociality and consumption.

Elevated levels of passive consumption and one-sided interactions amplify the anxiety risk associated with PSMU. Further longitudinal evidence can elucidate the connections between communication types, social media exposure, and anxiety, guiding the development of a model for healthy social media use.

The COVID-19 pandemic emerged as an international public health emergency and threat to individual psychological resilience.

To examine the prevalence of psychological issues and identify key associations with mental health indicators in young adults (ages 18-28) worldwide during the initial phase of the pandemic.

Through a cross-sectional online survey utilizing convenience sampling, we collected data on demographics, COVID-19-related questions, depression (Patient Health Questionnaire-9), anxiety (Generalized Anxiety Disorder-7), stress/trauma (Impact of Event Scale-Revised), and fear of COVID-19 (Fear of COVID-19 scale) between September 2020-January 2021. A total of 183 were eligible analysis. All statistical analyses were set at alpha = 0.05.

Over 70% of participants reported mild anxiety (n=129), 80% mild depression (n=136), 40% pandemic-related trauma (n=61), and 50% high fear (n=88). Female respondents reported higher anxiety (t(173)=-3.352, <.001), depression (t(166)=-3.310, P=.001), and trauma from COVID-19 ((t(151)=-2.004, P=.047). Hispanic/Latino/a/x participants reported higher depression (F(2,156)=7.761, P<.001) and trauma scores (F(2,143)=3.999, P=.020). Age in 2020 was associated with trauma total scores (F(1,154)=4.230, P=0.041, R2 = 0.027). Individuals who were mandated a quarantine were linked to lower levels of anxiety (F(2,175)=3.442, P=.034) and depression (F(2,170)=3.092, P =.048) than those not mandated. Those quarantined with close contacts were linked to lower anxiety (t(162.184)=2.705, P =.008) and trauma (t(149)=2.169; P=.032). Close contacts' hospitalization from COVID-19 infections were linked to lower anxiety (t(127)=2.855, P=.005), depression(t(123)=3.111, P=.002), and trauma (t(152)=-1.975, P=.050).

The findings highlight the significant effect COVID-19 had on mental health in young adults worldwide.

The study aims to evaluate the clinical outcomes in patients with hypermobility spectrum disorder (HSD) and hypermobile Ehlers-Danlos syndrome (hEDS) with chronic pain following treatment with cannabis-based medicinal products (CBMPs).

This was a case series conducted with the UK Medical Cannabis Registry. The primary outcomes were changes in the following validated patient-reported outcome measures at 1, 3, 6, 12, and 18 months compared with baseline: Short-Form McGill Pain Questionnaire 2 (SF-MPQ-2), pain visual analog scale score (Pain-VAS), Brief Pain Inventory (BPI), five-level EQ-5D (EQ-5D-5L), Single-Item Sleep Quality Scale (SQS), General Anxiety Disorder Seven-Item Scale (GAD-7), and Patient Global Impression of Change. The incidence of adverse events was analyzed as secondary outcomes. Statistical significance was defined as P <0.050.

A total of 161 patients met inclusion criteria. Improvements were observed in BPI severity and interference subscales, SF-MPQ-2, and Pain-VAS (P < 0.001). Changes were also seen in the EQ-5D-5L index value, SQS, and GAD-7 (P < 0.001). A total of 50 patients (31.06%) reported one or more adverse event with a total incidence of 601 (373.29%). The most frequent rating for adverse events was moderate (n = 258; 160.25%), with headache being the most common (n = 44; 27.33%).

An association was identified between patients with HSD/hEDS with chronic pain and improvements in pain-specific and general health-related quality of life following the commencement of CBMPs. CBMPs were also well tolerated at 18 months. These findings must be interpreted within the context of the limitations of study design but add further weight to calls for randomized controlled trials.

The objective was to assess the postsurgical outcomes of regenerative peripheral nerve interface (RPNI) surgery in a prospective cohort of major lower extremity amputation patients with chronic postamputation pain.

Chronic pain in lower limb amputation patients is commonly the result of neuroma formation after traumatic peripheral nerve injury. By implanting more proximal transected nerve ends into autologous free muscle grafts, RPNI surgery can treat postamputation pain by diminishing the development of neuromas. RPNI surgery in prior retrospective studies has been shown to mitigate postamputation pain.

Twenty-two lower limb amputation patients with established chronic postamputation pain were recruited from 2 studies in this prospective study. All patients underwent RPNI surgery to treat identified symptomatic neuromas within the residual limb. Patient-reported outcome instruments were administered preoperatively and postoperatively at 1 week, 4 months, and 12 months to examine residual limb pain (McGill Pain Questionnaire, PROMIS Pain Intensity, and PROMIS Pain Interference), phantom limb pain (modified PROMIS Pain Intensity and Phantom Limb sensation questionnaire), psychosocial status (PHQ-9, GAD-7, and PCS), and functional (OPUS) outcomes.

RPNI surgery significantly improved residual limb pain. While phantom limb sensation improved significantly, phantom limb pain demonstrated a modest decrease. Psychosocial outcomes also improved significantly after RPNI surgery. Prosthetic use slightly increased, and patients did not experience loss of function.

RPNI surgery leverages the processes of reinnervation to successfully treat residual limb pain and improve psychosocial outcomes in patients with chronic postamputation pain. Phantom limb pain may be more difficult to treat in chronic pain patients who have central sensitization at the time of surgery.

Psychological disorders like anxiety and depression are prevalent among dental professionals, being responsible for negatively affecting their mental health. Such factors are detrimental and may lead to suicidal thoughts and ideation. This study aimed to evaluate the impact of anxiety and depression on suicidal thoughts and ideation among dental professionals in Pakistan.

This descriptive, cross-sectional study formulated a self-reporting online questionnaire of dental professionals of Karachi, Pakistan between September and December 2023. The online questionnaire consisted of demographics and validated tools to measure anxiety using GAD-7, depression using PHQ-9, and Suicide thoughts and ideation using SIDAS.

A total of 636 dental professionals were recruited in the study. Overall, 76.1% of the participants reported moderate to severe anxiety, 64.1% experienced moderate to severe depression, and 11.9% of participants reported high levels of suicidal thoughts and ideation. Anxiety and depression had a statistically significant association with suicide among dental professionals (p-value < 0.001).

This study highlights the positive association of anxiety and depression with suicidal ideation and thoughts among dental professionals. Hence, it is important to monitor the mental health of dental professionals and provide essential health and support to overcome such psychological distress.

Adolescents with a history of suicide exposure, defined as experiencing the suicide death of a family member, friend, or other acquaintances, are more likely to experience mental health issues such as depression or anxiety.

This study aimed to explore prevalence rates and the network of adolescents' suicide exposure, depression, and anxiety symptoms, and to clarify the correlations between suicide exposure and symptoms of depression and anxiety.

A total of 8,957 adolescents were included in this cross-sectional study. Data regarding general information, symptoms of depression and anxiety, and suicide exposure were collected from mid-September to early October 2021. Network analysis was employed to assess relationships between suicide exposure and individual symptoms of both depression and anxiety. Central symptoms were identified by strength; the flow network was visualized to identify symptoms directly related to suicide exposure.

The prevalence rates of suicide exposure, depression, and anxiety were 5.28%, 12.87%, and 10.48%. Results indicated that suicide exposure was associated with both depression and anxiety, and had the strongest positive association with suicidal ideation. Central symptoms of the network were sad mood, nervousness, fatigue, irritability, and uncontrollable worry. Bridge symptoms were suicidal ideation and irritability. Appetite changes, suicidal ideation, uncontrollable worry, sleep difficulties, and irritability were symptoms directly related to suicide exposure.

There were significant inter-symptom associations between suicide exposure, depression, and anxiety in adolescents. It is recommended that future studies explore whether targeted interventions and long-term monitoring concerning these inter-symptom associations can protect adolescents with suicide exposure.

This study aimed to (1) identify latent classes of stigma and discrimination experiences among men who have sex with men (MSM) living with HIV; (2) examine the associations between class membership and mental health outcomes, and (3) investigate the moderating effects of social support and resilience. The study used the baseline (N = 224) and six-month follow-up data (N = 118) from a longitudinal cohort study on HIV and hypertension among African American and Asian Pacific American MSM in Hawai'i and Philadelphia from 2019 to 2023. Latent class analysis was conducted to characterize the patterns of stigma and discrimination experience. Multivariable regression was conducted to examine the association between class membership and mental health outcomes. Interaction terms were added to examine the moderation effects of social support and resilience on the association between class memberships and mental health outcomes. A five-class model was identified: Class (1) high on internalized homophobia and low on all discrimination experiences; Class (2) high on racial discrimination; Class (3) high on sexual identity discrimination; Class (4) low on internalized homophobia and all discrimination experiences; Class (5) high on physical disability discrimination and internalized homophobia. Class 5 consistently predicted worse mental health outcomes, compared to Class 4. The association between Class 2 (high racial discrimination) and depression was moderated by perceived social support. The study reveals complex experiences of intersectional stigma and discrimination among MSM living with HIV, highlighting the need for further research on the intersecting effects of multiple disadvantages among aging sexual minorities.

Youth with depression may be at a higher risk of developing bipolar disorder (BD). Self-reported, dimensional measures, like the Bipolar Spectrum Diagnostic Scale (BSDS), aim to assess for BD in these groups. We explored properties of this instrument within a cohort of depressed, help-seeking youth.

We used baseline data from two randomized controlled trials for depressed youth (aged 15-25 years) who had no history of BD or psychosis and who completed the BSDS (n = 240; mean Age = 19.9 years, SD = 2.7; Female = 57 %). Structured diagnostic assessments were repeated at 26-weeks to detect new-onset BD. We examined false-positive rates for concurrent BD using established thresholds on the BSDS, utilised factor analyses to determine its underlying structure, and explored associations between the BSDS and demographic, clinical, and personality variables using linear regressions.

False-positives rates were high. Most (60 %) participants scored above BSDS thresholds at baseline, though none developed BD over the 26-week study period. A three-factor model best fit BSDS items, representing depression, mania, and lability factors. BSDS total, mania and lability sub-scale scores were associated with similar characteristics, with a different pattern of association for the BSDS depression subscale.

With no long-term follow-up of the current sample nor a separate bipolar youth sample, we were unable to determine the overall discriminant validity, sensitivity, or longer-term predictive validity of the BSDS.

At recommended thresholds, BSDS has high false positive rates for detecting current BD in youth with moderate to severe depression, especially with mental state or personality disorder comorbidities.

Use of standardised scores, such as T-scores and percentile rank order scores, enhances measurement-based care. They facilitate communication between therapists and clients about test results, particularly for multidimensional measures such as the Symptoms Questionnaire (SQ-48). By transforming raw scores into a common metric, clinicians can more easily interpret and discuss patient profiles of scores on the various scales of the measure. This study explored the advantages and disadvantages of standardised scores and percentile ranks, with a specific focus on T-scores, utilising cross-sectional data from a general population sample (N = 516) and a clinical sample (N = 242). We outline various approaches for establishing T-scores and provide illustrative examples. The analysis of the SQ-48 revealed the necessity of first normalising raw scores to obtain accurate T-scores. Normalisation based on an IRT model is deemed superior, but formulas converting summed scale scores provide a good approximation. Regarding percentile rank order scores, we demonstrated that clinical percentiles offer more meaningful interpretations than population-based percentiles, due to restriction of range for the latter among clinical subjects. Gender and age group differences were identified, with significantly higher scores for women and individuals aged 55 and older. Benefits of normalised T-scores and the need for gender- and age-specific norms for the SQ-48 are discussed.

Psychiatric comorbidities are frequent in people with epilepsy (PWE) or psychogenic nonepileptic seizures (PNES), and the use of validated screening instruments to identify respective symptoms is recommended. Our aim was to investigate the recommendations resulting from routine screening for depression, anxiety and suicidality with the Neurological Disorders Depression Inventory for Epilepsy (NDDI-E) and the Generalized Anxiety Disorder Scale (GAD-7) in the outpatient clinic of a tertiary epilepsy center.

We retrospectively analyzed NDDI-E and GAD-7 scores (German versions) of 264 outpatients at a tertiary epilepsy center and extracted recommendations regarding psychopathology from the outpatient letters.

The screening revealed a likely major depression (NDDI-E ≥17) in 15.2% of PWE (without PNES, 30/197) and an NDDI-E score ≥17 in 51.2% of patients with PNES ± epilepsy (21/41), moderate to severe symptoms of generalized anxiety (GAD-7 ≥10) in 20.3% of PWE (40/197) and 56.1% of patients with PNES (23/41), and a high risk of suicidality (NDDI-E item 4 ≥3) in 8.1% of PWE (16/197) and in 24.4% of patients with PNES (10/41). The most frequently given recommendations regarding depression or anxiety were a psychiatric/psychotherapeutic treatment for PWE and an admission to the psychotherapy ward of the epilepsy center for patients with PNES. No evidence for active suicidal tendencies was found in any of the patients with a positive screening for suicidality.

Routine screening with NDDI-E and GAD-7 for depression, anxiety and suicidality is efficient and feasible and leads to individual recommendations for further assessment and treatment.

Therapeutic advances have allowed more adults aged ≥60 years with acute myeloid leukemia (AML) to receive life-prolonging treatments, with improvement in overall survival. In contrast to other cancers, the onset of AML is often sudden, high-risk treatment decisions must be made quickly, and survival is often compromised due to aging-related conditions (e.g., functional impairments). Studies have demonstrated that up to 78 % of older adults with AML and their caregivers experience significant psychological distress. Distress is associated with poor quality of life, increased healthcare utilization, and increased mortality. Shared decision making (SDM) can reduce patient and caregiver distress and is essential to achieve goal-concordant care. Therefore, interventions to alleviate distress and optimize SDM in older adults with AML and their caregivers are needed. We will conduct a multicenter randomized controlled trial to evaluate the efficacy of University of Rochester-Geriatric Oncology assessment for Acute myeloid Leukemia (UR-GOAL) compared to an attention control for reducing patient distress and improving observed SDM, patient-perceived SDM, and decisional conflict.

We will recruit 300 patients aged ≥60 years with newly diagnosed AML, their caregivers (one caregiver per patient when available), and up to 40 oncologists from four institutions: (1) Patients will view an educational video about AML diagnosis, treatment, and prognosis; complete the Best Worst Scaling values clarification process; and review a summary report of their values with tailored question prompts and resources; (2) Caregivers will view the same educational video and receive the same summary report as patients; and (3) Oncologists will review a summary report of the patient's aging-related conditions, perception of prognosis, and values. Patients, caregivers, and oncologists will then meet during clinical visits to discuss aging-related conditions, prognosis, and patient values, and reach a treatment decision. The primary outcome measure is distress (Distress Thermometer). Secondary outcome measures include observed SDM, patient perceived SDM, and decisional conflict.

This study will address significant knowledge gaps related to reducing distress and decisional conflict and improving SDM in older adults with AML. If successful, this research will inform future decisional interventions for a broader group of patients.