Search Results (1,027)

Background/Objectives: Von Hippel–Lindau (VHL) disease is a rare autosomal dominant hereditary disorder. Central nervous system hemangioblastomas are one of the most common tumor types associated with VHL disease. Although these tumors are histologically benign, delayed diagnosis and treatment may result in severe neurological dysfunction, permanent disability, and even death. However, little is known about the experiences of patients with VHL disease. The aim of this study was to gain a better understanding of the illness experiences and psychological responses of patients with VHL disease accompanied by central nervous system hemangioblastomas. Methods: A qualitative study based on a semi-structured guide was conducted. Twelve participants were recruited. Data were collected through face-to-face interviews and analyzed using the constant comparative method. Results: Four themes and their subthemes were identified: 1. powerlessness—unpredictable disease progression and uncontrollable continuity; 2. negative emotional experiences—guilt and self-blame, depression, and low self-esteem; 3. compromise—acceptance of fate, positive outlook, and sense of hope; and 4. persistent worry—worries about family members, anxiety regarding finances and employment, and uncertainty regarding the future. Conclusions: This study identified four major themes in the illness experiences of patients with VHL disease accompanied by central nervous system hemangioblastomas, which provided deep insights into the care needs of individuals with VHL disease. Healthcare providers should develop effective measures to enhance patients’ ability to maintain a good quality of life and confront the future with resilience. Full article

Objective: To analyse written submissions from individuals and families with lived experience of attention-deficit hyperactivity disorder (ADHD) to the 2023 Australian Senate Inquiry, using artificial intelligence (AI)-assisted thematic analysis. The aim was to identify priority concerns, service needs, and community-proposed solutions. Methods: A mixed-methods study of 505 publicly available submissions from individuals with ADHD and their families. Submissions were analysed using large language model (LLM)-assisted data extraction and thematic clustering, with human validation and review. Main Outcome Measures: Frequency and thematic distribution of (1) problems experienced; (2) services wanted; and (3) solutions suggested. Results: Thematic analysis of 480 eligible submissions revealed high costs and long wait times for assessment and treatment (each cited by 46%), lack of specialised care (39%), diagnostic delays (36%), and gender bias (27%). The most common service request was for affordable and accessible ADHD-specific care (71%), followed by services tailored to diverse populations and life stages. Proposed solutions focused on Medicare-funded access to psychological and psychiatric services (68%), expanded roles for general practitioners, improved provider training (39%), and recognition of ADHD under the National Disability Insurance Scheme. Submissions also highlighted misalignment between current clinical guidelines and public expectations. Conclusions: The findings highlight substantial unmet needs and systemic barriers in ADHD diagnosis and care in Australia. The AI-assisted analysis of consumer submissions offers a scalable method for integrating lived experience into policy development, providing numerical weighting to the individuals’ responses. Coordinated reforms in access, funding, and workforce training are needed to align services with both clinical evidence and community expectations. Full article

With emerging improvement in screening and treatment, most patients with prostate cancer (PCa) live for a long period beyond their diagnosis. Erectile dysfunction (ED) and bowel and urinary incontinence have been shown to be the most bothersome side-effects of most PCa treatment options for patients. With increasing long-term survival, most PCa patients face the prospect of experiencing symptoms, side-effects of available treatment options, and diminished quality of life. The objective of the study was to explore the impact of treatment-induced ED on masculinity among Black South African PCa patients. Twenty (20) prostate cancer patients, selected through purposive sampling and receiving some form of treatment at Pietersburg tertiary Hospital, with ages ranging from 67 to 85 years (mean age = 76 years; SD = 5.3), participated in the study. In-depth, individual semi-structured interviews were used to collect data and analyzed through Interpretative Phenomenological Analysis (IPA). The findings indicate that ED threatens or adversely impacts the participants’ perceptions of their sense of masculinity leading to diminished quality of life. The results demonstrate that loss of masculinity brought about by PCa treatment-induced ED is experienced both physically as well as psychologically. The results highlight a need for collaboration between medical and psychological professionals in the management of PCa patients. This is crucial for improving the overall health related quality of life for patients. Full article

Background/Objectives: The treatment of dual disorders (DDs) must be comprehensive and multidisciplinary. There is evidence supporting the effectiveness of psychotherapy in their treatment. However, clinical guidelines, consensus statements, and reviews on the treatment of DDs typically devote considerably less space to psychological therapy than to pharmacological therapy. Therefore, this work aimed to synthesize the available evidence, recommendations, and clinical experience on the psychological treatment of DDs to reach a consensus. Methods: Two consensus methods were sequentially implemented: the nominal group technique and the Delphi method. Results: The first part of this consensus review encompassed a compilation of general recommendations for the psychological treatment of DDs, evidence on the efficacy of the most frequently used therapies, and recommendations for the psychological treatment of severe dual mental disorders. These disorders include schizophrenia and other psychotic disorders, bipolar disorders, depressive disorders, and obsessive compulsive disorders. Conclusions: (1) Psychological treatment is effective; (2) integrated psychological treatment is more effective; (3) motivational interviewing, cognitive behavioral therapy, and relapse prevention are the psychological interventions with the most supporting evidence; (4) the best alternative is multicomponent strategies; (5) the most frequently studied severe mental disorders are schizophrenia and depression; (6) for dual schizophrenia, motivational interviewing and integrated cognitive behavioral therapy combined with other components are recommended; (7) for dual depression, cognitive behavioral therapy with relapse prevention or motivational interviewing is recommended; (8) for dual bipolar disorder, group therapies with psychoeducation or relapse prevention and inclusion of the family, contingency management, and family intervention are recommended; (9) more empirical evidence is needed, especially for obsessive compulsive and schizoaffective disorders; and (10) more randomized clinical trials are needed to improve current methodological limitations. Full article

Background/Objectives: Long COVID (LC) is associated with more than 200 symptoms. This study aimed to evaluate the correlation between symptoms clusters and pharmacological treatment in patients with LC and to explore differences by sex. Methods: We conducted a cross-sectional descriptive study including 304 participants diagnosed with LC according to the World Health Organization criteria. Symptoms during the acute phase, at the time of diagnosis of LC, and those persisting across both phases were collected by anamnesis. Symptoms were grouped into six clusters: systemic, neurocognitive, respiratory/cardiovascular, musculoskeletal, neurological/neuromuscular, and psychological/psychiatric. Drug use was assessed through a questionnaire verified by the medical records, including the consumption of cardiovascular drugs, antidepressants/anxiolytics, and anti-inflammatory/analgesics. Results: Patients reported a mean of 5.23 ± 1.10 symptoms in the acute phase, 4.20 ± 1.70 at LC diagnosis, and 3.83 ± 1.80 persisting across both phases. The most consumed pharmacological group was cardiovascular drugs (43.3%), followed by antidepressants/anxiolytics (34.8%). Psychotropic drugs and anti-inflammatory/analgesic drugs showed a positive association with all symptomatic groups (p < 0.05). Cardiovascular drugs showed a positive association with cardiorespiratory (β = 0.19, p < 0.05), neuromuscular (β = 0.11, p < 0.05), and psychological (β = 0.14, p < 0.05) symptoms. Conclusions: Psychotropic and anti-inflammatory/analgesic drugs were positively associated with all symptom clusters, while cardiovascular drugs were associated only with cardiorespiratory, neuromuscular, and psychological symptoms, highlighting the relevance of better characterization of treatment patterns in this population. Full article

Background: Adult females with Autism Spectrum Disorder (ASD) and Attention Deficit Hyperactivity Disorder (ADHD) are frequently underdiagnosed due to gender bias, overlapping symptoms, and limited awareness among healthcare professionals. The scarcity of research on this subject—particularly in the UK context—underscores the need for further investigation. Accordingly, the aim of this study was to explore the lived experiences of adult females receiving a late diagnosis of ASD and/or ADHD and to identify key barriers within the UK diagnostic pathway. This study addresses a critical knowledge gap by examining the factors contributing to delayed diagnosis within the United Kingdom. Study Design and Method: The study employed a qualitative approach, utilising an anonymous online questionnaire survey comprising nine open-ended questions. Responses were obtained from 52 UK-based females aged 35–65 years who had either received or were awaiting a diagnosis of ASD and/or ADHD. Data were analysed thematically within a constructivist framework. Findings: The analysis revealed three overarching themes: (i) limited understanding and lack of empathy among healthcare professionals, (ii) insufficient post-diagnostic support, with most participants reporting no follow-up care, and (iii) a complex, protracted diagnostic process, often involving waiting periods exceeding three years. Gender bias and frequent misdiagnosis were recurrent issues, contributing to significant psychological distress. These findings underscore the need for systemic reforms and align closely with gaps identified in the existing literature. Conclusions: The findings emphasise the urgent need for gender-sensitive diagnostic frameworks, enhanced professional training, and a person-centred approach to care. Key recommendations include shortening diagnostic waiting times, strengthening healthcare professionals’ knowledge base, and ensuring equitable and consistent post-diagnostic support. Full article

Background/Objectives. Chronic benzodiazepine (BDZ) use is frequently maintained beyond recommended durations due to neuroadaptation, psychological dependence, and withdrawal-related issues. Passiflora incarnata L., herba (P. incarnata) has shown anxiolytic and GABAergic activity that may mitigate withdrawal symptoms, while cognitive-behavioural therapy (CBT) targets maladaptive beliefs and behaviours sustaining BDZ misuse. This study investigates the independent and interactive effects of P. incarnata and CBT on BDZ dose reduction during a three-month tapering program. Methods. This retrospective observational study included 186 outpatients with anxiety or depressive disorders in clinical remission undergoing BDZ tapering, of whom 93 received a dry extract of P. incarnata as adjunctive treatment and 93, matched for diagnosis, age and sex, followed a standard tapering protocol. BDZ doses were assessed at baseline and three months. CBT was recorded as a binary variable based on the information documented in the medical records. An ANCOVA was performed to assess the impact of CBT and P. incarnata on BDZ reduction (change in mg diazepam equivalents), adjusting for sex, age, education, baseline anxiety and depression scores, initial BDZ and antidepressant dosage. A subgroup analysis was conducted to investigate the role of P. incarnata dosage in BDZ reduction. Results. Both CBT and P. incarnata were associated with significantly greater reductions in BDZ dosage at three months (CBT: p = 0.005, effect size: 0.032; P. incarnata: p < 0.001, effect size: 0.128). A significant interaction between CBT and P. incarnata was also observed (p = 0.037, effect size: 0.018), indicating a synergistic effect when both interventions were combined. Baseline sociodemographic characteristics, BDZ and antidepressant dosage and symptom severity did not differ significantly between groups. Patients taking 400–600 mg of P. incarnata dry extract showed a higher BDZ reduction compared to those taking 200 mg. Conclusions. These findings suggest that P. incarnata and CBT exert independent yet complementary effects in supporting BDZ tapering. Their combination appears to enhance dose reduction beyond either intervention alone, supporting a multimodal approach that addresses both neurobiological and psychological components of BDZ addiction. Prospective controlled studies are needed to confirm these results and to clarify their impact on long-term discontinuation outcomes. Full article

Background/Objectives: The Korean Survey for Cancer Survivorship (KSCS) aims to comprehensively assess cancer survivors’ health behaviors, quality of life (QoL), and socioeconomic challenges. This study evaluated the feasibility of the KSCS protocol and identified key factors influencing psychological health and QoL among cancer survivors. Methods: The nationwide survey targeted survivors diagnosed with breast, colorectal, liver, lung, stomach, prostate, and gynecological cancers who had completed active treatment within 1 to 10 years. The respondents were given the option to participate in the survey either online or in-person. The questionnaire has 229 questions, including internationally validated tools such as the EQ-5D-3L, PHQ-9, and GAD-7. Results: A total of 983 cancer survivors completed the survey (92.7% online, 8.3% in-person) and were categorized by post-diagnosis duration. Survivors diagnosed within 1–3 years reported higher rates of moderate-severe depression (11.4% vs. 8.3%), moderate-severe anxiety (5.9% vs. 5.1%), and poorest QoL (63.0% vs. 50.9%) compared to those diagnosed more than 5 years ago. Employment changes, such as loss of job, change of workplace, or work leave, were significantly associated with worse health outcomes, including higher rates of moderate-severe depression (OR = 4.39; 95% CI 2.43–7.96), moderate-severe anxiety (OR = 3.63; 95% CI 1.68–0.88), and having extreme QoL problems (OR = 6.37; 95% CI 2.03–20.00). Conclusions: The KSCS protocol is feasible for nationwide implementation and provides comprehensive data on health, psychological, and socioeconomic challenges among cancer survivors. Preliminary findings highlight employment’s critical role in cancer survivors’ well-being and the need for survivorship care that integrates socioeconomic and clinical factors. Full article

Oral squamous cell carcinoma (OSCC) is one of the most prevalent types of cancer in the oral cavity and head and neck region. Due to its location and psychological and social implications, early detection and treatment are very important. A liquid biopsy can be used to diagnose cancer by analyzing samples of bodily fluids, such as saliva, blood, or urine, for specific molecules released by tumor cells. The objective of this study was to evaluate the use of liquid biopsy in the diagnosis of oral squamous cell carcinoma. A systematic review was carried out, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines (PROSPERO: CRD420251238037). Articles taken into consideration for the review were published before 30 September 2025. The search for manuscripts for the review was conducted using PubMed, Scopus, Google Scholar, and Cochrane databases. Forty-three articles were deemed eligible for inclusion in the systematic review. Key data extracted from the studies included authorship, publication date, study location, methodology, number of participants, and reported complications. Most of the analyzed biomarkers showed promising potential for future use in liquid biopsy for OSCC diagnosis. Tumor DNA and miRNA demonstrated the highest diagnostic accuracy. The standard approach to diagnosis and planning treatment relies on tumor biopsy and diagnostic imaging. Liquid biopsy may complement this process by enabling early detection in high-risk populations and monitoring response to therapy. As such, it serves as a prognostic factor or therapeutic target, successfully identifying disease recurrence. Full article

Background/Objectives: Preeclampsia is a severe hypertensive disorder that has been linked to increased maternal psychiatric morbidity. However, existing literature remains inconsistent regarding whether this association is independent of underlying medical co-morbidities such as chronic hypertension and diabetes. Our objective was to precisely evaluate the Adjusted Odds Ratio (AOR) of developing Postpartum Depression symptomatology (probable PPD) following a diagnosis of preeclampsia in a prospectively tracked cohort, controlling for essential confounders. Methods: This prospective cohort study included 180 women (33 in the Preeclampsia group, 147 in the Normotensive reference group), with stringent exclusion of women with prior psychiatric history to reduce confounding. PPD was assessed postpartum using the Edinburgh Postnatal Depression Scale (EPDS ≥ 13 cutoff). Multivariable logistic regression was employed to calculate the AOR, adjusting for maternal age, chronic hypertension, and prepregnancy diabetes. Results: The multivariable analysis demonstrated a highly significant and independent association between the primary exposure and the outcome. Preeclampsia was associated with 12.7-fold increased odds of developing PPD (AOR: 12.7; 95% CI: 5.1–31.7; p < 0.001). In contrast, none of the included confounders—chronic hypertension (AOR: 1.96, p = 0.182), prepregnancy diabetes (AOR: 1.8, p = 0.372), or age (AOR: 0.99, p = 0.759)—showed a statistically significant independent association with PPD risk. The model achieved strong explanatory power (Nagelkerke R² = 0.327; Omnibus Test p < 0.001). Conclusions: Preeclampsia represents a powerful and independent determinant of the risk for significant PPD symptomatology, substantially increasing the adjusted odds of the condition. These findings mandate that women with a history of preeclampsia be designated a high-risk group and receive immediate, mandatory, and intensified postpartum mental health surveillance and preferential access to specialized psychological support. Full article

Background/aim: Despite the fact that qualitative research on postpartum depression (PPD) has been extensively researched globally, women’s perceptions of PPD misconceptions are mostly ignored in developing countries like Jordan. Thus, this study aims to explore Jordanian women’s sociocultural perceptions and misconceptions about PPD using the descriptive phenomenological design. Methods: Fourteen women who had either a normal or caesarean (C-section) delivery and resided in Irbid, Northern Jordan, participated in semi-structured in-depth interviews, which lasted 15 to 25 min in May 2025. Data were gathered via field note transcriptions of interviews, and analysis followed Colaizzi’s data analysis methodology. Results: Among participants, five women (all C-section deliveries) reported a PPD diagnosis, while the remaining normal delivery women reported experiencing depression before giving birth. The women’s sociocultural perceptions and misconceptions about PPD were found to be reflected in a number of themes. The theme “perceiving PPD as normal baby blues” captures the general lack of awareness regarding this disorder. Three important themes—“myths”, “psychological”, and “spiritual and religious failure”—show how little is known about the causes. The two primary themes that are impacted by sociocultural perspectives are “stigma” and “mistrust of professional care services”. The accuracy and misconceptions around this disorder are summed up in four basic themes: “emotional misconceptions”, “cultural misconceptions”, “false beliefs about health”, and “think of PPD as indolence”. Conclusions: Jordanian women have limited understanding and misconceptions of PPD. Adopting culturally relevant awareness campaigns is essential to disseminating the knowledge required to facilitate improved treatment pathways. Full article

Mayer–Rokitansky–Küster–Hauser (MRKH) syndrome encompasses a range of Müllerian duct anomalies characterized by congenital absence of the uterus and the upper two-thirds of the vagina in young women who otherwise exhibit normal endocrine function and a 46,XX karyotype. MRKH syndrome can occur in an isolated form (type I) or in association with other congenital anomalies (type II or MURCS association), which may include renal, vertebral, auditory, and cardiac defects. It represents one of the most frequent causes of primary amenorrhea, affecting approximately 1 in every 4000–5000 women. MRKH syndrome often remains undiagnosed until a patient presents with primary amenorrhea, despite normal development of secondary sexual characteristics. Both genetic and non-genetic factors have been proposed as contributing to abnormal embryonic development, although the exact etiopathogenesis remains unclear. Imaging plays a key role in the evaluation of genital tract anomalies, allowing non-invasive and comprehensive assessment. Alongside physical examination and pelvic ultrasound, pelvic MRI is essential for identifying the presence of rudimentary uterine tissue. MRKH syndrome can have profound and lasting psychological impacts, making it essential for patients and their families to receive counseling both before and throughout treatment. A range of therapeutic options—both surgical and non-surgical—have been proposed for managing MRKH syndrome. Vaginal dilation remains the first-line treatment, as it offers high success rates with minimal risk of complications. Vaginoplasty is considered a second-line option for patients who do not respond to dilation therapy. Additionally, uterine transplantation and gestational surrogacy provide opportunities for women with MRKH syndrome to achieve biological motherhood. This review provides an updated overview of Mayer–Rokitansky–Küster–Hauser (MRKH) syndrome, encompassing its etiological, clinical, diagnostic, psychological, therapeutic, and reproductive aspects. We also present a case involving a 19-year-old woman with MRKH syndrome who presented with primary amenorrhea, highlighting the crucial role and advantages of MRI in diagnosis, differential assessment, and treatment planning. Full article

Major depressive disorder (MDD), identified by the World Health Organization as the leading cause of disability worldwide, remains underdiagnosed due to the lack of objective diagnostic tools. Electroencephalogram (EEG) signals offer potential biomarkers, yet conventional analyses often overlook the brain’s nonlinear dynamics. In this study, we analyzed resting-stage EEG data to identify four microstate types in MDD patients. Symmetrical microstate–brain networks were then constructed for each microstate by using time series of four types of microstates as dynamic windows. Then, we compared microstate features (duration, occurrence, coverage, transition probability) and brain network parameters (clustering coefficient, characteristic path length, local and global efficiency) between MDD patients and healthy controls to analyze the characteristics of the changes in the brain activities of the patients with MDD and the topological patterns of the functional connectivity. The comparative analysis showed that MDD patients showed more frequent microstate transitions and reduced network efficiency, suggesting elevated energy consumption and impaired neural integration, which may imply a cognitive shift in MDD patients toward internal focus and psychological withdrawal from external stimuli. By integrating microstate and brain network features, we captured the temporal and spatial characteristics of MDD-related brain activity and validated their diagnostic utility using our previously proposed multiscale spatiotemporal convolutional attention network (MSCAN). Our MSCAN achieved an accuracy of 98.64% for MDD detection, outperforming existing approaches. Our study can offer promising implications for the intelligent diagnosis of MDD and a deeper understanding of its neurophysiological underpinnings. Full article

Cyber–physical systems (CPS) in healthcare represent a deep integration of computational intelligence, physical medical devices, and human-centric data, enabling continuous, adaptive, and personalized care. These systems combine real-time measurements, artificial intelligence (AI)-based analytics, and networked medical devices to monitor, predict, and optimize patient health outcomes. A key development in the field of CPS is the emergence of patient digital twins (DTs), virtual models of individual patients that simulate biological, behavioral, and social parameters. Using AI, DTs analyze complex medical and social data (genetics, lifestyle, environment, etc.) to support precise diagnosis and treatment planning. The implications of the bibliometric findings suggest that the field emerges from the conceptual phase, justifying the article’s emphasis on both the proposed architectures and their clinical validation. However, most research was conducted in computer science, engineering, and mathematics, rather than medicine and healthcare, suggesting an early stage of technological maturity. Leading countries were India, the United States, and China, but these countries did not have a high number of publications, nor did they record leading researchers or affiliations, suggesting significant research fragmentation. The most frequently observed Sustainable Development Goals indicate an industrial context. Reflecting insights from medical and social research, AI-based DT systems provide a holistic view of the patient, taking into account not only physiological states but also psychological and social well-being. These systems promote personalized therapy by dynamically adapting treatment based on real-time feedback from wearable sensors and electronic medical records. More broadly, CPS and DT systems increase healthcare system efficiency by reducing hospitalizations and supporting remote preventive care. Their implementation poses significant ethical and privacy challenges, particularly regarding data ownership, algorithm transparency, and patient autonomy. Full article

Psychological distress impacts a large portion of the general population. While effective treatments are available, few seek them out. This lack of treatment seeking may be due to several factors, particularly low mental health literacy (MHL). MHL is the knowledge an individual has regarding psychological disorders and their symptoms, treatments, and where to seek appropriate help when identified. The capacity to pay attention to present-moment experiences in MHL translates to the qualities of dispositional mindfulness (DM), the capacity to pay non-judgmental attention to present-moment experiences. The purpose of the present study was to evaluate the reliability and preliminary convergent validity of a newly developed, vignette-based assessment of psychological disorder recognition. A total of N = 299 participants were recruited via TurkPrime and completed measures of DM (FFMQ), MHL (MHLS), depression (PHQ-9), anxiety (GAD-7), and treatment-seeking attitudes (MHSAS). Participants were subsequently asked to read newly created vignettes based on ICD-11 criteria of major depressive, generalized anxiety, social anxiety, bipolar disorders, post-traumatic stress disorder, and schizophrenia. Participants then responded to questions assessing the recognition of disorder presence and identification. The vignettes with accompanying questions were titled the Psychological Disorder Recognition—Vignette (PDR-V) task. The PDR-V evidenced a Kuder–Richardson Formula 20 (KR-20) of 0.83, indicating excellent internal consistency. Independent sample t-tests indicated that participants with prior psychotherapy exposure, a history of mental health diagnosis, and, unexpectedly, those reporting lower education levels and no current mindfulness practice, scored significantly higher on the PDR-V. Spearman correlations revealed that higher scores on a validated MHL scale and specific facets of DM (describe, act with awareness) were positively correlated with PDR-V scores. Bipolar disorder evidenced the highest recognition as a psychological problem broadly, while social anxiety had the highest specific disorder identification accuracy rates. Generalized anxiety disorder had the lowest recognition and identification accuracy. While the PDR-V demonstrated promising preliminary psychometric properties, it also observed anomalies that warrant further investigation, as findings are limited by its cross-sectional nature. These findings suggest that the PDR-V is a versatile tool for differentiating the presence of a problem and accurately identifying the condition, supporting its potential as a reliable and sound measure. Full article