Search Results (4,706)

Background/Objectives: Incorporating parent training into cognitive-behavioral therapy for anxious youth has not been shown to significantly improve outcomes perhaps because these interventions have not addressed potential interfering psychological barriers to implementing parenting changes and rarely offer between-session support. There is growing evidence that Acceptance and Commitment Therapy (ACT) can target these psychological barriers and generate more flexible and adaptive behavioral repertoires in parents of children with a variety of presenting challenges. Methods: Following a pilot trial of “Acceptance and Commitment Therapy for Parents of Anxious Children (ACT-PAC)” a six-week group-based intervention focused on targeting psychological barriers to parenting change using mindfulness and acceptance approaches, we collected qualitative feedback from participants in two post-treatment phases by conducting individual interviews and a focus group with participants that completed the intervention. Results: Analysis of interview responses revealed that parents found ACT principles and processes to be helpful, and many also appreciated the ACT-PAC group setting that allowed parents to recognize their experiences were shared by others and to self-disclose in a non-judgmental space. Feedback from the focus group further provides preliminary evidence that ACT-PAC is acceptable to and feasible for parent participants and suggests modifications such as involving additional caregivers, making resources more readily available, and creative structural changes that may facilitate between-session practice. Conclusions: Results suggest that the group-based intervention can be both maintained and improved for future participants. Limitations to generalizability in light of possible selection bias and the small focus group sample size are addressed. Full article

Background/Objectives: Higher education requires students to communicate in complex academic and social contexts, including oral presentations, group work, help-seeking, assessment, and peer interaction. For students with developmental communication disorders, and communication-related developmental profiles, these demands may create hidden participation vulnerabilities that affect mental health, academic engagement, and belonging. This scoping review mapped empirical evidence among tertiary students, focusing on mental health, academic participation, social belonging, institutional support, and contextual influences. Methods: A scoping review was conducted in accordance with PRISMA-ScR guidance. Five databases, PubMed, PsycINFO, CINAHL, Scopus, and Web of Science, were searched for English-language, peer-reviewed empirical studies published from 2000 onwards. Eligible studies involved university, college, or tertiary students with developmental speech, language, fluency, pragmatic communication, or communication-related developmental profiles, who reported at least one mental health, academic, or social participation outcome. Data were charted and synthesised thematically, with methodological quality appraised using CASP-informed criteria. Results: Twenty-one studies were included. Evidence was strongest for stuttering and fluency-related participation, while research on developmental language disorder, speech sound disorder, pragmatic language impairment, cluttering, and mixed communication profiles was limited. Across studies, communication needs intersected with anxiety, depression, stress, self-efficacy, oral assessment, help-seeking, disclosure, stigma, accommodation access, and belonging. Key limitations included reliance on self-report, cross-sectional or retrospective designs, inconsistent diagnostic confirmation, and limited evidence for intervention. Conclusions: The available evidence suggests that developmental communication disorders and communication-related developmental profiles can function as hidden participation vulnerabilities in higher education. These vulnerabilities are shaped by students’ communication profiles and by communication-intensive university environments. Universities may therefore need communication-accessible teaching, flexible assessment, visible support pathways, and coordinated support across disability services, counselling, academic support, and speech–language pathology. Full article

We report the oldest female identified to date with a pathogenic NBEA variant who has been followed longitudinally. She presented with a complex, diagnostically inconclusive psychiatric phenotype extending in adulthood and a suspected mild neurodevelopmental impairment. The 64-year-old patient experienced recurrent episodes of mental state decompensation characterized predominantly by persecutory and health-related delusional ideation and anxiety. Her most recent psychiatric diagnosis was mixed conversion disorder. Although she never underwent formal cognitive testing, mild intellectual disability was suspected based on her educational attainment, occupational history, and social functioning. Additionally, the patient presented with a likely coincidental tremor. A history of childhood epilepsy could not be confirmed, as detailed epilepsy records were unavailable. Furthermore, the patient declined neuroimaging, precluding assessment of a possible relationship with the identified EXT2 deletion. This case expands the currently recognized neuropsychiatric spectrum possibly associated with pathogenic NBEA variants, highlights the importance of extending phenotypic characterization in later adulthood, and underscores the value of longitudinal follow-up. Full article

Background: Unhealthy alcohol use may lead to arrhythmia and cardiomyopathy, but its impact on sudden death is not well understood. Objective: To investigate the association of unhealthy alcohol use with sudden death. Methods: We conducted a case-control study in Wake County, a large (~1 million inhabitants), diverse county in North Carolina. We screened and adjudicated victims of sudden, unexpected, out-of-hospital deaths in adults aged 18–64 years reported by emergency medical services between 2013 and 2015. We randomly selected sex- and age-matched control patients from a university health system from the same county and time period. Characteristics of sudden death victims and controls were ascertained via standardized chart reviews. Unhealthy alcohol use was identified via chart review and was defined as any evidence of excessive alcohol use, such as it being stated in the social history or medical history, alcohol abuse being listed as a possible contributor to death, or alcohol-related diagnoses. We used logistic regression to estimate odds ratios (ORs) for the association of unhealthy alcohol use and sudden death, adjusting for age, sex, race, and other psychiatric diagnoses, including depression, anxiety, schizophrenia, bipolar disorder, and substance use disorders other than tobacco and alcohol. We also calculated the E-value to estimate the impact of any unmeasured confounders. Results: We identified 399 sudden death victims, of whom 374 (94%) had alcohol use data available. Among these 374 included victims, 256 (68%) were male, and 239 (62%) were White, with a median age at death of 55 years (IQR 48, 60). The demographic characteristics of the 1114 matched controls were similar to those of sudden death victims. Unhealthy alcohol use was present in 115 (31%) sudden death victims and 27 (2%) controls. In analyses adjusted for demographics only, unhealthy alcohol use was associated with a higher incidence of sudden death, with an OR of 17.5 (95% CI 11.4, 27.8). When further adjusted for other psychiatric diagnoses, the OR was 11.2 (95% CI 7.1, 18.0). The calculated E-value was 21.8, meaning an unmeasured confounder would need to be associated with both unhealthy alcohol use and sudden death by 21.8-fold to explain away the observed OR. Conclusions: Unhealthy alcohol use was strongly associated with higher sudden death risk in working-age adults. Our calculated E-value indicates it is unlikely that any unmeasured confounders alone would account for the observed association. Our findings suggest that interventions to reduce unhealthy alcohol use may be an effective strategy to prevent sudden death in working-age adults. Full article

The present integrative umbrella review aims to provide a comprehensive overview of the evidence and practices related to mental health and career transitions in elite sport toward the implementation of service provision through digital interventions. Following PRIO guidelines, an extensive search across five databases (2015–2025) identified 52 eligible manuscripts (e.g., conceptual, review, and position studies). Data extraction focused on mental health, dual-career pathways, career transition challenges and needs, and identity-related issues among high-performance athletes. The findings revealed a strong consensus that athlete well-being is shaped by the dynamic interaction of mental health symptoms, sport-specific stressors, identity processes, and structural conditions across the athletic lifespan. Mental health vulnerabilities (e.g., anxiety, depression, disordered eating, and distress) were consistently reported, particularly during injury, deselection, and retirement. Dual-career engagement, diversified identities, and proactive career planning emerged as key protective factors, while stigma, limited literacy, and uneven access to psychological services remained persistent barriers. Five main thematic areas (Matrix 1) operationalized in ten higher-order intervention domains (e.g., Matrix 2, screening, monitoring, literacy, and others) and 14 potential online implementation strategies (Matrix 3) were identified. However, the evidence highlights fragmented implementation and a lack of scalable, cross-national tools to support athletes during and beyond their competitive careers. Therefore, a harmonized, evidence-based, multidimensional framework for the development and implementation of digital support resources has been proposed. This integrative review underscores the need for integrated, culturally sensitive, and digitally enabled support systems to promote sustainable transitions and long-term athlete well-being. Full article

Objectives: We aimed to examine the association between bubble tea consumption and anxiety symptoms among adolescents in Eastern China and to explore the potential role of sleep disturbance in the observed association between bubble tea consumption and anxiety symptoms. Methods: This study utilized cross-sectional baseline data from the Zhejiang Childhood Behavior and Health Cohort. Bubble tea consumption frequency was categorized as 0, 1–2, and ≥3 days per week. Anxiety symptoms were assessed using the Generalized Anxiety Disorder—7 (GAD-7) scale, while sleep disturbance was measured through self-reported items. Associations between bubble tea consumption and anxiety symptoms were examined using multivariable logistic regression models, and dose–response relationships were evaluated with restricted cubic spline (RCS) models. Subgroup analyses stratified by age, sex, school type, residence, and body mass index (BMI) were conducted to assess the consistency of the associations. An exploratory mediation analysis with bootstrap confidence intervals was performed to evaluate the indirect association through sleep disturbance. Sensitivity analyses using a stricter definition of anxiety symptoms (GAD-7 ≥ 10) were conducted to assess robustness. Results: A total of 11,847 adolescents aged 12–18 years were included, of whom 32.03% met the GAD-7 threshold for any anxiety symptoms (GAD-7 ≥ 5, including mild symptoms). Compared with non-consumers, adolescents consuming bubble tea 1–2 days per week had higher odds of anxiety (OR = 1.12, 95% CI: 1.02–1.22), while those consuming bubble tea ≥3 days per week had substantially higher odds (OR = 1.53, 95% CI: 1.30–1.80). Each additional day of bubble tea consumption per week was associated with 10% higher odds of anxiety (OR = 1.10, 95% CI: 1.06–1.14). RCS analysis demonstrated a significant positive linear association between bubble tea consumption and anxiety (p for non-linearity > 0.05). Associations were consistent across age, sex, school type, residence, and BMI categories (all p for interaction > 0.05). Sensitivity analyses yielded similar results. Exploratory mediation analysis suggested that sleep disturbance may be statistically related to a portion of the observed association between bubble tea consumption and anxiety symptoms. Conclusions: Higher frequency of bubble tea consumption was associated with greater odds of anxiety symptoms among adolescents in a dose–response pattern. Sleep disturbance may statistically explain part of the association. These findings should be considered hypothesis-generating and require confirmation in prospective longitudinal studies. Full article

Quantum machine learning (QML) provides a framework for benchmarking wearable biosignal classification relevant to stress detection. Motivated by the burden of stress-related conditions, this study compares three quantum classifiers with seven classical baselines using heart rate and respiration rate features as inputs under noise-free and noisy conditions. Uncertainty was quantified using Nadeau–Bengio-corrected confidence intervals and percentile bootstrap ($B=1000$). The variational quantum classifier (VQC) achieved an accuracy of $99.47\%/97.30\%$ (noise-free/noisy), the quantum support vector classifier (QSVC) achieved $99.90\%/99.37\%$, and PegasosQSVC achieved $99.80\%/99.70\%$. Additionally, under the assessed proof-of-concept conditions, statistical equivalence between the QSVC and the best-performing classical model was established at $\Delta =1$ pp; PegasosQSVC under noise achieved equivalence at $\Delta =2$ pp with accuracy degradation of less than $0.10$ pp. The time feature was identified as the primary separability driver in a post hoc classical ablation. Tree-based models were robust on physiological features alone. The surveyed methods provide a reproducible, noise-aware benchmark for wearable physiological signal classification; however, the reported high accuracies are based on a deliberately separable proof-of-concept benchmark and do not demonstrate clinical utility or a quantum advantage. Full article

Background/objectives: Long COVID is associated with persistent, multi-system symptoms, yet little is known about how it affects individuals with intersecting vulnerabilities, such as a racialized identity and pre-existing mental health conditions. This study aimed to descriptively characterize the symptom burden, functional outcomes and mental health in this population. Methods: A cross-sectional, exploratory study was conducted among 51 adults in Canada who self-identified as racialized and as having a pre-existing mental health condition and reported long COVID symptoms. Participants completed an online survey, including validated measures of symptoms, fatigue, post-exertional malaise, cognitive function, mental health and disability. Descriptive statistics were used to summarize outcomes. Results: Participants reported a slight to moderate overall symptom burden, with the highest scores in respiratory and psychological domains. Functional impairment was moderate across work, social and daily activities (Work and Social Adjustment Scale mean = 17.35; World Health Organization Disability Assessment Schedule 2.0 mean = 16.61; Post COVID-19 Functional Status Scale mean = 2.20). Fatigue and post-exertional malaise were notable (Modified Fatigue Impact Scale mean = 43.39; DePaul Symptom Questionnaire—Post-Exertional Malaise mean = 22.47), and cognitive difficulties were commonly reported (Perceived Deficits Questionnaire mean = 33.43). Anxiety and depression scores were in the mild to moderate range respectively (General Anxiety Disorder-7 mean = 9.27; Patient Health Questionnaire-9 mean = 11.43). Conclusions: Clinically relevant fatigue, post-exertional malaise, and depression were found, alongside moderate functional limitations across life domains. The findings support the conceptualization of long COVID as a syndemic condition and underscore the need for equity-informed research, rehabilitation and public health strategies. Full article

Neurological disorders affect billions of people worldwide, with oxidative stress and its associated cellular mechanisms recognized as key pathological drivers of neuronal damage. Despite this, natural agents capable of targeting these mechanisms remain underexplored. Physalis angulata L. (PA) contains physalins and withanolides known for their neuroprotective properties, though its in vivo neuroprotective mechanism remains poorly characterized. This study evaluated the preventive neuroprotective effects of PA leaf extract using an integrated developmental, behavioral, and metabolomic approach in a H₂O₂-induced zebrafish (Danio rerio) model. PA extract demonstrated moderate-to-strong antioxidant capacity (ABTS IC₅₀ = 66.66 ppm; DPPH IC₅₀ = 114.91 ppm). Treatment with 50 ppm PA extract provided optimal neuroprotection, significantly restoring body length, yolk sac utilization, and heart rate, while markedly improving locomotor activity and reducing anxiety-like thigmotaxis behavior. Notably, PA extract demonstrated superior efficacy compared to N-acetylcysteine (NAC) across multiple developmental and behavioral endpoints. Metabolomic profiling of zebrafish embryo homogenates provided direct in vivo biochemical evidence of antioxidant pathway modulation, demonstrating that PA extract mitigated metabolic disruption by restoring amino acid metabolism (glycine, serine, and threonine), glutathione synthesis, glycerophospholipid homeostasis, and one-carbon pool metabolism. These findings demonstrate that P. angulata exerts multi-target neuroprotection by restoring antioxidant pathways and promoting metabolic homeostasis, supporting its potential as a natural therapeutic candidate for oxidative stress-related neurological conditions. Full article

Introduction. Chronic non-cancer pain is highly prevalent and profoundly diminishes quality of life. While pharmacological and interventional treatments are central, its psychosocial and spiritual dimensions remain under-addressed. This pilot study assessed the feasibility of a therapist-led support group intervention for patients with chronic non-cancer pain and explored preliminary psychospiritual outcomes. Methods. A two-arm, non-randomized pilot feasibility study was conducted among 58 outpatients of a university pain management clinic in Poland. Feasibility was assessed through recruitment, retention, attendance, and safety, while preliminary psychological and spiritual outcomes were evaluated using validated self-report instruments. The intervention group (n = 29) participated in eight group sessions combining psychoeducation, mindfulness-based techniques, and supportive dialogue inspired by the Simonton Method. The control group (n = 29) received standard care. Participants completed the Numeric Rating Scale to measure pain intensity, the Satisfaction with Life Scale, the Positive and Negative Affect Schedule, the WHOQOL-BREF, the Spiritual Well-Being Scale, the Generalized Anxiety Disorder Scale, and the Patient Health Questionnaire-9. Results. The intervention was feasible in terms of physician workload; however, patients adherence varied significantly. At baseline, the control group showed a significantly higher positive affect and existential well-being than did the intervention group. In exploratory within-group analyses, participants in the intervention group showed improved positive affect and reduced anxiety (p < 0.05), whereas existential well-being showed a trend toward improvement (p < 0.06). However, the self-selection design limits causal inferences. Nevertheless, participants reported social connectedness, meaning-making, and enhanced vitality. Discussion. This pilot feasibility study provides preliminary evidence that a therapist-led support group intervention integrating psychoeducation, mindfulness, and supportive components is practicable within multidisciplinary pain management. Further research in a larger, randomized trial is needed to evaluate adherence and safety, as well as clinical effects, more rigorously. Full article

Anxiety disorders and chronic stress are the most common types of mental disorder. According to the WHO, more than 359 million people worldwide suffered from these conditions in 2021. The function of mastication and the masticatory muscles undergo significant changes under the influence of a disturbed psychoemotional state. This manifests as their parafunctional activity, accompanied by increased tone and damage to elements of the dentofacial system, including increased tooth wear, chipping, cracks, and fractures. Attention to this problem is growing annually among researchers in both dental and neurological fields. This is evidenced by a wide range of therapeutic and preventive interventions aimed at correcting chronic stress, muscle hypertonia, and pathology of the dentofacial system. Despite the aforementioned measures, it is often only possible to slow down the pathological process rather than completely resolve it. This is because knowledge regarding the biology and pathophysiology of how chronic stress affects muscle activity remains limited. Understanding such mechanisms and establishing precise interrelationships could help identify targets for effective therapeutic interventions and eliminate the problem. This review of the literature systematizes information on how chronic stress and various autonomic stimuli affect changes in the functional activity of the masticatory muscles and the pathology of hard dental tissues. Full article

Background/Objectives: Depression, anxiety disorders, and substance use disorders frequently coexist in clinical settings and are main factors that worsen a patient’s prognosis. However, traditional artificial intelligence-based mental health studies have limitations in capturing the complex symptoms that occur in actual counseling situations by relying on social media data or focusing on binomial classification of single diseases. This study proposes a multi-label classification model that simultaneously detects the coexistence of depression, anxiety, and substance use disorder in actual counseling dialogue texts, and applies the Shapley Additive Explanatory (SHAP) method to explain the clinical basis of model prediction. Methods: We retrospectively analyzed 1661 de-identified Korean-language counseling session transcripts obtained from the publicly available AI Hub “Mental Health Counseling Dialogue” dataset (Republic of Korea; sessions collected between 2021 and 2023 from accredited domestic mental health counseling centers). Each session averaged 30 min (≈5000 Korean characters). Labeling was performed by two licensed clinical psychologists (inter-rater Cohen’s κ = 0.82). A Hierarchical Attention Network with Bidirectional LSTM (HAN-BiLSTM) was constructed; performance was compared with six baselines (Flat LSTM, TextCNN, KR-BERT, KoBERT, KoELECTRA, KLUE-RoBERTa) using stratified 5-fold cross-validation, paired t-tests with Bonferroni correction, and McNemar’s test. Top-ranked SHAP tokens were independently rated for clinical face validity by three psychiatrists. Results: The proposed model outperformed the baseline model not only for the labels of depression (F1 = 0.90) and anxiety (F1 = 0.85) but also for substance use disorder (F1 = 0.78) with poor data, achieving a macro-averaged F1 of 0.84 (95% CI 0.82–0.86; all p < 0.001 versus baselines). As a result of the SHAP analysis, clinically significant keywords such as “I want to die,” “anxiety,” and “drink” were identified as the model’s main basis for judgment, accurately tracking the client’s state, which dynamically changed as the dialogue progressed; three independent psychiatrists rated 88.7% of the top-15 SHAP tokens per label as clinically meaningful (Fleiss’s κ = 0.76). Conclusions: This study demonstrated that a deep learning-based multi-label approach is effective in early screening of complex mental health problems. In particular, the introduction of explainable AI (XAI) increases clinicians’ trust and suggests that it can be used as an AI-based clinical decision support system (CDSS) in the future. Full article

Perinatal mental illness affects up to 20% of new mothers worldwide, yet despite a growing research interest over the past decade, the etiology is still not fully understood, and clinical treatment guidelines remain inconsistent across countries and services. In this review, recent findings on neurobiological processes and evolutionary mechanisms, as they occur during the menstrual cycle, pregnancy, birth, postpartum and breastfeeding, are discussed. The intention is to raise awareness of physiological changes in pregnancy that might be relevant to the differential diagnosis and clinical treatment of perinatal psychiatric disorders such as depression, anxiety, PTSD after childbirth, bipolar relapse, postpartum psychosis, obsessive-compulsive symptoms, substance-use disorders, and suicidality. Areas addressed include the activities of the immune system, thyroid gland, cortisol, sleep and individual sensitivity to ovarian hormone fluctuations. Evolutionary biological mechanisms intended to sustain pregnancy and to ensure the survival of the newborn are assumed to have potent effects on the maternal brain. These non-pathological adaptations could provide grounds for a better understanding of risk factors and the etiology of perinatal mental illness. Full article

Anxiety disorders are characterized by dysregulation of monoaminergic signaling and remain a significant therapeutic challenge due to limitations associated with current pharmacological treatments. In this context, the essential oil of Morisonia flexuosa (Capparaceae) seeds was chemically characterized and evaluated for anxiolytic-like activity in adult zebrafish. Chemical profiling by GC–MS and GC–FID revealed a predominance of isothiocyanates, particularly butyl isothiocyanate (42.60%) and isobutyl isothiocyanate (42.28%). Acute toxicity assessment demonstrated no lethality at the tested doses. Behavioral analyses showed a significant increase in light preference in the light/dark paradigm, with moderate locomotor reduction insufficient to account for the behavioral shift solely by sedation. Pharmacological antagonism assays indicated that the anxiolytic-like effect was predominantly mediated by 5-HT1 and 5-HT2A/2C receptors. Chemometric analyses (PCA, HCA, and heatmap) revealed statistical association between compound abundance and behavioral endpoints, supporting the contribution of major isothiocyanates within the tested model. Notably, the strongest behavioral response was observed at the lowest concentration, suggesting an ideal effective concentration range. Collectively, these findings provide the first evidence that an isothiocyanate-rich essential oil from M. flexuosa exerts serotonergic-involved anxiolytic-like effects in zebrafish and supports further mechanistic investigation of its neuropharmacological potential. Full article

Returning to work (RTW) following sickness absence due to common mental disorder (CMD) symptoms, such as anxiety, depression and stress, is increasingly recognised as a critical yet complex phase of recovery. Despite this, individuals do not always experience the process as supportive or straightforward. This study explored the factors shaping RTW by examining the perspectives of service users, employment advisors (EAs) and human resource (HR) professionals. In a qualitative study, using purposive sampling, we recruited 17 participants across the three stakeholder groups. Data were collected through semi-structured interviews and analysed using thematic analysis. The findings suggest that RTW is shaped by a dynamic interplay between individual experiences, workplace relationships and organisational structures. Participants described returning to work as an ongoing and often uncertain process, influenced by shifts in confidence, expectations of support and the extent to which workplaces were able to respond flexibly to individual needs. While some accounts reflected collaborative and supportive environments, others highlighted disconnection, misalignment and unmet expectations across stakeholders. Overall, the findings point to RTW as a negotiated process, requiring alignment between employees, managers and organisational systems. The study highlights the importance of consistent, flexible and context-sensitive approaches to support sustainable RTW following CMD-related absence. Full article