Search Results (6,778)

Background: Aging is a complex process that involves various biological, psychological and social changes. Moreover, older people (≥65 years) are more susceptible to lower self-efficacy and social support, as well as deteriorating mental health. As the global population ages, there is a growing demand for evidence-based interventions tailored to address specific mental health problems, enhance social support and improve overall well-being. The aim of this study was to investigate the effectiveness of a seven-week mindfulness-based community intervention on mental health, self-efficacy and social support in older people. Methods: This quasi-experimental nonrandomized study included 257 participants who were divided into an intervention group and a comparison group that did not participate in the seven-week mindfulness-based community intervention and was not part of a waiting list. Assessments were conducted before the intervention began and 6 months after its completion. Results: The results revealed a significant reduction in depression in the intervention group (p < 0.001). Furthermore, the intervention led to a significant improvement in general self-efficacy, chronic disease self-management self-efficacy, physical activity and nutritional self-efficacy compared with the comparison group. Perceived social support increased within the intervention group; however, covariate adjusted between-group effects for social support were not statistically significant. Conclusions: Overall, the mindfulness-based community intervention was associated with improvements in current depressive symptoms and multiple self-efficacy domains at 6-month follow-up in older people in a community setting. Effects on perceived social support were less robust, and no statistically significant between-group differences were observed after adjustment for baseline covariates. The results of the present study show that this program leads to immediate health benefits in terms of mental health and self-efficacy in older people while contributing to the development of effective strategies for chronic disease self-management. Full article

Background and Objectives: Bladder cancer (BC) represents a significant global health burden, ranking as the tenth most commonly diagnosed malignancy worldwide, with an incidence rate of 5.6 per 100,000 person-years annually. The research team aimed to summarize evidence on specialized nursing-led interventions for bladder cancer management across the disease continuum. Materials and Methods: This scoping review used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) methodology to search four databases from January 2018 to November 2025. Results: This concise but informative scoping review of 20 studies revealed substantial clinical and patient-reported benefits from specialized nursing interventions. Enhanced recovery after surgery (ERAS) protocols incorporating structured nursing care demonstrated a 35% reduction in postoperative complications. Integrated nursing interventions during postoperative intravesical therapy significantly improved patient satisfaction, treatment compliance, and self-efficacy while reducing anxiety and depression. Digital health platforms, including internet-based and mobile applications, proved effective in reducing caregiver burden, enhancing disease knowledge, and improving coping strategies. Preoperative stoma education and postoperative ostomy care management significantly improved self-efficacy, stoma care knowledge, and overall health-related quality of life. Psychosocial interventions, including cognitive behavioral therapy and mindfulness-based approaches, demonstrated significant improvements in quality of life and reductions in fear of recurrence, depression, and anxiety. However, a critical evidence gap exists regarding bladder cancer-specific mental health interventions. Conclusions: Specialized nursing-led care plays a critical role in strengthening clinical and assistive practice in bladder cancer. Evidence from this scoping review shows that nursing-led interventions significantly improve clinical outcomes, patient satisfaction, symptom management, and quality of life across all phases of bladder cancer care while reducing caregiver burden and enhancing psychological well-being for both patients and families, reinforcing the value of integrating specialized nursing roles into routine bladder cancer management. Full article

Background/Objectives: Nurses are susceptible to compassion fatigue due to the nature of their professional responsibilities. Factors contributing to this vulnerability include daily patient interactions and organizational elements within their work environment, as well as work-related stress and sociodemographic characteristics, including age, marital status, years of professional experience, and, notably, gender. This research investigates the relationship between compassion fatigue and the levels of anxiety and depression, as well as the professional quality of life among nurses providing care to dementia patients in Greece. Methods: A cross-sectional survey was carried out with 115 nurses working in dementia care centers in Greece. The Hospital Anxiety and Depression Scale (HADS), the Professional Quality of Life Scale (ProQOL-5), and the participants’ personal, demographic, and professional information were all included in an electronic questionnaire. Multiple regression analysis was used. Results: A total of 42.6% of nurses rated their working environment as favorable. Additionally, 23.5% of the sample exhibited high levels of compassion satisfaction, whereas 46.1% demonstrated low levels of burnout. Female gender (p = 0.022) and a higher family income (p = 0.046) was positively associated with compassion satisfaction. Regression analysis indicated that elevated symptoms of anxiety and depression were found to correlate with decreased compassion satisfaction, increased burnout, and heightened secondary post-traumatic stress. Conclusions: Engaging in the care of patients with dementia, particularly throughout the pandemic period, has underscored a pronounced susceptibility to compassion fatigue, physical fatigue, pain, psychological stress, and a reduced quality of life. These results highlight the importance for nursing management to adopt specific organizational measures, including proper staffing levels, balancing workloads, and conducting routine mental health assessments. Full article

Background: Adolescence is a sensitive period for psychological, academic, and social development, and sports participation has been described as a potential protective factor for academic performance and psychological well-being. However, limited research has examined the combined influence of sports involvement, sport type, and family background on adolescents’ academic and psychological outcomes. This study aimed to investigate the associations between organized sport participation, sport type (football vs. judo), psychological well-being, psychosomatic symptoms, academic performance, and family socioeconomic background among adolescent boys. Methods: The sample consisted of 52 boys aged 11–14 years from a rural school, divided into football players (n = 13), judo athletes (n = 13), non-athletes (n = 13), and a contextual subgroup of students with special educational needs (SEN; n = 13), with the latter included for exploratory purposes only. Data included school-record-based academic performance and validated self-report measures of life satisfaction, depressive symptoms, psychosomatic complaints, perceived physical fitness, and socioeconomic background. Results: Athletes demonstrated significantly higher academic achievement than non-athletes in overall grade point average (p < 0.001), mathematics (p < 0.001), Romanian (p < 0.001), English (p = 0.03), and Hungarian (p < 0.001). They also reported higher life satisfaction (p < 0.001) but simultaneously showed slightly elevated depressive symptom scores (p < 0.001), indicating a paradoxical pattern of concurrent psychosocial benefits and psychological strain. Parental education (p < 0.001), parental occupational status (p = 0.01), and fathers’ occupational position (p = 0.02) were significantly higher among athletes’ families. Perceived physical fitness was also rated higher by athletes (p < 0.001). No significant differences were found in body mass index, family structure, or most psychosomatic symptoms. Conclusions: Sport participation was associated with more favorable academic and psychological indicators, yet also with elevated depressive symptoms, highlighting the dual nature of organized sport during adolescence. Future research should apply longitudinal designs, include female participants, and incorporate objective indicators of training load. Full article

Introduction: The COVID-19 pandemic had significant effects on mental health and lifestyle behaviours, especially among university students who experienced academic disruptions, social isolation, and fewer social interactions. Alcohol consumption has long been part of student culture. Still, the influence of post-pandemic academic reintegration on drinking patterns and psychological distress remains relatively unexplored, particularly in countries like Portugal, where student traditions heavily shape consumption habits. This study aimed to describe the prevalence of alcohol consumption, depression, anxiety, and stress in a sample of Portuguese university students during the post-pandemic academic period, and to explore associations with sociodemographic variables. Methods: A cross-sectional study was conducted in November 2021 with 90 students from a private higher education institution in northern Portugal. Data were collected via an online questionnaire including sociodemographic information, the Alcohol Use Disorders Identification Test (AUDIT), and the Depression, Anxiety and Stress Scale (DASS-21). Result: The majority of the participants were not at risk of alcohol addiction (95.3%). In total, 15.1% of students reported anxiety symptoms ranging from severe to extremely severe. A binomial logistic regression was performed to ascertain the effects of being away from home and psychological distress (DASS-42 score), on the likelihood that participants were at risk of alcohol addiction (Level 3 and 4 in the AUDIT scale). The logistic regression model was statistically significant, χ²(2) = 9.20, p = 0.010. Living away from home was associated with a substantially lower likelihood of high-risk status (B = −2.79, p = 0.034), corresponding to an odds ratio of 0.06, indicating a strong protective effect. DASS-42 total score was positively associated with high-risk status (B = 0.04, p = 0.039), such that higher psychological distress increased the odds of being classified as high risk. Conclusions: The findings reveal a low prevalence of alcohol risk but heightened symptoms of anxiety, depression, and stress. Psychological distress notably increases the likelihood of hazardous alcohol use, emphasising the importance of targeted mental health and alcohol-use interventions among university students. Full article

A significant body of research worldwide has examined how parents who set high expectations may increase adolescents’ risk of developing perfectionistic traits. However, studies exploring this relationship in the Global South are almost nonexistent. This study investigated how adolescents perceived parental expectations related to perfectionism and depressive symptoms among Nigerian adolescents. Participants completed the Frost Multidimensional Perfectionism Scale (FMPS), the Living Up to Parental Expectation Scale—Academic (LPE), and Beck’s Depression Inventory. Parental academic expectations were positively associated with personal standards and concern over mistakes, but parental expectations were negatively associated with depressive symptoms. Further analysis revealed that personal standards fully mediated the negative relationship between parental academic expectations on adolescents’ depressive symptoms. In contrast, concern over mistakes partially mediated the relationship between parental academic expectations and depressive symptoms. In contrast to previous research, parental academic expectations were associated with fewer depressive symptoms among Nigerian adolescents through indirect relationships with perfectionistic traits. Full article

Background/Objectives: This umbrella review critically evaluates the available evidence on psychobiotics for depressive and anxiety symptoms, emphasizing methodological quality, consistency of findings, and persistent gaps in the literature. Methods: A comprehensive search was conducted across PubMed/MEDLINE, Scopus, Web of Science, SciELO, Cochrane, and EBSCO (May–June 2025) to identify systematic reviews with meta-analyses of randomized controlled trials examining probiotic, prebiotic, and synbiotic interventions in adults with depressive and/or anxiety symptoms or diagnoses. Two reviewers independently screened studies, extracted data, and evaluated methodological quality using AMSTAR-2. Additional bibliometric, conceptual, and psychometric features were mapped, including geographical origin, publication timeline, scale distribution, and citation-based connectivity. Results: Thirty systematic reviews and meta-analyses were included. Methodological quality was predominantly moderate, low, or critically low in 76.6% of reviews. Probiotic interventions demonstrated consistent benefits for MDD (SMD = −0.50 [95% CI: −0.58 to −0.42], p = 0.0001). However, findings for anxiety were markedly inconsistent, despite the modest improvements in specific subgroups (SMD = −0.19 [95% CI: −0.28 to −0.10]; p < 0.01). Prebiotics for MDD interventions showed limited positive results (SMD = −0.25 [95% CI: −0.47 to −0.03]; p = 0.03). For anxiety, the effects are inconclusive (SMD = −0.07 [95% CI: −0.30 to 0.10]; p = 0.18). Evidence for synbiotics was scarce. Citation-mapping revealed a fragmented and unevenly connected evidence base. Conclusions: The current evidence suggests that probiotics may confer beneficial effects on depressive and anxiety symptoms; however, the same cannot be said for prebiotics and synbiotics. Evidence for the efficacy of prebiotics and synbiotics to treat depression and anxiety is still insufficient or heterogeneous. Registration: CRD420251164884. Full article

Background: Fibromyalgia syndrome (FMS) and post-traumatic stress disorder (PTSD) may co-occur and are associated with increased symptom burden, functional impairment, and reduced quality of life. Accumulating evidence suggests shared neurobiological mechanisms. Trauma-focused interventions targeting maladaptive memory processes may therefore represent a relevant therapeutic approach in this population. Objective: To evaluate the feasibility, tolerability, and preliminary clinical associations of a brief reconsolidation-based therapy in women with comorbid FMS and PTSD. Methods: This multicenter pilot study included adult women diagnosed with FMS and PTSD who underwent six sessions of reconsolidation therapy combining traumatic memory reactivation with propranolol administration. Clinical outcomes were assessed at baseline and at 3-month follow-up using the Fibromyalgia Impact Questionnaire (FIQ), the Impact of Event Scale–Revised (IES-R), the Montgomery–Åsberg Depression Rating Scale (MADRS), the Beck Depression Inventory (BDI), the Rosenberg Self-Esteem Scale (RSES), and the SF-36. Changes over time were analyzed using paired statistical tests and linear mixed-effects models. Results: Fourteen participants completed the intervention and follow-up assessments. The intervention was feasible and well tolerated. Changes over time were observed in fibromyalgia-related quality of life (FIQ scores), PTSD symptom severity (IES-R), and depressive symptoms (MADRS, BDI), as well as in selected SF-36 domains, including vitality, social functioning, and mental health. A progressive decrease in IES-R scores was observed across treatment sessions. Conclusions: This pilot study suggests that reconsolidation-based therapy is feasible in women with comorbid FMS and PTSD and was associated with changes in PTSD symptoms and fibromyalgia-related functional impact. Given the exploratory design and absence of a control group, these findings should be interpreted cautiously and warrant confirmation in larger, controlled trials. Full article

Background: Depressive symptoms are frequent sequelae of COVID-19 and may remain unrecognized in older outpatients, particularly those with post-COVID syndrome. The objective of the current study was to assess the under-detection of depressive symptoms in older ambulatory patients and to examine its relationship with post-COVID syndrome status. Methods: We conducted an observational outpatient cohort study of adults aged 60–89 years with prior SARS-CoV-2 infection (N = 85), recruited at two city polyclinics. Depressive symptoms were assessed through three detection channels: spontaneous complaint during the visit, a standardized direct question about current depressive symptoms, and the 15-item Geriatric Depression Scale (GDS-15). Agreement between complaint and direct question was evaluated using Cohen’s κ and McNemar’s test. Screening performance of complaint and direct question was assessed against GDS-15 thresholds (≥5; sensitivity analysis ≥ 6). Associations between post-COVID syndrome status and binary depressive-symptom indicators were expressed as risk ratios (RRs). Results: Spontaneous complaints missed a substantial proportion of cases: among complaint-negative patients, 18.3% (15/82) reported depressive symptoms on the direct question (κ = 0.149; McNemar p = 0.00052). Against GDS-15 ≥ 5, complaint sensitivity was 10.3% with specificity 100.0% (F1 = 0.19), whereas the direct question showed higher sensitivity (34.5%) with specificity 87.5% (F1 = 0.43). Using the alternative threshold GDS-15 ≥ 6, complaint sensitivity was 15.0% with specificity 100.0% (F1 = 0.26), and direct question sensitivity was 45.0% with specificity 87.7% (F1 = 0.49). A positive response to the direct question was more frequent in patients with post-COVID syndrome than in controls (RR = 2.70 (1.04–7.00)); stratified estimates suggested higher RRs in patients ≤ 75 years (RR = 4.55 (1.08–19.10)) and in women (RR = 2.67 (1.04–6.83)), with limited precision due to sparse events. Conclusions: In older post-COVID outpatients, reliance on spontaneous complaints leads to marked under-detection of GDS-15 screen-positive depressive symptoms. A standardized direct question improves initial case-finding but does not replace a validated screening scale; a stepped approach (brief direct question followed by a scale when indicated) may be warranted. Full article

Background/Objectives: Parkinson’s disease is the second most common neurodegenerative disorder, affecting patients’ daily lives in multiple domains, including functional status, health-related quality of life, and psychological well-being. This study examined the relationship between self-reported global activity level, functional status, Health Related QoL (HRQoL), and psychological state among patients with Parkinson’s disease in Greece. Methods: Thirty volunteers (mean age = 69.07, SD = 11.24), members of the Greek Parkinson’s Patients and Caregivers Association, completed (a) the Parkinson’s Disease Questionnaire to evaluate HRQoL and (b) the Hospital Anxiety and Depression Scale (HADS) to assess psychological state. Participants then performed (a) the Five Times Sit to Stand Test (FTSST) and (b) the Berg Balance Scale (BBS) to evaluate functional status. All questionnaires and the test used in the present study have been validated in Greek. Correlation analysis with Spearman r tests with Bonferroni correction was performed between the above variables. Subsequent linear regression models were used to identify independent predictors of HRQoL and balance using SPSS 29.0.2.0. Results: Participants reported elevated anxiety (M = 9.67, SD = 4.44) and depressive symptoms (M = 8.97, SD = 4.08), alongside relatively high HRQoL scores (M = 40.09, SD = 18.40). Impaired functional performance was observed, with 22 participants failing to complete the FTSST within 16 s and 16 scoring below 40 on the BBS. Functional status was strongly correlated with HRQoL (r = −0.696, p < 0.001) and activity level (r = −0.521, p < 0.008). Depression was also significantly associated with poorer HRQoL (r = 0.618, p < 0.008) and lower activity levels (r = −0.545, p < 0.008). Regression analyses revealed that balance (β = −0.526), disease duration (β = 0.437), anxiety (β = 0.411), and lower limb function (β = −0.351) were significant independent predictors of HRQoL (R² = 0.785; F(9, 20) = 12.69; p < 0.001), while HRQoL (β = −0.738) and lower limb function (β = −0.391) independently predicted balance (R² = 0.699; F(9, 20) = 4.72; p = 0.002), suggesting a bidirectional relationship between physical function and subjective well-being. Conclusions: Activity level, HRQoL, functional status, and psychological state in patients with Parkinson’s disease are interrelated factors. Increased levels of anxiety and depression, as well as reduced HRQoL, were observed. The findings point to a potentially reinforcing cycle between poor balance and diminished quality of life, with anxiety and age playing key roles. Overall, the results illustrate that functional, psychological, and HRQoL measures interact in complex ways, emphasizing the multidimensional profile of patients with Parkinson’s disease. Further studies with larger samples are required to confirm these findings. Full article

Background/Objectives: Hidradenitis suppurativa (HS) is a chronic, inflammatory, and recurrent disorder of the pilosebaceous unit with numerous comorbidities. Growing evidence suggests that depression and anxiety occur more frequently in HS patients, yet their relationship with clinical severity and especially subjective symptoms remains insufficiently understood. The aim of this study was to assess the prevalence and severity of probable depressive and anxiety symptoms in Polish patients with HS and to examine their associations with clinical disease severity, pain and itch intensity, and quality of life (QoL). Methods: Eighty-four HS patients were included in this cross-sectional study. Disease severity was assessed using Hurley staging and the IHS4. Pain and itch intensity were evaluated using the Numeric Rating Scale (NRS). Psychological assessment included self-administered screening questionnaires, such as PHQ-9 and HADS-D for depression and GAD-7 and HADS-A for anxiety. QoL was measured using DLQI and HiSQOL instruments. Statistical analyses were performed with p < 0.05 considered significant. Results: Possible depressive disorders were identified in 25.0% of patients. PHQ-9 and HADS-D scores differed significantly across Hurley stages and correlated positively with IHS4. Possible anxiety disorder according to GAD-7 criteria was present in 15.5% of patients. Both GAD-7 and HADS-A correlated with IHS4. They also showed correlations with pain and/or itch intensity. All psychological measures showed strong correlations with both QoL instruments. Conclusions: Depression and anxiety seem to be common in HS and closely associated with clinical severity and reduced QoL. Their relation with pain and itch requires further studies. These findings underscore the need for multidisciplinary management in HS care. Full article

Background: Depression and eating disorders (EDs) represent significant and often multiple public health concerns. Healthcare workers, including medical residents, were affected by several stressors that the COVID-19 pandemic has engendered and amplified, potentially exacerbating mental health issues. Despite this, limited evidence is available regarding the association between depressive symptoms and possible EDs among Public Health Residents (PHRs). Methods: A nationwide cross-sectional study, the ‘Public Health Residents Anonymous Survey in Italy (PHRASI),’ was conducted between June and July 2022. A total of 379 PHRs participated in this study, filling in a self-administered questionnaire which included the PHQ-9 for assessing depressive symptoms and the SCOFF (Sick, Control, One, Fat, Food) test as a screening tool for possible EDs. Multivariable logistic regression evaluated associations between sociodemographic and training/work-related factors, depressive symptoms, and EDs. Results: Overall, 40.6% of respondents screened positive for possible EDs. Depressive symptoms had a positive association with possible EDs (aOR = 2.76; 95% CI = 1.55–4.93). Other factors associated with higher ED odds included region of residence (aOR = 1.92; 95% CI = 1.06–3.47), intention to repeat the test for another postgraduate course (aOR = 3.22; 95% CI = 1.25–8.3), and working more than 40 h per week (aOR = 1.91; 95% CI = 1.19–3.07). Conversely, having more than one child (aOR = 0.32; 95% CI = 0.13–0.78) was associated with lower odds. Conclusions: The findings highlight a significant association between depressive symptoms and positive screening for possible EDs, underscoring the need for integrated mental health support and preventive interventions within medical residency programmes, especially in the context of public health crises. Full article

Background and Clinical Significance: Adams–Oliver syndrome type 3 (AOS3) is a rare congenital disorder typically characterised by terminal transverse limb defects and variable involvement of other organ systems. Although pathogenic variants in RBPJ are well established in AOS3, associated neurodevelopmental or psychiatric features have been only sporadically documented. Case Presentation: We describe a male patient first evaluated at the age of 10 years and subsequently re-evaluated at 14 years, with AOS3 presenting terminal limb defects together with autistic-like behaviour, cognitive difficulties, dyslexia, and recurrent depressive symptoms. Whole-exome sequencing (WES) identified a heterozygous pathogenic variant in RBPJ (c.505A>G; p.Lys169Glu), confirming the molecular diagnosis of autosomal dominant AOS3. Additional findings included a heterozygous missense variant in CACNA1A (p.Arg1678Cys), a gene linked to neurological disorders with broad phenotypic variability. Because of elevated homocysteine levels, the patient was also tested for MTHFR variants and was found to be heterozygous for C677T and A1298C. Conclusions: This case illustrates a rare combination of a validated AOS3-associated RBPJ variant, along with additional CACNA1A and MTHFR variants that may influence the patient’s neurocognitive and psychiatric characteristics. The results underscore the importance of comprehensive genetic testing in atypical AOS presentations and highlight the complexity of interpreting overlapping genetic factors. Full article

This study aimed to examine the interventional effects of positive psychology expressive writing (PPEW) on adolescents’ time attitudes and mental health. A total of 285 adolescents from Northwest China (M = 14.13, SD = 1.075; 53.3% female) were randomly assigned to either a PPEW group (n = 148) or a control group (n = 137). The PPEW group completed a six-week positive psychology expressive writing intervention, while the control group engaged in neutral writing tasks. All participants were assessed on time attitudes, positive affect, and depressive symptoms before and after the intervention. The results showed that, compared to the control group, the PPEW group scored significantly higher on Past Positive, Present Positive, and Future Positive, and significantly lower on Present Negative at post-test; however, a significant improvement in Past Negative was observed only within the PPEW group itself. Regarding mental health, depressive symptoms were significantly reduced in the PPEW group relative to the control group at post-test, but no significant change was observed in positive affect. In conclusion, positive psychology expressive writing can effectively foster the positive development of time attitudes in adolescents and may serve as a feasible approach to alleviating depressive symptoms. Full article

Knee osteoarthritis prognostic tools often target structural progression or surgery and require imaging or biomarker inputs that are not routinely available. Using Osteoarthritis Initiative data, we developed a fully clinical nomogram to estimate both the probability of long-term pain non-resilience (clinically important worsening) and, by complement, maintenance of acceptable pain in radiographic knee osteoarthritis. We included participants with radiographic knee osteoarthritis and complete worst-knee WOMAC pain scores at baseline, 24 and 48 months; non-resilience was defined as a ≥9-point increase on the 0–100 WOMAC pain scale over 4 years. A six-predictor Firth logistic regression model (age, body mass index, Kellgren–Lawrence grade, baseline pain, 0–24-month pain change and Center for Epidemiologic Studies Depression Scale score) was fitted and translated into a point-based nomogram. Among 2365 eligible participants, 527 (22.3%) were non-resilient. The model showed good performance, with optimism-corrected AUC 0.74 and Brier score 0.15, and decision-curve analysis indicated positive net benefit versus treat-none across 1–15% thresholds and small gains versus treat-all. Early pain worsening and higher depressive symptoms were the strongest predictors of non-resilience. This six-variable, clinic-ready nomogram provides a simple, well-calibrated tool for prognostic counseling and risk stratification in radiographic knee osteoarthritis and requires external validation before wider clinical use. Full article