Search Results (2,791)

Genetic cardiomyopathies (GCMs) are chronic heart muscle disorders requiring lifelong monitoring and treatment. Although quality of life (QoL) and health-related quality of life (HRQoL) are increasingly recognized as important outcomes in cardiomyopathy care, their conceptualization and measurement remain inconsistent. This scoping review aims to (a) identify the tools most commonly used to assess QoL and HRQoL in adults with genetic cardiomyopathies and (b) map the thematic areas of existing studies, including symptom burden, psychological distress, diagnostic challenges, and the impact of medical and psychological interventions. PubMed, Scopus, and PsycINFO were systematically searched, and the final search was completed in November 2025. Seventeen peer-reviewed studies met the inclusion criteria and were included in this scoping review. The review followed the PRISMA extension for Scoping Reviews and included both quantitative, qualitative and mixed-methods designs. Most studies employed standardized tools such as EQ-5D (N = 5), SF-36/SF36v2 (N = 5), and the Kansas City Cardiomyopathy Questionnaire (N = 3), while others included the Minnesota Living with Heart Failure Questionnaire (N = 2) and disease-specific or ad hoc measures. The most frequently investigated themes included impairments in physical functioning, emotional well-being, symptom burden, psychological distress, and social participation. Several studies showed that patients’ perceived QoL was more closely associated with symptom burden and psychological adjustment than with objective clinical indicators alone. Clinical interventions showed mixed or limited effects on QoL and HRQoL outcomes, even when clinical parameters improved. Qualitative research further emphasized the lived experiences of patients and families, highlighting unmet needs in care. Less commonly addressed findings concerned caregiver perspectives, patient–provider communication, treatment adherence, socioeconomic disadvantage, healthcare costs, productivity loss, and the experiences of patients with rarer cardiomyopathy-related conditions. The results highlight how QoL and HRQoL are central but still inconsistently assessed outcomes in cardiomyopathy research. This review calls for greater conceptual clarity between QoL and HRQoL, greater standardization in measurement tools, broader inclusion of psychosocial variables, and more patient-centred research approaches to better support individuals living with cardiomyopathies. Full article

Background/Objectives: Chronic primary pain (CPP) is a new diagnostic category including chronic pain conditions lacking clinical signs or a clear etiopathogenetic origin. These disorders may share a common neural mechanism known as central sensitization, where nociceptive neurons become hyper-responsive to standard or subthreshold pain stimuli, resulting in pain hyper-sensitivity. In this context, non-invasive brain stimulation (NIBS) appears to be a promising tool for improving CPP symptoms by targeting maladaptive brain activity and connectivity. To date, the effects of NIBS on CPP symptoms remain unexplored. To fill this gap, we conducted a meta-analysis, investigating the effect of NIBS in improving the three core symptoms of CPP, namely pain intensity, emotional distress, and functional disability. Methods: Following PRISMA guidelines, we screened four databases up to February 2025 for English-language, peer-reviewed randomized clinical trials that included CPP patients treated with NIBS and reported pre/post or follow-up scores on validated measures of at least one core symptom. Quality of life was examined as an additional outcome. Results: Fifty-four studies were included, with 1371 participants receiving real stimulation and 1103 sham. Findings highlighted that real stimulation improved CPP symptoms immediately after treatment and at one-month follow-up. Meta-regressions showed that longer CPP duration reduced short-term effects on emotional distress and diminished all outcomes at one-month follow-up. Conclusions: Further research is needed to establish standardized NIBS protocols for CPP management, to investigate the effectiveness at longer follow-up periods, and to test whether combining NIBS with other interventions enhances treatment effectiveness and durability. Full article

Fear is a transdiagnostic construct implicated in multiple psychiatric disorders, reflecting a partial dissociation between clinical phenotypes and underlying neurobiological mechanisms. Converging evidence suggests that aberrant fear processing plays a central role in cognitive and psychopathological models of psychosis. In this narrative review, we synthesize evidence on the neurobiological mechanisms of aberrant fear modulation in schizophrenia from a translational perspective, integrating findings from neuroimaging, preclinical models, pharmacological interventions, and psychotherapy. Schizophrenia is characterized by aberrant emotional processing and inappropriate neural responses to stimuli with reduced or absent objective salience, reflecting impaired discrimination of relevant environmental information. At the system level, evidence implicates dysregulation of cortico-limbic and salience-processing networks in altered fear learning, threat appraisal, and emotional prediction. Neurochemical findings indicate that dopamine–glutamate dysregulation and associated intracellular signaling pathways act as upstream modulatory mechanisms contributing to these network-level abnormalities. Therapeutic interventions, including antipsychotic drugs and psychotherapeutic approaches, partially modulate these systems, although effects remain heterogeneous. Overall, the evidence supports a hierarchical model in which aberrant fear processing in schizophrenia arises from disrupted salience attribution and impaired integration across cognitive, affective, and neurobiological levels. This intermediate dysfunction links molecular alterations to large-scale network disturbances and clinical symptom expression, providing a framework for more mechanism-based therapeutic strategies. Full article

Background/Objectives: Parkinson’s disease (PD) is increasingly recognized as a multisystem disorder affecting perceptual, emotional, and reward-related processes. While arts-based interventions in PD have primarily focused on active creative arts engagement, it remains unclear whether receptive arts engagement with visual art—how artworks are perceived and evaluated—is altered. Our objective is to determine whether aesthetic evaluation of visual artworks differs in individuals with PD compared to age-matched healthy controls. We further examine whether emotional interpretation, color-emotion associations, and experiential responses to art viewing are altered. Methods: In a cross-sectional case–control study, individuals with PD (n = 87) and age-matched healthy controls (n = 49) completed two online assessments. Participants evaluated 36 artworks from the Vienna Art Picture System in terms of liking, beauty, and subjective art attributes. Objective image-derived features were computed for each artwork. Interpretable machine learning models were used to test whether evaluation patterns predicted diagnostic group and to identify determinants of aesthetic judgments. Participants further completed a color-emotion association task using ambiguous expressive portraits and reported perceived changes in cognitive, emotional, motivational, and physical states following art viewing. Results: Aesthetic evaluation patterns did not support reliable classification of PD status, indicating no systematic group differences in liking, beauty, or attribute-based judgments between PD and controls. Instead, aesthetic judgments were robustly predicted by individual differences and objective artwork properties, including art-historical style, symmetry, complexity, and color-related features, whereas diagnostic group, gender, and age did not contribute to predictions. Emotional interpretation and color-emotion associations were largely comparable between groups, with a single specific deviation in color-emotion mapping. Positive emotions were less frequently associated with pink in people with PD. Self-reported experiential responses to art viewing did not differ significantly between groups. Conclusions: Aesthetic evaluation of visual artworks appears largely preserved in people with PD. These findings suggest that, in digital viewing contexts, substantial adaptation of visual content to make it accessible for people with PD may not be necessary, although subtle perceptual and emotional differences may still be relevant. Efforts may instead be better directed toward addressing practical barriers to visual art engagement. Full article

The rising prevalence of neurodevelopmental, emotional, and behavioral disorders in children has prompted interest in dietary strategies that target neuroinflammation, oxidative stress, and gut dysbiosis. Blueberries (Vaccinium spp.) contain substantial amounts of anthocyanins and other neuroactive polyphenols that may confer neuroprotective effects. We summarize the literature published between 2016 and 2025 to examine how the bioactives in blueberries affect symptoms relevant to children with diagnosed neurodevelopmental or emotional–behavioral disorders, including ADHD, mood problems, and cognitive difficulties. Mechanistically, anthocyanins appear to modulate gut microbial composition, modulate neuroinflammation and alleviate oxidative stress via the Nrf2 pathway, and support synaptic plasticity and neurogenesis. Clinical trials, although limited in number and sample size, have reported modest improvements in mood and verbal memory in typically developing children and adolescents, with some gains in attention and executive function. However, direct trials in children with diagnosed neurodevelopmental or emotional–behavioral conditions remain scarce. There are substantial hurdles to translating these findings. Anthocyanins have poor physicochemical stability and low bioavailability, and routine food processing degrades their activity. Emerging solutions such as green extraction from agricultural by-products, colon-targeted microencapsulation, and zero-waste engineering could address these limitations. Rigorous randomized controlled trials in children with diagnosed neurodevelopmental or emotional–behavioral disorders are essential, as are advances in food engineering. Both are needed to move blueberry-based interventions from the laboratory to application. Full article

Information disorders condition electoral processes, becoming a major institutional concern. In response, the European Union and various fact-checking organisations co-organised the Elections24Check project to curb disinformation in the 2024 European elections. This research analyses the activities, strategies, and editorial behaviour of the five Spanish fact-checking agencies that are integrated into the initiative. Through a content analysis applied to 3256 publications, the findings demonstrate the maturity of the Spanish ecosystem, which led the project by contributing 32.8% of the total content. Strategically, reactive action predominated, except for Newtral, which prioritised prebunking (62.6%). Political scrutiny was minor (6.6%), focusing on major coalitions and far-right leaders. Thematically, highlights included war conflicts, migration, and national/regional frameworks utilised for emotional polarisation, displacing the focus from the strictly European debate. In conclusion, Spain consolidates itself as a cornerstone of European fact-checking. However, the results reveal inefficiencies in the project’s extended timeframe, suggesting more constrained and effective frameworks for election campaigns. Furthermore, the persistence of narratives anchored to local agendas evidences a strategic fragmentation that hinders the construction of a fully pan-European public space. Full article

The Active Music Programme (MAP) is an interdisciplinary initiative designed to foster inclusion, communication, and emotional well-being through participatory music-making. Integrating active music education, guided improvisation, and creative interaction, MAP seeks to enhance quality of life for individuals with diverse abilities. This pilot project, implemented in a special education centre with adolescents and adults with Autism Spectrum Disorder (ASD), combines weekly collaborative sessions led by music and education professionals. Using a qualitative, participatory framework, the study aims to examine how musical engagement is expected to support shared attention, emotional regulation, and social connection, positioning MAP as a replicable model for inclusive education and community practice. Full article

Internal state terms (ISTs) include words describing emotions, thoughts, volitions, obligations, desires, and perceptions. This scoping review aimed to map and synthesize evidence regarding the production of ISTs in individuals with Autism Spectrum Disorder (ASD) without intellectual disability and to investigate the effects of age, gender, Theory of Mind (ToM) skills, and elicitation tasks on their production. A literature search was conducted manually and electronically in Scopus, ScienceDirect, ERIC, and PubMed, identifying 29 peer-reviewed empirical studies published between 2006 and 2025. Findings were heterogeneous. Some studies reported lower IST production in individuals with ASD compared to neurotypical controls, whereas others found differences only in specific IST categories, mainly cognition and emotion terms, or reported no significant group differences. Findings regarding gender, ToM skills, and elicitation tasks were mixed. In both groups, older participants produced more ISTs than younger participants; however, developmental trajectories suggested that emotion and cognition terms were particularly challenging for individuals with ASD, who required more time to acquire them than their typically developing (TD) peers. Furthermore, TD participants produced significantly more ISTs when narrating people’s everyday interactions, whereas communication context did not appear to influence IST production in individuals with ASD. Research examining IST production in preschoolers and adults with ASD remains limited, and little is known about the developmental trajectories of ISTs in this population. Full article

Background and objectives: Social media use has become pervasive among the general population, with growing concern regarding its potential effects on mental health and sleep. While existing studies report associations between social media engagement and psychological outcomes, limited attention has been given to users’ self-perceived impact. To assess the self-perceived impact of social media use on mental health and sleep-related outcomes among healthy adolescents and adults aged 16–50 years old, and to identify associated demographic and behavioral factors. Methods: A cross-sectional survey was conducted among residents of Jeddah, Saudi Arabia, aged 16–50 years without a history of psychiatric or chronic sleep disorders, using a structured online questionnaire. Perceived mental health impact was assessed using a six-item study-specific questionnaire evaluating participants’ subjective perceptions regarding emotional and psychological responses to social media exposure. Higher perceived impact was defined as a composite score of 12–24 points on the study-specific scale. Data included sociodemographic characteristics, patterns of social media use, perceived mental health impact assessed through a 6-item Likert scale, and sleep-related outcomes. Associations were evaluated using chi-square tests and logistic regression analysis. Results: Most participants reported daily social media use exceeding 3 h, with 44.9% engaging in late-night use and 87.6% using devices within 30 min before sleep. Overall, 18.6% exhibited higher perceived mental health impact. Higher odds were observed among younger participants, students, and single individuals. Snapchat and YouTube use, and late-night engagement were independently associated with increased perceived impact. Approximately one-third reported insomnia after social media use, and 44.3% perceived improved sleep with reduced usage. Conclusions: Social media use is widely prevalent and commonly perceived to negatively affect mental well-being and sleep, particularly with intensive and late-night use. Self-awareness of these effects may represent a valuable leverage point for prevention, supporting the need for targeted digital wellness strategies and public health interventions. Full article

Background and Objectives: Pharmacotherapy is a first-line treatment for bipolar disorder (BD), although half of individuals report suboptimal medication adherence. Medication adherence enhancement programs that are brief, person-specific, and remotely delivered may be an effective adjunct to treatment. The aim of this study was to qualitatively assess what individuals with BD who participated in a Customized Adherence Enhancement (CAE) program found most helpful and unhelpful about this program, focusing on elements most generalizable to medication adherence promotion. Materials and Methods: n = 14 participants with BD from the intervention arm of a randomized effectiveness trial of CAE vs. enhanced treatment–as-usual participated in one-on-one virtual, semi-structured interviews. Interviews were recorded, transcribed, and summarized using thematic content analysis to identify themes reflecting what was helpful and unhelpful about the program. Results: Participants identified six main themes reflecting impactful aspects of the medication adherence promotion program: practical tools (e.g., worksheets), self-awareness (e.g., identification of triggers), psychoeducation/content (e.g., specific CAE modules), emotional distress (e.g., difficult emotions arose during sessions), format (e.g., pros/cons of virtual format), and interventionist factors (e.g., rapport). Conclusions: Results provide participant-identified useful aspects of a remotely delivered, adjunctive medication adherence promotion program for individuals in treatment for BD in public-sector settings. Strategies for improvement and scale-up of the program include ensuring sufficient technologic and emotional support throughout the program. Future studies may investigate the longer-term impact of such interventions with multiple stakeholder input and consideration of diverse populations, settings, and cultural contexts. Full article

Background/Objectives: Disease count alone does not show which multimorbidity combinations diversify or persist. We examined longitudinal changes in clinically recognisable multimorbidity profiles across three national ageing cohorts. Methods: Harmonised data from the China Health and Retirement Longitudinal Study (CHARLS), the English Longitudinal Study of Ageing (ELSA), and the U.S. Health and Retirement Study (HRS) were analysed. Eight physician-diagnosed chronic conditions were encoded as binary states, and wave-to-wave transitions (four windows in CHARLS and ELSA; five in HRS) were assessed within each cohort. State-level measures characterised accumulation, branching, persistence, and stabilisation sensitivity, supplemented by sensitivity analyses, BranchScore decomposition, prevalence-adjusted enrichment, and a disease-count-preserving permutation null model. Results: The analysis included 17,142 CHARLS, 10,272 ELSA, and 22,034 HRS participants, with baseline multimorbidity of 23.7%, 41.0%, and 58.5%, respectively. Transitions are concentrated around common profiles. One- and two-condition states (hypertension, diabetes, heart disease, chronic lung disease, psychiatric or emotional disorders) showed faster accumulation and greater branching; later persistent states were dominated by cardiometabolic-musculoskeletal combinations, particularly hypertension-heart disease-arthritis and hypertension-diabetes-arthritis. Targeted stabilisation produced modest perturbations exceeding random benchmarks. Count-preserving null models showed that early branching was largely structural, whereas selected lock-in states exceeded null expectations. Conclusions: Across three ageing cohorts, multimorbidity trajectories reflected disease composition as well as count. Because branching was strongly influenced by disease-count geometry, early branching states should be interpreted as structural cohort-level features of the cumulative framework rather than inherently predictive clinical entities. Selected cardiometabolic-musculoskeletal profiles were more persistent and may help frame integrated long-term management; patient-level prediction requires outcome-based studies. Full article

Parental burnout, characterized by emotional exhaustion and a sense of detachment, is a significant challenge for families of children with autism spectrum disorder (ASD). While traditional research often focuses on socioeconomic status, this study examines how physical living conditions and household characteristics influence burnout levels in the Turkish context. A relational survey model was conducted with 131 parents of children with ASD. Data were collected via online surveys using a Sociodemographic Data Form and the Maslach Burnout Inventory (MBI), which was adapted to the parenting role. Multiple linear regression analysis was applied to identify variables predicting total burnout scores. The analysis revealed that most sociodemographic variables, including income, education level, and parental age, did not significantly predict burnout. However, the “number of rooms in the house” was identified as the only statistically significant predictor (p = 0.033). Specifically, as the number of rooms increased, the total burnout scores of parents significantly decreased. The findings suggest that physical living space serves as a critical “spatial resource” and a protective factor against parental burnout. For families of children with ASD, having a private area for self-regulation is more decisive for mental health than economic status alone. Future support strategies should prioritize improving the quality of life through spatial arrangements and respite services. Full article

The comorbidity of obesity and anxiety represents a complex condition with substantial health implications, exacerbating metabolic burden while compromising psychological well-being. Neurons in the lateral hypothalamus (LH) synthesize orexin-A and orexin-B, neuropeptides that orchestrate feeding behavior and energy expenditure, thereby directly regulating energy homeostasis and associated behaviors. Functioning as integrative modulators, orexins coordinate autonomic, neuroendocrine, arousal, reward, and stress circuits. Dysregulation of orexin signaling is strongly implicated in metabolic disorders, particularly obesity, as well as in psychiatric conditions including anxiety and depression, highlighting its central role in their comorbidity. This review provides a comprehensive overview of recent advances in understanding orexin-A neural circuits in feeding regulation, emphasizing mechanistic insights into the interplay between orexin signaling, energy balance, and anxiety–obesity comorbidity. Furthermore, it critically evaluates sources of heterogeneous therapeutic outcomes and outlines future strategies for precise modulation of the orexin system to restore metabolic and emotional homeostasis. Full article

Refugees are exposed to cumulative pre-migration, migration, and post-migration stressors that increase vulnerability to depressive disorders and impaired quality of life. This study assessed the prevalence and severity of depressive symptoms among adult refugees in Serbia and examined associations with sociodemographic characteristics, traumatic experiences, social support, and Health Related Quality of Life (HQoL). The study included 324 refugees residing in four reception centers in Serbia. Data were collected between April 2023 and November 2024 using self-report questionnaires. Depressive symptoms were assessed using the Patient Health Questionnaire-9 (PHQ-9), while HQoL was evaluated using the SF-36 Health Survey. The mean PHQ-9 score indicated mild-to-moderate depressive symptomatology. Clinically significant depressive symptoms were present in 41.4% of participants, while more than 70% reported at least mild symptoms. Depressive symptom severity was negatively associated with energy/fatigue, emotional well-being, social functioning, general health, and pain. The Energy/Fatigue domain emerged as the most prominent independent correlate of depressive symptom severity. Depressive symptoms were highly prevalent and were associated with impaired quality of life and psychosocial stressors. These findings highlight the importance of systematic mental health screening and psychosocial support among refugees. Full article

Background/Objectives: Parents of children with autism spectrum disorder (ASD) often face sustained emotional, practical, and social demands. However, evidence from Romania remains limited, particularly regarding the combined assessment of caregiver burden, emotional distress, and coping strategies of parents. This exploratory study compared these outcomes between parents of children/adolescents with ASD and parents of typically developing children and examined whether coping patterns varied according to selected sociodemographic characteristics. Methods: We conducted a cross-sectional comparative study in Târgu-Mureș, Romania, between 2024 and 2025. The sample included 92 parents: 46 parents of children/adolescents with clinician-confirmed ASD and 46 parents of typically developing children. Participants completed a demographic questionnaire, the Caregiver Burden Inventory (CBI), the Depression Anxiety Stress Scales-21 (DASS-21), and the Strategic Approach to Coping Scale (SACS). DASS-21 data were available for 44 ASD caregivers and 46 controls. Between-group comparisons were performed using t-tests, Mann–Whitney U tests, chi-square tests, or Fisher’s exact tests, as appropriate. Results: The groups were comparable in sex, age, residence, number of children, and household size, but differed significantly in marital status and educational level. Clinically relevant caregiver burden (CBI ≥ 36) was more frequent among parents of children with ASD than among controls (30% vs. 17%), although this difference was not statistically significant. Parents of children with ASD showed trend-level higher depressive and anxiety symptoms, with small effect sizes, whereas stress scores were similar between groups. Coping patterns varied according to sociodemographic characteristics. Marital status was associated with aggressive coping, urban residence was associated with indirect and aggressive coping, and number of children was associated with seeking social support. Conclusions: Parents of children with ASD showed a higher proportion of clinically relevant caregiver burden and trend-level elevations in depressive and anxiety symptoms, while stress scores were comparable between groups. Exploratory adjusted analyses suggested that ASD caregiver status remained associated with caregiver burden and depressive symptoms after controlling for educational level and marital status. Coping strategies appeared heterogeneous and context-dependent. Given the exploratory design, modest sample size, and multiple comparisons, these findings should be interpreted as preliminary and hypothesis-generating. Full article