Search Results (1,475)

Coital urinary incontinence is a frequently underdiagnosed manifestation of female pelvic floor dysfunction, characterized by involuntary urine leakage during sexual activity, particularly during vaginal penetration or orgasm. Although interest in this condition has increased in recent years, it remains insufficiently investigated in clinical practice and is often underreported by patients because of stigma, emotional distress, and the negative impact on intimate relationships and quality of life. Current evidence supports the existence of distinct pathophysiological mechanisms depending on the timing of urinary leakage. Leakage occurring during vaginal penetration is more commonly associated with stress urinary incontinence, urethral hypermobility, and pelvic support defects, whereas orgasm-associated urinary incontinence appears to be more closely related to detrusor overactivity and complex pelvic neurophysiological mechanisms. Hormonal changes associated with the peri- and postmenopausal period may further contribute to symptom progression through alterations in urethral and vaginal trophicity, local vascularization, and pelvic neuromuscular function. Clinical evaluation remains challenging because many affected women do not voluntarily report symptoms due to embarrassment or social stigma, therefore it requires targeted questioning regarding urinary leakage during sexual activity, associated lower urinary tract symptoms, and the impact on female sexual health. Therapeutic management should be individualized and tailored to the predominant underlying mechanisms, including pelvic floor rehabilitation, behavioral interventions, pharmacological treatment, local hormonal therapy, and surgical management of stress urinary incontinence or pelvic support defects. Minimally invasive and regenerative therapies, such as vaginal laser therapy, platelet-rich plasma, cellular therapies, and neuromodulation, represent promising therapeutic approaches. Greater awareness and proactive screening during urogynecological evaluation are essential for improving diagnosis, individualized treatment, sexual health, and overall quality of life in affected women. Full article

Background: Diet quality and amino acid intake influence both physical health and psychological well-being, potentially affecting eating disorder risk. This study aimed to investigate the relationship between dietary patterns, amino acid intake, and eating disorder risk. Methods: This cross-sectional study included 130 adults with overweight or obesity. All participants were assessed for eating disorder risk and body image distortion. Dietary intake was assessed using a validated food frequency questionnaire. Principal Component Analysis was performed to identify major dietary patterns, and logistic regression was used to estimate the odds of eating disorder risk in relation to dietary pattern adherence and specific amino acid intake. Results: Six major dietary patterns were identified; among these, the mixed Mediterranean-like and Comfort Food patterns showed significant associations with eating disorder risk. Greater adherence to the mixed Mediterranean-like pattern was associated with lower odds of eating disorder risk (OR = 0.60; 95% CI: 0.39–0.93; p = 0.023). Conversely, adherence to the Comfort Food pattern, characterized by sweets, milk, and dairy products, showed a trend toward higher odds of eating disorder risk (OR = 1.49; 95% CI: 0.99–2.23; p = 0.05) and body image distortion (OR = 1.70; 95% CI: 1.03–2.79; p = 0.03). Regarding amino acid intake, higher consumption of glutamic acid and glycine was associated with a lower eating disorder risk, whereas higher leucine intake was associated with higher eating disorder risk. Conclusions: Dietary patterns are associated with eating disorder risk and body image distortion. A mixed Mediterranean-like dietary pattern may have protective effects, whereas greater adherence to a Comfort Food pattern and higher intake of specific amino acids may increase the risk of eating disorders. However, further clinical studies are needed to confirm our findings. Full article

Background and objectives: Cancer survivors continue to face significant psychological and quality-of-life challenges following the COVID-19 pandemic. This study aimed to investigate levels of depression, anxiety, stress, quality of life, and perceived social support among patients with cancer during the post-COVID-19 period and to examine their interrelationships. Materials and Methods: A cross-sectional study was conducted among 162 Greek adults with cancer. Participants completed questionnaires assessing psychological distress (Depression Anxiety Stress Scale-21), health-related quality of life (EORTC QLQ-C30), and perceived social support. Descriptive statistics, factor analysis, group comparisons, and correlation analyses were performed. Results: High levels of psychological distress were observed, with 32.1% of participants reporting severe or extremely severe depression, 40.1% severe or extremely severe anxiety, and 29.0% severe or extremely severe stress. Quality of life was moderate, with emotional and social functioning being the most impaired domains, while fatigue, insomnia, and financial difficulties were the most prominent symptoms. Depression, anxiety, and stress were strongly associated with poorer quality of life and greater symptom burden. Higher perceived social support, particularly from family and friends, was associated with better quality of life and lower psychological distress. Conclusions: These findings highlight the need for comprehensive oncology care that incorporates routine psychological assessment and psychosocial support to improve cancer survivorship outcomes. Full article

Background: Borderline personality disorder (BPD) is characterized by emotional dysregulation and emotion-related impulsivity, particularly during late adolescence and early adulthood. Although mentalizing difficulties have been proposed as an important mechanism underlying borderline psychopathology, their contribution to emotion-related impulsivity beyond alexithymia and anxiety–depressive symptoms remains unclear. This study examined the relationships among mentalizing difficulties, emotional dysregulation, and emotion-related impulsivity in young individuals with BPD. Methods: A total of 166 participants aged 16–25 years were recruited in French-speaking Belgium, including 45 individuals with DSM-5 BPD and 121 non-clinical controls. Mentalization was assessed using the Reflective Functioning Questionnaire (RFQ-8), emotional dysregulation using the Difficulties in Emotion Regulation Scale (DERS), impulsivity using the UPPS-P Impulsive Behavior Scale, and alexithymia using the Toronto Alexithymia Scale (TAS-20). Group comparisons, quantile regressions, Spearman correlations, and adjusted multiple linear regressions were performed. Results: Participants with BPD reported significantly higher uncertainty regarding mental states (RFQu) than controls, and this difference remained significant after adjustment for clinical covariates. RFQu was associated with overall emotional dysregulation, particularly difficulties in behavioral control under distress, and with emotion-related impulsivity, especially negative urgency. Associations between RFQu and negative urgency remained significant after controlling for alexithymia, depressive symptoms, trait anxiety, and borderline status. Corresponding associations with positive urgency did not reach statistical significance. Conclusions: Mentalizing difficulties may account for additional variance in emotion-related impulsivity beyond alexithymia and general psychopathological distress. These findings support a developmental, mechanism-focused understanding of emerging BPD and highlight mentalization as a potential target for early intervention and future longitudinal research. Full article

Young women living in urban informal settlements experience intersecting structural and environmental conditions that shape health and well-being. Alcohol environments (the physical, social, and commercial contexts in which alcohol is sold, marketed and consumed) represent an important but understudied social and commercial determinant of health. Young women in these settings face intersecting vulnerabilities, including poverty, unemployment, and gender inequality, that increase their exposure to alcohol-related harm. Although alcohol use and alcohol-related harms are increasingly understood as shaped by social and commercial determinants of health, little is known about how young women experience alcohol environments in low-resource settings. This exploratory, site-specific secondary, qualitative analysis draws on data from a 2022 Photovoice project conducted over several weeks with 15 young women (ages 18–24) living in urban poverty in Kampala. Participants used photography and group discussions to explore how alcohol shapes their lives. Our inductive thematic analysis included all five participants from the Makindye site, where alcohol-related photographs and narratives emerged prominently during the Photovoice discussions. Six key themes were identified from 42 narrative excerpts and two photographs, highlighting alcohol’s dual role as both a source of livelihood and a source of harm. Participants described pervasive exposure to aggressive marketing, unregulated drinking venues, and the normalization of alcohol use, often linked to interpersonal violence, emotional distress, and disruption of household dynamics. Alcohol environments also constrained women’s mobility and safety, limiting their participation in public life. These findings suggest that alcohol environments may shape young women’s exposure to violence, economic precarity, and psychological distress in this setting. They also point to the potential value of gender-responsive policies, stronger regulation, and community-based prevention strategies to address alcohol-related harm and health inequities in low-resource urban settings. Full article

The COVID-19 pandemic affected maternal mental health in the UK, increasing postpartum emotional distress. This scoping review identified forms of postpartum emotional distress (PPED) examined during the pandemic, the methodologies and assessment tools used, analytical approaches, reported limitations, future research directions, and overall findings. This review followed Arksey and O’Malley’s framework and the Joanna Briggs Institute scoping review guidelines. A comprehensive, keyword-based search strategy was applied across electronic databases, initially on 28 January 2023, and updated on 20 July 2023, and 3 September 2025. Strict inclusion criteria were used, and data from eligible studies were charted and synthesised. This review of 35 UK studies on postpartum emotional distress (PPED) during COVID-19 found a dominant focus on depression and anxiety, with other PPED forms largely neglected. Quantitative designs overwhelmingly outnumbered qualitative and mixed-method approaches. Common limitations included low sample diversity, reliance on online self-report surveys, cross-sectional designs, convenience sampling, and social-media-based recruitment. This review is the first to map research approaches used to explore postpartum emotional distress (PPED) during COVID-19 in the UK. The limitations and future research directions identified in this review highlight an urgent need for more diverse sampling, longitudinal study designs, qualitative research exploring women’s lived experience narratives of different forms of postpartum emotional distress, greater consideration of biopsychosocial factors, and evidence-based interventions. Full article

Biomedical scientists/researchers are critical to advancing human health, but their experiences of occupational stress, burnout, and subsequent consequences are surmised but understudied. The current narrative review aimed to search and summarize existing literature and scientific discourse specific to biomedical scientist burnout to better understand the prevalence and unique drivers of stress in this population and highlight critical areas that require further research and intervention efforts. The authors searched six primary databases from August 2024 to December 2025 using defined search terms to identify peer-reviewed articles and scientific discourse related to occupational burnout of academic medicine biomedical faculty researchers, postdoctoral researchers, or lab personnel. Prevalence and primary drivers of burnout, stress mediators, and mitigation/intervention recommendations were extracted from the included works. A total of 16 empirical articles and 4 non-empirical works were included. Over 30% of biomedical scientists exhibit high occupational burnout, nearly 45% report high distress, and just over 34% experience high emotional exhaustion. Seven primary drivers of biomedical scientist distress were identified including intense workloads/expectations, funding pressures, and lack of perceived organizational support/recognition. Biomedical scientist burnout prevalence appears comparable to clinical faculty but is driven, in part, by distinct stressors. The attributable organization and societal cost of biomedical scientist burnout remain unquantified. The current review establishes a significant need for further research and tailored efforts to address the distinct needs of biomedical scientists across academic medical centers. Full article

Background/Objectives: Perceived stress and sleep quality are increasingly recognized as important determinants of emotional eating (EE), particularly among university students who are frequently exposed to academic pressures, psychosocial challenges, and lifestyle disruptions. Both stress and sleep quality are closely interconnected, with elevated stress contributing to sleep disturbances and poor sleep further exacerbating psychological distress. The present study aims to simultaneously examine the independent contributions of perceived stress and sleep quality to EE while accounting for other relevant sociodemographic, lifestyle, and anthropometric factors. Methods: This cross-sectional study was conducted among 1297 university students recruited from 10 geographical regions of Greece. Data on sociodemographic characteristics, academic profile, lifestyle behaviors, and anthropometric parameters were collected using standardized and validated assessment instruments. Perceived stress was measured using the Perceived Stress Scale (PSS), while sleep quality was evaluated with the Pittsburgh Sleep Quality Index (PSQI). Emotional eating was assessed using the Emotional Eating subscale of the Three-Factor Eating Questionnaire–Revised 18 (TFEQ-R18), and participants were subsequently classified into tertiles corresponding to low, moderate, and high levels of emotional eating. Results: Perceived stress was independently associated with EE in the multivariable analysis. Compared with students reporting low levels of stress, those experiencing high perceived stress exhibited almost threefold greater odds of being classified in higher emotional eating categories (OR = 2.86; p = 0.0001). Likewise, participants with moderate perceived stress were approximately twice as likely to demonstrate elevated emotional eating levels relative to their low-stress counterparts (OR = 2.01; p = 0.0001). Sleep quality was also independently associated with EE after adjustment for potential confounding factors. Specifically, students characterized by inadequate sleep quality had more than three times the likelihood of belonging to higher emotional eating categories compared with those reporting satisfactory sleep quality (OR = 3.08; p = 0.0001). The multivariable model demonstrated good fit (Likelihood Ratio Test, p < 0.001), and the proportional odds assumption was satisfied (p = 0.46). Conclusions: These findings underscore the important role of psychological distress and sleep health in EE behavior, independent of other sociodemographic, academic, lifestyle, and anthropometric factors. Given the observed associations, interventions incorporating stress-management and sleep-improvement components may represent promising approaches for addressing emotional eating among university students; however, longitudinal and intervention studies are needed to establish causality. Future longitudinal and intervention studies are needed to establish causality among perceived stress, sleep quality, and emotional eating. Full article

Background: Brazilian psychologists faced heightened occupational and emotional demands during the COVID-19 peak, yet evidence on longer-term changes in distress and self-care is limited. This repeated cross-sectional study compared psychological distress and multidimensional self-care among Brazilian psychologists at the pandemic peak (T1: April 2021; n = 578) and three years later (T2: April 2024; n = 524). Methods: Distress (DASS-21) and self-care indicators (perceived self-care, working hours, work–life balance, psychotherapy/psychiatric care) were assessed. Blockwise OLS and logistic models (M0–M3) estimated time differences; dose–response and moderation analyses used adjusted marginal means with FDR correction. Results: Anxiety and stress were lower at T2 (M3: anxiety β = −1.53; stress β = −2.08; p < 0.001), whereas depression showed no statistically significant change in fully adjusted models (β = −0.37, p = 0.456), with only a modest downward tendency evident in unadjusted and nonparametric comparisons. Clinically elevated (Moderate+) anxiety decreased robustly (OR = 0.56), while the reduction in Moderate+stress was attenuated after full adjustment (OR = 0.71, p = 0.049) and did not remain significant after FDR correction. Perceived self-care showed a dose–response association with lower distress, and stress declined most among telehealth and hybrid practitioners. Conclusions: Three years post-peak, anxiety and stress were lower, whereas depression showed no clear change in fully adjusted models, indicating heterogeneous recovery. Self-care and work conditions were key associated factors, underscoring the need for sustained workforce well-being strategies. Because the design was repeated cross-sectional, these findings reflect sample-level trends rather than within-person change. Full article

Background/Objectives: Empathy is a fundamental component of pediatric oncology nursing. This study aims to examine in depth how nurses working in pediatric oncology define empathy, experience it in clinical practice, and manage emotional and professional boundaries in the empathetic care process. Methods: A qualitative research design was used. Semi-structured individual interviews were conducted with 17 nurses with at least 2 years of experience in pediatric hematology-oncology units. The interviews were conducted via Zoom. Data were analyzed using Braun and Clarke’s thematic analysis, and data collection continued until thematic saturation was achieved. Results: Three main themes were identified: Understanding Empathy, The Journey of Empathy, and The Cost of Empathy. Nurses defined empathy as an indispensable part of high-quality pediatric oncology care; however, they reported conceptual uncertainty in distinguishing empathy from sympathy and indecision regarding appropriate emotional boundaries. Empathy was perceived as a dynamic process shaped more by clinical experience than formal education. Early professional experiences were often characterized by emotional distress, while increasing experience enabled nurses to regulate their emotions and adopt more sustainable empathic practices. Despite this adaptation, prolonged exposure to children’s suffering and death was associated with compassion fatigue and emotional exhaustion. The absence of structured empathy training and formal emotional support systems further intensified these challenges. Conclusions: In pediatric oncology nursing, empathy is a complex, evolving professional competency that demands continuous emotional regulation and boundary management. Structured empathy training, reflective supervision, and strengthening institutional support mechanisms are essential to promote sustainable empathic care while protecting nurses’ emotional well-being. Full article

Background/Objectives: Tinnitus is often a distressing and disabling condition that negatively affects individuals’ emotional well-being and quality of life. The aim of this study was to evaluate the relationship between perceived tinnitus handicap and sociodemographic and clinical characteristics, personality traits, and symptoms of depression, anxiety, and stress. Methods: Tinnitus patients with hearing loss (N = 127) underwent audiologic testing and completed the Tinnitus Handicap Inventory (THI), Depression Anxiety Stress Scales (DASS), and Eysenck Personality Questionnaire—Revised Short Form (EPQ-RS). Patient sociodemographic data (age, sex, and education level) and descriptive tinnitus characteristics were collected. The control group (N = 119) comprised tinnitus-free patients with hearing loss. Results: Patients experiencing catastrophic tinnitus reported significantly higher depression, anxiety, and stress scores compared to those with slight, mild, or moderate tinnitus grades. Education level was weakly negatively associated with THI scores. Conversely, weak-to-moderate positive relationships were observed for tinnitus loudness, pure tone average, the three DASS subscales, and the neuroticism subscale. Hierarchical multiple regression identified subjective tinnitus loudness, neuroticism, and total emotional distress (the total DASS score) as statistically significant predictors of the total THI score. Patients with tinnitus showed statistically significantly higher depression, anxiety, and stress subscale scores compared to tinnitus-free controls. Conclusions: The severity of tinnitus handicap is strongly correlated with subjective loudness, underlying neuroticism, and emotional distress. Patients with catastrophic tinnitus exhibit markedly higher levels of depression, anxiety, and stress. Consequently, clinical management of tinnitus must move beyond standard audiologic testing to include comprehensive psychological screening and targeted distress-reduction therapies. Full article

Why do humans produce dysphoric dreams and nightmares at all? This paper develops a cautious evolutionary theory of unpleasant dreaming by extending the logic of evolutionary psychiatry to dream life. Research on dream continuity suggests that dreams are not detached from waking mental life, but instead reflect current concerns, emotional preoccupations, memory fragments, and bodily states. Work on threat simulation, emotional processing during sleep, and the neurocognitive structure of nightmares further suggests that some disturbing dreams may not be mere malfunctions. Rather, they may be costly outputs of systems involved in salience tracking, threat rehearsal, emotional adaptation, or flexible model updating. At the same time, nightmare research shows that recurrent and trauma-linked nightmares can become clinically serious, producing sleep disruption, daytime distress, and functional impairment. This paper argues that the proper distinction is not between “useful dreams” and “pathological nightmares” in any simple sense, but between unpleasant dream processes that remain self-limiting and those that cross a threshold into maladaptive feedback loops. On that basis, dream engineering is defended not as routine suppression of unpleasant dreaming, but as a selective and limited intervention appropriate when recurrence, rigidity, carryover, and impairment indicate dysfunction. A structured research agenda is proposed to test this threshold model and to distinguish adaptive bad dreams from pathological nightmares. Full article

Background/Objectives: Young adults living with advanced cancer often experience substantial psychological and existential health challenges, while frequently being underserved by existing rehabilitative and palliative services. This mixed-methods study evaluated the effects and experiences of a nature-based intervention designed to ease the burden of distress and support coping in the context of an incurable illness. Methods: Four consecutive intervention groups participated in a six-week program consisting of one overnight nature camp and three outdoor sessions. Quantitative data on quality of life (FACT-G) were collected before and after each intervention cycle. At the session level, pre–post measures assessed distress, vitality, resilience, and perceived connectedness. Qualitative data consisted of post-intervention semi-structured group interviews. Results: Twenty-four participants completed the intervention. No significant change was observed in overall quality of life which is in line with expectations for palliative interventions for individuals with incurable illness. In contrast, session-level analyses showed consistent reductions in distress and increases in vitality, resilience, and connectedness across multiple domains. The qualitative findings indicated that the intervention provided a supportive context for emotional regulation, coping, social belonging and existential orientation. Conclusions: Together, the findings support that nature-based rehabilitative palliation may offer meaningful support for young adults living with advanced cancer. The study underscores the importance of multi-level mixed-methods evaluation for capturing the value of palliative interventions where temporality and situational benefit constitute central outcomes. Full article

Background/Objectives: The role of middle nurse managers is characterized by high levels of responsibility and complex relationships, which can generate significant stress and put their mental health at risk. A mixed-methods study was carried out to measure distress and work-related factors among Italian middle nurse managers and to explore their experiences in order to identify critical issues and possible actions for improvement. Methods: The study was conducted between October 2019 and January 2020. Results: In the quantitative phase, 65 middle nurse managers completed validated questionnaires on distress, perceived health, working environment, job satisfaction, and emotional workload. Although most participants reported feeling healthy, nearly 30% experienced distress ranging from mild to severe. These findings informed the qualitative phase, in which 10 middle nurse managers were interviewed to further explore the lived experiences. Qualitative analysis identified four main themes: (1) sources of stress at work; (2) the importance of personal and organizational support for middle nurse managers; (3) copingstrategies; (4) actions for change to improve work activities. All themes were further divided into sub-themes. Middle nurse managers report experiencing difficulties in their work, adopting strategies to adapt to everyday challenges, and expressing a need for support to improve the management of their work teams. Conclusions: The findings suggest that, despite generally positive well-being indicators, a substantial subgroup of middle nurse managers experience distress related to organizational constraints. Practical implications include strengthening organizational support, reducing excessive workload, and addressing staffing issues to better sustain middle nurse managers’ well-being. Full article

Adolescence is marked by a heightened need for belonging, peer acceptance, and emotional validation, with disruptions linked to loneliness and psychological distress. This perspective integrates belongingness theory with emerging research on companion artificial intelligence (AI), reconceptualizing these systems as relational substitutes that simulate, but do not provide, genuine interpersonal connection. Designed to offer continuous, emotionally responsive interactions, companion AI may be particularly appealing to socially isolated youth. However, these features can foster perceived intimacy, emotional dependence, and misinterpretations of programmed responses as authentic care. Drawing on developmental research and recent case evidence, this manuscript examines how AI-mediated interactions may reinforce social withdrawal, shape expectations of relationships, and contribute to mental health risk. These findings stress the importance of understanding the developmental implications of artificial forms of connection during adolescence and describe potential policies to mitigate the likelihood of negative outcomes. Full article