Search Results (1,224)

Background/Objectives: Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease associated with psychiatric burden, but longitudinal data on incident psychiatric outcomes remain limited. This study aimed to evaluate incident psychiatric disorders in adults with HS compared with matched non-HS controls and to assess sex-specific risk. Methods: We conducted a retrospective propensity score–matched cohort study using the TriNetX Global Collaborative Network. Adults with at least two HS diagnoses and no prior psychiatric diagnosis were compared with non-HS controls with repeated general health examination encounters and no psychiatric history. Time-to-event analyses estimated hazard ratios (HRs) with 95% confidence intervals (CIs). Sensitivity analyses used a 30-day lag and restriction to the most recent 5-year period. Results: After matching, 37,964 pairs were retained for the primary individual-outcome analysis. Median follow-up was shorter in the HS cohort than in matched controls (844 vs. 1505 days). HS was associated with increased risk of any psychiatric disorder (12.3% vs. 5.8%; HR 3.17, 95% CI 3.01–3.34) and severe psychiatric illness (0.6% vs. 0.1%; HR 6.70, 95% CI 4.77–9.41). Elevated risks were observed for bipolar/manic disorders, personality disorders, substance use disorders, psychotic disorders, suicidal ideation, depression, eating disorders, anxiety, and insomnia/parasomnia. Women had higher hazards of depression and anxiety, whereas men had higher hazards of substance use disorders; insomnia/parasomnia showed a nominal association with higher hazard in men. Conclusions: In this observational EHR-based study, HS was associated with broad incident psychiatric morbidity. These findings support consideration of proactive mental health assessment and integrated dermatologic–psychiatric care in patients with HS. Full article

Background and Objectives: Recovering from COVID-19 does not always imply a full return to health and may lead to the development of post-COVID-19 syndrome. Post-COVID-19 manifestations include, among others, symptoms of depression and/or anxiety. The aim of the study was to assess the prevalence of anxiety and depressive disorders and to identify their exogenous and endogenous predictors in individuals with post-COVID-19 syndrome. Materials and Methods: The study included 200 participants (116 women and 84 men, aged 18–80) diagnosed with post-COVID-19 syndrome. Participants completed psychological assessments, including the Hospital Anxiety and Depression Scale (HADS), the Generalized Anxiety Disorder 7 (GAD-7), and the Beck Depression Inventory (BDI). Comorbidities were also evaluated. Results: Based on the HADS, anxiety was identified in 41.5% of respondents and depression in 39.5%. Generalized anxiety disorder was screened positive for 36.5% of respondents (GAD-7), while mild depression was observed in 37.0% (BDI). Among participants with post-COVID-19 syndrome and diabetes, the risk of developing depression was three times higher than in individuals without comorbidities. In smoking women with post-COVID-19 syndrome and diabetes, the risk of developing depressive disorders was estimated to exceed 90%. Conclusions: The risk of developing anxiety and depressive disorders in individuals with post-COVID-19 syndrome and multimorbidity is very high, highlighting the need for preventive psychological care, including targeted screening programs, for those at greatest risk. Full article

Using the Hierarchical Taxonomy of Psychopathology (HiTOP) as our framework, the current study examines how 13 common psychological disorders can be grouped into different spectra in two groups of adolescents: a community sample (N = 951), and a clinic-referred sample (N = 173). Scores for the disorders were obtained using the parent version of the Child and Adolescent PsychProfiler. Taken together, the findings across the two samples for factor structure, reliability, and discriminant and concurrent validity indicate the most support for a three-factor CFA oblique model with primary factors for neurodevelopment disorders (that include Specific Learning Disorder, Autism Spectrum Disorder, Language Disorder, and Speech Sound Disorder), internalizing disorder problems (that include Generalized Anxiety Disorder, Persistent Depressive Disorder, Separation Anxiety Disorder, Obsessive–Compulsive Disorder, Posttraumatic Stress Disorder, Anorexia Nervosa, and Bulimia Nervosa), and externalizing disorder problems [(that include Attention Deficit/Hyperactivity Disorder (ADHD), and Oppositional Defiant Disorder/Conduct Disorder (ODD/CD)], with a covariance for the error variance for Anorexia Nervosa and Bulimia Nervosa. Additionally, the analysis for Sample 2 supports the concurrent validity of the factors in this model. A modification of this model, with ADHD cross-loading on the neurodevelopment disorders factor, did not produce an admissible solution. The findings indicate support for a neurodevelopmental spectrum in the HiTOP model, with ADHD and ODD/CD showing stronger statistical association with the externalizing factor than with the neurodevelopmental factor in the models tested. This finding pertains to dimensional structure and does not invalidate the neurodevelopmental classification of ADHD in DSM-5-TR. Full article

Background/Objectives: The rapid expansion of social media platforms has profoundly changed the way adolescents access reproductive health information. While digital environments increase accessibility to contraceptive content, they also facilitate the dissemination of misinformation, potentially influencing both contraceptive literacy and psychological well-being. The present study aimed to evaluate the relationship between sources of contraceptive information, contraceptive misinformation endorsement, contraceptive knowledge, and mental health indicators among Romanian adolescents and young adults. Methods: A cross-sectional observational study was conducted in a cohort of 210 Romanian adolescents and young adults. Participants completed a structured self-administered questionnaire assessing demographic characteristics, contraceptive information sources, digital health behaviors, contraceptive misconceptions, and contraceptive knowledge. Anxiety and depressive symptoms were evaluated using the Generalized Anxiety Disorder-7 (GAD-7) and Patient Health Questionnaire-9 (PHQ-9) scales. Correlation analyses and multivariable logistic regression models were performed to identify factors associated with poor contraceptive knowledge and moderate-to-severe anxiety. Results: Social media represented the primary source of contraceptive information for 58.1% of participants. Individuals relying predominantly on social media demonstrated significantly lower contraceptive knowledge questionnaire (CKQ) scores compared to those obtaining information from healthcare professionals (5.9 ± 1.8 vs. 8.1 ± 1.7, p < 0.001). Contraceptive misinformation endorsement was inversely correlated with CKQ scores (r = −0.44, p < 0.001) and positively associated with anxiety (r = 0.47, p < 0.001) and depressive symptoms (r = 0.41, p < 0.001). In multivariable analyses, primary reliance on social media (OR 2.21, 95% CI 1.12–4.34, p = 0.022) and low digital health literacy (OR 2.94, 95% CI 1.51–5.71, p = 0.001) were independently associated with poor contraceptive knowledge. Higher misinformation endorsement, infertility-related fears, and high social media exposure were independently associated with moderate-to-severe anxiety. Conclusions: Contraceptive misinformation endorsement was associated with lower contraceptive literacy and poorer psychological outcomes among adolescents and young adults. These findings highlight the growing importance of digital health literacy. However, given the cross-sectional design, the observed relationships should be interpreted as associations rather than causal effects, and longitudinal studies are required to clarify their directionality. Full article

Background and Objectives: Appendectomy during pregnancy is associated with preterm birth, but downstream neonatal outcomes, neonatal intensive care resource use, and caregiver-reported psychological symptom burden remain insufficiently characterized. We aimed to compare neonatal infection rates, NICU resource utilization, and caregiver psychosocial outcomes between preterm infants born after maternal appendectomy during pregnancy and preterm controls frequency-matched by gestational-age strata without antecedent non-obstetric surgery. Methods: In this single-center prospective cohort study (March 2023–December 2025), 121 preterm infants were enrolled: 54 born after maternal appendectomy during pregnancy (31 laparoscopic, 23 open) and 67 non-surgical preterm controls. Neonatal outcomes included culture-confirmed infection, death, or major neonatal morbidity, and neonatal intensive care resource metrics. Caregiver outcomes were assessed near discharge using the 36-Item Short Form Survey, Patient Health Questionnaire-9, Generalized Anxiety Disorder-7 scale, and Hospital Anxiety and Depression Scale. Group comparisons used normality-guided parametric or non-parametric tests and multivariable logistic regression; subgroup and mediation analyses were exploratory. Mediation analyses explored indirect pathways. Results: Culture-confirmed infection was numerically more frequent in appendectomy-group neonates than in controls (35.2% versus 20.9%; p = 0.078), but this difference was not statistically significant. NICU length of stay was significantly longer (47.3 ± 14.8 vs. 41.2 ± 12.6 days; p = 0.014), and caregiver Patient Health Questionnaire-9 depressive symptom scores were higher (12.4 ± 4.3 vs. 9.6 ± 3.8; p < 0.001). Open appendectomy and negative histopathology subgroups showed the strongest adverse signals. Exploratory mediation analysis suggested that a substantial portion of the appendectomy-caregiver depression association statistically co-varied with prolonged hospitalization (Sobel p = 0.008); this exploratory pathway analysis does not establish a causal mediation pathway. Conclusions: Preterm infants born after maternal appendectomy during pregnancy showed non-significant numerical increases in infection outcomes, significantly higher neonatal intensive care resource use, and higher caregiver-reported psychological symptom scores compared with non-surgical preterm controls, with open surgery and negative appendectomy representing clinically complex subgroups with less favorable exploratory signals. Full article

Background/Objectives: This study aimed to examine the associations between diet-related quality of life (DRQOL) and psychological distress, autonomic dysfunction, and migraine in patients with dizziness and balance disorders. Methods: In this retrospective cross-sectional study, 122 patients (56 men, 66 women; mean age 40.4 ± 12.8 years, minimum 14, maximum 65) from the vertigo outpatient clinic at JR Tokyo General Hospital completed self-reported questionnaires. These included the DRQOL scale, Dizziness Handicap Inventory (DHI), Hospital Anxiety and Depression Scale (HADS), Self-rating Depression Scale (SDS), Orthostatic Dysregulation (OD) checklist, and migraine assessments (POUNDing [Pulsating, duration of 4–72 h, Unilateral, Nausea, Disabling], MIDAS, migraine screener). Correlational analyses, group comparisons, and receiver operating characteristic (ROC) analyses were conducted. Results: Higher DRQOL scores indicate poorer DRQOL. DRQOL scores showed positive correlations with psychological distress (SDS: ρ = 0.57; HADS-A: ρ = 0.50; HADS-D: ρ = 0.53; all p < 0.001) and OD severity (ρ = 0.50, p < 0.001) but not with age, DHI, or individual migraine indices. Migraine screener-positive patients had significantly higher DRQOL scores (p < 0.01). DRQOL alone showed modest ability to discriminate migraine screener-positive from migraine screener-negative patients (AUC = 0.65); discrimination improved to an AUC of 0.77 in a multivariable model that also included age and sex. Conclusions: DRQOL appears to capture psychological and autonomic symptom burden rather than vestibular or headache severity, suggesting that it may serve as a complementary, patient-centered metric that adds a multidimensional perspective to conventional vestibular and headache assessments. 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

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

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

Background/Objectives: Thyroid dysfunction is frequently associated with mood and anxiety disorders, yet the directionality and diagnostic specificity of this relationship remain debated. Although numerous studies have examined major depressive disorder (MDD) and bipolar disorder (BD) separately, comparative data including generalized anxiety disorder (GAD) and accounting for non-thyroidal illness (NTI) effects remain scarce. This study aimed to evaluate thyroid function and its correlation with affective symptom severity across MDD, GAD, and BD in an inpatient cohort. Methods: Eighty-eight hospitalized patients with MDD, GAD, or BD were included in the study (MDD = 30, GAD = 30, BD = 28). Serum levels of TSH, FT4, and FT3 were measured 24–48 h after admission to minimize the influence of NTI. Psychiatric assessment included the Montgomery-Åsberg Depression Rating Scale (MADRS), Hamilton Anxiety Scale (HAM-A), and Young Mania Rating Scale (YMRS). Between-group differences were analyzed using ANOVA, and associations between thyroid parameters and symptom severity were examined using correlation and regression analyses. Results: ANOVA revealed that patients with MDD had significantly higher TSH levels compared with those with GAD and BD (p < 0.01). MDD patients also showed a higher prevalence of subclinical hypothyroidism (33.3%) than patients with GAD (13.3%) and BD (7.1%), as well as a higher prevalence of overt hypothyroidism (13.3%) compared with GAD (0%) and BD (7.1%). TSH levels correlated positively with MADRS scores (r = 0.45, p < 0.05) and HAM-A scores (r = 0.38, p < 0.05), particularly within the MDD group. In BD, FT4 and FT3 levels were elevated and positively correlated with YMRS scores (FT4: r = 0.30, p < 0.05; FT3: r = 0.42, p < 0.05). In regression analysis within the MDD subgroup, both hypothyroidism and male sex were independently associated with higher MADRS scores, indicating greater depressive symptom severity. Conclusions: These findings suggest diagnosis-specific patterns of thyroid dysfunction among psychiatric inpatients. Higher TSH levels and increased rates of hypothyroidism were most prominent in MDD and were associated with greater depressive and anxiety symptom severity, whereas elevated FT4 and FT3 levels in BD were associated with manic symptom severity. The results support systematic thyroid screening in depressive admissions, hormone-informed monitoring in bipolar disorder, and a more integrated endocrine–psychiatric approach to clinical care. Full article

Background and Objectives: Familial Mediterranean fever (FMF) is a chronic autoinflammatory disease characterized by recurrent inflammatory attacks and a persistent psychosocial burden. Although generalized anxiety symptoms have been investigated in FMF, disease-specific anticipatory concerns related to recurrent attacks remain insufficiently understood. This study aimed to investigate the associations of attack-related anticipatory anxiety symptoms with clinical characteristics, quality of life, and composite inflammatory indices in FMF. Materials and Methods: This exploratory cross-sectional study included 38 adult patients with FMF. Attack-related anticipatory anxiety symptoms were assessed using an exploratory six-item questionnaire. Generalized anxiety and quality of life were evaluated using the Generalized Anxiety Disorder-7 (GAD-7) and Short-Form–12 (SF-12), respectively. Composite inflammatory indices including the C-reactive protein–albumin–lymphocyte (CALLY) index, log-CALLY, hemoglobin–albumin–lymphocyte–platelet (HALP) score, and systemic immune-inflammation index (SII) were calculated from routine laboratory parameters. Results: Attack-related anticipatory anxiety scores demonstrated a significant positive correlation with GAD-7 scores (r = 0.581, p < 0.001) and an inverse correlation with SF-12 mental component scores (r = −0.380, p = 0.019). Direct correlations between attack-related anticipatory anxiety scores and composite inflammatory indices were weak and not statistically significant. In subgroup analysis, a higher annual attack burden was associated with higher GAD-7 scores, higher CRP and serum amyloid A values, and lower CALLY, log-CALLY, and HALP values. Differences in attack-related anticipatory anxiety, SF-12 MCS, and SII between attack burden groups did not reach statistical significance. In multivariable linear regression analysis, GAD-7 score remained independently associated with attack-related anticipatory anxiety symptoms (β = 0.438, p = 0.010). Conclusions: Attack-related anticipatory anxiety symptoms may represent an exploratory psychosocial dimension of FMF associated mainly with generalized anxiety symptoms and impaired mental well-being. Composite inflammatory indices appeared more closely related to annual attack burden than to attack-related anticipatory anxiety. These findings should be interpreted cautiously and considered hypothesis-generating. 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

Background/Objectives: Extant data suggest that the Stellate Ganglion Block (SGB) is effective for posttraumatic stress disorder (PTSD). Clinical data from a large healthcare system are lacking. We report data from a clinical project in the Veterans Health Administration. Methods: Retrospective data of PTSD and anxiety for 579 patients who received one or more SGBs were analyzed on the full sample and on those who had complete data using general linear models. Results: Receiving the first SGB provided a 36% and 30% reduction in PTSD symptom scores at 1-week and 1-month post-SGB, respectively. Those who received 2–4+ SGBs showed lower pre-SGB PTSD symptom scores and trends for lower scores at 1-week and 1-month post-SGB. Overall, 78% and 71% of patients had a reliable (Δ ≥ −5 points) change and 68% and 60% had a clinically meaningful (Δ ≥ −10 points) change in PTSD symptom scores from pre-SGB to 1-week and 1-month post-SGB, respectively. There were clinically meaningful reductions for anxiety in 51.5% and 48.3% at 1-week and 1-month post-SGB, respectively. Conclusions: These data corroborate existing data about the benefit of SGB for PTSD and anxiety and are unique in showing an association between repeat SGBs and lower PTSD symptoms at subsequent baseline. Full article

Background/Objectives: Anxiety disorders in people over 65 y of age are common. Treatment of those disorders is often based on studies involving much younger patients. Experience shows that those treatments are regularly ineffective in the elderly, due to differences in physiology and the disparate etiology of the disease. Here, we examine current trends in research to generate data for evidence-based approaches to treat anxiety disorders in the elderly. Our objective was to evaluate the scope, methodological characteristics, and therapeutic focus of current clinical trials for anxiety disorders in the elderly, and to determine whether the existing evidence pipeline is likely to meet the substantial unmet need for effective and well-tolerated treatments. Methods: We searched clinicaltrials.gov for studies addressing “Anxiety disorder” and related readouts and selected those studies that included patients older than 65 y, and that had anxiety measures as primary or secondary endpoints. Results: We find that over 99% of clinical “anxiety” trials exclude patients older than 65 y. Sixty-six trials fulfilled our inclusion criteria. Trials specifically recruiting the elderly are a rare exception. Unexpectedly, only 10 “anxiety” trials are sponsored by the pharmaceutical industry, despite the potential rewards in such investments. Discussion and Conclusions: Although most clinical trials are registered in clinicaltrials.gov., our work is limited by the fact that not all clinical trials carried out world-wide are included in that database. Our findings indicate that ongoing clinical research supporting evidence-based recommendations for the treatment of anxiety in the elderly is scarce. Detailed secondary analysis of clinical trial results for the efficacy and safety of anxiolytics in various age cohorts may at least be a useful instrument for hypothesis generation, to trigger additional clinical research specifically designed to address anxiety treatment in the elderly. Full article

This narrative review examines the prevalence and potential key causes of eating disorder risk among medical students across countries and training environments. Medical students frequently demonstrate a higher prevalence of eating disorder risk compared to the general population. Rates vary by instrument, geography, stage of training, and sample composition. Recurrent correlates include female gender, body image dissatisfaction, perfectionism, stress, anxiety, depression, lack of physical activity and problematic social media use. The review also highlights important methodological limitations in the literature, including predominantly cross-sectional design, heterogeneous screening tools, inconsistent reporting of all variables, limited longitudinal follow-up, and sparse inclusion of gender-diverse populations. Overall, the evidence supports eating disorder risk as an important medical student wellness issue while also showing that no single factor fully explains the observed burden. The findings support systemic changes in universities to help prevent eating disorders, including better student health education, confidential services and prioritizing student wellness. Longitudinal research is urgently needed to clarify modifiable risk factors as they relate to chronic stress in medical school and inform targeted prevention strategies. Full article