Search Results (2,647)

Background/Objective: Nursing and non-nursing students experience high stress levels, making them susceptible to mental health issues. This study compared stress, anxiety, and depression between these two groups after 2 years of the COVID-19 pandemic. Additionally, it explored the relationship between perceived helplessness, self-efficacy, and symptoms of mental stress and strain resulting from challenging internship conditions for nursing students. Methods: This cross-sectional study included 154 nursing students (mean age = 22.43 years) and 291 non-nursing students (mean age = 27.7 years). Data were collected using the Depression Anxiety Stress Scales (DASS-21), Perceived Stress Scale-10 (PSS-10), and a questionnaire on mental stress and strain. Results: Nursing students reported significantly higher scores in the DASS-21 subscales depression (ηp² = 0.016) and anxiety (ηp² = 0.037), and global stress (PSS-10; ηp² = 0.029) compared to non-nursing students, but no significant difference on the DASS-21 Stress subscale. The observed group differences in the present study may be partially attributed to group differences in demographic factors. Helplessness correlated strongly with nearly all scales of mental stress and strain during internships (all p’s < 0.001), while self-efficacy showed a strong negative correlation with non-occupational difficulties, health impairment, and emotional problems (all p’s < 0.001). Conclusions: Nursing students experience elevated depression, anxiety, and perceived stress levels compared to non-nursing students. Stronger feelings of helplessness and lower confidence in their ability to overcome challenges were strongly correlated with mental stress and strain during clinical training. Targeted interventions such as cognitive behavioral training and stress management should be integrated into nursing curricula to enhance resilience and coping strategies. Full article

Background: About half of all Major Depressive Disorder (MDD) patients have anxiety disorder. There is a neurologic basis for the comorbidity of balance (vestibular) disorders and anxiety. To detect comorbid anxiety disorder in MDD patients and, importantly, to investigate its relationship with depressive severity, we use Electrovestibulography (EVestG), which is predominantly a measure of vestibular response. Methods: In a population of 42 (26 with anxiety disorder) MDD patients, EVestG signals were measured. Fourteen (eight with anxiety disorder) were not on any anti-depressants, anti-psychotics or mood stabilizers. Using standard questionnaires, participants were depression-wise labelled as reduced symptomatic (MADRS ≤ 19, R) or symptomatic (MADRS > 19, S) as well as with or without anxiety disorder. Analyses were conducted on the whole data set, matched (age/gender/MADRS) subsets and compared with medication free subsets. Low-frequency EVestG firing pattern modulation was measured. Results: The main differences between MDD populations with and without anxiety disorder populations, regardless of being medicated or not, were (1) the presence of an increased 10.8 Hz component in the dynamic movement phase recordings, (2) the presence of asymmetric right versus left 7.6–8.9 Hz and 12.1–13.8 Hz frequency bands in the no motion (static) phase recordings, and (3) these differences were dependent on depressive severity. Conclusions: The EVestG measures are capable of quantifying anxiety in MDD patients. These measures are functions of depressive severity and are hypothesized to be linked to Hippocampal Theta (~4–12 Hz). Full article

Background/Objectives: Total intravenous anesthesia (TIVA) typically combines propofol and remifentanil. Remifentanil exerts minimal influence on motor evoked potential (MEP), whereas propofol partially reduces MEP amplitude. Remimazolam, a novel agent, is a component of TIVA. However, evidence of remimazolam on MEP is limited. We aimed to compare the effects of propofol and remimazolam, combined with remifentanil, on relative MEP depression. Methods: Using a crossover design, 18 patients undergoing spine surgery were randomly assigned to receive either propofol or remimazolam as the first agent. In the propofol first sequence, anesthesia was induced and maintained with propofol, which was then switched to remimazolam 60 min after surgery. In the remimazolam first sequence, remimazolam was used first and then switched to propofol. The primary outcomes measured were the MEP amplitude and latency. Results: MEP amplitude and latency during propofol and remimazolam infusions were as follows: amplitude (mean (SD); 635.3 (399.1) vs. 738.4 (480.4) μV, p = 0.047) and latency (median [IQR]; 22.4 [20.3–24.6] vs. 21.4 [19.6–23.5] ms, p = 0.070), indicating propofol caused greater depression in amplitude than remimazolam. However, an incident of severe body movement disrupting surgery occurred under remimazolam anesthesia in a young, healthy male patient, although bispectral index remained below 60. This suggests that remimazolam, at hypnotic levels similar to propofol, may result in reduced akinesia in major surgeries, such as spinal surgery, when neuromuscular blockade is not employed. Conclusions: Remimazolam demonstrated comparable or superior effects to propofol on MEP latency and amplitude when combined with remifentanil during spinal surgery, rendering it a potential alternative to propofol for MEP monitoring. Full article

Background: Depression that is resistant to two or more adequate treatment trials—treatment-resistant depression (TRD)—is a prevalent clinical challenge. Although psychotherapies have been recommended by clinical guidelines as an alternative or adjunctive treatment strategy, the effectiveness of psychotherapy in individuals with TRD has not yet been evaluated through meta-analytic methods, primarily due to a limited number of trials. This highlights the necessity of personalized research targeting this specific population. This systematic review and meta-analysis aimed to summarize the evidence on psychotherapy in treating TRD. Methods: A systematic search was conducted following the Guidelines from Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Articles were included if they quantitatively examined the efficacy of psychotherapy on depression symptoms in individuals diagnosed with depression who had not responded to at least two prior treatments (i.e., pharmacotherapy and/or psychotherapy). Results: A total of 12 studies were included. The quality of evidence was evaluated as being globally moderate. When pooling all psychotherapies, a small-to-moderate, but significant, effect on depressive symptoms was observed compared to the control group (SMD = −0.49, CI = −0.63; −0.34). The observed effect remained unchanged after removing the outlier (SMD = −0.47, CI = −0.62; −0.32). When examining depressive symptoms by type of psychotherapy, Mindfulness-Based Cognitive Therapy (SMD = −0.51, CI = −0.76; −0.25), Cognitive Behavioral Therapy (SMD = −0.53, CI = −0.92; −0.14), and Cognitive Therapy (SMD = −0.51, CI = −1.01; −0.01) showed a moderately significant effect on depressive symptoms compared to the control group. Conclusions: Although this potentially represents the first meta-analysis in this area, the number of studies specifically addressing this complex population remains limited, and the existing literature is still in its early stages. Research focusing on TRD is notably sparse compared to the broader body of work on depression without treatment resistance. Consequently, it was not possible to conduct meta-analyses by type of psychotherapy across all treatment modalities and by type of control group. Due to several study limitations, there is currently limited evidence available about the effectiveness of psychotherapy for TRD, and further trials are needed. Beyond the treatments usually offered for depression, it is possible that TRD requires a personalized medicine approach. Full article

Despite growing evidence supporting the efficacy of LSD-assisted psychotherapy in treating major depressive disorder (MDD), identifying reliable psychopharmacological biomarkers remains necessary. Oxytocin, a neuropeptide implicated in social bonding and flexibility, is a promising candidate due to its release following serotonergic psychedelic administration in healthy individuals; however, its dynamics in psychiatric populations are currently unexplored. This observational pilot study aimed to characterize salivary oxytocin dynamics during a single LSD-assisted psychotherapy session in our patients with treatment-resistant MDD. Participants received 100 or 150 µg LSD, and salivary oxytocin was measured at baseline, 60, 90, and 180 min post-LSD. Concurrently, participants rated subjective drug intensity (0–10 scale) at 60, 90, and 180 min. A linear mixed model revealed significant variation of oxytocin levels over time. Perceived psychedelic intensity also significantly varied over time. This supports oxytocin as a potential biomarker. Larger, controlled trials are warranted to replicate these findings and clarify the mechanistic links between oxytocin dynamics and clinical outcomes, including changes in depressive symptoms and mental flexibility. Full article

Background: Fibromyalgia (FM) is a chronic condition characterized by widespread pain, fatigue, cognitive difficulties, and psychological symptoms. Patients often present distinct personality traits and psychopathological patterns associated with symptom severity. Objective: To examine psychopathological profiles in FM patients based on functional, physical–somatic, and emotional impairment domains, as well as on cumulative disease severity. Materials and Methods: A cross-sectional study was conducted with 70 women clinically diagnosed with FM at a specialized Fibromyalgia Unit. Psychological functioning was assessed using the Personality Assessment Inventory, and disease impact was measured with the Fibromyalgia Impact Questionnaire. Hierarchical cluster analyses were used to classify participants into mild and severe clusters across FIQ domains, and psychological profiles were compared. Results: Patients with severe functional impairment had more affective dysregulation (76.43 vs. 70.20, p < 0.01) and somatic complaints (85.57 vs. 79.76, p < 0.05) than those with mild impairment. The severe–physical cluster showed greater mood instability, somatization, and suicidal ideation (60.94 vs. 53.61, p < 0.05). The severe–emotional cluster had higher rates of major depression (85.71% vs. 64.28%) and persistent depressive disorder (76.19% vs. 70.61%, p < 0.05). Severe showed more emotional instability and somatization, distinguishing it from mild. Greater cumulative severity intensified depressive and somatic disorders. Discussion: Findings support FM’s biopsychosocial profile, where emotional distress may relate to psychological and physical symptoms, reinforcing the need for personalized, multidisciplinary care and comprehensive assessment. Full article

Forty per cent of major depression patients are resistant to antidepressant medication. Thus, it is necessary to search for alternative treatments. Melatonin (N-acetyl-5-hydroxytryptamine) enhances neurogenesis and neuronal survival in the adult mouse hippocampal dentate gyrus. Additionally, melatonin stimulates the activity of Ca²⁺/Calmodulin-dependent Kinase II (CaMKII), promoting dendrite formation and neurogenic processes in human olfactory neuronal precursors and rat organotypic cultures. Similarly, ketamine, an N-methyl-D-aspartate receptor (NMDAR) antagonist, modulates CaMKII activity. Importantly, co-treatment of low doses of ketamine (10⁻⁷ M) in combination with melatonin (10⁻⁷ M) produces additive effects on neurogenic responses in olfactory neuronal precursors. Importantly, enhanced neurogenic responses are produced by conventional antidepressants like ISSRs. The goal of this study was to investigate whether hippocampal CaMKII participates in the signaling pathway elicited by combining doses of melatonin with ketamine acutely administered to mice, 30 min before being subjected to the forced swimming test. The results showed that melatonin, in conjunction with ketamine, significantly enhances CaMKII activation and changes its subcellular distribution in the dentate gyrus of the hippocampus. Remarkably, melatonin causes nuclear translocation of the active form of CaMKII. Luzindole, a non-selective MT₁ and MT₂ receptor antagonist, abolished these effects, suggesting that CaMKII is downstream of the melatonin receptor pathway that causes the antidepressant-like effects. These findings provide molecular insights into the combined effects of melatonin and ketamine on neuronal plasticity-related signaling pathways and pave the way for combating depression using combination therapy. Full article

Introduction: Burnout syndrome, long described as an “occupational phenomenon”, now affects 15–20% of the general workforce and more than 50% of clinicians, teachers, social-care staff and first responders. Its precise nosological standing remains disputed. We conducted a mechanistic review of electroencephalography (EEG) studies to determine whether burnout is accompanied by reproducible brain-function alterations that justify disease-level classification. Methods: Following PRISMA-adapted guidelines, two independent reviewers searched PubMed/MEDLINE, Scopus, Google Scholar, Cochrane Library and reference lists (January 1980–May 2025) using combinations of “burnout,” “EEG”, “electroencephalography” and “event-related potential.” Only English-language clinical investigations were eligible. Eighteen studies (n = 2194 participants) met the inclusion criteria. Data were synthesised across three domains: resting-state spectra/connectivity, event-related potentials (ERPs) and longitudinal change. Results: Resting EEG consistently showed (i) a 0.4–0.6 Hz slowing of individual-alpha frequency, (ii) 20–35% global alpha-power reduction and (iii) fragmentation of high-alpha (11–13 Hz) fronto-parietal coherence, with stage- and sex-dependent modulation. ERP paradigms revealed a distinctive “alarm-heavy/evaluation-poor” profile; enlarged N2 and ERN components signalled hyper-reactive conflict and error detection, whereas P3b, Pe, reward-P3 and late CNV amplitudes were attenuated by 25–50%, indicating depleted evaluative and preparatory resources. Feedback processing showed intact or heightened FRN but blunted FRP, and affective tasks demonstrated threat-biassed P3a latency shifts alongside dampened VPP/EPN to positive cues. These alterations persisted in longitudinal cohorts yet normalised after recovery, supporting trait-plus-state dynamics. The electrophysiological fingerprint differed from major depression (no frontal-alpha asymmetry, opposite connectivity pattern). Conclusions: Across paradigms, burnout exhibits a coherent neurophysiological signature comparable in magnitude to established psychiatric disorders, refuting its current classification as a non-disease. Objective EEG markers can complement symptom scales for earlier diagnosis, treatment monitoring and public-health surveillance. Recognising burnout as a clinical disorder—and funding prevention and care accordingly—is medically justified and economically imperative. Full article

Background: International migration is a growing global phenomenon involving diverse groups, such as labor migrants, international marriage migrants, refugees, and international students. International migrants face unique mental health challenges influenced by adversities such as social isolation and limited access to mental health services. This study employs bibliometric methods to systematically analyze the global body of literature on international migrants’ mental health. Methods: The literature on the mental health of international migrants published until October 2024 was searched using the Web of Science database. The search terms included (‘International migrants’ OR ‘migrant workers’ OR ‘international students’ OR ‘refugees’ OR ‘asylum seekers’ OR ‘smuggled migrants’) AND ‘mental health’. VOSviewer was used to conduct bibliometric analysis, focusing on co-authorship patterns, keyword co-occurrence, and citation networks. Results: Over the past four decades, research on the mental health of international migrants has grown substantially, with major migration destinations such as the United States, Europe, and Australia playing prominent roles in this field. ‘Post-traumatic stress disorder (PTSD)’ was the most frequent keyword in publications, with strong links to ‘trauma’ and ‘depression’. In recent years, with the impact of global socioenvironmental changes and emergencies such as the COVID-19 pandemic, the research focus has gradually shifted towards social support, service accessibility, and cultural adaptation. Conclusions: International migration is a far-reaching global phenomenon, and addressing the mental health of migrant populations is essential for advancing public health, social cohesion, and sustainable development. This study provides the first bibliometric overview of research in this domain, mapping its thematic evolution and collaborative structure. The findings offer valuable insights into the field’s development and may support future interdisciplinary collaboration and the formulation of culturally informed, evidence-based approaches in migrant mental health. Full article

Stress is a major factor that threatens the body’s homeostasis or well-being. Excessive stress causes psychological anxiety and tension, which disrupts the balance of the autonomic nervous system that maintains the body’s balance, resulting in hormonal imbalance and brain changes. In this study, we investigated the effects of Withania somnifera (Ashwagandha) extract on depression, neurobehavior, and hippocampal changes in model mice exposed to stress. Using an excessive restraint stress-induced depression model, we measured the behavioral changes and the levels of brain-derived neurotrophic factor (BDNF) and antioxidant genes in five groups: control, stress, low-dose W. somniferous extract (20 mg/kg/day), high-dose W. somniferous extract (40 mg/kg/day), and L-theanine (50 mg/kg/day, positive control). Stressed mice showed poorer performance in the open field and elevated plus maze tests compared with the control group. The impaired performance was restored following W. somniferous extract administration. In addition, W. somniferous extract restored the decreased expression of BDNF in the hippocampus caused by restraint stress, improved the balance of stress hormones (i.e., cortisol, dopamine, and norepinephrine), and also regulated BDNF, inflammatory genes, and antioxidant genes in brain tissue. Therefore, W. somniferous extract can induce antidepressant and anti-stress effects by maintaining brain BDNF expression and preventing hippocampal tissue alterations caused by restraint stress. Full article

Background/Objectives: Juvenile idiopathic arthritis (JIA) and inflammatory bowel disease (IBD) are chronic autoimmune conditions that impact the physical and psychological well-being of pediatric patients. While previous studies have shown a high prevalence of mental health challenges among youth with chronic conditions, the prevalence of mental health issues in Canadian pediatric patients with JIA and IBD remains unclear. We aimed to estimate the prevalence of documented mental health disorders and related medication use of youth with JIA or IBD at a tertiary care centre. Methods: We conducted a retrospective chart review of youths aged 12–17 diagnosed with JIA or IBD at McMaster Children’s Hospital (MCH) to understand the prevalence of generalized anxiety disorder (GAD), separation anxiety disorder, social anxiety disorder (SAD), obsessive–compulsive disorders (OCD), eating disorders, major depressive disorder (MDD), adolescent adjustment disorder, suicide attempt/suicide ideation, self-harm behaviour, substance use disorder, and attention deficit disorders (ADD). Results: We reviewed 429 patient charts, including 303 patients with IBD and 126 with JIA. Our findings identified 90 IBD patients and 20 JIA patients who had one or more documented mental health conditions. Proportionately, there was a higher prevalence of mental health conditions among IBD patients (30%) compared to JIA patients (16%). The most frequently observed conditions in both IBD and JIA patients were GAD (63%, 50%), ADD (33%, 35%), and MDD (29%, 15%). Conclusions: These findings highlight the critical need for early mental health screening and integrated care approaches that address both medical and psychosocial needs in adolescents with chronic illnesses. Future research should incorporate prospective study designs, include diverse geographic and demographic populations, and explore targeted interventions to improve mental and physical health outcomes in this vulnerable group. Full article

Background/Objectives: Depression is a major disorder that has been described in terms of its underlying neurological characteristics, often measured via EEG. However, almost all previous research into the EEG correlates of depression has used a unitary model of Major Depressive Disorder (MDD), whereas there is strong evidence that MDD is heterogeneous in its symptomatology and neurological underpinnings. Methods: To investigate the EEG signatures of four subtypes of depression defined according to the previous literature, the Zung Self-rating Depression Scale was administered to 54 male and 46 female volunteers (M age = 32.53 yr). EEG data were collected during an Eyes Closed condition and examined for differences in connectivity across brain networks in the alpha- and beta-bands. Results: The results were examined in terms of the number and direction of connectivity differences between depressed and non-depressed participants within each depression subtype, the alpha- and beta-band connectivities, the regions of the brain that were connected, and the possible functional reasons why specific brain regions were differently connected for depressed and non-depressed participants within each MDD subtype. Conclusions: The results suggested some differences in the alpha- and beta-band connectivity between some of the MDD subtypes that are worth considering as representing different neurological signatures across the depression subtypes. These findings represent an initial challenge to defining depression as a unitary phenomenon, and suggest possible benefits for further research into the underlying neurological phenomena of depression subtypes. Full article

Radiation therapy serves as a fundamental treatment for primary and metastatic brain tumors, whether used alone or combined with surgery and chemotherapy. Despite its oncological efficacy, this treatment paradigm frequently induces radiation-induced brain injury (RBI), a progressive neuropathological condition characterized by structural and functional damage to healthy cerebral parenchyma. Patients with RBI frequently develop affective disorders, particularly major depressive disorder and generalized anxiety disorder, which profoundly impair psychosocial functioning and quality of life. The pathophysiology involves complex mechanisms such as neuroinflammation, oxidative stress, blood–brain barrier disruption, and white matter damage. Current management strategies include antidepressants, corticosteroids, and neuroprotective agents, while emerging therapies targeting neuroinflammation and neural repair show promise. This review comprehensively examines the pathogenesis of RBI-related affective disorders and evaluates both conventional and novel treatment approaches. By synthesizing current evidence, we aim to provide insights for developing more effective interventions to improve patient outcomes and quality of life. Full article

The fourth member of the Shahejie Formation in the Leijia area of the western depression of the Liaohe Oilfield represents a typical shale oil reservoir. However, post-hydraulic fracturing operations in this region are often hindered by significant discrepancies in well productivity, low fracturing fluid flowback efficiency, and an unclear understanding of reservoir damage mechanisms during fracturing. These challenges have become major bottlenecks restricting the efficient exploration and development of shale oil in this block. In this study, a series of laboratory-simulated experiments were conducted to investigate the primary mechanisms of formation damage induced by fracturing fluids in shale oil reservoirs. An experimental methodology for evaluating reservoir damage caused by fracturing fluids was developed accordingly. Results indicate that guar gum-based fracturing fluids exhibit good compatibility with formation-sensitive minerals, resulting in relatively minor damage. In contrast, capillary trapping of the aqueous phase leads to moderate damage, while polymer adsorption and retention cause low to moderate impairment. The damage associated with fracturing fluid invasion into fractures is found to be moderately high. Overall, the dominant damage mechanisms of guar gum fracturing fluids in the Shahejie Member 4 shale oil reservoir are identified as aqueous phase trapping and polymer adsorption. Based on the identified damage mechanisms, corresponding optimization strategies for fracturing fluid formulations are proposed. The findings of this research provide critical insights for improving shale oil development strategies in the Leijia area. Full article

The insular cortex has emerged as a key region implicated in a wide array of cognitive, emotional, and sensory processes. The anterior part of the insula (AIC) is central to emotional awareness, decision-making, and interoception, while the posterior insula (PIC) is more associated with somatosensory processing. The insula acts as a functional hub within the salience network and integrates homeostatic, affective, and cognitive information; thus, its role in different mental disorders seems to be prominent. Altered structure and connectivity of the insular cortex are evident in several psychiatric conditions. In schizophrenia, reductions in insular volume—especially on the left—correlate with hallucinations, emotional dysregulation, and cognitive deficits. Bipolar and major depressive disorders exhibit AIC volume loss and aberrant connectivity patterns linked to impaired affect regulation and interoceptive awareness. Anxiety disorders show functional hyperactivity of the insula, especially in response to fear-inducing stimuli, though findings on structural changes are mixed. Overall, growing evidence underscores the insular cortex’s central role in psychiatric pathophysiology and highlights its potential as a target for future diagnostic and therapeutic strategies. Full article