Search Results (24,323)

There remains a widespread lack of knowledge regarding hidradenitis suppurativa (HS) among physicians in the United States, impeding timely diagnosis and implementation of comprehensive treatment interventions. Despite the presence of supporting communities for affected adolescents and their caretakers, the overall awareness of HS remains low, and a greater consensus on the treatment of HS is needed. Current research highlights the lack of standardized pediatric guidelines for treatment of HS largely due to the varied nature of the disease and limited efficacy of current therapies. Our study aims to explore the relationship between the chronic skin condition HS and social–emotional concerns, mental health, and physical health issues in US children and adolescents. Using the Arksey and O’Malley framework and PRISMA-ScR reporting, we searched PubMed/MEDLINE, Scopus, Web of Science, Cochrane Library, and Embase for U.S. studies (2015–2025) on pediatric HS (<18 years) and social–emotional, mental health, or quality-of-life outcomes. Recommendations were synthesized, and study quality was appraised with CASP checklist methods and rigor. Ten studies (2020–2025) met inclusion criteria. Pediatric HS was associated with depression, anxiety, social withdrawal, shame, low self-esteem, and reduced quality of life. Physical comorbidities increased psychosocial burden. Socioeconomic and racial disparities worsened outcomes and access to care. Studies emphasized early diagnosis, routine screening, multidisciplinary management, and disparity-focused interventions. Findings may inform clinical practice and guide research initiatives aimed at improving outcomes for children and adolescents with HS. Full article

Suicidal ideation among college students is a multicausal public health concern shaped by individual, family, social, and academic factors. Although prior research has consistently documented associations between psychological distress and suicide risk in this population, most studies analyze risk factors in isolation, leaving the joint contribution of variables across ecological levels insufficiently understood. The present study, framed within Bronfenbrenner’s ecological model of human development and Joiner’s interpersonal theory of suicide, examined the simultaneous influence of clinical, protective, academic, and victimization variables on suicidal ideation in college students. A cross-sectional design was employed with a sample of 553 undergraduate and graduate students (68.9% women; mean age = 20.93 years, SD = 3.81) from the University of Málaga (Spain), recruited through snowball and convenience sampling. Participants completed validated self-report measures of suicidal ideation (Paykel Suicide Scale), depression and anxiety (HADS), eating disorders (CBCAR), self-esteem (RSE), academic stress (SISCO), academic procrastination (APS-SF), bullying, cyberbullying, and social exclusion (QAEU), social support (QFSSS), family satisfaction, healthy habits, and family history of mental illness. Data were analyzed through Pearson and Spearman correlations and a robust multiple linear regression (ordinary least squares with HC3 robust standard errors and bias-corrected and accelerated bootstrap confidence intervals from 5000 resamples), complemented by an ordinal regression as a sensitivity analysis. The regression model accounted for 44.1% of the variance in suicidal ideation, with depression, anxiety, eating disorders, family history of mental illness, and bullying showing significant positive associations and self-esteem the strongest protective association. An ordinal regression sensitivity analysis yielded a consistent pattern, supporting the robustness of these findings. Family and social support, although correlated with lower ideation, lost statistical weight in the multivariate models, suggesting that their contribution operates indirectly, mainly through depression and self-esteem. Findings support the integration of clinical, social, and personal-resource components into college prevention programs, prioritizing early detection of psychopathology, anti-bullying protocols, interventions to strengthen self-esteem, and greater visibility of campus psychological services. Full article

The following article investigates the way in which popular media in Western culture reinforces a shared imagination linked to the treatment and care of people experiencing mental health conditions that are often associated with horror, violence, and crime. These representations haunt our vision of what it means to receive a mental health diagnosis, instilling fear and negative perceptions of mental illness in our psyche. The violent and disturbing imagery that is often used to portray mental illness, and made for entertainment purposes, reinforces a shared subconscious fear that haunts our imagination. These portrayals of mental illness fail to bridge the gap between human trauma, a medical diagnosis and a positive return to the community. This article uses examples of popular media from the twenty-first century to demonstrate how imagery linked to the age of asylums persists in today’s representations of mental health experiences. These images are reinforced by mainstream news stories, which draw on the most sensational and frightening incidents of mental health episodes. In summary, this article will highlight the way that popular media is influenced by society and has the power to reshape our understandings of mental health experiences for the better. To do this, there is a need for positive change within the mental health system, and more balance within news stories about mental health conditions. Full article

Smart textiles offer promising opportunities to address multiple aspects of relaxation-focused mental health interventions, which include monitoring and therapy. This paper presents a usability evaluation of a cushion-based smart textile system called Amiga, designed to guide users through breathing exercises that could be used in the future to support relaxation-focused interventions intended for independent use. A experimental user study with 20 participants was conducted to assess the system’s effectiveness, user performance, user experience, and overall satisfaction using structured interviews and validated usability questionnaires. The system achieved a mean System Usability Scale (SUS) score of 81.875 with standard deviation ($\sigma$ = 11.8), exceeding the established SUS benchmark of 68 and corresponding to the ‘Excellent’ category rating, under a predefined assistance-free criterion. The system was designed for respiratory phases (Ph) and respiration rate (RR) monitoring through a guided-breathing exercise where 90% completed with only 40% passing the quality criteria, achieving an average pace synchronization accuracy (PSA) of 61.2 % and phase duration accuracy (PDA) of 30% with a tolerance of ±1 s, thus providing a initial baseline for autonomous use and highlighting opportunities to improve on-boarding and in-application guidance. Most participants reported positive feedback regarding their confidence and overall satisfaction. Usability challenges were identified related to physical interaction with the cushion and clarity of on-screen instructions, providing clear directions for future design refinement. These findings demonstrate the feasibility of smart textile-based devices for home-based breathing exercises. Full article

Background: This study investigates the role of ELOVL6 in the weight gain induced by olanzapine and the mechanisms underlying the female-specific response. Methods: An olanzapine-induced weight gain model in SD rats was developed. Transcriptome sequencing and metabolomics identified genes and metabolites linked to female-specific weight gain. Validation was conducted in HL7702 cells, and DNA pulldown, ChIP-qPCR, and molecular docking explored the molecular mechanism. A genetic polymorphism association study was also performed. Results: Female rats showed more pronounced weight gain compared to males following olanzapine treatment. Transcriptomic and metabolomics analyses revealed that olanzapine significantly upregulates hepatic ELOVL6 expression and long-chain fatty acid synthesis in females. Inhibition of ELOVL6 restores the elevated levels of the lipid, SREBP-1c and FAS induced by olanzapine. The transcription factor HNF-3α is implicated in ELOVL6 regulation, and some olanzapine metabolites can directly interact with HNF-3α. Furthermore, a single-nucleotide polymorphism (SNP) at the ELOVL6 promoter -1427 bp correlates with weight gain in female patients. Conclusions: Olanzapine metabolites interact with HNF-3α, enhancing ELOVL6 transcription. The upregulated ELOVL6 promotes long-chain fatty acid synthesis via the SREBP-1c/FAS pathway, contributing to female-specific weight gain. Full article

Pornography use during adolescence is a relevant issue from social, educational, and public health perspectives. As with other behaviours, its correlates may involve complex and nonlinear relationships. This study uses data from the 2023 Spanish Survey on Drug Use in Secondary Education (ESTUDES), a major source for analysing potentially addictive behaviours among adolescents in Spain because of its large sample size (original sample: N = 42,208; complete-case analytical sample: N = 33,543). Pornography use was modelled as a binary outcome using logistic regression, XGBoost, LightGBM, and CatBoost. The models included sociodemographic characteristics, family-related factors, parental control, substance use, selected sexual behaviours, indicators of mental well-being, and addictive Internet use. The four methods showed similar predictive performance. CatBoost achieved the highest AUC and the lowest Brier score and log loss, whereas LightGBM obtained the highest accuracy, specificity, and precision. Logistic regression yielded the highest sensitivity, negative predictive value, balanced accuracy, and F1-score. SHAP analysis identified sex as the most influential predictor, followed by addictive Internet use, cannabis and alcohol use, family conflict, and selected risky sexual behaviours. The findings suggest that pornography use among adolescents forms part of a broader behavioural and psychosocial profile. Whereas sex operated mainly as a strong direct predictor, problematic Internet use showed substantial interactions with age and cannabis and alcohol use. This study demonstrates how explainable machine learning can complement conventional regression by identifying the main correlates, nonlinear patterns, and interactions associated with adolescent pornography use. Full article

Background/Objectives: Psychological well-being is an important indicator of occupational mental health among special education teachers, as it is closely associated with work engagement, professional performance, and attitudes toward students with disabilities. Despite its importance, limited research has examined factors associated with psychological well-being among special education teachers in Arab contexts. Therefore, this study examined the level of psychological well-being among special education teachers and investigated the relative contributions of mindfulness and empathy. In addition, the study tested the mediating role of empathy in the relationship between mindfulness and psychological well-being. Methods: A cross-sectional quantitative predictive correlational design was employed with a sample of 259 special education teachers in Riyadh, Saudi Arabia. Data were collected using an Arabic-adapted version of Ryff’s Psychological Well-Being Scale, the short form of the Five-Facet Mindfulness Questionnaire, and the Empathy Scale for Teachers. Path analysis was conducted to test a partial mediation model examining the mediating role of empathy in the relationship between mindfulness and psychological well-being. Results: The findings indicated high levels of psychological well-being among special education teachers. Mindfulness and empathy accounted for significant variance in psychological well-being, and path analysis showed that empathy partially mediated the relationship between mindfulness and psychological well-being. Conclusions: These findings highlight the potential importance of mindfulness and empathy in relation to the psychological well-being of special education teachers and suggest the value of giving greater attention to these dimensions in pre-service preparation and ongoing professional support programs. The study also contributes context-specific evidence from Saudi Arabia to the literature on teacher well-being in special education. Full article

Automatic detection of stress in social media text holds promise for supporting digital mental health, but most existing Transformer-based approaches are opaque and computationally demanding. This work presents DR-Transformer, a Dual-Regularized Transformer that combines two complementary mechanisms: (i) a group sparsity penalty ($L_{2,1}/L_2$ elastic net) applied to the query and key projection matrices of every attention head, which encourages whole-row sparsity, producing more concentrated and inspectable attention patterns; (ii) a supervised contrastive loss on the [CLS] projection, which organizes the latent space according to the stress label. The architecture is intentionally lightweight (six layers, eight heads, 256-dim embeddings; ∼9.5 M parameters) and runs entirely on consumer-grade hardware (NVIDIA GTX 1660, 6 GB). Experiments on the publicly available Dreaddit dataset (binary stress classification, 2838 train/715 test segments) compare DR-Transformer against Logistic Regression, BiLSTM, a Standard Transformer of identical architecture, and MentalBERT. Across five seeded runs, DR-Transformer (Full) reaches $F_1=0.876$ (bootstrap 95% CI $0.852$–$0.898$), outperforming the Standard Transformer ($F_1=0.842$; McNemar $p<0.001$ with Bonferroni correction) and performing comparably to the much larger MentalBERT ($F_1=0.879$; $p=0.421$). Sparse regularization increases the fraction of near-zero attention weights (below $0.01$) from $0.215$ to $0.682$, while the supervised contrastive loss improves the silhouette score of [CLS] embeddings from $0.312$ to $0.483$. Dual regularization thus combines accuracy, efficiency, and structurally induced attention concentration in a single model which can be trained without specialized infrastructure. We use the term “interpretable” throughout in this restricted, structural sense—to refer to concentrated and inspectable attention—rather than in the sense of established causal or mechanistic faithfulness; this is only partially and indirectly supported by our token deletion analysis. Full article

Background/Objectives: Children with complex chronic conditions (CCCs) present profound clinical uncertainty for pediatric nurses, who must navigate unpredictable disease trajectories, ambiguous symptom presentations, and emotionally demanding care situations. This study explored the lived experiences of pediatric nurses caring for children with CCCs, with a specific focus on how they perceive, navigate, and manage clinical and emotional uncertainty in daily practice. Methods: A Gadamerian hermeneutic phenomenological study was conducted in pediatric units within tertiary hospitals in Riyadh, Saudi Arabia, using purposive, maximum-variation sampling. Fifteen pediatric nurses participated in semi-structured interviews conducted in English. Data were analysed using hermeneutic phenomenological analysis informed by the framework of Alsaigh and Coyne. Reporting followed the Consolidated Criteria for Reporting Qualitative Research (COREQ) guidelines. Results: Three themes emerged: navigating the unknown, reflecting nurses’ encounters with diagnostic ambiguity and unpredictable illness trajectories; the emotional weight of not knowing, capturing the psychological burden of sustained uncertainty; and finding footing in uncertainty, describing adaptive strategies including relational anchoring, peer support, and meaning-making through caregiving. Conclusions: Clinical uncertainty is an inherent and pervasive feature of pediatric chronic illness care. Pediatric nurses develop relational and meaning-making strategies, alongside more limited cognitive appraisal strategies, to manage uncertainty, yet require greater institutional recognition and support. Targeted interventions addressing uncertainty tolerance, reflective practice, and structured peer support are proposed as potential approaches, warranting future evaluation, to strengthen nursing resilience and support care quality for children with CCCs. Full article

Background: Enhancing self-management and coping strategies in cancer patients is critical to improving their quality of life and treatment outcomes. eHealth interventions, such as mobile apps, telehealth platforms, and online support tools, offer accessible, personalized, and cost-effective solutions that empower patients to actively manage their symptoms, adhere to treatment plans, and reduce psychological distress. These digital tools play a pivotal role in bridging care gaps, especially for individuals facing barriers to in-person support, underscoring their growing importance in modern oncology care. Aim: The aim of this study was to evaluate the efficacy of an eHealth intervention in enhancing self-management and coping strategies in cancer patients. Methods: This study was designed as a randomized controlled trial (RCT) and is reported in accordance with the CONSORT guidelines to ensure transparent and comprehensive reporting. A study and control group pre-test/post-test design was employed to investigate the impact of the intervention in the cities of Shaqra and Sajir, Riyadh, Saudi Arabia. A total of 212 participants were recruited using the Symptom-Management Self-Efficacy Scale (SMSE) and the Jaloweic Coping Scale. Result: Before the intervention, the correlation between coping behaviors and self-management practices was weak and statistically insignificant for both groups (study: r = 0.091, p = 0.351; control: r = 0.048, p = 0.622). After the intervention, a significant positive correlation emerged in the study group (r = 0.267, p = 0.006), suggesting that improvements in coping behaviors were associated with enhanced self-management practices. However, no significant change was observed in the control group (r = 0.081, p = 0.412). Conclusions: The intervention significantly improved self-management practices and coping behaviors in the study group, while the control group showed minimal or no improvement. The findings indicate that self-management and coping strategies are interrelated, and demographic factors such as age, education, and income influence the extent of improvement. Trial Registration: ClinicalTrials.gov identifier NCT07457112, registered on 5 March 2026, retrospectively registered. Full article

Depression, anxiety disorders and sleep disorders are becoming increasingly prevalent among college students. While psychotherapy and pharmacotherapy remain important interventions, their practical implementation in university settings may be constrained by factors including limited service accessibility, scheduling constraints, privacy concerns, stigma, and poor long-term adherence. As a low-threshold supportive intervention that can be readily integrated into campus environments, art healing offers a complementary approach to promoting college student mental health. This review includes 20 studies retrieved from the Web of Science and PubMed databases. These studies provide evidence for the mental health benefits of auditory art, visual art, and integrated art healing. The findings indicate that music-based interventions (the primary form of auditory art) have relatively robust supporting evidence for alleviating stress and anxiety; visual art and integrative art healing also yield measurable positive mental health outcomes. However, existing research is limited by heterogeneous intervention delivery protocols, small sample sizes, short follow-up periods, and substantial variation in methodological quality. Current evidence supports art healing as a complementary strategy for mental health promotion in higher education settings, rather than an alternative treatment modality. Future work should test standardized protocols in multi-site student samples. Long-term follow-up designs to further clarify its target populations, underlying mechanisms, and sustained efficacy. Full article

Background/Objectives: Traumatic birth perception has been associated with adverse psychological outcomes during the postpartum period, including postpartum depressive symptoms. Perceived social support may be related to both traumatic birth perception and maternal mental health. However, the associations among these variables remain insufficiently understood. This study aimed to examine the relationships among traumatic birth perception, perceived social support, and postpartum depression in postpartum women in Türkiye and to explore the indirect association of perceived social support in this relationship. Methods: This cross-sectional study was conducted with 297 postpartum women in Türkiye using an online survey. Data were collected using a Personal Information Form, the Traumatic Birth Perception Scale, the Perceived Social Support Scale (F-SozU K-3), and the Edinburgh Postnatal Depression Scale. Data were analyzed using descriptive statistics, Pearson correlation analysis, and regression-based indirect association analysis using Hayes’ PROCESS macro. Results: Traumatic birth perception was positively associated with postpartum depression (p < 0.001), whereas perceived social support was negatively associated with postpartum depression (p < 0.001). Traumatic birth perception was also negatively associated with perceived social support (p < 0.001). The indirect association analysis indicated that perceived social support was significantly associated with the relationship between traumatic birth perception and postpartum depression. Women reporting higher traumatic birth perception tended to report lower perceived social support and higher postpartum depressive symptoms. Conclusions: The findings suggest that traumatic birth perception, perceived social support, and postpartum depression are significantly interrelated among postpartum women. Higher levels of perceived social support were associated with lower levels of postpartum depressive symptoms. Given the cross-sectional nature of the study, causal inferences cannot be made. Longitudinal studies are needed to clarify the temporal relationships among these variables. Full article

The regular practice of physical exercise is often associated with promoting benefits for practitioners. In recent decades, street running has become popular worldwide, with most participants being recreational runners who engage in the activity primarily to promote health, well-being, leisure, and quality of life, although some also participate with competitive goals. Among the psychological aspects related to exercise, studies have shown that some individuals may become susceptible to “exercise dependence,” a condition in which exercise takes a central role in a person’s life. As a result, individuals may exhibit characteristics such as excessive training, injuries; weight control issues, withdrawal symptoms when unable to exercise and even problems in social relationships when exercise is exclusively prioritized. Background/Objectives: The aim of this study was to investigate and analyze levels of susceptibility to running dependence and its relationship with exercise volume and mood states (tension, depression, anger, vigor, fatigue, and mental confusion). Methods: This was a quantitative cross-sectional study involving 761 regular Brazilian runners (59.8% male and 40.2% female) who consented to participate and answered the Sociodemographic Questionnaire, the Escala de Dependência de Corrida (EDC), a Brazilian Portuguese adaptation of the Negative Addiction Scale (NAS), and the Brunel Mood Scale (BRUMS). The analysis plan was conducted through descriptive statistics (mean, standard deviation, median, 1st and 3rd quartiles, interquartile range, and 95% confidence intervals) and inferential statistics (Spearman’s Correlation and Kruskal–Wallis Test). In all tests, the significance level adopted was p < 0.05. Results: The sample was divided into three groups of susceptibility to exercise dependence: low (37.6%), moderate (36.4%), and high (26%). Scores indicative of greater susceptibility to exercise dependence showed positive correlations with running practice volume (years of experience, weekly training frequency, weekly training duration, and weekly mileage), as well as with vigor. Although a statistically significant correlation was also observed for tension, its magnitude was trivial (rs = 0.080). Comparisons using the Kruskal–Wallis test showed that higher susceptibility levels were associated with greater running volumes and higher raw vigor scores, whereas no significant group differences were observed for the remaining mood states. Conclusions: Higher susceptibility to exercise dependence was associated with greater running volume and higher raw vigor scores. No consistent associations were observed with negative mood states, except for a trivial correlation with tension. These findings suggest that greater susceptibility to exercise dependence among runners was primarily associated with higher raw vigor scores rather than with broader alterations in mood states. Full article

(1) Background/Objectives: Sarcopenia is common in older surgical candidates and may affect perioperative risk and recovery after total hip arthroplasty (THA). Quantifying its burden and severity gradient in THA pathways can inform surgeon-led optimization. (2) Methods: A cross-sectional analysis of baseline preoperative data at a tertiary center (December 2019 to December 2022) was conducted. Consecutive adults with hip osteoarthritis undergoing primary THA were screened. Sarcopenia was staged per EWGSOP2: probable (low handgrip), confirmed (probable and low skeletal muscle index by whole-body DXA), and severe (confirmed and low gait speed). (3) Results: Of 312 screened patients, 203 completed baseline assessment (95 men, 108 women). According to the EWGSOP2 algorithm, 57 patients (28.1%; 95% CI 22.3–34.6%) had low handgrip strength, 30 (14.8%; 95% CI 10.6–20.3%) fulfilled criteria for confirmed sarcopenia, and 21 (10.3%; 95% CI 6.9–15.3%) had severe sarcopenia. No significant association was observed for sex. Sarcopenia diagnosis was associated with older age, lower body mass index (BMI), higher comorbidity burden, lower functional independence, greater cognitive impairment, poorer mental health, and worse hip-related function (all p < 0.05). In multivariable analysis, older age (OR 1.51 per 5-year increase; 95% CI 1.11–2.12), lower BMI (OR 0.88 per kg/m²; 95% CI 0.79–0.98), and lower functional independence (Barthel Index: OR 2.02 per 10-point decrease; 95% CI 1.20–3.60) were independently associated with confirmed sarcopenia. Across EWGSOP2 categories, differences in age, BMI, pain, comorbidity, functional independence, cognition, mental health and hip function showed significant differences (all p < 0.05), with ordered trends in most domains but no uniform monotonic pattern. (4) Conclusions: In THA candidates, sarcopenia is prevalent and is related to older age, lower BMI and lower functional independence. Integrating sarcopenia screening by EWGSOP2 may help to identify THA candidates with greater clinical vulnerability who may warrant further preoperative assessment and targeted optimization strategies. Full article

Background: Primary care providers are increasingly using screening programs to identify patients at risk of mental disorders. Early diagnosis of bipolar disorder type I (BDI) is essential for a better outcome. Endophenotypes are an important subtype of biomarkers. Furthermore, previous studies show anxiety trait as a possible BDI endophenotype, but there is a lack of replication. Objective: Our study evaluates the presence of anxiety trait and bipolarity risk in bipolar disorder type I first-degree relatives (FDR). Methods: We evaluated 219 participants (119 healthy controls, 68 healthy FDR and 32 affective unipolar FDR), including sociodemographic data, psychiatric history, Spielberg’s State and Trait Anxiety Inventory (STAI), General Health Questionnaire, Beck Depression Inventory, and Mood Disorder Questionnaire (MDQ) scores as a measure of bipolarity risk. Results: In our sample, affective unipolar BDI’s first-degree relatives showed the highest scores in STAI anxiety trait compared to healthy controls and BDI’s healthy first-degree relatives. STAI-Trait only correlated significantly with bipolarity risk (MDQ) in the unipolar affective first-degree relatives subgroup. Conclusions: Although further investigation is warranted, trait anxiety is a potential endophenotype for BDI. It exhibits high heritability and confers an increased lifetime risk for unipolar affective disorder and a predisposition toward bipolarity. Full article