Search Results (2,097)

Background/Objectives: Cognitive behavioural therapy (CBT) is an effective intervention for promoting personal recovery among individuals diagnosed with schizophrenia; however, Saudi Arabia has a shortage of healthcare professionals trained to deliver it. Mental health nurses are well positioned to help address this gap. This study explored mental health nurses’ perspectives on a proposed culturally adapted CBT intervention for individuals diagnosed with schizophrenia and identified perceived barriers and facilitators to its implementation. Methods: Situated within the development phase of the Medical Research Council framework for complex interventions, the study examined perceived acceptability and anticipated feasibility rather than efficacy. Three face-to-face focus groups involving 19 mental health nurses were conducted between December 2020 and February 2021 at a tertiary mental health hospital in Riyadh, Saudi Arabia, during the COVID-19 pandemic. The focus group questions were informed by a systematic review of culturally adapted CBT components, and data were analysed using framework analysis. Results: Three themes emerged: acceptability, with nurses recognising the value of CBT in promoting recovery; barriers, including lack of role clarity within mental health nursing policy, dominance of the medical model, and engagement difficulties among individuals diagnosed with schizophrenia; and facilitators, including supportive nursing management, training opportunities, and family involvement. Conclusions: Mental health nurses expressed support for delivering CBT but identified organisational and training-related barriers. Successful implementation will require clear policy frameworks, structured culturally adapted CBT training, ongoing clinical supervision, supportive nursing management, and collaborative approaches that appropriately involve families. Full article

Background: In recent decades, doctoral education has undergone a profound transformation. As a result, PhD students have become an increasingly vulnerable population, facing greater risk of mental health problems than the general population. A particularly important subgroup comprises PhD students in medicine and health sciences, who often combine doctoral training with clinical work. Their dual roles expose them to additional pressures, with an increased risk of burnout. Given that their context differs considerably from the typical university environment, in this systematic review, we aim to synthesize the current evidence on burnout, impostor syndrome, and research engagement, along with related indicators of psychological distress, among PhD students in medicine and health sciences, as well as identify key risk and protective factors and highlight gaps for future research. Methods: A systematic literature search was conducted in March 2026 across the Web of Science, Scopus, and Ovid MEDLINE databases. Following a screening process based on PRISMA guidelines, 27 studies were included; due to substantial heterogeneity, findings were synthesized narratively. Results: Psychological difficulties appeared to be more strongly associated with institutional factors rather than personal traits. Burnout was highly prevalent and linked to professional isolation and poor relationships with supervisors. Impostor syndrome emerged as a recurrent theme in qualitative accounts, though it was formally assessed with a validated instrument in only one study. Moreover, research engagement did not appear to protect students from burnout. Conclusion: Burnout and psychological distress are widespread among PhD students in medicine and health sciences, and impostor feelings emerged as a recurrent theme, although formally measured in only one study. These findings highlight the need for structural and institutional changes rather than relying solely on individual psychological support. Full article

Recurrent vulvovaginal candidiasis (RVVC), commonly defined as ≥3 symptomatic episodes per year, affects an estimated 138 million women worldwide. This structured narrative review (PubMed/MEDLINE and open-indexed sources, January 2020–July 2026, as well as selected pre-2020 landmark studies) synthesizes epidemiological and metabolic risk factors (including SGLT2-inhibitor-associated susceptibility), host immunogenetic and vaginal microbiome mechanisms, emerging preventive pharmacotherapies, and patient-reported outcomes within a unified clinical framework. RVVC arises from interacting host, microbial, metabolic, behavioral, and iatrogenic domains—diabetes-related hyperglycemia, innate immune polymorphisms (MBL2, TLR2), altered bacterial–fungal vaginal communities, and non-albicans Candida in difficult-to-treat cases. Fluconazole maintenance remains a guideline-supported suppressive option but relapse after discontinuation is common; oteseconazole and ibrexafungerp expand prevention choices, while probiotics show inconsistent, low-certainty benefit. RVVC consistently impairs health-related quality of life, sexual function, and mental health and imposes substantial economic burden; regional data from Southeastern Europe underscore diagnostic and access gaps. We propose a multifactorial host–pathogen–microbiome model that favors individualized, diagnosis-driven management and routine incorporation of validated patient-reported outcomes. Research priorities include harmonized case definitions, head-to-head trials of new agents, validated quality-of-life instruments, longer post-treatment follow-up, and real-world cost-effectiveness evaluations. Implementation research, equitable access strategies, clinician education, and national health policy are essential to translate evidence into improved patient outcomes globally. Full article

Background: Mental health has become a fundamental component of the sports world. Although previous studies have addressed psychological aspects of women’s soccer, no comprehensive review has mapped both mental health symptoms and adaptive psychological resources and psychophysiological markers in professional, semi-professional, and competitive adolescent women’s soccer. Objective: This scoping review aimed to map recent evidence from 2020 to 2025 on mental health in professional and semi-professional women’s soccer including competitive settings for adolescents, identifying key psychological constructs, assessment instruments, and risk and protective factors within the competitive sport context. Methods: Following the methodological guidelines of the Joanna Briggs Institute (JBI) and Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews (PRISMA-ScR), a systematic search was conducted in PubMed/MEDLINE, Scopus, and Web of Science. Thirteen empirical studies that explicitly assessed mental health dimensions in professional and semi-professional women’s soccer players were included. Results: The most frequently studied constructs were psychological stress, competitive anxiety, resilience, motivation, and well-being. The main risk factors included intense competitive demands, accumulated fatigue, and performance pressure. Predominant protective factors were individual resilience, social support, team cohesion, and self-confidence. The most used instruments were validated scales including the Brunel Mood Scale (BRUMS), Sport Anxiety Scale-2 (SAS-2), Competitive State Anxiety Inventory-2 Revised (CSAI-2R), Generalized Anxiety Disorder-7 (GAD-7), Sport Mental Health Assessment Tool-1 (SMHAT-1) and qualitative interviews. Resilience emerged as a central concept; although it was measured directly in only two studies, it emerged conceptually as a central theme in the evidence, and recent qualitative studies have highlighted the influence of the institutional environment and technical support. Conclusions: The available evidence which is heterogeneous and limited to 13 studies points to a growing body of research on mental health in women’s soccer, focused primarily on stress and resilience. However, significant gaps remain, including a lack of multi-season longitudinal studies tracking players across full competitive cycles, limited representation of Latin American and Asian contexts (one study each), the absence of position-specific analyses such as studies focused on goalkeepers and insufficient attention to positive well-being. Prospective and intervention-based studies are needed to develop a comprehensive understanding of mental health in elite sports and in competitive adolescent settings. Full article

Background: Artificial intelligence (AI)-driven conversational systems are increasingly capable of simulating empathy, adapting to individual users, and fostering emotional bonds that blur the boundary between tool and companion. This scoping review maps the extent and nature of published evidence regarding psychological mechanisms underlying emotional reliance on AI chatbots and associated mental health implications. Methods: Conducted in accordance with PRISMA-ScR guidelines, we systematically searched PubMed/MEDLINE, PsycINFO, Web of Science, Scopus, and IEEE Xplore from database inception to March 2026. Two independent reviewers screened records and extracted data using the PCC (Population, Concept, Context) framework. Thematic synthesis was performed to map evidence across psychological, clinical, and developmental domains. Results: Of 1847 records identified, 46 studies met inclusion criteria. Key themes included: (1) the ELIZA effect as a foundational mechanism of human–AI attachment, with documented cases of severe dependency including fatal outcomes; (2) anthropomorphization and artificial intimacy fostered by adaptive, personalized AI design; (3) proposal of Generative AI Dependency (GAID) as a conceptual framework mapping onto behavioral addiction components, pending empirical validation; (4) particular vulnerability of adolescents and lonely individuals to exclusive affective bonds with AI; and (5) potential erosion of human relational capacities, empathy development, and tolerance for interpersonal complexity. Significant gaps were identified in longitudinal research, validated screening tools, and intervention protocols. Conclusions: Emotional reliance on AI represents an emerging clinical phenomenon with addiction-like features requiring specific diagnostic frameworks, evidence-based interventions, and ethical design guidelines. Future research should prioritize longitudinal studies examining developmental impacts and neurobiological investigations of AI-mediated reinforcement mechanisms. Full article

This review examines the evolving relationship between social media use and health from the perspective of the World Health Organization (WHO), which defines health as a state of complete physical, mental, and social well-being. Drawing on recent empirical findings and systematic reviews, this paper synthesizes current evidence regarding how social media use relates to the three dimensions of health and may facilitate the spread of health misinformation. As social media has become deeply integrated into daily life, understanding these dynamics is increasingly important for developing evidence-based strategies that promote public health in the digital era. Under the theme “What We Have Known so far,” this review highlights the dual nature of social media as a double-edged sword. On one hand, social media facilitates health promotion, knowledge sharing, social support, and the development of social capital and interpersonal relationships, improving the three dimensions of well-being. On the other hand, excessive or problematic use has been associated with adverse mental, physical and social health outcomes, while exposure to online misinformation poses substantial challenges to effective public health communication. This review further emphasizes that social media impacts vary across platforms, user characteristics, patterns of engagement, and combinations of platforms. Under the theme “What We Need to Investigate in the Future,” several research priorities are identified. These include adopting an integrated framework that simultaneously considers physical, mental, and social health; moving beyond cross-sectional designs toward longitudinal and causal approaches and examining platform-specific effects and the influence of individuals’ broader social media portfolios; incorporating objective behavioral measures alongside self-reported data and investigating the emerging role of generative artificial intelligence in health communication and misinformation; and developing evidence-based interventions to improve social media literacy and promote healthier patterns of use. Overall, this review argues that future research should move beyond asking whether social media is beneficial or harmful to health and instead identify when, how, for whom, and under what circumstances it promotes or compromises well-being. Such an integrated perspective will provide a stronger scientific foundation for public health policies and healthier digital societies. Full article

Previous studies have shown that Bouldering Psychotherapy (BPT), an emerging integrative intervention combining bouldering with psychotherapeutic techniques, may promote improvements in mental health and well-being. This pilot study aimed to examine the effects of BPT on symptoms of depression and anxiety in a Brazilian population and explore participants’ perceptions of its psychological and social impacts. Eleven participants completed an eight-week BPT program and were compared with a matched control group. Symptoms of anxiety and depression were assessed before and after the intervention. Qualitative data were collected through semi-structured interviews and analyzed using word-frequency analysis and reflexive thematic analysis. The BPT group showed a significant reduction in depressive symptoms (p = 0.015, d = 0.66) and a marginally non-significant reduction in anxiety symptoms (p = 0.059, d = 0.44). The qualitative findings indicated perceived improvements in psychological well-being, emotional regulation, self-awareness, social connectedness, and psychological skills. Participants also reported transferring skills and insights acquired during the program to everyday life. Overall, the findings suggest that BPT may improve mental health, particularly depressive symptoms, while fostering supportive social relationships and positive psychological experiences. The results support the feasibility of adapting BPT to the Brazilian context and encourage further research on climbing-based psychotherapeutic interventions. Full article

This study conceptualizes the youth observatory as an analytical and governance-oriented framework for examining social change, inequality, and youth development in urban contexts characterized by persistent structural disparities, using Cartagena, Colombia, as an empirical case study. Rather than conceptualizing the observatory solely as a technical mechanism for data collection and monitoring, the article argues that it should be understood as a platform for knowledge production capable of identifying emerging patterns in youth trajectories, institutional fragmentation, and evolving forms of civic engagement. The research employed a qualitative, descriptive, and interpretive design based on documentary analysis and a focus group comprising institutional stakeholders involved in youth-related initiatives. Findings indicate that the principal challenge in Cartagena is not the absence of youth-related information but the fragmentation, discontinuity, and weak articulation of existing institutional and knowledge-production systems. As a result, valuable evidence remains underutilized in policy formulation and institutional decision-making processes. The findings further demonstrate that education, labour-market integration, political participation, cultural access, mental health, and digital vulnerability should not be treated as discrete dimensions but rather as interconnected and mutually reinforcing components of contemporary youth experience. Ultimately, this article contributes to current debates by proposing the youth observatory as an analytical, interpretive, and governance mechanism that links evidence generation, public deliberation, and policy development. The study provides both empirical and conceptual foundations for the establishment of youth observatories in contexts marked by urban inequality, institutional fragmentation, and accelerated social transformation. Full article

Background: Problematic social media use among adolescents has emerged as a growing public health concern. This study examined gender differences in problems related to social media use and their behavioural, psychosocial, family-related, and school-related correlates among Finnish adolescents. Methods: In this cross-sectional study, binary logistic regression analyses were conducted using data from the Finnish sample of the 2024 European School Survey Project on Alcohol and Other Drugs (ESPAD), including 3293 adolescents aged 15–16 years. Results: Overall, 45% of girls and 30% of boys were classified as having problems related to social media use. Significant gender interactions were observed in the associations of gaming-related problems and perceived family socioeconomic status with problems related to social media use. Gaming-related problems were the strongest correlate, with a substantially stronger association among boys. Elevated psychological distress was associated with a higher likelihood of problems related to social media use, particularly among girls, whereas higher parental monitoring was associated with a lower likelihood only among girls. Truancy and plans for general upper secondary school were both associated with a higher likelihood of problems related to social media use among girls and boys. Conclusions: The findings suggest that problems related to social media use are closely linked to adolescent well-being and behaviour. Prevention and intervention efforts may therefore benefit from addressing problematic social media use as part of adolescent mental health and digital well-being strategies, combining universal approaches with targeted support for adolescents experiencing problematic patterns of digital media use. Full article

Background: The COVID-19 pandemic exacerbated longstanding social and health inequities in predominantly Black and Latino communities in North and Central Brooklyn, in the form of disproportionately high hospitalization and mortality rates. Community organizations served as critical sources of information and resources during this period. Methods: The Bureau of Brooklyn Neighborhood Health within the NYC Health Department, conducted semi-structured virtual interviews with 19 representatives from 15 organizations that had partnered with the Bureau within the past five years. Interviews were conducted between November 2021 and February 2022. Transcripts were coded and analyzed using a hybrid deductive–inductive approach incorporating constant comparative techniques. Results: Partners described worsening food insecurity, inequitable vaccine and testing access, digital divide challenges, funding instability, staffing shortages, and escalating mental health needs. Organizations pivoted from routine operations to provide emergency food distribution, virtual programming, mental health support, advocacy, and disseminating information as trusted messengers in the community. Conclusions: Findings underscore the essential role of local community organizations in crisis response and recovery. Future preparedness efforts must center community expertise, strengthen cross-sector collaboration, streamline funding processes, and investments in social and digital infrastructures to advance health equity and community resilience. Full article

Emerging adults (18–25 years) experience the highest prevalence of mental illness, including anxiety and depression, affecting more than 11 million individuals in the United States. Traditional treatment approaches, such as psychotherapy and pharmacotherapy, may not fully address the complex and interrelated risk factors unique to emerging adults. Targeting lifestyle behaviors, including diet, sleep, physical activity, and substance use, has emerged as a promising adjunctive strategy for the prevention and treatment of mental illness. Growing evidence suggests that these behaviors frequently co-occur and may exert synergistic effects on mental health outcomes. This review synthesizes findings from observational studies and randomized controlled trials examining the relationship between combined lifestyle behaviors and mental illness in emerging adults. A total of 17 studies met inclusion criteria, including 14 observational studies and three intervention trials. Observational findings consistently indicated that lifestyle patterns characterized by a greater number of unhealthy behaviors were associated with higher levels of depression, anxiety, and psychological distress. In contrast, the three intervention studies did not demonstrate significant improvements in mental health outcomes following lifestyle interventions. Overall, the findings suggest a synergistic effect of multiple lifestyle behaviors associated with mental illness in emerging adults. However, substantial heterogeneity in how studies defined and categorized “healthy” versus “unhealthy” behaviors limited cross-study comparisons. This review highlights the need for standardized measurement approaches and more rigorous intervention trials to elucidate the potential synergistic effects of combined lifestyle modifications on mental health outcomes in this population. Full article

Background/Objectives: Elderly patients (≥65 years) with atopic dermatitis (AD) often carry multimorbidity and face elevated risks with Janus kinase (JAK) inhibitors. Phase III trials included few older adults, and real-world data beyond 12 months remain scarce. We evaluated 36-month efficacy, safety, and drug persistence of upadacitinib 15 mg once daily in 62 Chinese elderly patients. Methods: This retrospective cohort study was conducted at Sir Run Run Shaw Hospital (March 2022-July 2026). All patients received upadacitinib 15 mg once daily. Assessments included Week 4 pruritus Numerical Rating Scale (NRS) response, Eczema Area and Severity Index (EASI) 75/90, and Investigator’s Global Assessment (IGA) 0/1 at Weeks 12 and 24. Drug persistence was estimated with the Kaplan–Meier method (36-month cutoff), and predictors were identified by Cox regression. Results: Median age was 70.0 years, 75.8% were male, and baseline EASI was 34.5, with substantial comorbidity (Charlson Comorbidity Index [CCI] 5.0; psychotropic use 46.8%). Week 4 itch response was 70.8%. EASI 75 reached 75.0% (IGA 0/1 44.4%) at Week 12, rising to 88.0% (64.0%) at Week 24. Persistence declined from 88.7% at Month 3 to 66.1% at Month 6, the steepest drop, reaching 38.7% at Month 36. Treatment-emergent adverse events (TEAEs) occurred in 54.8% and serious adverse events (SAEs) in 8.1%, with herpesvirus infection (21.0%) being the most common event, and there were no adverse event (AE)-related discontinuations, major adverse cardiovascular events (MACE), or venous thromboembolism (VTE). In multivariate analysis, Week 4 itch response predicted longer persistence (hazard ratio [HR] = 0.203, 95% confidence interval [CI]: 0.091-0.452, p < 0.001), while psychotropic medication use predicted shorter persistence (HR = 2.814, 95% CI: 1.237-6.403, p = 0.014). Conclusions: Upadacitinib showed robust efficacy and acceptable safety over 36 months in elderly AD patients. Persistence dropped most sharply between Months 3 and 6. Week 4 itch response and psychotropic medication use independently predicted persistence. A structured Month 3 visit integrating itch reassessment, mental health screening, and dose optimization may improve long-term outcomes. Full article

The mental health of young people has increasingly emerged as a public health priority due to the growing prevalence of mental health problems during adolescence and early adulthood. The literature has identified community-based programs as effective strategies for promoting well-being and preventing psychological symptomatology. In this context, the present study aimed to evaluate the impact of the interventions provided by junior psychologists working in the Youth Health Offices of the Cuida-te Program of the Portuguese Institute of Sports and Youth (IPDJ) on the quality of life, well-being, and mental health of Portuguese youth through a pre- and post-intervention analysis. A total of 1164 young people, aged between 12 and 29 years old, participated across three editions of the program. Self-report instruments were used to assess the quality of life, the well-being, and the psychological symptoms (stress, depression, and anxiety) of the participants. The results revealed statistically significant improvements between pre- and post-intervention assessments, including increased quality of life and well-being, as well as reduced levels of stress, depression, and anxiety. These findings were observed among both female and male participants and across different age groups. Non-binary participants showed less pronounced results, although with no statistically significant differences identified, suggesting the need for more research with larger samples and for inclusive interventions tailored to the specific needs of sexual and gender minorities. Overall, the work carried out appears to constitute an effective and cost-effective community-based response for the prevention of mental health symptoms and the promotion of mental health in adolescents and young adults, reinforcing the importance of permanent, accessible, and inclusive public policies. Full article

Background/Objectives: The objectives of this study were to compare emotional well-being, depressive symptoms, and psychiatric medication use between adults with and without diabetes in Spain and to identify sex-specific factors associated with these outcomes among individuals with diabetes. Methods: A population-based matched study was conducted using data from the 2023 Spanish National Health Survey (SNHS 2023). Adults aged ≥35 years with physician-diagnosed diabetes were individually matched (1:1) to controls without diabetes according to sex, exact age, and autonomous community of residence. Low emotional well-being (WHO-5 score < 50), clinically relevant depressive symptoms (PHQ-8 ≥ 10), and psychiatric medication use were assessed. Conditional logistic regression and sex-specific multivariable logistic regression models were fitted. Results: The study included 3710 participants (1855 with diabetes and 1855 matched controls without diabetes). The prevalence of low emotional well-being was significantly higher among participants with diabetes than among matched controls in both men (16.4% vs. 11.6%; p = 0.004) and women (28.8% vs. 21.6%; p < 0.001). Likewise, clinically relevant depressive symptoms were more frequent among individuals with diabetes (men: 32.7% vs. 24.9%, p < 0.001; women: 54.4% vs. 40.2%, p < 0.001), as was psychiatric medication use (men: 20.5% vs. 15.2%, p = 0.005; women: 39.5% vs. 30.2%, p < 0.001). After full adjustment, diabetes remained independently associated with low emotional well-being (men: aOR 1.48, 95% CI 1.03–2.13; women: aOR 1.43, 95% CI 1.14–1.78), depressive symptoms (men: aOR 1.31, 95% CI 1.02–1.69; women: aOR 1.38, 95% CI 1.08–1.77), and psychiatric medication use (men: aOR 1.34, 95% CI 1.02–1.75; women: aOR 1.35, 95% CI 1.06–1.73). Poor social support, physical inactivity, and several chronic comorbidities emerged as the factors most consistently associated with adverse mental health outcomes among individuals with diabetes. Conclusions: Adults with diabetes in Spain experience a substantially greater burden of adverse mental health than matched individuals without diabetes. Integrating routine mental health assessment and psychosocial support into diabetes care may help improve both psychological well-being and disease management. Full article

Background: Commercial digital mental health platforms have expanded across the Gulf since 2020, yet cancellation in this delivery model remains understudied. We aimed to identify factors independently associated with session cancellation on a Saudi Arabic-language commercial platform and to determine whether they describe user or provider behaviour. Methods: We conducted a retrospective cohort analysis of 36,544 booked sessions from 21,904 unique users (October 2023–April 2026); the outcome was binary cancellation (cancelled vs. completed). Multivariable logistic regression with cluster-robust standard errors estimated adjusted odds ratios (aORs) for user, provider, and booking characteristics; secondary analyses decomposed cancellation by recorded initiator and modelled age, lead time, and calendar time flexibly. Reporting followed STROBE guidelines. Results: Crude cancellation was 25.6%. Cancellation was strongly patterned by visit type (follow-up aOR 0.26, 95% CI 0.21–0.32), lead time (≥8 days 2.10, 95% CI 1.90–2.33), session type (free 1.19, 95% CI 1.10–1.27), and provider specialty; age reduced odds modestly (aOR 0.90 per decade, p < 0.001) and gender was null (aOR 0.95, p = 0.119). Cause-specific models showed that the lead-time gradient reverses by initiator: at ≥8 days versus same-day, user-initiated cancellation was less likely (aOR 0.62, 95% CI 0.49–0.78), whereas provider-initiated cancellation was far more likely (aOR 4.75, 95% CI 4.23–5.35), and provider-specialty differences were confined almost entirely to provider-initiated cancellation. The very low adjusted odds for emergency sessions (aOR 0.17, 95% CI 0.13–0.23) reflect how emergency bookings are administratively coded on the platform rather than genuine behavioural non-adherence and are regarded as artefactual. Discrimination was moderate (apparent AUC 0.700, development sample). Conclusions: Cancellation reflected operational features of the booking, but its largest correlates—lead time, free-session status, and provider specialty—operate predominantly through provider-side scheduling rather than patient non-adherence. Full article