Search Results (289)

Growing evidence indicates that the gut microbiota is not a static ecosystem but a rhythmic metabolic organ whose oscillatory activity is tightly coordinated with host circadian biology. Disruption of this temporal alignment, through irregular diet, sleep disturbance, shift work, or social jet lag, may profoundly alter microbial composition and the production of neuroactive metabolites. These alterations have emerged as potential contributors to the pathophysiology of mood disorders. This review introduces the concept of chrono-metabolic psychiatry, a framework integrating circadian rhythms, gut microbiota dynamics, and host metabolic signaling in the development and course of depressive and bipolar disorders. In this framework, the term “chrono-metabolic” refers to the integration of biological timing, host metabolic regulation, and microbiota-derived metabolic signaling. Chrono-metabolic psychiatry therefore shifts the focus from static dysbiosis or neurotransmitter imbalance alone to the time-dependent interactions among circadian misalignment, microbial rhythmicity, immune regulation, metabolite production, and affective instability. Diurnal fluctuations in short-chain fatty acids, tryptophan–kynurenine metabolites, bile acids, and microbial-derived neurotransmitters interact with clock gene regulation, hypothalamic–pituitary–adrenal axis activity, neuroinflammation, and synaptic plasticity. Chrono-disruption may represent a transdiagnostic vulnerability factor and may confirm the bidirectional relationship between mood instability and microbiota rhythmicity. Emerging therapeutic implications, including chrono-nutrition, time-restricted feeding, targeted probiotic administration (“chronobiotics”), and the microbiota-modulating effects of psychotropic medications are discussed. By shifting from a compositional to a temporal–metabolic perspective, this model highlights the importance of microbial oscillations rather than static dysbiosis alone. Integrating circadian biology into microbiota research may enable metabolomic stratification and pave the way for precision psychiatry approaches grounded in host–microbe metabolic crosstalk. Future longitudinal and time-resolved multi-omics studies are needed to validate this framework and to translate it into clinically actionable interventions. Full article

Background/Objectives: Several randomized controlled trials have found that dietary interventions promoting self-guided shifts away from ultra-processed foods (UPFs) and toward minimally processed, nutrient-dense foods may alleviate depressive symptoms. However, translating these interventions into scalable and sustainable real-world approaches remains a key challenge. Adopting a minimally processed dietary pattern requires sustained effort (e.g., meal planning, shopping, and preparation) within environments where UPFs are pervasive and convenient. These demands may be especially burdensome for individuals experiencing depressive symptoms. Consequently, interventions that rely heavily on individual effort may be difficult to maintain. Commercial meal delivery services may offer a structural solution by reducing logistical and cognitive barriers to dietary change, yet little is known about how individuals with depressive symptoms experience this approach. Methods: In a parent study, we conducted a randomized pilot study of a meal delivery service designed to provide minimally processed meals to adults with moderate to moderately severe depressive symptoms; here we report qualitative findings from post-intervention interviews with participants assigned to the meal delivery condition (n = 20). Results: Participants appreciated reductions in preparatory effort and mental load, which supported adherence. Dietary changes were also linked to improved mood through increased energy, mood stability, and more positive self-evaluation. However, social settings were a near-universal barrier, and acceptability depended on palatability, compatibility with personal preferences, and perceived autonomy. Several participants also described a temporal adjustment process (early cravings/withdrawal followed by adaptation). Conclusions: Overall, these findings suggest participant-informed priorities for future testing and refinement of scalable meal delivery interventions for depression, including personalization and choice, quality control, and support for social and withdrawal-related challenges. Full article

Background: Obesity is associated with metabolic dysregulation, mood disturbance, and poor sleep quality. Although dietary fiber and probiotic supplementation have both been proposed as microbiome-targeted strategies for obesity management, their independent and combined effects remain unclear. Methods: In this double-blind, randomized, placebo-controlled 2 × 2 factorial trial, 56 adults with obesity were randomized to placebo, dietary fiber, probiotic, or combined supplementation for 8 weeks. One withdrew during baseline assessment, and 55 participants were included in the intention-to-treat analysis. Outcomes included metabolic syndrome-related indicators, mood assessed by the Profile of Mood State, and sleep quality assessed by the Pittsburgh Sleep Quality Index. Intervention effects were evaluated using factorial ANCOVA with baseline adjustment. Results: No significant dietary fiber × probiotic interactions were detected. Dietary fiber supplementation showed selective favorable effects, mainly on HDL cholesterol and mood-related outcomes. Probiotic supplementation showed a significant main effect primarily on HDL cholesterol but did not remain significant after FDR correction. Sleep-related improvements were observed only in within-group analyses and were not supported by significant factorial ANCOVA effects. Combined supplementation did not provide additional benefits over single-component interventions. Conclusions: Dietary fiber supplementation may have selective favorable effects in adults with obesity, particularly on HDL cholesterol and mood-related outcomes. The absence of additional benefit from combined supplementation suggests that the effectiveness of synbiotic strategies may depend on the compatibility between the selected dietary fiber and probiotic strains. Full article

Nursing students in their training process often suffer from anxiety due to stressful situations, and emotional intelligence can help them to manage these situations. The aim of this study is to analyse the associations between the dimensions of perceived emotional intelligence and anxiety in students undergoing their training cycles in different special services in order to check if there are differences between them. It is an observational, cross-sectional and correlational study with a sample of 85 nursing students who had not received training in emotional intelligence. Two measurement instruments were used: the Trait-State Anxiety Inventory (STAI) to assess anxiety and the Trait Meta-Mood Scale (TMMS-24) to measure EI. Data were analysed using Pearson’s coefficient when the distribution was normal, and Spearman’s coefficient in the non-normal distribution. The results showed in the group—ER-Emergency and Oncology—there was a significant negative relationship between state and trait anxiety and emotional understanding and regulation. In contrast, in the Primary Care setting there was also a positive relationship between emotional perception and trait anxiety. The study concludes that nursing students who understand and manage their emotions may have a lower risk of anxiety. Furthermore, if they identify emotions appropriately, the risk of suffering from anxiety in the long term may be lower. This finding was observed when the student did the internship in Primary Care. So there is a difference depending on the clinical context. Full article

Background: Adolescence is a critical period for emotional well-being, and individuals with gluten-related disorders (GRDs) may face additional psychological challenges. This study aims to explore the relationship between emotional well-being and GRDs in adolescents. Methods: A cross-sectional study was conducted using data from the DESKcohort project, consisting of a biannual panel survey on health, health behaviours, and associated determinants, collected in secondary education centres. The final analytical sample consisted of 9265 students aged 12 to 18 years. Data were collected from October 2021 to June 2022. The dependent variables relate to emotional well-being and are assessed through a series of mood-related questions. The independent variables included were having GRDs, health behaviours and socioeconomic factors. Poisson regression models with robust variance were used to assess the association between the impact of GRDs and emotional states, providing prevalence ratios with 95% confidence intervals. Results: Prevalence of adolescents with GRD was 1.15%, with a higher rate in girls (1.51%) compared to boys (0.79%) (p < 0.001). While there were no significant emotional differences between adolescents with and without GRDs overall (p > 0.05), Poisson regression models with robust variance showed that those with digestive symptoms had a significantly higher prevalence of emotional distress, most notably in feeling sad or depressed (PR = 2.52; 95% CI: 1.64–3.88) and fatigue (PR = 1.90; 95% CI: 1.51–2.38). Conclusions: The presence of digestive symptoms in adolescents with self-reported GRDs is associated with a higher prevalence of emotional distress. Public health strategies should specifically target this symptomatic subgroup to address their psychological and nutritional needs. Full article

Background/Objectives: Intermittent fasting (IF) has been widely investigated for its metabolic effects, including improvements in insulin sensitivity, lipid metabolism, and inflammatory markers. However, its psychological and experiential dimensions remain comparatively underexplored. The present narrative review examines IF within a psychobiological framework, integrating evidence from metabolic science, neuroendocrinology, and affective neuroscience to explore its potential impact on emotional regulation and interoceptive processes. Methods: A structured narrative literature search was conducted across PubMed, Scopus, and Google Scholar, focusing on studies published between 2010 and 2025. Eligible studies included human and relevant animal research addressing metabolic, hormonal, interoceptive, and psychological responses to IF. Evidence was synthesized thematically to identify convergent mechanisms linking metabolic adaptations to emotional and regulatory outcomes. Results: Available literature suggests that IF is associated with a metabolic shift toward lipid utilization, characterized by increased ketone body production, particularly β-hydroxybutyrate. These adaptations appear to be accompanied by modulation of neuroendocrine pathways and may influence central nervous system functioning through mechanisms potentially related to neuroinflammation, mitochondrial efficiency, and synaptic plasticity. Emerging evidence further suggests that IF may modulate BDNF signaling and gut–brain axis activity, although direct causal pathways in humans remain to be established. At the psychological level, IF is associated with heterogeneous emotional outcomes: structured fasting protocols have been linked to modest improvements in perceived stress and mood in metabolically healthy individuals, whereas irritability, anxiety, or behavioral rigidity may emerge in those with pre-existing psychological vulnerabilities. Individual differences in interoceptive sensitivity, emotion regulation strategies, and moderating biological factors—including sex, circadian timing, and habitual physical activity—appear to influence these responses. Conclusions: Overall, IF may be conceptualized as a context-dependent psychobiological stressor whose effects extend beyond metabolic regulation to include interoceptive and emotional processes. These effects appear bidirectional, potentially promoting psychological resilience in some individuals while increasing the risk of affective destabilization or maladaptive behaviors in others. Current evidence remains limited by a lack of integrative and longitudinal studies combining metabolic and psychological measures. Future research adopting multidisciplinary approaches is needed to clarify the mechanisms underlying individual variability and to better define the potential benefits and risks of IF in both clinical and non-clinical populations. Full article

Music emotion recognition (MER) can be formulated as a multimodal optimization problem that predicts an emotion label from coupled audio and lyric sequences. Existing methods typically perform unimodal learning or coarse global fusion, which overlooks fine-grained temporal-token correspondences between musical dynamics and lyric semantics. We propose MELT (Music Emotion Learning with Temporal token-level fusion), an optimization-driven framework with four modules: a BERT-based lyrics semantic encoder (LSE), a segment temporal encoder (STE) that models audio-segment dependencies via a Transformer, a token-level temporal fusion (TTF) module with gated cross-attention, and an emotion mood head (EMH) for four-class prediction. Training is conducted end-to-end by jointly minimizing a supervised classification term and an auxiliary cross-modal contrastive alignment term, yielding a unified objective that improves both class separability and representation consistency. On the MoodyLyrics benchmark, MELT achieves 87.6% weighted F1 for four-class emotion recognition (angry, happy, relaxed, sad), outperforming unimodal baselines and representative early/late fusion strategies. Ablation results further verify that temporal encoding, gated token-level fusion, and joint optimization each contribute to the final performance. Full article

The scientific pursuit of understanding human “emotion” has historically been plagued by a fundamental lack of conceptual consensus. Researchers, clinicians, and the lay public frequently utilize terms such as “emotion,” “feeling,” “affect,” and “mood” as interchangeable synonyms, creating a linguistic ambiguity that hampers both experimental precision and diagnostic validity. In response to this “umbrella term” crisis, the Walla Emotion Model (WEM), also referred to as the ESCAPE Model (Emotions Convey Affective Processing Effects), introduces a redefined and distinct terminology designed to disentangle the neurophysiological, experiential, and behavioral components of affective phenomena. The essence of this new model is the removal of the umbrella aspect from the term emotion and defining “emotion” strictly as behavioral output, and “feeling” as the conscious perception of released neurochemicals, both resulting from non-conscious affective processing. By doing so, the WEM provides a logical, clear, and easy-to-apply terminological lens for diagnosing, communicating, and treating clinical conditions that include what has previously been termed “emotion” dysregulation. When “emotion” is used as an umbrella term, it depends on the school one follows how one would explain such clinical conditions. The most critical argument for introducing the WEM is that each prior school has had its focus on another set of phenomena that generate an “emotion”. The WEM terminology provides a clear separation of brain activity, subjective experience, and expression regarding affective phenomena. Various clinical conditions that include “emotion” dysregulation exist; however, to highlight the potential benefits of the WEM, the current essay has its focus on two of the most frequent conditions, namely Borderline Personality Disorder (BPD) and Major Depressive Disorder (MDD). The goal is to provide an analysis of the WEM architecture, evaluating its utility in clinical neuropsychology, and delineating its theoretical advantages when combined with traditional categorical and dimensional models. However, it is important to emphasize that this essay is only theoretical. It does not include any direct empirical support, but it suggests the replacing of existing terminology with WEM terminology. Full article

Background: Endometriosis is a chronic, estrogen-dependent inflammatory disorder affecting millions of women worldwide and constitutes a major cause of chronic pelvic pain and reduced quality of life. Increasing evidence suggests that the burden of the disease extends beyond physical symptoms and includes substantial psychological distress. This systematic review aimed to summarize current evidence regarding the association between endometriosis and mental health outcomes, including depression, anxiety, sleep disturbances, sexual dysfunction, and quality of life. Methods: A systematic literature search was conducted in PubMed, Europe PMC, and Google Scholar to identify studies published between 2015 and 2025 evaluating psychological outcomes in women diagnosed with endometriosis. Studies were screened according to predefined inclusion criteria and analyzed qualitatively. A total of 93 studies were included in the final review. Results: Women with endometriosis consistently demonstrated higher prevalence and severity of depressive symptoms and anxiety compared with control populations. Health-related quality of life was significantly reduced across studies. Chronic pelvic pain, particularly its intensity, persistence, and neuropathic-like characteristics, emerged as a key factor mediating the relationship between endometriosis and psychological distress. Additional contributors included sleep disturbances, fatigue, impaired sexual functioning, reduced self-esteem, and relationship difficulties. Emerging evidence also suggests that chronic inflammation, neuroimmune interactions, and gut–brain axis dysregulation may contribute to the coexistence of endometriosis and mood disorders. Conclusions: Endometriosis is associated with adverse mental health outcomes and reduced quality of life. These findings highlight the importance of multidisciplinary management strategies integrating pain control, psychological assessment, and psychosocial interventions to improve overall patient well-being. Full article

Background/Objectives: High-altitude exposure represents a complex psychophysiological stressor involving hypoxia, physical effort, sleep disruption and psychological strain. The endocannabinoid system (ECS) plays a key role in stress regulation, yet its epigenetic modulation under extreme environmental conditions remains poorly characterized. This pilot and exploratory study investigated DNA methylation and descriptive microRNA (miRNA) expression patterns of CNR1 and FAAH genes, and their associations with mood and anxiety outcomes, in trekkers exposed to Himalayan high altitude. Methods: Twenty-one healthy lowlanders completed a longitudinal expedition from 2860 m to 5050 m. Psychometric measures (SVARAD, BDI, SAS, SHAPS) and saliva samples were collected at baseline (T0) and at high altitude (T1). DNA methylation of CNR1 and FAAH regulatory regions was quantified by pyrosequencing. Exosomal miRNAs targeting these genes were profiled using qRT-PCR, on pooled samples; results are presented descriptively. Results: DNA methylation analysis revealed heterogeneous, sex-specific epigenetic patterns following high-altitude exposure. A significant increase in CNR1 promoter methylation at CpG4 was observed in males at T1, whereas methylation remained largely stable in females. Descriptive miRNA expression data showed bidirectional differences between groups, consistent with context-dependent stress regulation. Convergent directional patterns between miR-23b-3p expression and CNR1 methylation in males were observed. However, given the descriptive nature of the miRNA data, this observation is purely exploratory and requires replication before any mechanistic conclusions can be drawn. Psychometrically, participants showed a mild mood decline without overt clinical symptoms. Sex-specific differences in the relationship between CNR1 methylation and psychometric outcomes were observed and warrant further investigation in adequately powered cohorts. Conclusions: These preliminary findings suggest that CNR1 epigenetic regulation warrants further investigation as a potential indicator of stress adaptation and psychological responses and underscore the need to consider sex differences when evaluating resilience and vulnerability to extreme environments. Full article

To examine the complex relationships among physical activity, emotion regulation, psychological stress, and mood states in college students, this study analyzed questionnaire data collected from 494 participants. Network analysis was employed to construct a global association network, compare gender differences, and characterize patterns of directed statistical dependencies via directed acyclic graph (DAG) analysis. The results showed that: (1) the network comprised 25 nodes and 94 non-zero edges, reflecting extensive conditional associations across the four domains; (2) bridge centrality analysis identified cognitive reappraisal, self-related emotions, and anger as key bridge nodes, with cognitive reappraisal exhibiting the highest bridge strength; (3) accuracy and stability analyses yielded a centrality stability coefficient (CS) of 0.749 for strength, indicating adequate network stability; (4) network comparison tests revealed no significant gender differences in overall network structure or global strength, although certain local edge weights differed; (5) DAG analysis suggested that stable directional dependencies were primarily concentrated within individual subsystems, with no marked structural differences observed between male and female groups. In conclusion, physical activity, emotion regulation, psychological stress, and mood states appear to constitute an interconnected psychological adaptation system. Cognitive reappraisal, self-related emotions, and anger likely serve as pivotal bridge nodes warranting priority in future longitudinal research and targeted interventions. Full article

Background: Isolated Generalized Dystonia (IGD) severely reduces quality of life. Deep brain stimulation of the subthalamic nucleus (STN-DBS) is effective for refractory IGD, but the factors influencing efficacy remain unclear. Methods: Twelve IGD patients treated with bilateral STN-DBS (2016–2021) were retrospectively analyzed. Clinical outcomes (BFMDRS, HAMA, HAMD, MOCA, MMSE) were evaluated at baseline and the last follow-up (12–60 months). The electrode position and volume of tissue activated (VTA) in STN subregions were analyzed using Lead-DBS V3.0. Results: STN-DBS significantly improved BFMDRS-M and BFMDRS-D scores (p < 0.001) without cognitive or mood deterioration. BFMDRS-M improvement correlated positively with the VTA of the whole STN and motor subregion (p < 0.05) but not with associative/limbic subregions. The preoperative HAMD score was negatively associated with motor improvement (p = 0.002). Conclusions: STN-DBS safely improves motor function in IGD. Efficacy depends on the VTA within the STN sensorimotor subregion. The preoperative HAMD score may predict the long-term outcome, helping guide patient selection and surgical planning. Full article

Heart failure (HF) is a leading cause of morbidity and mortality worldwide, and its co-occurrence with psychiatric disorders poses significant therapeutic challenges. This narrative review examines the safe use of psychopharmacological agents in patients with HF, focusing on mood stabilizers (particularly lithium) and antipsychotics. We summarize clinically relevant pharmacokinetic and pharmacodynamic interactions between these agents and guideline-directed HF therapies, including ACEIs, ARBs, ARNIs, beta-blockers, MRAs, SGLT2 inhibitors, and diuretics. Lithium is particularly prone to interactions due to its narrow therapeutic index and dependence on renal sodium handling, with RAAS inhibitors, thiazide diuretics, and SGLT2 inhibitors increasing the risk of toxicity. Antipsychotics are associated with QT prolongation, orthostatic hypotension, and electrolyte disturbances, with substantial variability between agents. This review highlights key clinical risks, provides a practical summary of drug interactions, and outlines principles for individualized, multidisciplinary management. Care requires coordinated cardiology–psychiatry collaboration, careful drug selection, and assessment of renal function, electrolytes, drug levels, and ECG parameters. Further studies and improved guideline integration are needed. Full article

Background: Testosterone is the most abundant biologically active sex steroid in women, yet the therapeutic implications of its age-related decline remain undercharacterized. Published trials have focused predominantly on sexual function, leaving gaps in understanding how testosterone replacement therapy (TRT) affects broader symptom domains and metabolic biomarkers in women. Objective: To investigate whether individualized, biomarker-guided TRT in women is associated with improvements across multiple symptom domains and favorable hormonal, hematologic, and cardiometabolic biomarker changes, and to examine whether symptomatic benefit varies with treatment duration. Methods: In this retrospective observational study, women (n = 332; ages 27 to 78; mean 45.7 ± 7.1 years) receiving TRT as part of routine clinical care through a telehealth-based platform completed a structured survey at a single post-treatment time point assessing eight symptom domains: energy/fatigue, memory, concentration, irritability, depression, anhedonia, sexual interest, and relationship satisfaction. Respondents were stratified by TRT duration (1 month to >12 months) and a subset (n = 120) underwent paired biomarker assessment at baseline and 12 weeks for total testosterone, free testosterone, SHBG, hemoglobin, and triglycerides. Results: Improvement was reported across all eight domains, with energy/fatigue showing the strongest response (84.3% improved). Depression, irritability, anhedonia, and sexual interest each exceeded 65% improvement. Cognitive domains showed a delayed trajectory, with meaningful gains emerging at 4 to 6 months. Quality of life improvement was reported by 89.7%, with significant improvement rising from 5.4% at 1 month to 51.5% at greater than 12 months. Energy/fatigue (64.2%) and mood (49.7%) ranked above sexual desire (41.3%) as self-identified areas of greatest benefit. All five biomarkers changed favorably: total testosterone +151.8% (d = 3.60), free testosterone +216.7% (d = 3.01), hemoglobin +5.5% (d = 2.03), SHBG −13.3% (d = 1.57), and triglycerides −12.6% (d = 1.28). Conclusions: Individualized TRT in women was associated with broad symptomatic improvement spanning energy/fatigue, depression, irritability, anhedonia, cognitive function, and sexual interest, with duration-dependent gains and favorable biomarker changes across all five markers assessed. These findings suggest that the value of testosterone in women extends beyond sexual function and supports the need for larger controlled trials with extended follow-up. Full article

Global aging is accelerating, with the proportion of the population aged 60 and above projected to reach 22% by 2050. In cold-region communities, the visual landscape environment is closely associated with the health of older adults, particularly showing associations with blood pressure (BP) and emotion states. However, associations between these factors across different landscape spaces and potential gender differences remain underexplored. This study utilized eye-tracking experiments to collect visual attention data from older adults in three types of cold-region community spaces: inter-building spaces, walkways and squares. The ground, buildings, trees, lawn, and the sky were identified as the primary Areas of Interest (AOIs). The Profile of Mood States (POMS) scale was used to assess emotion during walking experiments, revealing suggestive gender–environment interaction characteristics. Systolic blood pressure (SBP), diastolic blood pressure (DBP), and pulse pressure (PP) were measured, and a Mann–Whitney U test indicated that DBP in community squares exhibited significant environmental dependency (U = 114.5, p = 0.004, r = 0.44). Hierarchical Linear Models (HLMs) revealed that, after controlling for individual differences, the number of fixation points on ground was independently associated (i.e., independent of measured individual characteristics) with elevated SBP ($\gamma =0.31, p=0.011$), while fixation on trees was associated with reduced SBP ($\gamma =-0.24, p=0.018$). Furthermore, gender moderation effects were observed: the association between ground fixation and SBP was stronger in females ($\gamma =0.18, p=0.022$), whereas the association between sports facilities and DBP was stronger in males ($\gamma =0.29, p=0.009$). Based on these findings, evidence-based design strategies are proposed, including the optimization of ground safety, gender-differentiated planting configurations, and targeted layouts for sports facilities. These results provide empirical support for age-friendly community design in cold regions. Full article