Search Results (441)

(1) Background: Suicide is a worldwide leading cause of death among people with mental disorders. Psychoeducation is an integral component of mental health care that may offer patients valuable tools to understand their conditions, develop coping strategies, and engage more effectively in the treatment process. In the present scoping review, we aimed to summarize the evidence on the implementation of psychoeducational interventions in inpatient settings after suicide attempts. (2) Methods: In August 2024, we searched the Web of Knowledge (all databases), PsycINFO, and CINAHL databases following the PRISMA-ScR guidelines. We included original articles evaluating the effects of psychoeducational interventions for patients hospitalized in psychiatric settings after a suicide attempt. We provided a narrative synthesis of the study characteristics and the main findings of the included studies. (3) Results: We included five papers reporting the results of six studies, of which two were randomized controlled trials. Participants were diagnosed with diverse mental disorders, and interventions were generally short in the hospitalization phase, with follow-ups in the short or long term. Outcomes were focused on suicidal ideation, depressive symptoms, and general functioning, along with feasibility and acceptability of the intervention. Psychoeducational interventions were generally well accepted, but more evidence is needed to determine their efficacy. (4) Conclusions: Psychoeducational intervention in an inpatient psychiatric setting may be important for the prevention of future suicide attempts. Nevertheless, research on the topic is still scarce. Methodologically sound randomized controlled trials evaluating the long-term efficacy of psychoeducational interventions on suicide prevention are needed. Future research should also investigate the utility of psychoeducation in non-psychiatric inpatient settings. Full article

Borderline personality disorder (BPD) is a complex and heterogeneous condition characterized by emotional instability, impulsivity, and impaired regulation of interpersonal relationships. This narrative review integrates findings from recent neuroimaging, neurochemical, and treatment studies to identify core neurobiological mechanisms and highlight translational potential. Evidence from 112 studies published up to 2025 is synthesized, encompassing structural MRI, resting-state and task-based functional MRI, EEG, PET, and emerging machine learning applications. Consistent disruptions are observed across the prefrontal–amygdala circuitry, the default mode network (DMN), and mentalization-related regions. BPD shows a dominant and stable pattern of hyperconnectivity in the precuneus. Transdiagnostic comparisons with PTSD and cocaine use disorder (CUD) suggest partial overlap in DMN dysregulation, though BPD-specific traits emerge in network topology. Machine learning models achieve a classification accuracy of 70–88% and may support the tracking of early treatment responses. Longitudinal fMRI studies indicate that psychodynamic therapy facilitates the progressive normalization of dorsal anterior cingulate cortex (dACC) activity and reductions in alexithymia. We discuss the role of phenotypic heterogeneity (internalizing versus externalizing profiles), the potential of neuromodulation guided by biomarkers, and the need for standardized imaging protocols. Limitations include small sample sizes, a lack of effective connectivity analyses, and minimal multicenter cohort representation. Future research should focus on constructing multimodal biomarker panels that integrate functional connectivity, epigenetics, and computational phenotyping. This review supports the use of a precision psychiatry approach for BPD by aligning neuroscience with scalable clinical tools. Full article

Background: Chronic obstructive pulmonary disease (COPD) is a heterogeneous lung condition marked by persistent airflow limitation and is currently the fourth leading cause of death worldwide, accounting for 3.5 million deaths in 2021. While its physical manifestations such as dyspnea, chronic cough, and sputum production are well known, its psychological impact, particularly the high prevalence of depression among patients, remains under-recognized. Objectives: This narrative review aims to summarize the existing data on the association between COPD and depression, analyze their pathophysiological connections, explore treatment possibilities, and highlight the interrelationships between these conditions. Methods: A non-systematic literature search was conducted using PubMed, Scopus, and Google Scholar. Studies, reviews, and key publications addressing the relationship between COPD and depression were selected based on clinical relevance. Findings were synthesized thematically to provide a comprehensive and critical overview. Results: Depression in patients with COPD is linked to worse quality of life, increased functional impairment, higher suicide risk, and poorer adherence to treatment. Contributing mechanisms include chronic systemic inflammation, hypoxemia, oxidative stress, and psychosocial risk factors such as low educational level, socioeconomic disadvantage, and comorbidities. Despite evidence of this strong association, treatment strategies remain limited and underutilized, and no unified approach has yet been established. Conclusions: Depression represents a major comorbidity in COPD that exacerbates both disease burden and patient suffering. Further research is essential to clarify the underlying mechanisms and to develop integrated therapeutic approaches. Enhancing our understanding and management of this comorbidity holds promise for significantly improving patient outcomes and overall quality of life. Full article

The recent global coronavirus pandemic highlighted the ever-present threat of respiratory virus outbreaks and the consequent need for ongoing research into antiviral therapy. To this end, structural analogues of the guanidinium-based drug camostat mesylate have been synthesised to probe their potential inhibition of Transmembrane Serine Protease 2 (TMPRSS2), a human protease that is essential for infection by many respiratory viruses, including Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). Our in vitro fluorescence-based protease assays and supporting computational docking studies suggest that C-terminal camostat analogues retain TMPRSS2 inhibition potencies (IC₅₀ = 1–3 nM, BE = −6.6 to −7.0 kcal/mol) that match or exceed that of the parent drug. Analogues 1c and 1d emerge as lead candidates in this regard, thereby validating the rationale behind C-terminal structural modifications and highlighting these derivatives as promising scaffolds for the future development of targeted antiviral therapeutics. Replacement of camostat’s ester functionality with peptide linkages largely preserves non-covalent binding but disrupts in vitro protease inhibition, findings consistent with the parent drug’s known role as an acylating suicide inhibitor. Docking studies confirm that the replacement of aromatic residues with flexible, equivalent-length alkyl chains is detrimental to drug binding. These function and binding data offer new directions for the synthesis of further analogues of camostat and of other guanidinium-based protease inhibitors that have yet to be refined via structure–activity relationship studies. Further investigation will support tailoring this class of drugs for repurposing in antiviral therapy. Full article

Objective: Cyberbullying among children and adolescents is a serious and increasingly prevalent issue worldwide. Victims often experience various emotional issues such as depression, anxiety, and suicidal thoughts, as well as disruptive and impulsive behavioral problems. Therefore, effective therapeutic interventions and social support are essential. This study investigated the effects of group sandplay therapy (GST) on children who have been victims of cyberbullying. Method: This study was designed as a non-randomized controlled trial with an intervention group and a control group. The participants included 127 children aged 11 to 12 years old who had experienced cyberbullying, with 64 participants in the GST intervention group and 63 participants in a matched control group based on gender and age. The intervention group participated in 10 GST sessions, each lasting 40 min, held once a week in groups of three or four. The control group received no treatment. The Korean Youth Self Report (K-YSR) was employed to evaluate the effectiveness of the intervention. Results: The results indicated that the GST intervention group experienced significant reductions in anxiety/depression (F = 7.09, p = 0.009, d = 0.49), somatic symptoms (F = 10.02, p = 0.002, d = 0.58), and aggressive behavior (F = 3.94, p = 0.049, d = 0.36) on the K-YSR scale compared to the control group. Conclusions: Thus, GST was found to be effective in alleviating negative emotions and aggressive behavior in children affected by cyberbullying. Full article

Introduction: The introduction of the transdiagnostic approach in psychiatry shifts the focus from discrete diagnoses to shared symptoms across various disorders. The Transdiagnostic Global Impression—Psychopathology (TGI-P) scale is a newly developed tool designed to assess psychiatric symptoms across diagnostic boundaries. It evaluates ten core symptom domains—positive, negative, cognitive, manic, depressive, addiction, anxiety, sleep, hostility, and self-harm—regardless of specific diagnoses. Objective: This study aims to evaluate the efficacy of cariprazine across these ten transdiagnostic symptom domains. Methods: A systematic literature review and meta-analysis were conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Searches were performed on EMBASE and clinicaltrials.gov. Efficacy measures such as the Positive and Negative Syndrome Scale (PANSS), Montgomery–Åsberg Depression Rating Scale (MADRS), Young Mania Rating Scale (YMRS), Hamilton Anxiety Rating Scale (HAM-A), and Columbia-Suicide Severity Rating Scale (C-SSRS) were used to assess cariprazine’s effect on the ten transdiagnostic symptoms. Multilevel random-effects meta-analyses were conducted to evaluate the efficacy of cariprazine versus placebo in alleviating depressive and anxiety symptoms across clinical trials. Results: A total of 30 studies were included in the review. Cariprazine showed therapeutic benefits on positive, negative, manic, and depressive symptoms in specifically designed trials. Preliminary positive effects were seen on anxiety, hostility, and cognitive symptoms across disorders. However, specific trials have not been conducted for anxiety disorders or cognitive impairment. Meta-analyses demonstrated that cariprazine significantly reduces both depressive and anxiety symptoms compared to placebo. Cariprazine significantly improved sleep-related symptoms in both mania and depression trials. Suicidality was evaluated in non-suicidal populations, and no increase was observed. Addiction symptoms were part of the exclusion criteria in the RCTs, so they could not be assessed. Previous reports of cariprazine’s anti-craving and anti-abuse effects come from real-world evidence rather than RCT data. Conclusions: Cariprazine appears to be promising in addressing a broad range of symptom domains across psychiatric conditions. Full article

Background: The gut–brain axis (GBA) has been demonstrated to be involved in normal neurodevelopment, with its dysfunction potentially contributing to the onset of mental disorders. In this systematic review and meta-analysis, we aimed to examine the relationship between levels of specific biomarkers of intestinal permeability or inflammation and scores of depressive symptoms or suicidality. Methods: All studies investigating the link between depressive symptoms and/or suicidality and biomarkers associated with intestinal permeability or inflammation were included. Studies providing data for comparisons between two groups—depressive or suicidal patients vs. healthy controls, or suicidal vs. non-suicidal patients—were included in the meta-analysis. Studies examining the correlation between depressive symptoms and biomarker levels were also included into the review. Data were independently extracted and reviewed by multiple observers. A random-effects model was employed for the analysis, and Hedge’s g was pooled for the effect size. Heterogeneity was assessed using the I² index. Results: Twenty-two studies provided data for inclusion in the meta-analysis, while nineteen studies investigated the correlation between depressive symptoms and biomarker levels. For depressive symptoms, when compared to the controls, patients showed significantly increased levels of intestinal fatty acid-binding protein (I-FABP) (ES = 0.36; 95% CI = 0.11 to 0.61; p = 0.004; I² = 71.61%), zonulin (ES = 0.69; 95% CI = 0.02 to 1.36; p = 0.044; I² = 92.12%), antibodies against bacterial endotoxins (ES = 0.75; 95% CI = 0.54 to 0.98; p < 0.001; I² = 0.00%), and sCD14 (ES = 0.11; 95% CI = 0.01 to 0.21; p = 0.038; I² = 10.28%). No significant differences were found between the patients and controls in levels of LPS-binding protein (LBP) and alpha-1 antitrypsin (A-1-AT). For suicidality, four studies were identified for quantitative analysis, three of which focused on I-FABP. No significant differences in I-FABP levels were observed between suicidal patients and the controls (ES = 0.24; 95% CI = −0.30 to 0.79; p = 0.378; I² = 86.44%). Studies investigating the correlation between depressive symptoms and levels of intestinal permeability and inflammation biomarkers did not provide conclusive results. Conclusions: A significant difference was observed between patients with depressive symptoms and controls for biomarkers of intestinal permeability (zonulin, which regulates tight junctions), inflammatory response to bacterial endotoxins (antibodies to endotoxins and sCD14—a soluble form of the CD14 protein that modulates inflammation triggered by lipopolysaccharides), and acute intestinal epithelial damage (I-FABP, released upon enterocyte injury). Studies investigating suicidality and related biomarkers were limited in number and scope, preventing definitive conclusions. Overall, these findings suggest that biomarkers of gut permeability represent a promising area for further investigation in both psychiatric and forensic pathology. They may have practical applications, such as supporting diagnostic and therapeutic decision-making in clinical settings and providing pathologists with additional information to help determine the manner of death in forensic investigations. Full article

Anorexia Nervosa (AN) is a psychiatric illness with serious medical and physiological implications. Anorexia Nervosa is characterised by significant disruptions in weight, growth and physical health resulting from disordered behaviours such as food restriction, purging and inappropriate exercise. The illness is associated with substantial physical, psychological, social and economic burdens affecting all areas of functioning. Typically emerging in adolescence, AN can have a chronic course and high risk of mortality, with evidence suggesting that approximately 10% of individuals diagnosed with AN will die from medical complications or completed suicide. Whilst inpatient treatment reduces mortality risks through nutritional and weight restoration, outpatient treatment is the preferred level of intervention. In the case of adolescents, family-based treatment (FBT) is the recommended and most researched outpatient model for medically stable adolescents. However, access to FBT is limited, and there are several barriers that exist to receiving care from trained clinicians. This review provides a literature update on studies reporting the real-world access challenges for FBT, with particular attention paid to non-research settings. The review also highlights how digitally delivered treatment, specifically telehealth, has been used to increase access to FBT and examines the preliminary outcomes of telehealth-delivered FBT, which appear comparable to traditional in-person care. Despite these promising findings, provider, intervention and systemic factors have challenged the delivery of traditional in-person and telehealth FBT in real-world settings. Critical areas for future research include the need to understand the impact of potential confounders and what adaptions may be required to increase model feasibility in community settings, where access to specialist services is often limited and access challenges are most felt. Full article

Background: It is common for patients with eating disorders (ED) to report traumatic experiences early in their lifetime. The objective of this study was to explore the presence and types of traumatic events and the comorbidity with Post-Traumatic Stress Disorder (PTSD) in a sample of adolescents with severe ED. Method: A total of 118 adolescents treated at our Eating Disorders Day Care Hospital (EDDCH) were systematically evaluated for depressive symptoms, disordered eating, early traumatic experiences, and presence of PTSD. Likewise, various clinical variables were collected including comorbidities, age upon ED diagnosis, number of hospital admissions, presence of non-suicidal self-injury, and suicide attempts. Results: Seventy-seven (65.3%) of adolescents of the total sample reported exposure to four or more traumatic events (bullying, psychological abuse, and sexual abuse being the most common). Fifty-seven of them (48.3% of the total sample) scored significantly high in PTSD assessment. Patients with ED and comorbid PTSD (PTSD+) presented higher disordered eating (p < 0.001) and depressive symptoms (p < 0.001) and also a higher prevalence of both non-suicidal self-injury (p = 0.031) and suicide attempts (p = 0.004). The depressive symptoms, measured with the CDI, emerged as an independent predictor of belonging to the PTSD+ group, explaining 22.9% of the variance. Conclusions: It is imperative to systematically screen adolescents with severe ED for traumatic events and PTSD, especially in patients presenting with more depressive symptoms and suicidal or non-suicidal self-injury behaviours, since this subset of patients could be at a higher risk of PTSD. Offering specific psychotherapeutic care targeting PTSD and/or posttraumatic symptoms in addition to the ED standard of care could arguably improve the prognosis of the ED in comorbid patients. Full article

A growing knowledge base highlights the importance of accounting for a variety of social and structural determinants of health (SDOH) when understanding mental and behavioral health among adolescents and young adults. The objective of the current study is to examine patterns of self-reported SDOH deficits and characterize participant health indicators and social identity across classes. Data is from a cross-sectional national study of young people who were recruited through study advertisements on social media and surveyed online. Data were collected between June 2022 and October 2023. Eligibility included (1) ages 13–22 years, (2) living in the United States, and (3) proficient in English. Health indicators included suicide attempts, suicidal ideation, drug overdose, perceived likelihood of living to age 35, non-suicidal self-injury, recent alcohol use, and depression. Five classes of SDOH deficits were identified: (1) Economic Instability, (2) Low Overall SDOH Deficits, (3) High Social SDOH Deficits (adversity and discrimination), (4) High Economic SDOH Deficits, and (5) High Overall SDOH Deficits. Differences across class by health indicators and marginalized identity were found, with high proportions of gender minority and sexual minority youth in both the High Overall SDOH Deficit group and the High Social SDOH Deficit classes. Black youth were more likely to be part of the High Economic SDOH Deficits class. The findings encourage a public health approach that recognizes that improving the health of today’s young people must be connected to policies that reduce poverty, improve neighborhoods, and increase access to basic goods, services, and healthcare. Full article

This paper explores suicidality and suicide research from an autoethnographic analysis framed through grief concepts. Self-identifying as a Muslim in the United States, the author explains how lived experiences being racialized through Islamophobia, identifying as a genderfluid non-binary woman, being socially biracial, holding a postpartum bipolar diagnosis, and being connected to a diaspora, are critical elements to develop a deeper sociocultural understanding of suicide. Grief concepts that are used to analyze these themes include disenfranchised grief, ambiguous loss, anticipatory grief, and secondary loss. While these grief concepts are understood as part of the author’s embodied lived experience as an individual, there is also a collective grief that is explored through the author’s bilingual experience with Arabic as it relates to the topics of suicide and genocide occurring in the Arabic-speaking diaspora located in Gaza, Palestine. A conceptual framework is offered to make sense of the author’s lived experience by both incorporating and challenging existing academic perspectives on suicide and research. The emic, or insider, perspective is contextualized such that it may hold implications beyond the individual author, such as for U.S. Muslims and other hard-to-reach populations. A positionality statement demonstrates the author’s reflexivity of being an insider ‘participant’–researcher in conducting transformative research approaches with the U.S. Muslim community. Further directions are shared for scholars with lived experience who may seek to utilize comparable individual or collaborative autoethnographic approaches with such majority-world communities. Full article

Online safety guidance is frequently delivered as a specialist technology issue without considering adolescents’ home lives, offline vulnerabilities, or wellbeing. Yet, while the digital world offers connection, autonomy, and entertainment, vulnerable teens also encounter more violent content, sexual exploitation, and content concerning body image, self-harm or suicide than their non-vulnerable peers. Many struggle with social inclusion or less engaged and credible caregiver e-safety support, which may contribute to their negative experiences online. To improve their online safety and resilience, caregivers and educators might consider offline factors that can mediate exposure to online harms. This study compared the experiences of 213 adolescents with family vulnerabilities to 213 age- and gender-matched non-vulnerable adolescents. The contribution of (a) e-safety education, (b) close friendships, (c) a trusted adult at school, and (d) life-affecting worry was considered. No differences were found for exposure to, or engagement with, e-safety education. However, despite having received e-safety education, those with family vulnerabilities were more at risk of encountering severe online harms. This was mediated by life-affecting worry and parental e-safety guidance. These findings provide unique insights into the impact of family vulnerabilities on adolescents’ exposure to online harms and suggest a more holistic intervention framework for caregivers. Full article

Background: Unhealthy lifestyles constitute significant risk factors for adolescent suicide, and their detrimental effects may persist from adolescence into adulthood. This research study sought to examine how Body Mass Index (BMI), alongside various lifestyle behaviors among teenagers in Korea, correlates with suicidal thoughts, the formulation of suicide plans, and actual suicide attempts. Methods: The research examined unprocessed information collected during the 2022 Korean Youth Risk Behavior Web-based Survey (KYRBS), which was administered by the Korea Disease Control and Prevention Agency (KDCA). Lifestyle factors associated with suicidal behavior were selected as independent variables. The sample was stratified according to BMI for further analysis. Logistic regression models were applied to assess the association between lifestyle factors and the risk of adolescent suicide. Results: The analysis identified significant correlations between unhealthy dietary patterns, hazardous drinking behavior, smoking, and a sleep duration of less than 5 h, all of which were associated with a heightened suicide risk among adolescents. Notably, underweight adolescents who had a sleep duration of less than 5 h demonstrated a markedly elevated risk of suicidal ideation (OR = 2.391, 95% CI [1.035–5.525]). Among overweight adolescents, frequent coffee consumption was significantly associated with both suicidal planning (OR = 1.850, 95% CI [1.133–3.020]) and suicide attempts (OR = 1.958, 95% CI [1.024–3.742]). Importantly, hazardous drinking behavior was strongly associated with suicide attempts (OR = 2.277, 95% CI [1.132–4.580]). Non-smoking behavior exhibited a significant relationship with a decreased likelihood of suicidal ideation (OR = 0.706, 95% CI [0.507–0.983]) and suicidal planning (OR = 0.528, 95% CI [0.299–0.930]). Furthermore, among obese adolescents, non-smoking behavior significantly decreased the risk of suicidal ideation compared to smoking (OR = 0.514, 95% CI [0.297–0.887]). Conclusions: The study revealed that the combined impact of unhealthy behaviors—smoking, eating an unhealthy breakfast, sleeping for less than 5 h, and hazardous drinking behavior—significantly affect suicide-related behaviors in adolescents. The interaction between BMI and lifestyle factors is a critical determinant of these behaviors. Specifically, sleep health exerts a substantial influence on suicide-related behaviors in underweight adolescents, while smoking strongly correlates with suicidal behaviors in overweight and obese adolescents. Targeted attention to the interplay of smoking, diet, sleep, and alcohol consumption with BMI is crucial for the early detection and prevention of adolescent suicide. Full article

Objectives: Patients with cancer often experience severe mental distress, and suicide is an important issue, particularly prevalent in individuals with lung cancer. The present study aimed to investigate the longitudinal incidence of suicide among patients with lung cancer using national registry data. Methods: A population-based retrospective review of patients diagnosed with lung cancer in 2008 was conducted. Longitudinal medical records, including clinical outcomes and medical insurance data, were investigated. The primary outcome was the incidence of suicide, compared between patients undergoing the first curative treatment option (surgery or non-surgery). Cox proportional hazard regression models were used to adjust for medical history, sociodemographic variables, and lifestyle factors. Results: Among the 4495 patients included, 1306 (29.1%) underwent surgery as the first treatment. Compared to the non-surgery group, the surgery group was younger and had a lower Charlon comorbidity score (p < 0.001), higher physical activity (p < 0.001), and higher income level (p < 0.001). The total number of suicides was 28 (0.62%). The surgery group demonstrated similar trends in the development of suicide and early 5-year follow-up to those of the non-surgery group. Conclusions: The longitudinal risk of suicide among patients with lung cancer increased. Both surgical and non-surgical treatment groups demonstrated similar suicide trends, although patients in the surgery group had multiple protective factors. Full article

(1) Objectives: This study aimed to investigate the intervention effects of physical activity and sedentary behavior on the relationship between various influencing factors and mental health outcomes in the elderly. (2) Methods: Complied data collected from a nationwide survey conducted between 2013 and 2022 were analyzed using the X-Learner algorithm to explore these relationships. (3) Results: The findings indicate that engagement in both high- and moderate-intensity physical activities leads to statistically significant improvements in depression, suicidal ideation, and stress levels compared to non-participation. (4) Conclusions: The study emphasizes the essential role of physical activity in enhancing the mental health of the elderly in South Korea, demonstrating that high- and moderate-intensity exercise can effectively reduce depression, suicidal thoughts, and perceived stress. It also highlights the detrimental effects of prolonged sedentary behavior on the mental health of older adults. Full article