Search Results (3,375)

Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) and the dual GIP/GLP-1 co-agonist tirzepatide are increasingly prescribed for obesity and type 2 diabetes in populations enriched for binge-spectrum eating pathology. A recurring controversy asks whether these agents treat eating pathology or merely mask it. This critical narrative review argues that, posed as a simple binary, the question is under-specified, and reframes it around three problems. The central is a measurement problem: several intended effects of GLP-1 RAs are scored as improvement by eating-disorder instruments, creating a diagnostic blind spot. In the one disorder where a weight-acting drug has been tested against a placebo, efficacy on weight coincided with no effect on the psychological core—the dissociation that confounds measurement during GLP-1 RA therapy. The second is a phenotype problem: because BED subtypes already moderate response to drug versus psychological treatment, an agent acting on appetite and reward should not act uniformly, though this remains a hypothesis. The third concerns the post-discontinuation trajectory, and a therapy–harm asymmetry emerges across the spectrum. A factorial, phenotype-stratified trial with disorder-core endpoints and drug-free follow-up could resolve these questions; meanwhile, prudent practice combines uncontaminated pre-treatment screening, monitoring not reliant on confounded self-report, discontinuation planning, and integration with psychological care. Full article

Thoracoabdominal aortic aneurysm (TAAA) is a complex vascular disorder involving both thoracic and abdominal segments of the aorta and remains associated with substantial morbidity and mortality. One of the most serious complications after thoracoabdominal aortic aneurysm (TAAA) repair is spinal cord ischemia (SCI), which may progress to spinal cord infarction and result in irreversible neurologic deficits including paraplegia, neurogenic bladder dysfunction, and bowel dysfunction. The incidence of SCI after TAAA repair varies with the extent of aneurysmal involvement, operative duration, and patient comorbidities. The primary pathophysiologic mechanism involves interruption of radiculomedullary arterial flow, compounded by systemic hypotension and limited collateral circulation. Because SCI profoundly affects functional recovery and long-term quality of life, prevention and early recognition are central to perioperative management. Established neuroprotective strategies emphasize maintenance of spinal cord perfusion through meticulous hemodynamic optimization, cerebrospinal fluid (CSF) drainage, and temperature modulation. Intraoperative neuromonitoring using motor and somatosensory-evoked potential facilitates early detection, while newer modalities such as near-infrared spectroscopy and CSF lactate monitoring may offer additional insight. When SCI occurs despite prophylaxis, rapid initiation of rescue measures including CSF drainage, hemodynamic augmentation, and other discussed treatments may improve neurologic outcomes. Long-term care focuses on rehabilitation, symptom management, and psychological support. Therefore, this review aims to consolidate medical evidence to improve the prevention, detection, and treatment of spinal cord infarction associated with thoracoabdominal aortic aneurysm repair. Full article

Background: Transitional age youth aged 18–25 years are more likely to engage in risky behaviors, displaying significantly higher alcohol and illicit drug use levels than adolescents and older adults. College students are particularly vulnerable at this critical life juncture as transitioning to adulthood may impact emotional health and well-being, contributing to anxiety, depression, and feelings of hopelessness, all of which are linked to increased risk of substance use and disorders. Objective: This study characterizes the design and status of the MAPme Project, a prospective project centered on substance use and emotional wellness during and beyond college. Herein, we describe the 2018–2024 pilot cohort that was followed during the first two years of college, remotely during the COVID-19 pandemic, and upon the return to campus. We also describe our latest 2025+ cohort with ongoing data collection. Participants: The 2018–2024 cohort comprised 301 college freshmen who completed online assessments at baseline (Wave 1). The 2025+ cohort has currently enrolled 618 students and counting. Methods: We provide descriptive information on both cohorts, along with preliminary associations of pre- and early collegiate substance use outcomes, psychopathology, sleep patterns, and personality traits. Results: Approximately 64% of first-year students reported use of a substance in the 90 days leading up to college in 2018. Alcohol and cannabis were the most prevalent substances used in both cohorts with males consuming more alcohol than females. Females reported greater levels of daily stressors and mood symptoms. Other health and personality characteristics and observed associations between psychosocial risk and protective factors are described. Prior studies demonstrate the ability to test research hypotheses in the social, health, and clinical areas of psychology with robust statistical power. Conclusions: Substance use and emotional well-being vary considerably upon entry into college/university and at any particular moment in time. The MAPme Project encourages the engagement of students to address challenges associated with lack of awareness, inclusivity, and acceptance of scientific research. Overcoming barriers of inclusivity and empowering the community is key to the successful adoption and implementation of campus health and community-oriented research programs and systematically enhancing research training. Full article

Background/Objectives: Depression and anxiety disorders exhibit significant clinical heterogeneity, which complicates diagnosis and treatment. This study investigated whether tripartite interactions between biological sex, the serotonin transporter gene promoter region (5-HTTLPR), and brain-derived neurotrophic factor (BDNF) G196A polymorphisms explain specific symptom-level variations. Methods: A community sample of 271 Australian adults was genotyped for common 5-HTTLPR (short/long) and BDNF (G/A) variants. Participants completed self-reported measures of anxiety (SAS), depression subtypes (SDS; clinical content scales), and psychological resilience (CDRISC). Morning salivary cortisol, BMI, and substance use were assessed as potential confounds. Statistical analyses utilised a three-way factorial ANCOVA to test for interactions on raw scores, controlling for age. Significant omnibus interactions were decomposed via planned stratified ANCOVAs within each 5-HTTLPR stratum. Results: The BDNF GA genotype exerted opposite effects on anxiety and anhedonia depending on sex and 5-HTTLPR background. In females, GA was associated with increased symptoms on an ss background, whereas in males, GA was associated with increased symptoms on an ll background. These effects were highly specific to anxiety and anhedonic depression, while depressed mood, cognitive, and somatic subtypes remained unaffected. Findings were independent of cortisol, BMI, smoking, alcohol use, and psychological resilience. Conclusions: The findings reveal a complex, sex-dependent genetic interaction that selectively influences anhedonia and anxiety. They should be interpreted in the context of modest subgroup sizes following genotype stratification and require replication in larger independent cohorts. Nonetheless, this study highlights the value of considering sex-stratified genetic backgrounds and symptom specificity to advance personalised precision medicine in psychiatry. Full article

Employment is an important determinant of psychological, social, and economic wellbeing, yet individuals with mental health disorders often face barriers to workforce participation. This study examined the impact of mental health disclosure on perceptions of trustworthiness, job suitability, and value to the company, focusing on Major Depressive Disorder (MDD), Emotionally Unstable Personality Disorder (EUPD), and schizophrenia. Using experimental vignette methodology, 330 participants evaluated a job candidate before and after a simulated HR background check, which revealed either no diagnosed mental disorder (control condition) or a diagnosis of MDD, EUPD, or schizophrenia. Quantitative analyses indicated that disclosure of mental disorders was associated with declines in perceived trustworthiness, suitability, and value. Qualitative thematic analysis revealed that hiring decisions were guided by concerns about emotional stability, absenteeism, and reputational risk, tempered by considerations of fairness, support, and reasonable workplace adjustments. Across the mental health disorder conditions, rejection rates were relatively low (6–16%). The findings highlight the nuanced role of HR background checks (which can include social media checks) in shaping employability evaluations. The study contributes to understanding how disclosure of mental disorders influences employability perceptions and provides practical implications for fostering inclusive employment practices. Full article

Objective: This study investigated the associations between tinnitus-related features, psychological symptoms, and everyday functioning. Material and Methods: In this study, 293 patients with primary subjective tinnitus participated. Participants received otorhinolaryngological and audiological evaluations and completed the Tinnitus Handicap Inventory (THI), Beck Depression Inventory (BDI), and Generalised Anxiety Disorder-7 (GAD-7) questionnaires. Results: Significant positive correlations were observed between total THI scores and several tinnitus characteristics, including subjective loudness, pitch, complexity, and sound intolerance. Higher THI scores were also associated with higher depression and anxiety scores. Psychoacoustically matched tinnitus intensity was positively correlated with perceived tinnitus loudness; however, no significant association was found between overall THI scores and psychoacoustic tinnitus intensity. Longer tinnitus duration was positively correlated with both tinnitus loudness and participant age, while age was also positively associated with tinnitus loudness. Subjective tinnitus loudness, pitch, complexity, and sound intolerance were positively correlated with both BDI and GAD-7 scores. After applying the Bonferroni correction for multiple comparisons, the following correlations were no longer statistically significant: psychoacoustic tinnitus intensity with subjective tinnitus loudness and the THI Functional (F) subscale; tinnitus duration with subjective tinnitus loudness; subjective tinnitus loudness with BDI and GAD-7 scores; and age with subjective tinnitus loudness and tinnitus pitch. However, all remaining significant correlations were retained. In linear regression analyses, THI scores were independently associated with sound intolerance, tinnitus pitch, and BDI scores, while THI scores were also independently associated with BDI scores and sound intolerance in reciprocal models. Conclusions: In this single-centre, cross-sectional study of patients with tinnitus and without a control group, greater tinnitus handicap was associated with subjective tinnitus pitch, sound intolerance, and depressive symptoms. Subjective tinnitus loudness was positively associated with psychoacoustically matched tinnitus intensity before correction for multiple testing but was not retained after Bonferroni adjustment. Several subjective tinnitus characteristics remained associated with symptoms of depression and anxiety after adjustment for multiple comparisons. These findings describe associations within the studied population and should not be interpreted as evidence of causal relationships or generalised beyond similar clinical populations without further multicentre, longitudinal, controlled studies. Full article

Background/Objectives: Internet Gaming Disorder (IGD) is included in ICD-11 and poses a substantial risk to Saudi university students, yet no structured nursing intervention framework exists within Saudi higher education health services. This paper presents the Resilience-Based Nursing Intervention Framework (RBNIF), a three-tiered, theory-driven nursing architecture translating evidence on impulsivity, resilience, and IGD into practice specifications for this setting. Methods: Using secondary analysis of a dataset of 207 gaming students from four King Saud University colleges, framework development followed a four-phase Medical Research Council (MRC) process: theoretical identification (I-PACE, Dual Process Theory, COM-B), evidence synthesis, Behavior Change Wheel/Intervention Mapping, and cultural adaptation via Bernal et al.’s Ecological Validity Framework. Results: The sample (58.9% male; 20–25 years, 61.4%; bachelor’s level, 73.9%) yielded three tiers differentiated by a dual-domain screening rule (elevated impulsivity and/or low resilience, rather than a single combined score): Tier 1 (universal psychoeducation); Tier 2 (six-session group program, S-UPPS-P ≥ 52 and/or CD-RISC-10 ≤ 20; 63 of 207 participants [30.4%]); and Tier 3 (10-session RIRDH clinical program, IGDS9-SF ≥ 36, met by 38 of 207 participants [18.4%]). Fifty-two participants (25.1%) met the elevated-impulsivity criterion, and 51 (24.6%) met the low-resilience criterion. Each tier specifies nursing competencies and behavior change techniques, with cultural adaptation integrating Islamic values concepts (sabr, mizan, tawakkul), family protocols, and single-sex delivery. Conclusions: To our knowledge, the RBNIF is the first theory-driven, culturally adapted nursing intervention architecture for IGD in Saudi university health services; a focused, non-systematic search of PubMed, Scopus, and CINAHL identified no directly comparable published framework. It is pre-implementation and requires feasibility testing, pilot evaluation, and a cluster-randomized controlled trial (c-RCT). Full article

Background: Despite the WHO’s recognition of Gaming Disorder in the ICD-11, epidemiological data on its prevalence and neuropsychiatric correlates among Saudi Arabian university students remain limited. Such data are critical for calibrating campus mental health resources and developing evidence-based screening protocols. This study aimed to estimate the prevalence of Internet Gaming Disorder (IGD) in a sample of Saudi university student gamers and evaluate the clinical utility of impulsivity and resilience as case-detection tools. Methods: In a cross-sectional survey of students who engaged in electronic gaming for at least one hour per week (N = 207; 58.9% male), participants completed the IGDS9-SF, CD-RISC-10, and S-UPPS-P scales. Data were analyzed using binary logistic regression and Receiver Operating Characteristic (ROC) curves to identify predictors and compare the discriminative validity of the constructs. Results: Among these student gamers, the overall IGD prevalence was 18.4%, with significantly higher rates in males (24.6%) than females (9.4%; χ²(1) = 7.71, p = 0.006). Significant predictors of IGD included sex, daily gaming hours, higher impulsivity, and lower resilience. ROC analysis revealed that a composite impulsivity-resilience index (AUC = 0.80) outperformed single-construct screening using only impulsivity (AUC = 0.71) or resilience (AUC = 0.68). Cases exhibited markedly higher impulsivity and lower resilience than non-cases. Conclusions: Among Saudi university student gamers, IGD prevalence is clinically significant, particularly among heavier and male gamers. A composite impulsivity-resilience screening index showed superior detection accuracy in this sample and warrants further validation for integration into university mental health assessment protocols. Full article

Background: Family caregivers of children with rare diseases are more likely to have symptoms of anxiety, depression, and post-traumatic stress disorder (PTSD). The WHO’s Group Problem Management Plus (Group PM+) is an evidence-based intervention providing psychological help for adults impaired by distress while exposed to adversity. Our objective was to adapt and beta test Group PM+ with family caregivers. Methods: Family caregivers were >18.0 years at enrollment experiencing psychological distress. Rare Group PM+ is five weekly sessions teaching stress management, problem solving, and building social support. Assessments were the PTSD Checklist for DSM-5 (PCL-5), Patient Health Questionnaire-9, and Generalized Anxiety Disorder-7. Paired Wilcoxon signed-rank tests measured the median baseline and 2-week follow-up values. Results: Sessions were reduced to 90 min and delivered through telehealth. Eight participants enrolled, including seven females with mean age of 40 years. Completion and retention rate were 100% (8/8). Participant-identified barriers to joining included: time constraints; concerns about re-traumatization; and confidentiality. PCL-5 decreased from a median of 29 to 17.5; GAD-7 from 11.5 to 4.5; and PHQ-9 median scores decreased but not significantly. Conclusions: Rare Group PM+ demonstrated initial acceptability and feasibility. Future research should examine initial efficacy in a larger rigorous pilot randomized controlled clinical trial. Full article

Background/Objectives: This systematic review examines psychological interventions for children with neurodevelopmental disabilities within a neurodiversity framework, emphasizing that variations in cognition, behavior, and neurological functioning represent natural forms of human diversity rather than deficits. Methods: A systematic literature search was conducted across the PubMed, PsycINFO, and Google Scholar databases for studies published between 2010 and 2025. Studies were included if they focused on children with autism spectrum disorder (ASD), learning or intellectual disabilities (LD/ID), or specific learning disabilities (SpLD), and evaluated psychological or behavioral interventions. Results: A total of 34 studies met the inclusion criteria after screening and full-text review. The findings indicate that traditional interventions, such as Applied Behavior Analysis (ABA) and Cognitive Behavioral Therapy (CBT), demonstrate effectiveness in improving adaptive behavior, emotional regulation, and cognitive functioning. However, more recent approaches, including Naturalistic Developmental Behavioral Interventions (NDBI), person-centered therapies, and gamified interventions, show greater alignment with neurodiversity principles by emphasizing individual strengths, autonomy, and environmental adaptation. Conclusions: Despite promising outcomes, the evidence base remains uneven, with a predominant focus on autism and limited high-quality studies addressing other neurodevelopmental conditions. The review highlights the need for more rigorous, inclusive, and longitudinal research, as well as the integration of neurodivergent perspectives in intervention design. Overall, the findings suggest that interventions incorporating individualized, strengths-based, and context-sensitive adaptations are associated with more consistent improvements in both functional outcomes and quality of life. Full article

Background and Objectives: Forgetting has been a passive process of memory failure; an active and controlled neurocognitive process is critical for cognitive efficiency, goal-directed behaviors, and emotional coping. This systematic review aims to provide a human-based summary of the scientific understanding of forgetting from neurobiological and psychological perspectives. Materials and Methods: A literature review from 2000 – 2025 was performed using PubMed/MEDLINE, PsycINFO, and Scopus. Original peer-reviewed human-based studies that used behavioral tasks, neuroimaging methods, electroencephalography, and physiological stress inductions were considered. Results: Active control processes have been identified in the forgetting paradigm, and intentional forgetting involved prefrontal–hippocampal downregulation, whereas unintentional forgetting occurred due to limited resources, interference, and competition at the stage of information retrieval. Stress-induced disruption of the ability to recall memories operated specifically via executive and inhibitory functions. Pathological forgetting in mild cognitive impairment was explained by encoding impairments and poor consolidation, but not by accelerated long-term decay. Post-Traumatic Stress Disorder (PTSD) and Major Depressive Disorder (MDD) featured pathological forgetting associated with decreased specificity, negative bias, and poor prefrontal–medial temporal lobe inhibition, resulting in asymmetrical memory retention. Forgetting has been recognized as a dynamic and multidetermined process, which involves executive control, hippocampal–cortical interactions, and emotional modulation. Different pathologies of forgetting occur depending on the disrupted domain, indicating that differential forgetting patterns specific to particular domains, such as encoding failures in Mild Cognitive Impairment (MCI) and inhibitory deficits in PTSD, may have implications for differential diagnoses and interventions. Conclusions: Executive and emotion-regulatory dysfunction leads to maladaptive forgetting and is characterized by less specificity, more interference, and weaker inhibition. Disrupted hippocampal amygdalar prefrontal networks, in disorders like PTSD and MDD, disrupt memory suppression, resulting in intrusive emotional memories with loss of context. Full article

Background/Objectives: Takotsubo cardiomyopathy (TTC), also known as “broken heart syndrome”, is an acute and reversible cardiac condition often triggered by emotional or physical stress. Increasing evidence suggests a strong comorbidity between TTC and psychiatric disorders, particularly anxiety and depression. However, the nature, prevalence, and implications of these associations remain incompletely understood. This scoping review aimed to systematically map the available evidence on the association between Takotsubo cardiomyopathy and anxiety and depressive disorders, characterize the prevalence and nature of these psychiatric comorbidities, evaluate the methods used for their assessment, and identify knowledge gaps to guide future research and clinical practice. Methods: A systematic search of MEDLINE (via PubMed), Embase, Web of Science, and Google Scholar was conducted for peer-reviewed human studies published up to December 2025 in English or French. Eligible studies reported on psychiatric comorbidities in TTC populations, including pre-existing disorders, psychiatric triggers, or psychological sequelae. A standardized extraction grid and the Joanna Briggs Institute appraisal tools were used for data collection and quality assessment. Results: Eighteen studies were included. Depression and anxiety were prevalent among TTC patients, frequently preceding or accompanying cardiac events. Emotional stressors such as bereavement or panic attacks were commonly cited as triggers. Despite this, only a minority of studies used validated psychometric tools, and longitudinal psychiatric follow-up was rare. Most studies were limited by small sample sizes, retrospective designs, and heterogeneity in diagnostic approaches. Conclusions: The findings reveal a consistent association between TTC and affective disorders, underscoring the role of the brain–heart axis. Integrating psychiatric screening and follow-up into TTC management may enhance outcomes. Future interdisciplinary research is needed to clarify causal pathways and inform prevention and treatment strategies. Full article

Background/Objective: Family caregivers of individuals with serious mental illness and substance use disorders experience substantial psychological burden. However, emerging evidence suggests many develop resilience and post-traumatic growth despite adversity. This integrative review synthesizes evidence on resilience, coping strategies, post-traumatic growth, and protective factors among these caregivers. Methods: The Whittemore and Knafl integrative review framework guided this synthesis. A systematic literature search was conducted across PubMed, CINAHL, and PsycINFO databases for peer-reviewed articles examining resilience, coping mechanisms, and post-traumatic growth in family caregivers of individuals with serious mental illness and substance use disorders. Qualitative, quantitative, and mixed-methods studies were included. Study quality was assessed using the Mixed Methods Appraisal Tool (MMAT). Data were extracted and analyzed using thematic synthesis to identify common patterns. Results: Multiple protective factors facilitate resilience and post-traumatic growth, including cultural values, family connectedness, religious faith, and emotional intelligence. Individual characteristics such as personality traits and decision-making styles influence adaptation outcomes. Structured interventions including psychoeducation, mindfulness practices, and peer support show initial evidence of enhancing caregiver resilience and psychological well-being, based on a single randomized controlled trial and cross-sectional associations. The caregiving experience provides opportunities for meaningful personal transformation despite significant burden. Conclusions: Family caregivers of individuals with serious mental illness and substance use disorders possess substantial capacity for positive psychological change. Healthcare professionals should implement strength-based, family-centered interventions acknowledging caregiver resilience. Future research employing longitudinal designs and investigating intervention mechanisms is essential to advance caregiver-focused mental health services. Full article

Pediatric obesity is a complex, multifactorial pandemic with serious early-onset comorbidities, including prediabetes, type 2 diabetes, metabolic dysfunction-associated steatotic liver disease (MASLD), and cardiovascular disorders. While lifestyle modifications and the Mediterranean diet remain primary interventions, artificial intelligence (AI) is emerging as a critical tool for early diagnosis and personalized management. This review evaluates the current role of AI in predicting and treating childhood obesity and its complications. A literature search was conducted on PubMed and Google Scholar for English-language articles published from 2015 onward. Search terms included combinations of keywords related to “obesity”, “pediatric”, “comorbidities” (e.g., MASLD, diabetes), and “artificial intelligence” (e.g., machine learning, deep learning, multi-omics). Eligible study types ranged from original articles to systematic reviews and clinical guidelines. By integrating multi-omic data (genome, epigenome, transcriptome, metabolome, microbiota) with socio-psychological metrics, AI can predict obesity risk and early complications. Machine learning (ML) and deep learning have successfully identified specific metabolites, gut flora alterations, neurological pathways, and metabolic SNPs linked to obesity susceptibility. Furthermore, ML-driven prognostic models enable risk assessment for MASLD or diabetes progression, while specialized software supports remote lifestyle monitoring and tailored dietary interventions. AI has the potential to revolutionize pediatric obesity management through precision medicine. However, challenges regarding data privacy, digital literacy, and equitable access persist. Because current evidence relies heavily on limited and heterogeneous pediatric datasets, large-scale, well-characterized, and externally validated cohorts are essential to establish the clinical applicability of AI models before routine implementation. Full article

Background: Psychiatric disorders are common but often unrecognized complications in patients with burns. This study aimed to determine the association between psychiatric disorders and demographic and clinical factors in the Burn Unit of Dr. Cipto Mangunkusumo National General Hospital (RSCM). Methods: This retrospective cross-sectional study used the electronic medical records (EMR) of adult patients with burns admitted between 2023 and 2025. Results: Of the 201 inpatients with burns, 73.1% were diagnosed with a psychiatric disorder, most commonly adjustment disorder (53.2%); among patients with major burns, this rose to 83.1%. Female sex (odds ratio (OR) = 0.421; p = 0.032), multiple concurrent psychosocial stressors (OR = 0.389; p = 0.012), and more than three operative procedures (OR = 0.127; p = 0.010) were independent predictors. There were no independent links between burn extent (Total Body Surface Area) and psychiatric outcomes, or between length of stay (LOS) and psychiatric outcomes. A significant proportion of inpatients with burns had psychiatric disorders. Conclusions: The risk of psychiatric morbidity was significantly associated with female sex, multiple psychosocial stressors, and an increased operative burden, but not with burn severity. These results support regular psychiatric screening as an integral part of the comprehensive treatment of patients with burns, especially in high-risk groups. Full article