Search Results (1,520)

Background/Objectives: The rapid expansion of social media platforms has profoundly changed the way adolescents access reproductive health information. While digital environments increase accessibility to contraceptive content, they also facilitate the dissemination of misinformation, potentially influencing both contraceptive literacy and psychological well-being. The present study aimed to evaluate the relationship between sources of contraceptive information, contraceptive misinformation endorsement, contraceptive knowledge, and mental health indicators among Romanian adolescents and young adults. Methods: A cross-sectional observational study was conducted in a cohort of 210 Romanian adolescents and young adults. Participants completed a structured self-administered questionnaire assessing demographic characteristics, contraceptive information sources, digital health behaviors, contraceptive misconceptions, and contraceptive knowledge. Anxiety and depressive symptoms were evaluated using the Generalized Anxiety Disorder-7 (GAD-7) and Patient Health Questionnaire-9 (PHQ-9) scales. Correlation analyses and multivariable logistic regression models were performed to identify factors associated with poor contraceptive knowledge and moderate-to-severe anxiety. Results: Social media represented the primary source of contraceptive information for 58.1% of participants. Individuals relying predominantly on social media demonstrated significantly lower contraceptive knowledge questionnaire (CKQ) scores compared to those obtaining information from healthcare professionals (5.9 ± 1.8 vs. 8.1 ± 1.7, p < 0.001). Contraceptive misinformation endorsement was inversely correlated with CKQ scores (r = −0.44, p < 0.001) and positively associated with anxiety (r = 0.47, p < 0.001) and depressive symptoms (r = 0.41, p < 0.001). In multivariable analyses, primary reliance on social media (OR 2.21, 95% CI 1.12–4.34, p = 0.022) and low digital health literacy (OR 2.94, 95% CI 1.51–5.71, p = 0.001) were independently associated with poor contraceptive knowledge. Higher misinformation endorsement, infertility-related fears, and high social media exposure were independently associated with moderate-to-severe anxiety. Conclusions: Contraceptive misinformation endorsement was associated with lower contraceptive literacy and poorer psychological outcomes among adolescents and young adults. These findings highlight the growing importance of digital health literacy. However, given the cross-sectional design, the observed relationships should be interpreted as associations rather than causal effects, and longitudinal studies are required to clarify their directionality. Full article

Burn injuries are increasingly recognized as chronic conditions with enduring physical, psychological and social consequences that extend beyond acute survival. This narrative review synthesizes and interpretatively discusses recent evidence on health-related quality of life (HRQoL) in adult burn survivors, focusing on recovery patterns following discharge. Persistent physical sequelae—particularly chronic pain, pruritus, contractures and scarring—remain major determinants of reduced HRQoL, mainly mediated by functional limitation and self-perception. Psychological morbidity is common, with high rates of depression, anxiety and post-traumatic stress disorder, particularly early after injury, although post-traumatic growth may also emerge. Social reintegration, including return to work, is often delayed or incomplete and is influenced by injury severity, mental health status and social support. Recovery trajectories are nonlinear: the greatest improvements occur within the first six months, followed by slower gains up to 18–24 months, after which many patients fail to reach population norms. Pain and psychological symptoms may persist for years. Overall, these findings support a multidisciplinary, longitudinal approach to burn care, emphasizing early risk stratification and rehabilitation to optimize individualized recovery. In this narrative review, we aim to outline the main dimensions of long-term quality of life, with a particular focus on the temporal dynamics of recovery patterns. Full article

Background: Alcohol use disorder (AUD) is a grave mental health condition that can result in significant health and social consequences. The medications Naltrexone and Nalmefene are indicated for the treatment of AUD, with Naltrexone having received the most extensive research attention. Methods: The majority of papers assessing universal measures of alcohol consumption employed two primary metrics: total alcohol consumption (TAC) and the number of days per month where individuals engaged in heavy drinking (HDD). Indicators pertaining to the maintenance of complete abstinence were excluded due to the absence of sufficient data. The safety of both substances was also assessed, as were the frequency of side effects and independent patient dropout. The study also incorporated practical factors of the therapy, such as the route of administration, dosage regimen, and the drug’s patient convenience, which can have a significant impact on adherence to therapy. Results: Nalmefene, administered in an “as needed” regimen, demonstrated statistically significant activity in reducing HDD and total alcohol consumption (TAC) among patients with AUD, particularly those with elevated World Health Organization (WHO) DRL risk. Preliminary findings from the ESENSE1 (Efficacy of Nalmefene in Alcohol Dependence; the first phase III study), ESENSE 2 (Efficacy of Nalmefene in Alcohol Dependence, the second phase III study), and SENSE (the final phase III long term-safety and cost-effectiveness study) studies indicate a substantial decrease in HDD and TAC following the initial month of treatment. These effects persist throughout the subsequent follow-up period. Several Japanese studies have corroborated the effectiveness of Nalmefene, demonstrating its efficacy across both short-term and long-term applications. Furthermore, these studies have substantiated its safety profile, indicating that there is no inherent risk of addiction or the emergence of withdrawal symptoms. The mild nature of adverse events (most commonly nausea and dizziness) led to a relatively low discontinuation rate of Nalmefene treatment. A subsequent study, employing a recognized methodology, corroborated the efficacy of psychosocial support in enhancing treatment outcomes. Meta-analyses demonstrate that Naltrexone exhibits comparable efficacy in reducing the frequency and severity of alcohol consumption. In select populations, the injectable form (LAI) of this pharmaceutical agent facilitates less frequent dosing, which is advantageous for the treatment process. A comparison of Nalmefene and Naltrexone reveals that the latter does not demonstrate a significant impact on the likelihood of individuals returning to heavy alcohol consumption. Conclusions: In the treatment of AUD, both naltrexone and nalmefene have been shown to yield positive outcomes, particularly in terms of reducing the HDD and TAC. According to the World Health Organization (WHO) classification, Nalmefene is indicated for individuals with a high risk of developing serious conditions. It has been demonstrated to produce rapid and sustained results while exhibiting a favorable safety profile, characterized by the absence of significant adverse effects. Naltrexone is a medication that has proven to be effective. LAI may have a positive impact on the efficacy of treatment. Full article

Background/objective: Cybersex addiction and hypersexual behavior represent escalating challenges in global mental health. This study analyzed the sociodemographic and clinical profiles of a cohort of males undergoing treatment, examining the concurrent associations between therapeutic support duration and symptomatic severity. Method: An observational, descriptive, and cross-sectional study was conducted with a predominantly male clinical cohort (n = 27; 26 males and 1 female) enrolled in therapeutic support programs. Assessment instruments included the Internet Sex Screening Test (ISST), the Hypersexual Behavior Inventory (HBI), and the Rosenberg Self-Esteem Scale (RSES). Results: Findings revealed a pornography consumption pattern characterized by high intensity and early onset of behavioral addiction. A significant prevalence of low self-esteem was detected (48.1%). Statistical analysis demonstrated that neither age of onset nor self-esteem levels significantly correlated with current disorder severity. Conclusions: A descriptive pattern was identified regarding the duration of therapeutic follow-up, where patients with longer program tenure exhibited lower scores in impulse control difficulties. While early onset and self-esteem function as concurrent clinical characteristics, they do not linearly correlate with current clinical severity. Therapeutic support duration is associated with specific indicators of clinical stability, suggesting the potential utility of long-term nursing-led interventions. Full article

Detailed attention and cognitive rigidity contribute to poorer social functioning and mental health. These cognitive functions can be measured using questionnaires or behavioral tasks but existing methods have limitations. The Detail and Flexibility Questionnaire (DFlex) addresses several of these limitations. This study developed a Japanese translation of the DFlex and collected valid evidence for its intended score interpretations. Sixty participants with autism spectrum disorder (ASD), 140 without ASD, and five participants who chose not to disclose whether they had an ASD diagnosis completed the Japanese version of the DFlex and the Japanese version of the Autism-Spectrum Quotient (AQ). Data from 192 participants were analyzed. Internal consistency was good as was the internal structure, except for one item. McDonald’s omega and Cronbach’s alpha demonstrated good internal consistency and item–total correlation was acceptable, except for one item. The Japanese DFlex correlated strongly with the AQ Attention to Detail and Attention Switching subscales, supporting convergent validity. Regarding known-group validity, the ASD and non-ASD groups showed significant differences on the Cognitive Rigidity and Attention to Detail subscales. Based on its reliability and internal structural validity, the Japanese DFlex provides a better understanding of ASD-related cognitive traits for both research and clinical practice. Full article

Background and Clinical Significance: “Hikikomori”—a state of prolonged social withdrawal affecting an estimated 2% of Japan’s working-age population—is frequently associated with underlying anxiety disorders, such as gaze phobia, and contributes to the socio-economic burden known as the “8050 problem,” in which aging parents support their socially isolated adult children. While Morita therapy is effective for such conditions, nursing support has historically lacked a systematic theoretical framework. This case report presents a novel nursing model analyzing the transformation process from toraware (mental preoccupation) toward mokuteki-hon-i (purpose-driven action). It proposes the ‘side-by-side’ nursing approach as a potentially important element in supporting patient autonomy in similar clinical settings. Case Presentation: A man in his 20s, diagnosed with gaze phobia and experiencing long-term withdrawal following traumatic bullying, was referred to our specialized short-care program. After initial preparation through structured psychoeducation regarding Morita therapy principles (toraware, sei-no-yokubo, mokuteki-hon-i), he participated in a 14-month Morita therapy-based short-care program combining individual and group interventions. Initially, the patient exhibited severe social avoidance and was trapped in a cycle of seishin-kogo-sayo (psychic interaction). Nurses applied ‘Strategic Inattention to Symptoms’ (shojo-fumon) and provided specific role suggestions, such as serving as a secretary in group discussions, to elicit his sei-no-yokubo (desire for life). Through the reframing of his anxiety as a constructive drive, the patient shifted to a purpose-driven stance. Outcomes showed improved self-adjustment skills in public spaces and successful social reintegration through sustained part-time employment. Conclusions: Nursing care characterized by ‘intentional non-intervention’—which involves waiting in a ‘side-by-side’ manner within a minimally structured environment—may contribute to fostering patient autonomy in similar clinical contexts. This ‘experience-oriented’ approach appeared to elicit inner strengths and support self-regulation in this case, warranting further investigation in multi-case designs. The relative contributions of individual nursing support and group therapeutic milieu cannot be disentangled in a single-case design. Full article

Background/Objectives: Vitamin D is a nutrient-related secosteroid system with endocrine, paracrine, immunological, and neurodevelopmental actions relevant to nutritional psychiatry. Psychiatric research has often treated vitamin D either as a cross-sectional correlate of depression or as a non-specific supplement expected to act across heterogeneous diagnostic categories. This narrative review aimed to develop a more discriminating framework in which vitamin D is considered a lifespan neuroimmune and immunometabolic signal whose psychiatric relevance depends on developmental timing, biological context, and phenotype. Methods: Evidence was integrated from developmental epidemiology, neonatal dried-blood-spot studies, randomized trials, meta-analyses, Mendelian randomization studies, clinical guidelines, and mechanistic neuroscience. The review focuses on prenatal and neonatal 25-hydroxyvitamin D, vitamin D-binding protein, free and bioavailable vitamin D, vitamin D receptor signaling, immune and microglial pathways, neurotransmitter systems, neurotrophic signaling, mitochondrial function, oxidative stress, hypothalamic–pituitary–adrenal-axis regulation, and the gut–microbiota–immune–brain axis. Results: The available evidence does not support vitamin D as a universal treatment for psychiatric disorders. Instead, vitamin D deficiency and altered vitamin D biology appear most relevant in biologically and clinically defined risk states, including neurodevelopmental vulnerability, inflammatory depression, psychosis liability, severe mental illness with nutritional deprivation, metabolic comorbidity, and cognitive frailty. Mechanistic data support plausible links with cytokine biology, the tryptophan–kynurenine pathway, dopaminergic and serotonergic systems, stress regulation, and neuroimmune homeostasis. Conclusions: Vitamin D should be conceptualized in psychiatry as a context-dependent neuroimmune and immunometabolic signal rather than a generic psychotropic intervention. Future studies should prioritize biomarker-enriched, developmentally timed, nutrition-centered models of precision prevention and adjunctive care. Full article

Background: Insomnia is common among people with mental health conditions and can exacerbate symptoms, impair functioning and negatively impact treatment outcomes. Community mental health services require practical data to quantify the burden of insomnia in routine care and to identify groups at a higher risk of experiencing clinically significant insomnia. Methods: We conducted a retrospective analysis of anonymized routinely collected clinical data from adult psychiatric outpatients attending the Community Mental Health Center in Bra (Department of Mental Health, Asl Cuneo 2, Italy). Consecutive patients were included over a three-month period (1 September to 30 November 2025). Insomnia severity was assessed using the Insomnia Severity Index (ISI). Diagnoses were established by psychiatrists using the Structured Clinical Interview for DSM-5 (SCID-5). Results: The sample included 506 patients (mean age: 45.1 ± 16.7 years; 265 women, 52.4%). The mean ISI total score was 12.18 ± 6.99. Clinically significant insomnia (ISI ≥ 15) was present in 205 out of 506 patients (40.5%), while severe insomnia (ISI ≥ 22) was present in 55 out of 506 patients (10.9%). The ISI score differed across diagnostic groups (ANOVA, F(8, 497) = 2.82, p = 0.0046, η² = 0.043). Post hoc comparisons revealed higher ISI scores in patients with depressive disorders than in those with anxiety disorders (Tukey, p = 0.0056). In a multivariable logistic regression model (outcome: ISI score of at least 15), adjusted for age, sex, education and the complexity of concurrent psychotropic medication (number of medication classes), depressive disorders were associated with clinically significant insomnia (OR: 1.99; 95% CI: 1.07–3.73). Attention deficit hyperactivity disorder (ADHD) also showed higher odds (OR: 3.64; 95% CI: 1.26–10.55). Medication complexity was also associated with an ISI score of at least 15 (OR: 1.43 per additional class; 95% CI: 1.16–1.77). In a sensitivity model additionally adjusting for benzodiazepine prescription (yes/no), benzodiazepine prescription was associated with ISI ≥ 15 (OR 1.82; 95% CI 1.13–2.95), while the estimate for medication complexity was attenuated using this association (OR 1.17; 95% CI 0.90–1.53). The eating disorders group was excluded from multivariable models due to the very small sample size (n = 4). Conclusions: Clinically significant insomnia was prevalent among this sample of psychiatric outpatients, with modest differences in insomnia severity across diagnostic groups. Sensitivity analyses suggested that the signal of medication complexity may be partly accounted for by benzodiazepine prescribing, supporting the cautious interpretation of medication-related correlates in routine cross-sectional data. These findings support routine insomnia screening in psychiatric outpatient care, while prospective studies are needed to clarify directionality and clinical implications. Full article

Refugees are exposed to cumulative pre-migration, migration, and post-migration stressors that increase vulnerability to depressive disorders and impaired quality of life. This study assessed the prevalence and severity of depressive symptoms among adult refugees in Serbia and examined associations with sociodemographic characteristics, traumatic experiences, social support, and Health Related Quality of Life (HQoL). The study included 324 refugees residing in four reception centers in Serbia. Data were collected between April 2023 and November 2024 using self-report questionnaires. Depressive symptoms were assessed using the Patient Health Questionnaire-9 (PHQ-9), while HQoL was evaluated using the SF-36 Health Survey. The mean PHQ-9 score indicated mild-to-moderate depressive symptomatology. Clinically significant depressive symptoms were present in 41.4% of participants, while more than 70% reported at least mild symptoms. Depressive symptom severity was negatively associated with energy/fatigue, emotional well-being, social functioning, general health, and pain. The Energy/Fatigue domain emerged as the most prominent independent correlate of depressive symptom severity. Depressive symptoms were highly prevalent and were associated with impaired quality of life and psychosocial stressors. These findings highlight the importance of systematic mental health screening and psychosocial support among refugees. Full article

Background and Objectives: Healthcare workers (HCWs) involved in the COVID-19 response are at increased risk of mental health disturbances, including sleep disorders. This study aimed to assess the prevalence and predictors of insomnia among HCWs in Almaty, Kazakhstan. Materials and Methods: A cross-sectional study was conducted between 11 and 26 September 2021, including 553 HCWs. Insomnia symptoms were assessed using the Insomnia Severity Index (ISI). The primary binary outcome was defined as an ISI score ≥ 10, while ISI ≥ 15 was used descriptively to indicate moderate-to-severe insomnia symptoms. Associations were evaluated using chi-square tests and multivariable logistic regression models. Statistical significance was set at p < 0.05. Results: Overall, 38.10% of HCWs with complete ISI data had insomnia symptoms based on the predefined ISI ≥ 10 threshold. In multivariable analysis, Kazakh nationality (AOR = 2.11, 95% CI: 1.05–4.23), advanced education (AOR = 2.03, 95% CI: 1.13–3.65), physician role (AOR = 4.92, 95% CI: 1.25–19.30), and working with COVID-19 patients for >1 year (AOR = 2.28, 95% CI: 1.33–3.89) were significantly associated with increased odds of insomnia. Conclusions: Insomnia symptoms were common among surveyed HCWs during the COVID-19 pandemic and were associated with selected demographic and occupational characteristics, including professional role, education level, and duration of work with COVID-19 patients. These findings highlight the need for targeted mental health interventions and structural support systems for HCWs in Kazakhstan. Full article

Background: Congenital heart defects (CHD) are prevalent, affecting 1% of live births globally. Despite improved survival rates, adults with CHD face increased risks of psychological distress and neurocognitive deficits. The P-BAHn study (P-BAHn = “Psyche Bei Angeborenen Herzfehlern”, Psyche for congenital heart defects) evaluates the mental health status and psychosocial challenges of German children and adolescents with CHD, focusing on retrospectively assessed COVID-19-related burden and patient-/parent-rated experiences with psychological, psychotherapeutic, or psychiatric treatment (PST). Methods: A cross-sectional, online-based survey was conducted using the National Register for Congenital Heart Defects (NRCHD). The final dataset comprised 1567 respondent-level records from 1310 families, including 992 parent reports and 575 self-reports from children/adolescents aged 6 to <18 years. The survey assessed mental health, emotional well-being, psychosocial status, demographics, medical history, and psychological treatment. Data were analyzed descriptively using chi-square tests and t-tests for exploratory unadjusted group comparisons. In addition, exploratory multivariable logistic regression analyses were performed for selected key outcomes. Results: School-related stress was common in young CHD patients (45.3%) and was associated with older age and female sex (51.5% female vs. 35.6% male) in adjusted analyses. Overall, 17.0% of patients reported having a mental illness, most commonly anxiety (6.8%), eating disorders (5.6%), and depression (4.7%); neither sex nor CHD severity was significantly associated with self-reported mental illness in adjusted analyses. Less good/poor self-rated health was associated with older age and complex CHD in both patient and parent reports. Retrospectively assessed pandemic-related changes were perceived as quite or extremely stressful by 23.9% of patients. High COVID-19-related burden was associated with female sex, whereas CHD severity was not significant after adjustment. Among patients with previous or current PST, patient- and parent-rated treatment benefit varied by patient sex and CHD complexity. Previous/current PST was reported by 25.9% of patients and 23.8% of parents and was associated with older age in both respondent groups and with complex CHD in parent reports. Among patients with previous/current PST, 56.4% reported high perceived support. Conclusions: The P-BAHn study highlights the need for targeted psychosocial support for children and adolescents with CHD, including female patients, those with complex conditions, and patients reporting school- or crisis-related burden. Retrospectively reported pandemic-related burden underscores the importance of integrating crisis-sensitive strategies into psychosocial care frameworks. Longitudinal studies are essential to understand mental health trajectories and to evaluate the sustained patient- and parent-perceived benefit as well as clinical effectiveness of PST use. Enhancing support services and refining intervention models will improve the well-being and quality of life for young CHD patients. Full article

Background/Objectives: Limited data exist on care delivery, engagement, and clinical outcomes among rural populations accessing telehealth mental health services, particularly within integrated psychotherapy-and-psychiatry models. This retrospective observational 12-week cohort study aimed to examine access, engagement, and preliminary clinical outcomes for rural and non-rural patients receiving services through a national outpatient telehealth mental health program. Engagement and clinical outcomes were expected to be comparable among rural and non-rural patients. Methods: Descriptive and inferential analyses were conducted to examine access to care, engagement, and changes in depressive symptoms, anxiety symptoms, and suicidal ideation among rural and non-rural patients receiving telehealth mental health services over a 12-week treatment period. Clinical outcomes were evaluated using the Patient Health Questionnaire-9 (PHQ-9) and the Generalized Anxiety Disorder-7 (GAD-7). The full sample included 8354 rural and 177,864 non-rural patients and was used to assess access and engagement in treatment. A clinical sample (rural n = 2096; non-rural n = 43,067) that included patients who completed 12 weeks of care was further examined to assess symptom improvement outcomes. Results: Rural patients demonstrated greater baseline symptom severity and medical complexity relative to non-rural patients. Mean time to first appointment was 5.2 days among rural patients and 5.5 days among non-rural patients, with comparable engagement across groups and rural patients averaging approximately 1–2 touch points per week in care. Patient satisfaction ratings averaged 4.9 out of 5. Within the clinical sample, rural patients demonstrated clinically meaningful symptom improvement across depression and anxiety outcomes. Mean PHQ-9 scores improved by 7.0 points (95% CI: 6.72–7.28), and mean GAD-7 scores improved by 6.1 points (95% CI: 5.83–6.37). Additionally, 70.5% of rural patients achieved a minimal clinically important difference in PHQ-9 or GAD-7 scores, and 66.7% of patients reporting suicidal ideation at baseline no longer endorsed suicidal ideation at endline. Conclusions: These findings support the feasibility and preliminary effectiveness of large-scale virtual mental health care models for rural populations. Rural patients demonstrated engagement and clinical outcomes comparable to non-rural patients despite greater baseline severity and medical complexity. Full article

Background: Mental health disorders such as depression, anxiety, and stress are increasingly prevalent among university students and contribute to long-term cardio-cerebrovascular disease (CCVD) risk. However, limited research has examined the interplay between mental health, CCVD risk factors, and religiosity/spirituality within Southeast Asia’s multicultural context. Methods: This cross-sectional study investigated these relationships among 484 undergraduate students enrolled in medical and health sciences programs across Peninsular Malaysia. Mental health status was assessed using the Depression, Anxiety, and Stress Scale (DASS-21). Self-reported clinical indicators associated with early CCVD vulnerability were also assessed. Religiosity and spirituality were measured using the Duke University Religion Index (DUREL), Brief Religious Coping (RCOPE), Spirituality Scale (SS), and Spiritual Coping Questionnaire (SCQ). Results: High prevalence rates of severe anxiety (50.4%), depression (29.3%), and stress (21.1%) were observed, with significant associations across ethnicity, religion, and academic programs. Higher religiosity and spirituality were generally associated with better mental health outcomes. However, coping style emerged as a key modifier of the relationship between religiosity/spirituality and mental health outcomes, with negative religious coping associated with greater psychological distress, whereas positive coping demonstrated mixed associations and partial mediating effects. Students with poorer mental health also exhibited higher CCVD risk burden. Conclusions: These findings highlight the importance of culturally and spiritually sensitive strategies in promoting student well-being. Full article

Background/Objectives: Feeding and Eating Disorders (FEDs) are among the most challenging mental disorders due to their pervasive symptomatology and high relapse rates. While considerable research has focused on the role of personality in the onset and maintenance of FEDs, it remains unclear whether specific personality dimensions and emotion dysregulation mechanisms predict clinical severity and purging behaviors. This study aimed to explore the role of personality dimensions, emotion dysregulation, and purging behaviors in predicting psychological distress in patients with FEDs, adopting a dimensional and integrated perspective. Methods: A sample of cisgender women in a semi-residential treatment for FEDs or obesity (n = 124) was recruited in southern Italy and assessed using a psychodiagnostics survey, including the Eating Disorder Inventory-3 (EDI-3), the Symptom Checklist-90-R (SCL-90-R), and the Personality Inventory for DSM-5 (PID-5). Results: Patients with bulimia nervosa exhibited higher psychological distress compared to patients with other FEDs and Obesity, which was not significantly determined by the co-occurrence of personality disorders. Negative affectivity, detachment, and purging symptoms were significantly related to psychological distress in patients with FEDs and Obesity (p ranging from 0.028 to <0.001). Moreover, the results showed an indirect effect of emotion regulation on the relationship between self-esteem and purging symptoms in patients with FEDs and Obesity (β = 0.107; p = 0.046). Conclusions: These findings suggest that specific personality dimensions, emotion dysregulation, and purging symptoms are associated with psychological distress in individuals with FEDs and Obesity. Therefore, it is necessary to reflect on the impact of these psychological components in planning tailored treatment for FED patients. Full article

Background: Cardiovascular disease remains the leading global cause of morbidity and mortality. Mental health disorders are common comorbidities that significantly influence how patients access and navigate specialist care. Increasingly, mental illness is recognized not merely as a comorbidity but as a potential driver of inequities in cardiovascular care, affecting diagnosis, referral, procedural management, and long-term secondary prevention. These concerns are particularly relevant in cardiac surgery, where care pathways are complex and resource-intensive. Aims and Objectives: This narrative review examines recent evidence on inequalities in access to cardiac surgery and postoperative outcomes among patients with mental health disorders. Particular emphasis is placed on severe mental illness, mood disorders, anxiety-related conditions, and mixed psychiatric cohorts. Materials and Methods: A structured narrative review approach was employed. PubMed and ScienceDirect were systematically searched for peer-reviewed studies published between 2020 and 2025, including cohort studies, registry analyses, systematic reviews, and meta-analyses. The evidence was synthesized thematically, focusing on access to care, perioperative management, clinical outcomes, underlying mechanisms, ethical considerations, policy implications, and future research directions. Results: Evidence suggests that patients with mental health disorders are more likely to undergo cardiac surgery via emergency pathways, experience longer hospital stays, and have higher rates of readmission. Individuals with severe mental illness are less likely to receive invasive coronary procedures compared to the general population and exhibit higher short- and long-term mortality following acute coronary syndromes. Among psychiatric subgroups, psychosis-spectrum disorders appear to be associated with the greatest excess risk of morbidity, mortality, and adverse long-term surgical outcomes. Conclusions: Patients with mental health disorders face inequities across the entire surgical pathway, including preoperative, perioperative, and postoperative phases. Key contributing factors include stigma, diagnostic overshadowing, fragmented healthcare systems, socioeconomic disadvantage, and insufficiently developed models of integrated care. Addressing these disparities requires redesigned referral pathways, strengthened multidisciplinary collaboration (including cardiology, cardiac surgery, psychiatry, and primary care), and a shift toward interventional research aimed at reducing inequities rather than solely documenting them. Full article