Search Results (2,644)

Objective: This study aimed to identify psychological characteristics associated with suicidal ideation among Palestinian university students in the West Bank during a period of escalating regional violence (October 2023), with data collected prior to the end of the war, a period marked by intensified political violence and collective trauma. The goal was to identify empirically derived psychological profiles of distress and coping using Latent Profile Analysis. Method: A cross-sectional survey of 900 students assessed depression, anxiety, self-efficacy, resilience, help-seeking attitudes, and suicidal ideation during the past 12 months. Latent Profile Analysis (LPA), logistic regression, and moderated mediation analysis were employed to investigate the relationships between distress, self-efficacy, resilience, and suicidal ideation. Results: Results indicate that depression and anxiety are associated with increased 12-month suicidal ideation, but greater self-efficacy appears to reduce this risk. The mediation analysis revealed that self-efficacy partially explains the relationship between distress and suicidal ideation; however, resilience did not have a significant moderating effect. The LPA identified three distinct psychological profiles, with the highest-risk group exhibiting significant distress and low self-efficacy. Conclusions: These results highlight the significant mental health burden faced by Palestinian youth and underscore the importance of internal psychological resources, particularly self-efficacy, that are associated with lower levels of suicidal ideation. Enhancing self-efficacy may offer a culturally relevant approach for prevention efforts in politically unstable environments. Full article

Although trauma exposure (TE) has been shown to be a robust predictor of youth involvement in the juvenile justice system, evidence regarding the role of TE amongst youth who recidivate has been more mixed. Recidivist youth are a population of particular concern, given evidence of declining mental health and diminished likelihood of returning to an adaptive developmental course. One way in which TE may contribute to these negative outcomes over time is through potentiating or “driving” mental health problems, which are especially prevalent among trauma-exposed youth in the justice system. To examine this hypothesis, longitudinal data were obtained over a 10-year period from a sample of 5615 juvenile justice-involved youth (1499 girls and 4116 boys) who completed a mental health screening at each admission to detention. Results of analyses assessing the associations among trauma exposure, linear and quadratic time, and mental health problems were consistent with the hypothesis that increases in TE were associated with increasing anger/irritability, depression/anxiety, somatic complaints, and suicidal ideation across repeat admissions. With the exception of alcohol/drug use, all mental health outcomes followed a quadratic trajectory over the course of multiple admissions. Rates of mental health problems were consistently highest for girls and White youth across all waves. These results add to our understanding of the role of trauma in mental health problems among persistent offenders and may help to inform interventions designed to reduce youth contact with the potentially iatrogenic effects of justice system involvement. Full article

Background: Stress is a critical determinant of mental health, yet conventional monitoring approaches often rely on subjective self-reports or physiological signals that lack real-time responsiveness. Recent advances in large language models (LLMs) offer opportunities for speech-driven, adaptive stress detection, but existing systems are limited to retrospective text analysis, monolingual settings, or detection-only outputs. Methods: We developed a real-time, speech-driven stress detection framework that integrates audio recording, speech-to-text conversion, and linguistic analysis using transformer-based LLMs. The system provides multimodal outputs, delivering recommendations in both text and synthesized speech. Nine LLM variants were evaluated on five benchmark datasets under zero-shot and few-shot learning conditions. Performance was assessed using accuracy, precision, recall, F1-score, and misclassification trends (false-negatives and false-positives). Real-time feasibility was analyzed through latency modeling, and user-centered validation was conducted across cross-domains. Results: Few-shot fine-tuning improved model performance across all datasets, with Large Language Model Meta AI (LLaMA) and Robustly Optimized BERT Pretraining Approach (RoBERTa) achieving the highest F1-scores and reduced false-negatives, particularly for suicide risk detection. Latency analysis revealed a trade-off between responsiveness and accuracy, with delays ranging from ~2 s for smaller models to ~7.6 s for LLaMA-7B on 30 s audio inputs. Multilingual input support and multimodal output enhanced inclusivity. User feedback confirmed strong usability, accessibility, and adoption potential in real-world settings. Conclusions: This study demonstrates that real-time, LLM-powered stress detection is both technically robust and practically feasible. By combining speech-based input, multimodal feedback, and user-centered validation, the framework advances beyond traditional detection only models toward scalable, inclusive, and deployment-ready digital mental health solutions. Full article

Background/Objectives: Suicide is a critical public health issue that leads to premature mortality among young people and requires substantial public health interventions. Demonstrating the importance of developing effective suicide prevention programs through health indicators can be valuable. This study aims to examine the change in suicide rates and Years of Life Lost (YLL) in Türkiye over the 2013–2023 period—a country that displays characteristics of both developed and developing nations—and to reveal the productivity losses using the human capital approach. Methods: The data for this descriptive study were obtained from the Turkish Statistical Institute between 2012 and 2023. YLL was computed by determining the difference between the age at which an individual died by suicide and their expected age of death for both males and females. Years of Potential Life Lost (YPLL) was estimated using the same method as YLL for individuals aged 15–64 (working age). The time trend of suicide and YLL rates was calculated using Annual Percentage Change and the Average Annual Percent Change values, based on a Poisson-based Generalized Linear Model and the Joinpoint regression method. Using the human capital approach, the economic cost of the labor force lost due to suicide was estimated. Results: The YLL per death was 33.57 years for males, 47.73 years for females, and 37.06 years overall. The age group with the highest YLL percentage is 20–24 among males (23.55%) and 15–19 among females (33.06%). An increase of 7.8% was observed among males from 2018 to 2021. The mean changes in the overall time trend were found to be significant in male suicides. Among females, there was a 5.3% decrease until 2017, followed by a 4.5% increase from 2017 onwards. Combined, male and female suicide rates have significantly increased since 2017. The financial loss associated with suicide over a 12-year period totaled USD 10,775,943,197 with an annual loss of USD 897,995,266. The premature mortality cost per death was estimated at USD 278,400.84 for men and USD 186,625.16 for women, while the premature mortality cost per YLL was USD 8292.23 for men and USD 3910.36 for women. Conclusions: Changes in the temporal trend of suicide may be associated with societal events. The study reveals that premature deaths due to suicide in Türkiye are a multidimensional public health problem that significantly affects not only individuals but also the overall productivity and economic structure of society. Full article

Incidence of NSSI rises during adolescence and peaks in young adulthood. Secondary school and university students, representing these age groups, have been the focus of research on how emotion regulation strategies impact NSSI. However, a comprehensive study of the interrelations among different symptoms is needed. Research based on network analysis, a questionnaire survey on emotion regulation strategies and NSSI was conducted with 378 secondary school students and 593 first-year university students, all of whom reported a history of engagement in NSSI. The results indicated that Cognitive reappraisal symptoms showed a positive or no correlation with NSSI, while expressive suppression symptoms demonstrated a negative or no correlation. Secondary school and university students using cognitive reappraisal or expressive suppression also tended to use the other type of emotion regulation strategy simultaneously. In secondary school NSSI groups, core symptoms were linked to cognitive reappraisal, while in university groups, they were linked to expressive suppression. Intervention targets for NSSI in secondary school students included “I keep my emotions to myself”, and for university students, “I control my emotions by not expressing them.” Research reveals a complex mechanism underlying the link between NSSI and emotion regulation strategies in university and secondary school students, offering valuable insights for promoting the psychological health of adolescents and youths. Full article

Background/Objectives: Adolescents’ screen time has increased alongside rising rates of depression and suicidal ideation and behavior. This study examined associations between excessive screen time and mental health among U.S. high school students, and explored whether social image factors (overweight perception, sports team participation, and academic performance) mitigate these associations. Methods: We analyzed data from the 2019 Youth Risk Behavior Surveillance System (YRBSS) (N = 13,677). Screen time was categorized as <2, 2–3, ≥4 h per day for television watching and digital device use (excluding school-related use). Multivariate logistic regression analyses estimated adjusted odds ratios (AORs) and 95% confidence intervals (CIs) for associations between screen time and mental health outcomes, adjusting for demographic and social image factors. Results: Overall, 31.7% of students reported using digital devices for ≥4 h per day, compared with 10.2% who watched television for ≥4 h per day. Using digital devices for ≥4 h per day was significantly associated with difficulty concentrating (AOR = 1.68), insufficient sleep (AOR = 1.43), feeling sad or hopeless (AOR = 1.86), and suicidal ideation (AOR = 1.69 for considering suicide; AOR = 1.77 for planning suicide) compared with using digital devices for <2 h per day, after adjusting for demographic and social image factors. Significant associations between television viewing and mental health outcomes appeared to be largely explained by social image factors. Female students and certain racial/ethnic groups were more likely to report mental health difficulties. Students with a positive social image reported lower odds of poor mental health outcomes and excessive screen time. Conclusions: Excessive digital device use is associated with poor mental health and suicidal ideation among high school students, with female students particularly vulnerable. Social image factors were also associated with screen time and mental health outcomes. Interventions that promote school engagement, sports team participation, and a positive social image may help mitigate the adverse effects of excessive screen time. Full article

Background: Free fatal falls (FFF) are a frequent occurrence in forensic medicine. Many variables, such as the victim’s sex, BMI, intoxication, height of the fall, and mental illness, can influence injury patterns. Previous studies identified fracture patterns and frequencies mostly with general anatomical detail, focusing on broad areas. As specific fractures might be roots for new statistical connections, this leaves a gap in our understanding. Using postmortem computed tomography, we aim to establish fracture frequencies and identify possible new statistical connections. Methods: In total, we retrospectively analyzed seventy-nine cases of confirmed deaths due to falls using the database of the Department and Institute of Forensic Medicine in Lublin. Our inclusion criteria were death due to free fall onto hard, non-deformable surfaces. We excluded cases of ground-level falls. All victims must have undergone postmortem computed tomography. Furthermore, each analyzed case documented individual intrinsic variables (sex, age, body mass, height, pre-existing mental conditions, and drug or alcohol use) and extrinsic variables (fall height, landing surface, time between the fall and death, and known cause of the fall). Results: Injuries in free fatal falls tend to focus on the axial skeleton. Suicides experience more severe, bilateral fractures, often involving the pelvis and limbs, while accidents tend to have unilateral injuries with rare limb involvement. We established new correlations with the height of the fall for the maxilla, mandible, anterior and posterior regions of the occipital bone, and the temporal bone. Moreover, our research confirmed previously noted correlations between the height of the fall and fractures of the limbs (and their individual bones), the lumbar vertebrae, and the chest. Conclusions: Our findings highlight that free fatal falls are characterized by distinct skeletal injury patterns that differ between accidents and suicides, with bilateral pelvic and limb fractures being particularly indicative of intentional falls. The integration of PMCT with autopsy improves the detection of these patterns. It provides valuable diagnostic and medico-legal insights, supporting a more precise determination of the cause and manner of death. Full article

Non-suicidal self-injury (NSSI) has become an increasingly salient mental health concern among adolescents, and it commonly co-occurs with depression, anxiety, borderline personality disorder, substance use, and childhood maltreatment, forming a complex psychological risk structure. Despite a growing body of literature, a systematic understanding of the structural links between NSSI and psychiatric comorbidities remains limited. This study uses bibliometric and visualization methods to map the developmental trajectory and knowledge structure of the field and to identify research hotspots and frontiers. Drawing on the Web of Science Core Collection, we screened 1562 papers published between 2005 and 2024 on adolescent NSSI and comorbid psychological problems. Using CiteSpace 6.3.R1, VOSviewer 1.6.20, and R 4.3.3, we constructed knowledge graphs from keyword co-occurrence, clustering, burst-term detection, and co-citation analyses. The results show an explosive growth of research in recent years. Hotspots center on comorbidity mechanisms of mood disorders, the impact of childhood trauma, and advances in dynamic assessment. Research has evolved from describing behavioral features toward integrative mechanisms, with five current emphases: risk factor modeling, diagnostic standard optimization, cultural sensitivity, stratified intervention strategies, and psychological risks in special populations. With big data and AI applications, the field is moving toward dynamic prediction and precision intervention. Future work should strengthen cross-cultural comparisons, refine comorbidity network theory, and develop biomarker-informed differentiated interventions to advance both theory and clinical practice. Full article

(1) Background: With the continuous expansion of graduate education, the mental health of postgraduates has become a growing concern for both academia and society. Understanding how family and institutional resources influence psychological outcomes is critical for developing effective support strategies; (2) Methods: A cross-sectional survey was conducted among 3998 postgraduate students across China, including 3393 master’s students (51.78% female, M = 24.21, SD = 1.521) and 605 doctoral students (37.19% female, M = 27.77, SD = 2.841). Multi-group structural equation modeling was employed to examine how family functioning and supervisor–postgraduate relationships influenced mental health, research self-efficacy, and suicidal tendencies; (3) Results: The findings showed that although most structural relationships were consistent across groups, two critical pathways were nonsignificant at the doctoral stage, providing evidence of partial structural invariance; (4) Conclusions: The study suggests that while family and school support generally play a protective role, their influence varies across educational stages. Tailoring psychological interventions to the distinct needs of master’s and doctoral students is essential, offering both theoretical insights into the dual role of contextual resources and practical guidance for targeted mental health support in graduate education. Full article

Psychiatric illness during childhood and adolescence is a growing concern, placing increased pressure on psychiatric services. Reliance on an evidence-based assessment tool may facilitate the identification and management of symptoms and may facilitate accountability. The purposes for this study were to characterize the psychiatric symptoms of a sample of pediatric patients accessing outpatient psychiatry using the DSM Level 1 Cross-Cutting Measure (CCSM), compare patient and caregiver ratings (CCSM), and explore patients’ acceptability of using the CCSM. The sample consisted of 51 patients (mean age 14 years) and 46 caregivers (mean age 43 years). Patient and caregiver ratings suggested problems with sleep, inattention, depression, irritability/anger, and anxiety. The most common discordance concerned suicide ideation. Most patients (34 of 38) reported that the assessment tool was easy to complete. The CCSM may be a useful, evidence-based, standardized, transdiagnostic assessment tool aligned with the DSM-5 that can be used in a variety of mental health settings to identify symptoms, inform treatment planning, and track progress. Full article

Available reviews of the literature have failed to adequately address research on non-suicidal self-injury (NSSI) that has been conducted in developing countries, with the aim of this study being to systematically review empirical research on NSSI that has been conducted among adolescents and young adults living in countries located on the African continent. Guided by the Joanna Briggs Institute methodology for mixed methods systematic reviews, searches were conducted in six databases—PubMed, Scopus, PsychINFO, African Journals Online, African Index Medicus, and Sabinet African Journals—with searches being conducted from inception to 31 December 2024. These searches identified 33 unique records published in peer-reviewed journals or presented in postgraduate theses during the period 1985 to 2024; with the process of data synthesis identifying three broad analytic themes: the nature of NSSI, risk/protective factors associated with NSSI engagement, and the functions of NSSI. Key findings in relation to these themes: (1) highlight the value of an ethnomedical perspective in cross-cultural research on NSSI, and (2) suggest that the conventional focus on intrapersonal and proximal interpersonal influences on NSSI (in relation to both risk/resilience and NSSI functions) could usefully be extended to include influences emanating from the broader sociocultural context in which individuals are embedded. These findings are discussed in terms of their implications for future research. Full article

Background/Objectives: Nitrous oxide (N₂O), commonly known as laughing gas, is increasingly being used recreationally. While neurological risks are recognized, psychiatric effects remain underexplored. This study investigates neuropsychiatric presentations among patients referred to the Emergency Mental Health (EMH) team at Sunshine Hospital, Melbourne, Australia, associated with recreational N₂O use. Methods: We conducted a retrospective observational review of EMH referrals between August 2020 and July 2024. Inclusion criteria were patients with documented recreational N₂O use within the preceding 12 months. Cases were operationally defined as presenting with either predominantly psychiatric features (psychosis or suicidal ideation/self-harm documented by clinician) or predominantly neurological features (ataxia, paresthesia, pyramidal signs, or other focal deficits). Primary outcomes included type and severity of neuropsychiatric presentation, concurrent substance use, and disposition from the Emergency Department. Results: Of 25 identified patients, 23 met inclusion criteria (12 males, 11 females; mean age 29.3 ± 8.3 years). Psychotic symptoms were reported in 11/23 (47.8%, 95% CI 27.3–69.0) and suicidal ideation or self-harm in 8/23 (34.8%, 95% CI 17.2–55.7). Neurological symptoms, including paraesthesia and ataxia, occurred in 5/23 (21.7%, 95% CI 7.5–43.7). Concurrent substance use was documented in 19/23 (82.6%, 95% CI 61.2–95.0), most frequently cannabis, alcohol, and tobacco. Over half of patients (12/23; 52.2%, 95% CI 30.6–73.2) identified as culturally and linguistically diverse (CALD). Conclusions: Among EMH-referred ED patients, recreational N₂O use is associated with a spectrum of neuropsychiatric presentations, including psychosis, suicidality, and neurological symptoms. These findings reflect clinical associations rather than causal relationships and highlight the need for early recognition, targeted assessment, and appropriate follow-up in high-risk patients. Full article

Objective: Suicide attempts have become one of the most serious problems worldwide in recent years. Suicide attempts are known to be genetically highly associated with serotonin and BDNF in international studies. Methods: In this study, we investigated the association with rs6265 (BDNF), and rs11030101 (BDNF), rs3813034 (Serotonin Transporter, SLC6A4) rs4680 (TPH1), rs1800532 (TPH1), rs1386493 (TPH2), rs6311 (HTR2A), rs6313 (HTR2A), rs6314 (HTR2A), rs6296 (HTR1B), gene polymorphism in Korean suicides with major depressive disorder who visited the emergency room. Results: A case-control study was conducted with 226 suicide and suicide attempts with major depressive disorder and 1469 general controls, and genotypes were determined by PCR-RFLP method. Significant associations between the rs11030101 (BDNF) genotype and suicide/suicide attempters were confirmed (OR 0.44, 95% CI 0.23–0.84, p = 0.0004), and significant associations between the rs11030101 (BDNF) allele and suicide/suicide attempters were confirmed (OR 0.63, 95% CI 0.50–0.80, p = 0.0002), in addition to the recessive genotype (OR 0.55, 95% CI 0.29–1.03, p = 0.03) and overdominant genotype (OR 0.66, 95% CI 0.49–0.88, p = 0.0046). Also, significant associations between the rs3813034 (SLC6A4) recessive genotype and suicide/suicide attempts were confirmed in the study results (OR 2.03, 95% CI 1.12–3.68, p = 0.028). After correction for multiple testing, none of the serotonin-related polymorphisms displayed any significant case–control differences. Conclusions: The BDNF gene may influence suicide attempts in Korean patients with major depression who have performed a suicide attempt. Replication in larger studies and other populations is needed. Full article

Castration-resistant prostate cancer (CRPC) remains difficult to treat with conventional chemotherapy. We evaluated a stem cell-based enzyme-prodrug strategy using hTERT-immortalized adipose-derived stem cells engineered to express rabbit carboxylesterase 2 (hTERT-ADSC.CE2) in combination with irinotecan (CPT-11). hTERT-ADSC.CE2 cells were generated via lentiviral transduction and confirmed to overexpress CE2. Their tumor-homing capacity toward PC3 prostate cancer cells was assessed, along with prodrug activation, apoptosis induction, and in vivo tumor suppression in a CRPC mouse model. hTERT-ADSC.CE2 cells demonstrated enhanced migration toward PC3 cells and higher expression of tumor-homing factors than the controls. Under CPT-11, they exhibited a strong “suicide” effect and induced selective killing of PC3 cells, with upregulation of BAX and cleaved caspase-3 and downregulation of BCL-2. By day 14, the combination arm showed significantly lower tumor burden than both the control and irinotecan-alone arms (p < 0.05). The pattern is consistent with intratumoral activation and localized SN-38 exposure. hTERT-ADSC.CE2 combined with irinotecan provides potent, tumor-targeted cytotoxicity and markedly suppresses CRPC progression. This cell-mediated prodrug activation system may represent a promising therapeutic approach for advanced prostate cancer. Full article

Background: During adolescence, the brain is undergoing anatomical and physiological maturation processes with changes to cognitive development. However, in adolescents with phenylketonuria (PKU), executive function and mental health are adversely affected by high blood phenylalanine (Phe) levels. Objectives: We aim to describe clinical outcomes in adolescents with PKU. Methods: Cross-sectional questionnaires were performed on quality of life (EuroQol “EQ-5D-5L” questionnaire), anxiety and depression (Hospital Anxiety and Depression Scale- HADS) and food neophobia in a single PKU centre. Retrospective data on metabolic control (previous 12 months) and medical history, and current data on anthropometry, dietary treatment, and comorbidities were collected. Results: In total, 33 adolescents with PKU participated with a mean age of 13.5 ± 1.3 y (16 boys, 17 girls). All were on a Phe restricted diet, with 3 also prescribed sapropterin. Questionnaires were self-completed by n = 25/33 (76%) adolescents. A mean of 36 ± 26 blood Phe spots were performed over 12 months. There was a mean of 83% of blood Phe < 600 µmol/L and 49% < 360 µmol/L. In total, 39% (n = 13/33) of adolescents were overweight/obese, 18% (n = 6/33) overweight and 21% (n = 7/33) obese. Medical history documented mental health disorders (anxiety/depression) in 7 cases, low mood, suicidal thoughts and self-harming in 5, and neuro diversity in 4 (autism and/or attention-deficit hyperactivity disorder (ADHD). In the HADS questionnaire, 12% (n = 3/25) of adolescents scored borderline abnormal for anxiety and 12% (n = 3/25) abnormal for depression. Mean anxiety scores for females were almost twice as high compared to males. No significant correlation was found between blood Phe and anxiety/depression scores. However, higher Phe levels showed a trend towards reduced enjoyment and emotional responsiveness, including lower scores on measures of pleasure, cheerfulness, and emotional reactivity. Although not statistically significant, these findings suggest a potential subtle association between poorer metabolic control and mood disturbances in adolescents with PKU. No food neophobia was identified in our study. Conclusions: Adolescents with PKU presented with high levels of depression and anxiety. Long term studies focusing on quality of life and neurocognition even when achieving the PKU European guidelines are necessary. Different therapeutic options are needed to improve the outcome of patients with PKU. Full article