Search Results (3,264)

Background/Objectives: (P)rehabilitation, comprising structured exercise, nutritional optimisation, and/or psychological support delivered pre- or postoperatively, has demonstrated efficacy in improving outcomes across the cancer care continuum. However, access remains limited. Technology-enabled (p)rehabilitation offers a novel solution with the potential to enhance equity and continuity of care. This systematic review aimed to evaluate the efficacy of technology-enabled (p)rehabilitation on perioperative and patient-reported outcomes among individuals undergoing thoracic and/or abdominopelvic cancer surgery. Methods: Six databases were search from inception to October 2024. Eligible studies were randomised controlled trials (RCTs) comparing technology-enabled (p)rehabilitation with usual care, placebo, or non-technology-based interventions in adults undergoing thoracic and/or abdominopelvic cancer surgery. Outcomes included postoperative complications, hospital readmissions, hospital length of stay (LOS), quality of life (QoL), pain, anxiety, depression, fatigue, distress, and satisfaction. Higher scores indicated improved QoL or worse symptom severity. Risk of bias was assessed using the revised Cochrane tool, and evidence strength was determined using GRADE methodology. Relative risks (RR) and mean differences (MD) were calculated using random-effects meta-analysis. Results: Seventeen RCTs (18 publications, n = 1690) were included. Trials most commonly evaluated application-based platforms (n = 8) and the majority exhibited some risk of bias. Technology-enabled (p)rehabilitation was associated with a significant reduction in LOS (MD = 1.33 days; 95% CI: 0.59–2.07; seven trials), and improvements in pain (MD = 6.12; 95% CI: 3.40–8.84; four trials), depression (MD = 2.82; 95% CI: 0.65–4.99; five trials), fatigue (MD = 10.10; 95% CI: 6.97–13.23; three trials) and distress (MD = 1.23; 95% CI: 0.30–2.16; single trial) compared with controls. Conclusions: Technology-enabled (p)rehabilitation shows promise in reducing LOS and improving selected patient-reported outcomes following thoracic and abdominopelvic cancer surgery. Although evidence is limited due to the small number of studies, modest sample sizes, methodological heterogeneity, and intervention variability, the overall findings justify further investigation. Large-scale, adequately powered clinical trials are required to confirm efficacy and guide clinical effectiveness and implementation studies. Full article

Introduction: Patients with colorectal cancer who undergo ileostomy surgery confront multifaceted challenges that significantly impact their daily lives and cause symptoms of anxiety and depression. The aim of this study was to explore the anxiety and depression experienced by colorectal cancer patients undergoing ileostomy with three assessments. Materials and Methods: This longitudinal study included 96 patients with newly diagnosed colorectal cancer who underwent scheduled ileostomy surgery at two public hospitals in Attica. The Hospital Anxiety and Depression Scale (HADs) was used, which included patients’ characteristics. Measurements were collected at three distinct time points: preoperatively (Time 1), postoperatively between the 12th and 14th day (Time 2), and after stoma closure, approximately one year later (Time 3). Statistical analysis was performed using the SPSS 26.0 statistical package and the statistical significance level was set at p < 0.05. Results: The proportion of participants reporting moderate levels of anxiety (scores 8–10) was 15.6% at Time 1, which increased to 27.1% at Time 2, and had a slight increase to 28.1% at Time 3. The increase was statistically significant between Time 1 and Time 2 and at Time 1 and Time 3 (p < 0.001). Regarding high levels of anxiety (scores >11), the percentage of affected individuals increased from 13.5% at Time 1 to 17.7% at Time 2 and reached 15.6% at Time 3. The comparison between Time 1 and Time 2 revealed a statistically significant increase (p = 0.016), while the subsequent decrease between Time 2 and Time 3 was not statistically significant (p = 0.508). In terms of depression, at Time 1, 84.4% of patients had low depression, which decreased significantly to 56.3% at Time 2 and 39.6% at Time 3 (p < 0.001 for all comparisons). The percentage of patients who were moderately depressed at Time 1 was 9.4%; this percentage increased significantly to 32.3% at Time 2 and remained high, reaching 29.2% at Time 3. Finally, the proportion of patients who had high levels of depression at Time 1 was 6.3%, a figure that rose to 11.5% and 31.3% for Time 2 and Time 3, respectively. Conclusions: Anxiety and depression experienced by colorectal cancer patients undergoing ileostomy surgery escalate postoperatively and remain at high levels after ileostomy closure. Understanding these mental health challenges is crucial for providing comprehensive patient care. Further research is needed on the early recognition and management of these emotional difficulties, which are key elements of holistic oncology care. Full article

Practical training and recruitment strategies are critical for the sustainable implementation of psychosocial interventions. However, few studies have examined how to prepare community partners and doctoral students to support culturally adapted psycho-oncology interventions. This pre-pilot study aims first to evaluate two distinct training programs and recruitment procedures, and second to explore preliminary pre-post outcomes of the Caregiver-Patients Support to Cope with Advanced Cancer (CASA) intervention, using the Consolidated Framework for Implementation Research (CFIR). Three clinical psychology graduate students received CASA training, and two community partners completed Recruitment training. We present descriptive pre- and post-assessments, along with qualitative feedback, for both training and institutional (Puerto Rico Biobank) and community-based recruitment outcomes. A related-samples nonparametric analysis examined pre- and post-CASA intervention signals. Results indicated knowledge gains among doctoral students (pre-test M = 3.3; post-test M = 9.3) and community partners (pre-test M = 4.5; post-test M = 9.5). Preliminary outcomes revealed significant improvements in spiritual well-being (Z = −2.618, p = 0.009) and quality of life (Z = −2.957, p = 0.003) and a reduction in depressive (Z = −2.764, p = 0.006), anxiety (Z = −2.667, p = 0.008), and distress (Z = −2.195, p = 0.028) symptoms following CASA. Of 26 recruited dyads, institutional referrals enrolled 16 dyads (61.5%), while community partners referred 10 dyads with a 90.9% success rate. Findings support the feasibility of both training and CASA exploratory outcomes suggest meaningful psychosocial benefits for Latino dyads coping with advanced cancer. Combining institutional infrastructure with community engagement may enhance sustainability and equitable access to psycho-oncology care. Full article

Background and Objectives: Bladder cancer (BC) represents a significant global health burden, ranking as the tenth most commonly diagnosed malignancy worldwide, with an incidence rate of 5.6 per 100,000 person-years annually. The research team aimed to summarize evidence on specialized nursing-led interventions for bladder cancer management across the disease continuum. Materials and Methods: This scoping review used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) methodology to search four databases from January 2018 to November 2025. Results: This concise but informative scoping review of 20 studies revealed substantial clinical and patient-reported benefits from specialized nursing interventions. Enhanced recovery after surgery (ERAS) protocols incorporating structured nursing care demonstrated a 35% reduction in postoperative complications. Integrated nursing interventions during postoperative intravesical therapy significantly improved patient satisfaction, treatment compliance, and self-efficacy while reducing anxiety and depression. Digital health platforms, including internet-based and mobile applications, proved effective in reducing caregiver burden, enhancing disease knowledge, and improving coping strategies. Preoperative stoma education and postoperative ostomy care management significantly improved self-efficacy, stoma care knowledge, and overall health-related quality of life. Psychosocial interventions, including cognitive behavioral therapy and mindfulness-based approaches, demonstrated significant improvements in quality of life and reductions in fear of recurrence, depression, and anxiety. However, a critical evidence gap exists regarding bladder cancer-specific mental health interventions. Conclusions: Specialized nursing-led care plays a critical role in strengthening clinical and assistive practice in bladder cancer. Evidence from this scoping review shows that nursing-led interventions significantly improve clinical outcomes, patient satisfaction, symptom management, and quality of life across all phases of bladder cancer care while reducing caregiver burden and enhancing psychological well-being for both patients and families, reinforcing the value of integrating specialized nursing roles into routine bladder cancer management. Full article

Background/Objectives: Nurses are susceptible to compassion fatigue due to the nature of their professional responsibilities. Factors contributing to this vulnerability include daily patient interactions and organizational elements within their work environment, as well as work-related stress and sociodemographic characteristics, including age, marital status, years of professional experience, and, notably, gender. This research investigates the relationship between compassion fatigue and the levels of anxiety and depression, as well as the professional quality of life among nurses providing care to dementia patients in Greece. Methods: A cross-sectional survey was carried out with 115 nurses working in dementia care centers in Greece. The Hospital Anxiety and Depression Scale (HADS), the Professional Quality of Life Scale (ProQOL-5), and the participants’ personal, demographic, and professional information were all included in an electronic questionnaire. Multiple regression analysis was used. Results: A total of 42.6% of nurses rated their working environment as favorable. Additionally, 23.5% of the sample exhibited high levels of compassion satisfaction, whereas 46.1% demonstrated low levels of burnout. Female gender (p = 0.022) and a higher family income (p = 0.046) was positively associated with compassion satisfaction. Regression analysis indicated that elevated symptoms of anxiety and depression were found to correlate with decreased compassion satisfaction, increased burnout, and heightened secondary post-traumatic stress. Conclusions: Engaging in the care of patients with dementia, particularly throughout the pandemic period, has underscored a pronounced susceptibility to compassion fatigue, physical fatigue, pain, psychological stress, and a reduced quality of life. These results highlight the importance for nursing management to adopt specific organizational measures, including proper staffing levels, balancing workloads, and conducting routine mental health assessments. Full article

Introduction: The COVID-19 pandemic had significant effects on mental health and lifestyle behaviours, especially among university students who experienced academic disruptions, social isolation, and fewer social interactions. Alcohol consumption has long been part of student culture. Still, the influence of post-pandemic academic reintegration on drinking patterns and psychological distress remains relatively unexplored, particularly in countries like Portugal, where student traditions heavily shape consumption habits. This study aimed to describe the prevalence of alcohol consumption, depression, anxiety, and stress in a sample of Portuguese university students during the post-pandemic academic period, and to explore associations with sociodemographic variables. Methods: A cross-sectional study was conducted in November 2021 with 90 students from a private higher education institution in northern Portugal. Data were collected via an online questionnaire including sociodemographic information, the Alcohol Use Disorders Identification Test (AUDIT), and the Depression, Anxiety and Stress Scale (DASS-21). Result: The majority of the participants were not at risk of alcohol addiction (95.3%). In total, 15.1% of students reported anxiety symptoms ranging from severe to extremely severe. A binomial logistic regression was performed to ascertain the effects of being away from home and psychological distress (DASS-42 score), on the likelihood that participants were at risk of alcohol addiction (Level 3 and 4 in the AUDIT scale). The logistic regression model was statistically significant, χ²(2) = 9.20, p = 0.010. Living away from home was associated with a substantially lower likelihood of high-risk status (B = −2.79, p = 0.034), corresponding to an odds ratio of 0.06, indicating a strong protective effect. DASS-42 total score was positively associated with high-risk status (B = 0.04, p = 0.039), such that higher psychological distress increased the odds of being classified as high risk. Conclusions: The findings reveal a low prevalence of alcohol risk but heightened symptoms of anxiety, depression, and stress. Psychological distress notably increases the likelihood of hazardous alcohol use, emphasising the importance of targeted mental health and alcohol-use interventions among university students. Full article

Background/Objectives: This umbrella review critically evaluates the available evidence on psychobiotics for depressive and anxiety symptoms, emphasizing methodological quality, consistency of findings, and persistent gaps in the literature. Methods: A comprehensive search was conducted across PubMed/MEDLINE, Scopus, Web of Science, SciELO, Cochrane, and EBSCO (May–June 2025) to identify systematic reviews with meta-analyses of randomized controlled trials examining probiotic, prebiotic, and synbiotic interventions in adults with depressive and/or anxiety symptoms or diagnoses. Two reviewers independently screened studies, extracted data, and evaluated methodological quality using AMSTAR-2. Additional bibliometric, conceptual, and psychometric features were mapped, including geographical origin, publication timeline, scale distribution, and citation-based connectivity. Results: Thirty systematic reviews and meta-analyses were included. Methodological quality was predominantly moderate, low, or critically low in 76.6% of reviews. Probiotic interventions demonstrated consistent benefits for MDD (SMD = −0.50 [95% CI: −0.58 to −0.42], p = 0.0001). However, findings for anxiety were markedly inconsistent, despite the modest improvements in specific subgroups (SMD = −0.19 [95% CI: −0.28 to −0.10]; p < 0.01). Prebiotics for MDD interventions showed limited positive results (SMD = −0.25 [95% CI: −0.47 to −0.03]; p = 0.03). For anxiety, the effects are inconclusive (SMD = −0.07 [95% CI: −0.30 to 0.10]; p = 0.18). Evidence for synbiotics was scarce. Citation-mapping revealed a fragmented and unevenly connected evidence base. Conclusions: The current evidence suggests that probiotics may confer beneficial effects on depressive and anxiety symptoms; however, the same cannot be said for prebiotics and synbiotics. Evidence for the efficacy of prebiotics and synbiotics to treat depression and anxiety is still insufficient or heterogeneous. Registration: CRD420251164884. Full article

Background/Objectives: Parkinson’s disease is the second most common neurodegenerative disorder, affecting patients’ daily lives in multiple domains, including functional status, health-related quality of life, and psychological well-being. This study examined the relationship between self-reported global activity level, functional status, Health Related QoL (HRQoL), and psychological state among patients with Parkinson’s disease in Greece. Methods: Thirty volunteers (mean age = 69.07, SD = 11.24), members of the Greek Parkinson’s Patients and Caregivers Association, completed (a) the Parkinson’s Disease Questionnaire to evaluate HRQoL and (b) the Hospital Anxiety and Depression Scale (HADS) to assess psychological state. Participants then performed (a) the Five Times Sit to Stand Test (FTSST) and (b) the Berg Balance Scale (BBS) to evaluate functional status. All questionnaires and the test used in the present study have been validated in Greek. Correlation analysis with Spearman r tests with Bonferroni correction was performed between the above variables. Subsequent linear regression models were used to identify independent predictors of HRQoL and balance using SPSS 29.0.2.0. Results: Participants reported elevated anxiety (M = 9.67, SD = 4.44) and depressive symptoms (M = 8.97, SD = 4.08), alongside relatively high HRQoL scores (M = 40.09, SD = 18.40). Impaired functional performance was observed, with 22 participants failing to complete the FTSST within 16 s and 16 scoring below 40 on the BBS. Functional status was strongly correlated with HRQoL (r = −0.696, p < 0.001) and activity level (r = −0.521, p < 0.008). Depression was also significantly associated with poorer HRQoL (r = 0.618, p < 0.008) and lower activity levels (r = −0.545, p < 0.008). Regression analyses revealed that balance (β = −0.526), disease duration (β = 0.437), anxiety (β = 0.411), and lower limb function (β = −0.351) were significant independent predictors of HRQoL (R² = 0.785; F(9, 20) = 12.69; p < 0.001), while HRQoL (β = −0.738) and lower limb function (β = −0.391) independently predicted balance (R² = 0.699; F(9, 20) = 4.72; p = 0.002), suggesting a bidirectional relationship between physical function and subjective well-being. Conclusions: Activity level, HRQoL, functional status, and psychological state in patients with Parkinson’s disease are interrelated factors. Increased levels of anxiety and depression, as well as reduced HRQoL, were observed. The findings point to a potentially reinforcing cycle between poor balance and diminished quality of life, with anxiety and age playing key roles. Overall, the results illustrate that functional, psychological, and HRQoL measures interact in complex ways, emphasizing the multidimensional profile of patients with Parkinson’s disease. Further studies with larger samples are required to confirm these findings. Full article

Background/Objectives: Hidradenitis suppurativa (HS) is a chronic, inflammatory, and recurrent disorder of the pilosebaceous unit with numerous comorbidities. Growing evidence suggests that depression and anxiety occur more frequently in HS patients, yet their relationship with clinical severity and especially subjective symptoms remains insufficiently understood. The aim of this study was to assess the prevalence and severity of probable depressive and anxiety symptoms in Polish patients with HS and to examine their associations with clinical disease severity, pain and itch intensity, and quality of life (QoL). Methods: Eighty-four HS patients were included in this cross-sectional study. Disease severity was assessed using Hurley staging and the IHS4. Pain and itch intensity were evaluated using the Numeric Rating Scale (NRS). Psychological assessment included self-administered screening questionnaires, such as PHQ-9 and HADS-D for depression and GAD-7 and HADS-A for anxiety. QoL was measured using DLQI and HiSQOL instruments. Statistical analyses were performed with p < 0.05 considered significant. Results: Possible depressive disorders were identified in 25.0% of patients. PHQ-9 and HADS-D scores differed significantly across Hurley stages and correlated positively with IHS4. Possible anxiety disorder according to GAD-7 criteria was present in 15.5% of patients. Both GAD-7 and HADS-A correlated with IHS4. They also showed correlations with pain and/or itch intensity. All psychological measures showed strong correlations with both QoL instruments. Conclusions: Depression and anxiety seem to be common in HS and closely associated with clinical severity and reduced QoL. Their relation with pain and itch requires further studies. These findings underscore the need for multidisciplinary management in HS care. Full article

Background/Objectives. Chronic benzodiazepine (BDZ) use is frequently maintained beyond recommended durations due to neuroadaptation, psychological dependence, and withdrawal-related issues. Passiflora incarnata L., herba (P. incarnata) has shown anxiolytic and GABAergic activity that may mitigate withdrawal symptoms, while cognitive-behavioural therapy (CBT) targets maladaptive beliefs and behaviours sustaining BDZ misuse. This study investigates the independent and interactive effects of P. incarnata and CBT on BDZ dose reduction during a three-month tapering program. Methods. This retrospective observational study included 186 outpatients with anxiety or depressive disorders in clinical remission undergoing BDZ tapering, of whom 93 received a dry extract of P. incarnata as adjunctive treatment and 93, matched for diagnosis, age and sex, followed a standard tapering protocol. BDZ doses were assessed at baseline and three months. CBT was recorded as a binary variable based on the information documented in the medical records. An ANCOVA was performed to assess the impact of CBT and P. incarnata on BDZ reduction (change in mg diazepam equivalents), adjusting for sex, age, education, baseline anxiety and depression scores, initial BDZ and antidepressant dosage. A subgroup analysis was conducted to investigate the role of P. incarnata dosage in BDZ reduction. Results. Both CBT and P. incarnata were associated with significantly greater reductions in BDZ dosage at three months (CBT: p = 0.005, effect size: 0.032; P. incarnata: p < 0.001, effect size: 0.128). A significant interaction between CBT and P. incarnata was also observed (p = 0.037, effect size: 0.018), indicating a synergistic effect when both interventions were combined. Baseline sociodemographic characteristics, BDZ and antidepressant dosage and symptom severity did not differ significantly between groups. Patients taking 400–600 mg of P. incarnata dry extract showed a higher BDZ reduction compared to those taking 200 mg. Conclusions. These findings suggest that P. incarnata and CBT exert independent yet complementary effects in supporting BDZ tapering. Their combination appears to enhance dose reduction beyond either intervention alone, supporting a multimodal approach that addresses both neurobiological and psychological components of BDZ addiction. Prospective controlled studies are needed to confirm these results and to clarify their impact on long-term discontinuation outcomes. Full article

Background and Objectives: Atopic dermatitis and psoriasis are life-long inflammatory diseases affecting more than just the skin. Although their link with mental comorbidities has been established, the role of using self-assessment questionnaires is still debated. The aim of our study was to evaluate differences in the quality of life (DLQI) as well as depression (PHQ-9) and anxiety (GAD-7) questionnaire data and determine their link with individual patient and skin disease factors. Materials and Methods: Demographic, clinical and questionnaire data were collected from Riga 1st hospitals archive. For statistical evaluation, the Mann–Whitney U test and Spearman’s rank correlation coefficient were used. Results: The median DLQI for atopic dermatitis and psoriasis was 10.5 and 10, respectively. The prevalence among women with atopic dermatitis who had a PHQ-9 ≥ 10 was 42.9%, compared to 50.0% in men, and GAD-7 ≥ 10 prevalence was 14.3% and 20.0%, respectively. Psoriatic women had a PHQ-9 ≥ 10 prevalence of 25.0% compared with 28.9% in men. The prevalence of GAD-7 ≥ 10 was 20.0% in females and 15.8% in males. GAD-7 score was elevated in patients with psoriatic genital involvement. Multiple positive correlations were noted between PHQ-9, GAD-7 and DLQI scores. Conclusions: Patient quality of life and prevalence of anxiety and depression symptoms are impacted by psoriasis and atopic dermatitis, with similar patterns observed across genders and comorbidities. Genital involvement could be associated with more severe anxiety symptoms. The correlations between PHQ-9, GAD-7 and DLQI scores indicate that further evaluation might be necessary if quality of life is impaired. Full article

Background/Objectives: Single-sided deafness (SSD) impairs speech perception, reduces spatial hearing, decreases quality of life, and is frequently accompanied by tinnitus. Cochlear implantation (CI) has become an established treatment option, but long-term prospective evidence across multiple functional and psychological domains remains limited. This study investigated auditory performance, subjective hearing outcomes, tinnitus burden, and psychological well-being over a two-year follow-up in a large SSD cohort. Methods: Seventy adults with SSD underwent unilateral CI. Assessments were conducted preoperatively and at 6 months, 1 year, and 2 years postoperatively. Outcome measures included the Freiburg Monosyllable Test (FS), Oldenburg Inventory (OI), Nijmegen Cochlear Implant Questionnaire (NCIQ), Tinnitus Questionnaire (TQ), Perceived Stress Questionnaire (PSQ), Generalized Anxiety Disorder scale (GAD-7), and General Depression Scale (ADS-L). Longitudinal changes were analyzed using Wilcoxon signed-rank tests with effect sizes; Holm-adjusted p-values were applied for baseline-to-follow-up comparisons. Results: Speech perception improved markedly within the first 6 months and remained stable through 2 years, with large effect sizes. All OI subdomains demonstrated early and sustained improvements in subjective hearing ability. Several hearing-related quality-of-life domains assessed by the NCIQ, particularly social interaction, self-esteem, and activity participation, showed medium-to-large long-term improvements. Tinnitus severity decreased substantially, with marked reductions observed by 6 months and maintained thereafter; the proportion of tinnitus-free patients increased at follow-up, although tinnitus symptoms persisted in a substantial subset of participants. Perceived stress was reduced initially at the early follow-up and remained below baseline thereafter. Anxiety and depressive symptoms mostly stayed within nonclinical ranges, showing no lasting changes after adjusting for multiple comparisons. Conclusions: In this prospective cohort, cochlear implantation was associated with durable improvements in auditory outcomes, tinnitus burden, and selected patient-reported quality-of-life domains over two years. Although significant functional and patient-centered improvements were noted, persistent tinnitus and diverse psychosocial outcomes underscore the need for personalized counseling and comprehensive follow-up that incorporate patient-reported outcomes and psychological assessments. Full article

Background/Objectives: Socioeconomic stressors, such as financial strain, rising living costs, and perceived price burden, have gained relevance in the post-pandemic period and may adversely affect adolescent mental health. This study examined the association between subjective financial stress and symptoms of depression, anxiety, and emotional/behavioral difficulties among adolescents in Northern Italy. Methods: Data were obtained from the 2025 Corona and Psyche South Tyrol (COP-S) population survey. A total of 2554 adolescents aged 11–19 years and their parents participated; 1598 adolescents provided complete data for analyses of socioeconomic stressors (parent-reported Family Affluence Scale III, adolescent self-reported and parent proxy and self-reported burden due to price increases). Mental health outcomes included depressive symptoms (PHQ-2), generalized anxiety (SCARED-GAD), and emotional/behavioral difficulties (SDQ). Associations were assessed using chi-square tests, Kendall’s tau correlations, and two-factor ANOVA models. Results: Elevated depressive symptoms were present in 10.7% of adolescents, emotional/behavioral difficulties in 13.9%, and anxiety symptoms in 27.9% of adolescents. Female adolescents consistently showed higher symptom levels in all domains. Self-reported financial burden was the strongest and most consistent correlate of mental health problems, demonstrating small-to-moderate positive correlations with depressive symptoms (τ = 0.20, p < 0.001), emotional/behavioral difficulties (τ = 0.14, p < 0.001), and anxiety (τ = 0.25, p < 0.001). Parent-reported burden showed weaker and less consistent associations, and the Family Affluence Scale III was not significantly related to any of the mental health outcomes. ANOVA models indicated that adolescents’ own perception of financial burden significantly predicted anxiety levels in both age groups (11–14 and 15–19 years), whereas discrepancies between adolescent and parent burden perceptions were particularly relevant among younger adolescents. Conclusions: In this affluent European region, subjective financial strain, especially adolescents’ perception of burden due to rising prices, is a stronger determinant of depressive symptoms, anxiety, and psychosocial difficulties than parental burden reports or structural affluence indicators. Adolescents, especially females, appear to be particularly vulnerable. These findings underscore the importance of addressing subjective financial stress in adolescent mental health and public health strategies. Full article

The rapid expansion of mindfulness research has generated both enthusiasm and controversy regarding its actual clinical value. While meditation is often regarded as the central mechanism of mindfulness-based interventions, other components such as psychoeducation and informal practice may play an equally significant role in improving mental health outcomes. This critical review examines the relative contributions of these elements to the therapeutic impact of mindfulness and clarifies the extent to which its effects are comparable to established treatments, particularly Cognitive Behavioral Therapy (CBT). Evidence from meta-analyses and high-quality trials indicates that mindfulness programs achieve moderate efficacy in reducing symptoms of anxiety, depression, and stress, but effect sizes are frequently inflated by methodological limitations. Importantly, cognitive and emotional regulation skills, especially acceptance and non-judgment, appear to sustain long-term benefits more consistently than meditation alone. These findings highlight the need for rigorous longitudinal studies and component-focused designs to identify the mechanisms that drive clinical change. By distinguishing between evidence-based applications and overstated claims, this review contributes to a more balanced understanding of mindfulness and its appropriate integration into healthcare. Full article

Suicide in children and young adults is a leading cause of premature mortality, and there is a need to develop a more profound understanding of the factors that contribute to these deaths. This study is part of the nationwide Retrospective Investigation of Health Care Utilization in Individuals who died by Suicide in Sweden 2015, conducted at Lund University, Sweden. The aim was to examine symptoms and diagnoses in children and young adults who died by suicide, as documented in their medical records at their last visits for primary care, somatic specialist care, or psychiatric care 24 months prior to suicide, and to apply contemporary psychological research in youth suicidality to the findings to formulate clinical implications. The proportions of symptoms and diagnoses in children (0–17 years), young adults (18–24 years), males, and females are described. The main symptoms noted in the cohort were depressive symptoms (28%), anxiety symptoms (26%), and pain (25%). The diagnoses predominately covered mental and behavioural disorders, and the most frequent of the mental and behavioural diagnoses were neurotic, stress-related, and somatoform disorders (32%) and mood (affective) disorders (29%). The diagnoses and symptoms were not sufficient to uncover suicidality in children and young adults. The clinical implications for alternative assessments and preventive interventions are discussed. Full article