Search Results (4,655)

Background/Objectives: Lung cancer is increasingly recognized in young adults, but data specific to patients younger than 30 years remain scarce. We aimed to characterise the clinicopathological features, molecular profiles, and survival outcomes of lung cancer in adults younger than 30 years. Methods: A retrospective cohort study was conducted at the Department of Respiratory Disease, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China. Patients aged 18 to 30 years with pathologically confirmed primary lung cancer, admitted between August 2011 and October 2021, were identified from the pathology and oncology databases of the study centre; eligibility and exclusion criteria and the resulting analytic cohort are summarized below (a screened/excluded patient count could not be reconstructed retrospectively; see Limitations). Demographics, histology, stage (eighth-edition TNM), driver mutations, and treatment were extracted, and the extent of missing data for each variable was assessed. Molecular testing was not performed prospectively for this study; rather, we report driver-mutation results that had already been generated as part of routine clinical care for patients in whom testing was clinically indicated and archived tissue was available. Overall survival (OS) was estimated using the Kaplan–Meier method and compared using the log-rank test; hazard ratios (HRs) were derived from univariate Cox regression and are reported as exploratory/descriptive given the non-randomized comparison (see Discussion). Results: Among 139 patients meeting eligibility criteria, the cohort was predominantly female (65.5%) and most individuals were never-smokers (92.8%), with adenocarcinoma predominating (93.5%). Stage I (61.2%) and stage IV (30.2%) were most common. Of 34 patients (24.5%) with available molecular testing results, 23 (67.6%) carried a driver mutation, of whom 19 (82.6%) had stage IV disease. Among mutation-positive patients—drawn from a selectively tested subcohort enriched for advanced-stage disease—ALK rearrangement was most frequent (13; 56.5%). In the stage IV subgroup, patients who received first-line tyrosine kinase inhibitors (TKIs) had a longer observed OS than those who did not (median, 88 vs. 24 months); this exploratory, non-randomized comparison is reported descriptively rather than as an adjusted treatment-effect estimate (see Limitations). Conclusions: In this single-centre retrospective cohort, adults aged <30 years with lung cancer were predominantly female never-smokers with adenocarcinoma. Among the selectively tested advanced-stage subgroup, ALK fusions were common. These data justify further multicentre study and broader contemporary molecular characterisation. Full article

Biodegradable magnesium (Mg)-based implants represent a paradigm shift in orthopedic biomaterials, offering temporary mechanical support, inherent osteogenic bioactivity, and elimination of hardware removal surgery. These properties are particularly attractive for sports orthopedic applications, including anterior cruciate ligament (ACL) reconstruction, rotator cuff repair, meniscal fixation, and osteochondral fragment refixation, where young, active patients demand rapid return to function and where permanent metallic hardware poses long-term risks of stress shielding, imaging artifact, and reoperation. Despite extensive preclinical evidence demonstrating that Mg-based interference screws promote fibrocartilaginous enthesis regeneration, attenuate peri-tunnel bone loss, and achieve biomechanical fixation comparable to titanium, no human clinical trial has yet evaluated Mg fixation devices for soft-tissue reconstruction in sports medicine. Meanwhile, clinical fracture fixation data from over 468 patients across multiple trials and a meta-analysis confirm complication rates equivalent to those of titanium. This narrative review synthesizes the current evidence on Mg alloy design, surface engineering strategies, preclinical sports medicine applications, clinical translation in fracture fixation, imaging compatibility, and the remaining barriers to clinical adoption in sports orthopedic surgery. By mapping the translational gap between promising animal data and the absence of clinical sports medicine trials, this review aims to guide future research priorities and accelerate the pathway toward clinical application of Mg-based devices in sports orthopedics. Full article

Background/Objectives: Urinary tract infection (UTI) is among the most common serious bacterial infections occurring in the first 90 days of life and a leading indication for parenteral antibiotic therapy. Despite its clinical importance, no randomized trial has compared empiric antibiotic regimens, route of administration, or treatment duration specifically in this population. This review synthesizes current evidence to support rational antibiotic treatment decisions for neonates (ages 0–28 days) and young infants (ages 29–90 days), including those born prematurely. Methods: A targeted PubMed and MEDLINE search was conducted through July 2026. Studies reporting treatment outcomes, pharmacokinetic data, or antibiotic safety in infants aged 0–90 days were included. Broader pediatric data were incorporated where age-specific evidence was unavailable and are presented with explicit population caveats. Results:Escherichia coli is the predominant uropathogen across all age strata; extended-spectrum beta-lactamase (ESBL)-producing organisms account for a clinically important minority of community-acquired isolates. No comparative trial of empiric regimens existed for confirmed UTI in this age group. Shorter intravenous courses were not associated with higher 30-day recurrence rates for either nonbacteremic or bacteremic UTI after exclusion of meningitis. Intravenous-to-oral (IV-to-oral) transition with amoxicillin–clavulanate was pharmacokinetically supported and clinically safe in selected term neonates, based on indirect evidence from neonatal infection trials. Non-carbapenem therapy is appropriate for ESBL UTI without concomitant bacteremia in clinically improving infants. Exclusion of meningitis before shortening intravenous therapy or initiating oral step-down is essential, particularly in neonates ≤ 28 days of age. Conclusions: Short parenteral courses with timely transition to oral antibiotics are recommended in appropriately selected infants with UTI, consistent with antimicrobial stewardship principles and supported by observational evidence. The evidence base is limited, with key gaps in empiric regimen selection, management of premature infants, ESBL treatment in bacteremic patients, and optimal duration of parenteral and oral antibiotic therapy. Full article

Body mass index (BMI) does not capture fat distribution or muscle–fat heterogeneity, so adverse patterns go undetected. We present a methodological framework—not a validated prediction tool—combining three laboratory-free constructs: an Office-Based Framingham cardiovascular risk score, a modified proxy-based FINDRISC, and a direct segmental multi-frequency bioelectrical impedance analysis (DSM-BIA)-derived Metabolically Unhealthy Obesity (MUO) index, with a weighted patient similarity network. We tested six predefined hypotheses in 1684 young adults (mean age 22.5 ± 8.3 years; 50.2% female). Framingham was applied off-label below 30 years, so its outputs give only relative within-cohort ordering; unavailable FINDRISC items were scored zero, so standard FINDRISC categories do not apply. BMI-defined obesity occurred in 6.9%, high visceral fat in 21.7%, high MUO in 21.8%, a BIA-defined TOFI (thin outside, fat inside)-like phenotype in 5.2%, and a sarcopenic-obesity-like phenotype in 9.9%. Visceral fat correlated with percent body fat (r = 0.855). The network resolved nine interpretable communities (modularity Q = 0.63; permutation p = 0.005), including a BIA-defined TOFI-like community (cross-validated AUC = 0.93); k-means, hierarchical, PCA and UMAP clustering recovered convergent axes. All hypotheses were supported, indicating internal construct consistency, not external validation. Laboratory, imaging and longitudinal validation is required before any diagnostic or prognostic claim. Full article

Background/Objectives: Genomic sequencing can shorten the diagnostic pathway for selected symptomatic neonates and young infants, but evidence from such cohorts should not be extrapolated to population newborn screening. This study describes molecular findings and potential clinical implications in 25 unrelated patients younger than 6 months at referral with heterogeneous, predominantly neurological phenotypes and no established molecular diagnosis. Methods: The first 17 patients underwent whole-exome sequencing (WES), and the subsequent 8 underwent whole-genome sequencing (WGS) under sequential laboratory protocols; allocation was not randomized, and the study was not designed to compare platforms. Results: Pathogenic or likely pathogenic findings providing a definitive or likely molecular diagnosis were identified in 7/25 patients (28.0%; 95% confidence interval [CI], 14.3–47.6), including sequence variants, one 20q13.33 deletion, and mosaic trisomy 9. An additional RANBP2 variant was interpreted as a susceptibility-associated finding in a patient with infection-related encephalitis, yielding clinically relevant findings in 8/25 patients (32.0%; 95% CI, 17.2–51.6). Three definitive diagnoses involved disorders with established disease-specific management considerations; however, patient-level treatment changes, turnaround times, and outcomes were not systematically assessed. Conclusions: These findings support the diagnostic value of genomic testing in selected symptomatic neonates and young infants, while the small, heterogeneous cohort, sequential non-equivalent workflows, and incomplete outcome data preclude conclusions about comparative WES/WGS performance or population newborn screening. Full article

Cerebral venous sinus thrombosis (CVST) is an uncommon cerebrovascular disorder with heterogeneous manifestations and may occasionally precede the diagnosis of an underlying malignancy. We report the case of a 24-year-old man who presented with recurrent fever, headache, pharyngodynia, and systemic inflammation initially attributed to a sinonasal or odontogenic infectious process. He subsequently developed binocular horizontal diplopia, left abducens nerve palsy, papilledema, severe headache, and nausea. Neuroimaging demonstrated extensive CVST involving the left internal jugular vein, bilateral transverse sinuses, and superior sagittal sinus, without ischemic, hemorrhagic, or tumoral brain parenchymal lesions. Thrombophilia testing identified heterozygous prothrombin G20210A as the only established inherited thrombophilic factor. Despite initial neurological stabilization, the patient developed a rapidly recurrent frontal calvarial, epicranial, and cranio-dural lesion extending toward the superior sagittal sinus, without brain parenchymal involvement or imaging evidence of leptomeningeal disease. Initial morphological assessment suggested Langerhans cell histiocytosis. However, comprehensive histopathological and immunohistochemical reassessment demonstrated diffuse strong CD30 expression, nuclear and cytoplasmic ALK positivity, CD43 expression, and focal epithelial membrane antigen and granzyme B positivity, while CD1a and S100 were negative. These findings established the diagnosis of systemic ALK-positive anaplastic large cell lymphoma with secondary extra-axial cranio-dural involvement. Systemic staging demonstrated disseminated nodal disease and a noncontiguous cranio-dural extranodal lesion, consistent with stage IV disease. Treatment with anticoagulation and six cycles of brentuximab vedotin combined with cyclophosphamide, doxorubicin, and prednisone resulted in a favorable neurological and oncological outcome, with no metabolically active or residual enhancing disease on follow-up imaging. This case emphasizes the importance of continued etiological investigation in young patients with extensive CVST and an atypical clinical course, even when plausible infectious and inherited thrombotic risk factors coexist. Full article

Next-generation sequencing (NGS) is currently regarded as a preferable method for detection of actionable alterations in non-small cell lung carcinomas (NSCLCs). RNA-based NGS is particularly efficient in detection of gene fusions and allows for mRNA expression analysis of relevant genes. This study describes a novel library preparation pipeline for targeted RNA sequencing, which is based on the 5′ rapid amplification of the cDNA ends (5′ RACE) and anchored multiplex PCR. The NGS panel was designed for the analysis of 15 genes relevant to NSCLC therapeutic decisions (ALK, BRAF, CD274 (PD-L1), EGFR, ERBB2 (HER2), KRAS, MET, NRAS, NRG1-2, NTRK1-3, RET and ROS1). The validation against PCR was performed for 168 NSCLC samples. The NGS assay successfully detected all 85 mutations previously identified by PCR. It also confirmed the absence of tested mutations in 82 out of 83 PCR-negative samples. The only discordant case was subsequently analyzed by digital droplet PCR and demonstrated low fraction of the mutated allele. The newly designed NGS panel was subsequently used for the analysis of 272 carcinomas from young (≤50 years old) patients with no driver mutations identified by PCR tests or with failed PCR analysis. NGS was successful in 240 (88.2%) cases, including 35 (64.8%) PCR-failed samples. Driver mutations were detected in 55 tumors, including three previously unreported fusions (PAPLN::ALK, CD55::ROS1 and FKBP15::RET). We conclude that 5′ RACE-based RNA sequencing is a viable approach for NSCLC molecular testing. Full article

Financial toxicity is a significant but often overlooked consequence of cancer for adolescents and young adults (AYAs, 15–39 years old), who face limited savings, unstable employment, and insurance gaps that heighten financial stress. As part of a larger initiative to determine whether our cancer center can use an existing social drivers of health (SDOH) screening process to identify patients who may benefit from targeted supportive interventions, we sought to characterize financial strain, toxicity, and SDOH needs in AYAs treated in our cancer center and compare them to both younger and older cancer patients. This is a cross-sectional observational study at Mayo Clinic of patients with an oncology-related department visit between 8 September 2023–4 June 2024 (N = 81,731) who completed routine institutional electronic screenings for financial strain and SDOH. Survey items assessed financial strain, transportation barriers, and food insecurity; institutional billing data captured financial toxicity (unresolved balances, collection referrals, write-offs). AYAs (n = 5655) were more likely than non-AYAs to report medium/high financial strain, have unpaid debt, or have an unresolved balance, referral to a collection agency, or bad debt write-off, with nearly double the odds of medium/high financial strain compared to patients over 40 (OR 2.02, 95% CI 1.84–2.23, p < 0.001). Within AYAs, ages 26–32 bore the greatest burden: 24.2% in the medium/high-risk category, 9.4% with unresolved billing issues or collections, and 11.6% reporting food insecurity. These findings identify AYAs—particularly those 26–32—as a distinct high-risk group for financial toxicity and health-related social needs, underscoring the need for targeted interventions, tailored financial navigation, and policy efforts to reduce economic barriers to care. Future research should evaluate the effectiveness of these interventions in mitigating financial toxicity, addressing health-related social needs, and improving patient outcomes in this population. Full article

Objectives: Chronic rhinosinusitis (CRS) is a prevalent chronic inflammatory upper airway disease. Despite a higher radiological disease burden in males, clinical CRS diagnoses are disproportionately registered in females, suggesting systematic underdiagnosis in young men. The 22-item Sinonasal Outcome Test (SNOT-22) represents the reference patient-reported outcome measure (PROM) for sinonasal symptom burden. This study aimed to determine the prevalence of sinonasal symptom burden and to identify associated clinical, laboratory, and lifestyle parameters in a large cohort of young male adults. Methods: In this prospective cross-sectional study, 500 young male adults underwent, as part of the conscription examination, standardized assessment including the SNOT-22, spirometry (FEV₁%), whole blood count (eosinophils), and serum CRP. SNOT-22 scores were categorized as none (0–20), moderate (21–50), and severe (>50). Associations were analyzed using Spearman correlation, Mann–Whitney U, and Chi² tests. Results: The mean SNOT-22 score was 18.8 (SD 15.2; range 0–73). A total of 38.2% of participants scored ≥21, indicating at least moderate sinonasal symptom burden. SNOT-22 correlated significantly with CRP (r = 0.117, p = 0.009) and inversely with relative FEV₁% (r = −0.103, p = 0.022). Eosinophils showed a numeric gradient across SNOT-22 categories (3.08% vs. 3.31% vs. 3.56%) without reaching significance. Conclusions: More than one third of young male adults reported significant self-reported sinonasal symptom burden. Symptom severity was associated with systemic inflammatory markers and reduced pulmonary function, supporting the unified airway concept. These findings support the utility of SNOT-22 as a low-threshold assessment tool for self-reported sinonasal symptom burden in preventive health examinations. Full article

Background/Objectives: Survival in children, adolescents and young adults (CAYA) with bone sarcoma remains inferior to that of many other early-life cancers. Early recognition and treatment initiation may reduce the risk of presenting with advanced disease. We aimed to synthesize evidence on five predefined diagnostic intervals, separately synthesize pathway-specific intervals, and identify factors associated with diagnostic interval duration. Methods: A systematic review was conducted according to PRISMA guidelines. We included studies reporting the duration of a diagnostic interval in at least five patients aged 0–39 years with primary bone sarcomas, including osteosarcoma, Ewing sarcoma, and less common histological subtypes. MEDLINE, Embase, the Cochrane Central Register of Controlled Trials (CENTRAL), Web of Science, and Scopus were searched for studies published between 2000 and 2025. Risk of bias was assessed using a custom domain-based tool. Results: Twenty-nine studies including 9271 patients from high-income countries met the inclusion criteria. Substantial heterogeneity in study design, populations, and interval reporting precluded meta-analysis. Reported median intervals were patient intervals of 13–84 days, diagnostic intervals of 15–123 days, total diagnostic intervals of 28–150 days, treatment intervals of 7–24 days, and total intervals of 66–88 days. Older age within the CAYA population and axial tumor location were the factors most consistently associated with longer diagnostic intervals. No consistent association between diagnostic interval duration and survival was identified. Pathway-specific intervals provided additional insight into different components of the diagnostic pathway, particularly after initial healthcare contact, although evidence remained limited. Conclusions: Diagnostic interval durations varied substantially across studies, reflecting methodological heterogeneity and differences in diagnostic pathways. Standardized prospective studies are needed to strengthen the evidence base. Full article

Background/Objectives: Young-onset ischemic stroke shows substantial etiologic heterogeneity. However, the value and diagnostic yield of advanced cardiac and autoimmune evaluations in young adults remain uncertain. Methods: Patients aged 25–55 years admitted with acute ischemic stroke to King Fahd University Hospital in Saudi Arabia between January 2020 and December 2025 were included. Evaluation followed a multidisciplinary young-stroke pathway, incorporating neurovascular imaging, cardiac assessment, and targeted autoimmune and rheumatologic investigations. A Clinically Meaningful Diagnostic Yield (CMDY) was defined as a diagnostic finding that resulted in etiologic reclassification, management modification, or changes to secondary prevention strategy. Results: A total of 480 patients were included (median age, 40 years; 67.7% men). CMDY was observed in 200 (41.7%) patients. Among 79 patients initially classified as having embolic stroke of an undetermined source, 35 (44.3%) were assigned a determined etiologic mechanism following evaluation and follow-up. Patients with undetermined stroke etiology decreased from 16.5% after first-pass evaluation to 9.2% after diagnostic completion. Patent foramen ovale/atrial septal defect-associated stroke mechanisms were identified in 61 patients (12.7%), autoimmune/inflammatory stroke mechanisms in 26 patients (5.4%), and atrial fibrillation-related cardioembolic stroke in 18 patients (3.8%). Clinically relevant mechanisms were identified in 169 patients (35.2%) whose primary etiologic classification remained unchanged. Independent predictors of CMDY were hypertension, prior stroke or transient ischemic attack, multi-territory infarction, and cortical infarction. Conclusions: Etiologic evaluation yielded clinically meaningful findings in over two-fifths of young adults with ischemic stroke and influenced etiologic assessment, treatment, and secondary prevention. Diagnostic yield was greatest among patients with prior cerebrovascular events and cortical or multi-territory infarctions, supporting a selective, phenotype-driven approach that warrants prospective multicenter validation. Full article

Background: Functional Neurological Disorder (FND) and Postural Orthostatic Tachycardia Syndrome (POTS) are both complex, often debilitating conditions that frequently affect young women and involve high symptom burdens and psychiatric comorbidity. Although clinical overlap between these two disorders has long been observed, quantitative evidence assessing their co-occurrence has been lacking. Objective: The aim of this review was to determine the frequency of POTS in patients with FND and FND in patients with POTS through meta-analysis of the available literature, and to describe overlapping putative factors between the two conditions. Methods: A comprehensive literature search was conducted across PubMed and Google Scholar up to April 2025. The meta-analysis was conducted and reported in accordance with PRISMA guidelines. Studies reporting original data on the frequency of POTS in individuals with FND and FND in individuals with POTS were included. Meta-analyses were performed using random-effects models. Quality assessment was conducted using the JBI critical appraisal tools. Evidence relating to overlapping putative factors between POTS and FND was synthesised narratively. Results: From over 37,000 records, 11 studies comprising 1199 participants were included. The pooled proportion of POTS among individuals with FND was 14% (95% CI: 5–26%), with the highest rates seen in those with functional seizures (26%). Substantial heterogeneity (I² = 94.6%) reflected differences in methodology, age group, setting, and diagnostic criteria. Evidence regarding FND in POTS remains limited. Overlapping putative factors included biopsychosocial predisposing factors, female gender, altered interoception, psychological trauma and stress response, immune dysregulation, neurohumoral factors and comorbidities. Conclusions: The findings suggest that the proportion of POTS among individuals with FND is higher than expected by chance alone. An overview of their overlap highlights potential shared biopsychosocial mechanisms and provides a framework for integrated clinical care. Recognising their co-occurrence and the need for careful differential diagnosis between these conditions may inform screening, diagnosis, and multidisciplinary management strategies. This perspective supports a non-dualistic, neuroscience-based approach and identifies priorities for future research. Full article

Background and Clinical Significance: Skin-limited Langerhans cell histiocytosis (LCH) is a clinically heterogeneous disease, ranging from self-healing forms to fulminant multi-organ failure, the latter being more often described in infants, especially preterm neonates. The optimal therapy for cutaneous LCH remains controversial; the possibilities vary from a watchful waiting approach to systemic chemotherapy. Case Presentation: This case report describes an exceptionally rare and clinically challenging course of skin-limited LCH in a prematurely born infant treated at the Department of Oncology and Hematology, Children’s Hospital Zagreb, Croatia. At presentation, the patient exhibited several features suggestive of aggressive disease biology. However, therapeutic decision-making was complicated by extreme prematurity and young age, both of which significantly increased vulnerability to treatment-related toxicity. Following failure of topical therapy, systemic treatment was initiated according to the LCH-IV trial, primarily due to concerns regarding potential evolution into multisystem LCH. During treatment, the patient developed multiple life-threatening complications, namely severe infections (Staphylococcus aureus endocarditis, Pneumocystis jirovecii pneumonia, and Enterobacter cloacae sepsis), aggravated by secondary hypogammaglobulinemia, neutropenia, and iatrogenic adrenal insufficiency. Conclusions: The varied nature of cutaneous LCH underscores the necessity for a tailored treatment approach. When deciding on the treatment modality, clinicians should weigh the benefits of aggressive therapies, ensuring better disease control, against the potential for severe adverse effects, particularly in young, fragile infants with immature immunity. Full article

Background/Objectives: The prognostic significance of young age in breast cancer (BC) remains controversial, with varying findings across studies. This study aimed to evaluate the imaging characteristics, pathological features, and survival outcomes of BC in young patients aged ≤ 35 years by dividing them into two groups and to compare outcomes between these subgroups to determine whether very young age alone is associated with worse prognosis. Methods: This retrospective study included patients aged ≤ 35 years with malignant breast lesions who underwent image-guided interventions at a single center between January 2011 and December 2024. Patients were divided into two groups: Group 1 (≤30 years) and Group 2 (31–35 years). Demographic, imaging, and pathological data, as well as survival outcomes, were analyzed. Results: A total of 34 patients (Group 1: n = 14, Group 2: n = 20) with malignant breast lesions underwent 40 image-guided procedures. No significant differences were observed between groups in imaging features, pathological characteristics, or pTNM stage distribution. Median follow-up was 68 months. One-year overall survival (OS) was 100% in both cohorts; 5-year OS rates were 100% and 92.3%, respectively, with no statistically significant difference (p = 0.784). Median event-free survival (EFS) was 60.5 months, also without a significant difference between groups (p = 0.897). None of the clinicopathological factors assessed were significantly associated with OS in this exploratory analysis. Conclusions: In women ≤ 35 years, tumor characteristics and patient outcomes were similar between those aged ≤ 30 and 31–35 years. OS and EFS were favorable in both groups, indicating that within the ≤35-year population studied, being ≤30 years old was not associated with worse outcomes than being 31–35 years old. Although advanced stage disease was more frequently observed in the younger group, this difference was not statistically significant. Full article

Background/Objectives: The rising prevalence of severe adolescent obesity has increased the number of young patients referred for bariatric surgery. The psychiatric and psychosocial profiles of adolescents and of adult women undergoing this treatment remain insufficiently characterized. This study compared preoperative and postoperative psychiatric, psychosocial, and metabolic profiles of adolescents and adult women undergoing bariatric surgery. Methods: This prospective cohort study recruited 77 consecutive female patients (32 adolescents aged <18 years; 45 adult women aged 18–25 years) at a single bariatric center in Poland between December 2022 and December 2023. All participants underwent comprehensive preoperative and one-year postoperative assessments including laboratory testing, standardized psychiatric interviews, and psychometric screening with the Beck Depression Inventory (BDI) and the Patient Health Questionnaire-9 (PHQ-9). Results: Preoperatively, adolescents were more severely affected for their age (median BMI-for-age z-score 3.53) and waited longer between the first obesity clinic visit and surgery. Adolescents more frequently reported self-harm behaviors and moderate-to-severe depression on the BDI, whereas adult women more often reported psychoactive substance use. Both groups achieved comparable improvements in laboratory and comorbidity outcomes at one year, although relative weight loss was greater in adult women (median total weight loss 37.6% vs. 28.4%, p < 0.0001). Postoperatively, a greater proportion of adolescents than adult women improved with respect to social anxiety (50.0% vs. 13.3%, p = 0.0007) and BDI depression severity (53.1% vs. 24.4%, p = 0.02), whereas a greater proportion of adult women improved with respect to psychoactive substance use (46.7% vs. 12.5%, p = 0.003). Generalized anxiety and suicidal ideation declined within both groups, but the extent of improvement did not differ significantly between them. These differences persisted, and for several outcomes became larger, after adjustment for the reduction in BMI, which was smaller in adolescents. Conclusions: In this observational cohort, bariatric surgery was associated with distinct psychiatric and psychosocial outcome profiles in adolescents compared with adult women. Because the study was uncontrolled and included no non-surgical comparison group, these findings are hypothesis-generating and cannot establish a causal effect of surgery or of its timing; confirmation in larger, multicenter studies with appropriate comparison groups is required. Comprehensive multidisciplinary perioperative care and tailored postoperative psychological support appear important for both age groups. Full article