The temporal lobes are key hubs for memory and cognition. Although 40 Hz transcranial alternating current stimulation (tACS) has shown potential cognitive benefits, evidence for accelerated bilateral temporal stimulation remains limited. This study aims to evaluate its cognitive and neural effects. In this randomized, double-blind, controlled trial, 100 Alzheimer's disease (AD) patients were randomized 1:1 to active or sham 40 Hz tACS over the bilateral temporal. Cognitive outcomes at three time points were analyzed using mixed repeated-measures analysis of variance (ANOVA). Resting-state functional near-infrared spectroscopy (fNIRS) data from baseline and Week 4 were analyzed using ANOVA, followed by network-based statistics with family-wise error (FWE) correction. Eighty-five participants completed the trial. Significant Group × Time interactions were observed for Alzheimer's Disease Assessment Scale-Cognitive Subscale (ADAS-Cog) total (p = 0.010), memory (p = 0.007), and praxis (p = 0.002), but not for the Mini-Mental State Examination (MMSE) (p = 0.075). The fNIRS analysis revealed a functional network primarily involving the frontal and parietal regions, comprising 38 connections and 18 nodes (p = 0.010). Active-group connectivity changes were associated with ADAS-Cog total, language, praxis, and MMSE variations, but not in the sham group. Accelerated bilateral temporal 40 Hz tACS improved cognition and modulated frontotemporoparietal connectivity. Larger multicenter studies with biomarkers are warranted.

Peripheral hormonal dysfunction is associated with multiple neurological disorders, yet how astrocytes sense circulating stress-related hormones to influence depression pathogenesis remains incompletely understood. Here, we showed that disruption of secretin receptor (SCTR) signaling in dorsal raphe nucleus (DRN) astrocytes promotes depression-like behaviors. We identified AMPKα1 as a key downstream effector of astrocytic SCTR signaling and demonstrate its role in regulating astrocytic secretion of metallothionein-1 (Mt1) and downstream megalin-mediated AMPKα2 signaling in serotonergic neurons. We further identified the transcription factor Foxc2 as a downstream target of neuronal AMPKα2 that modulates depressive-like behaviors through suppression of serotonergic activity and reduced neuronal excitability. Mechanistically, AMPKα2 regulates phosphorylation of the acetyltransferase KAT7, thereby modulating histone H4 acetylation and Foxc2 transcription. Together, these findings delineate an astrocyte-neuron signaling axis linking SCTR-AMPKα1 signaling in astrocytes to epigenetic regulation of Foxc2 by AMPKα2-KAT7/H4ac signaling in serotonergic neurons, providing fundamental insight into circuit-level mechanisms underlying depression.

Fatigue and depressive symptoms are common among individuals with multiple sclerosis (MS) and impose a substantial burden on daily functioning and overall well-being. Lifestyle factors, including dietary patterns, may contribute to symptom burden, although evidence remains inconsistent. This cross-sectional study aimed to examine fatigue and depressive symptoms in adults with MS and explore their associations with adherence to the Mediterranean diet and individual dietary components. Mediterranean diet adherence was assessed using the Mediterranean Diet Adherence Screener (MEDAS). Fatigue severity was measured with the Fatigue Severity Scale (FSS), and depressive symptoms with the Center for Epidemiologic Studies Depression Scale (CES-D). Associations were examined using non-parametric tests, Spearman correlation, and multivariable linear regression. A total of 112 adults with MS (mean age 45.26 ± 9.9 years) were included. Clinically significant fatigue (FSS ≥ 4) was present in 92.0%, while 89.9% were at high risk for depressive symptoms (CES-D ≥ 16). Low adherence to the Mediterranean diet was observed in 51.8% of participants. Fatigue severity differed according to Mediterranean diet adherence, with lower adherence associated with greater fatigue severity ( = 0.035). Depressive symptoms were not associated with dietary adherence but were strongly correlated with fatigue severity (ρ = 0.600,  < 0.001) and remained independently associated with fatigue severity in multivariable analysis, while female sex was associated with lower fatigue severity. Additional associations were observed between specific dietary components, including red meat, fruit juice, and olive oil, and symptom severity. The study revealed a high burden of depressive symptoms and fatigue among individuals with MS, alongside generally suboptimal adherence to the Mediterranean diet. Lower adherence was associated with higher fatigue severity. Fatigue and depressive symptoms were strongly interrelated. These findings underscore the importance of addressing both overall well-being and diet in the comprehensive management of individuals with MS.

Rates of suicide are 2-3 times higher among youth detained in the legal system (YD) compared to non-detained youth. A prior study found that 40% of YD endorsing a suicide attempt denied suicide ideation. These youth were characterized clinically by high rates of anger and low rates of depression, somatic complaints, and neglect. The present study seeks to replicate these findings in a substantially enlarged sample of YD. N = 1,250 YD endorsing a lifetime suicide attempt were administered an interview to assess mental health history. 45% of YD endorsing a lifetime suicide attempt denied suicide ideation. Youth denying suicide ideation endorsed a significantly higher rate of anger/irritability. This enlarged YD sample replicates results that a significant number of YD who attempted suicide denied ideation and that these youth were characterized by high anger/irritability. Implications for case identification and theory advancement for a comprehensive are discussed.

Latinx youth in the United States experience disproportionate exposure to community violence, which contributes to elevated rates of mental health symptoms. Research suggests that individual differences, such as cognitive flexibility (CF) and bilingualism, may serve as protective factors in the context of exposure to community violence. The present study examined associations among community violence exposure, bilingual proficiency, CF, and mental health symptoms among Latinx children. We also tested whether CF moderated associations between community violence exposure, bilingual proficiency, and mental health symptoms. Participants included 50 3rd -5th grade Latinx students (M = 9.84, age range = 8-12, SD = 1.04, 48% female) recruited from a charter school that serves a predominantly Latinx student body. CF was measured using the Wisconsin Card Sorting Test, bilingualism was assessed through the Woodcock-Muñoz Language Survey III, and mental health symptoms, including anxiety and depression, were measured using the Revised Child Anxiety and Depression Scale. Results demonstrated that greater exposure to community violence was associated with increased symptoms of anxiety and depression, and that CF moderated these effects, buffering against adverse mental health outcomes. Contrary to study hypotheses, bilingualism was not significantly associated with CF or mental health symptoms. These findings highlight CF as a potential marker of resilience among Latinx children exposed to community violence. Future research should explore interventions that enhance CF to mitigate the psychological impact of trauma in this population.

The Youth Anxiety Measure for DSM-5 (YAM-5) was developed to assess symptoms of major anxiety disorders (Part I) and specific fears and phobias (Part II) in children and adolescents in accordance with current diagnostic criteria. Despite growing interest in the YAM-5, research has primarily focused on Part I, leaving Part II comparatively understudied, while evidence on the psychometric properties of both components in children from age eight onward remains limited. The present study examined the factorial structure and psychometric properties of both parts of the YAM-5 in a community sample of Spanish-speaking children aged 8 to 12 years. Participants were 515 children (M = 9.82, SD = 1.20) enrolled in primary education in Spain. Confirmatory factor analyses supported the original five-factor structure of both parts of the instrument. The YAM-5 total scale and the total scores of Parts I and II demonstrated good-to-excellent internal consistency, while most subscales showed acceptable-to-good reliability, with stronger internal consistency observed for Part I. Evidence of convergent, divergent, and discriminant validity was also found. These results provide further support for the YAM-5 as a suitable tool for assessing anxiety-related symptoms and facilitating their early identification among school-aged children in community settings.

PURPOSE: The aim of this study was to evaluate the loss of autism diagnosis (LAD) in individuals with Autism Spectrum Disorder (ASD) and to compare the clinical features of LAD cases with those who continued to meet criteria for ASD without Intellectual Disability (ID). METHOD: This study included 60 children aged 5-18 years who were previously diagnosed with ASD and were classified either as having lost the diagnosis (LAD) or as continuing to meet criteria for ASD without ID. Data were obtained through clinical interviews and retrospective review of medical records. Comorbidities were evaluated using the Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version (K-SADS-PL). Symptom severity and clinical characteristics were assessed using the Childhood Autism Rating Scale (CARS), Strengths and Difficulties Questionnaire (SDQ), Aberrant Behavior Checklist (ABC), and Social Communication Questionnaire (SCQ). RESULTS: The LAD group had an earlier age at ASD diagnosis, earlier initiation of special education, and a longer duration of preschool education. Symptom severity measured by CARS and SCQ was lower in the LAD group. At least one comorbid psychiatric diagnosis was present in 80% of the LAD group, with Attention-Deficit/Hyperactivity Disorder, Anxiety Disorders/Specific Phobia, and Specific Learning Disorder being the most common. A moderate positive association was observed between SCQ-Lifetime scores and the time required to achieve LAD. CONCLUSION: Early diagnosis, earlier initiation of special education, and lower ASD symptom severity at diagnosis were associated with LAD. Despite loss of the ASD diagnosis, subthreshold psychiatric symptoms and non-ASD psychiatric diagnoses remained highly prevalent.

INTRODUCTION: Health systems are increasingly oriented toward value-based care, emphasizing patient-centered outcomes such as health-related quality of life (HRQoL). During hospitalization, HRQoL reflects the interplay of sociodemographic, geographic, and clinical factors, which may be particularly influential in middle-income settings where structural inequities can affect patient-reported outcomes. OBJECTIVE: To identify factors independently associated with HRQoL measured during hospitalization in adults treated at a high-complexity institution in a middle-income country. METHODS: We conducted a cross-sectional analytical study nested within an institutional prospective cohort (2023-2025). We included hospitalized adults with a complete in-hospital HRQoL assessment using the EQ-5D-3L descriptive system and the EQ visual analogue scale (EQ VAS). The EQ VAS score was analyzed as the primary continuous outcome. Associations were evaluated using bivariate analyses and multivariable linear regression. RESULTS: A total of 46,083 patients were included, with a median EQ-VAS score of 70 (IQR, 60-80). Functional impairment was most commonly reported in usual activities (62.46%). In the multivariable linear regression model, lower EQ-VAS scores were independently associated with increasing age (β = - 0.150 per year) and ICU admission (β = - 1.661), whereas professional education (β = 2.364) and surgical admission (β = 1.672) were associated with higher scores. Across diagnostic groups, mental and behavioural disorders (β = - 2.949) and respiratory diseases (β = - 2.036) showed the strongest negative associations, while pregnancy-related conditions were associated with the highest scores (β = 3.982). CONCLUSION: EQ VAS scores measured during hospitalization were independently associated with sociodemographic and clinical factors, underscoring the multifactorial determinants of self-rated health in acute hospital settings.

PURPOSE: To evaluate the measurement invariance of the Pediatric Quality of Life Index (PedsQL) in a population of children and adolescents participating in mental health treatment. METHODS: We analyzed PedsQL data from three child and adolescent mental health service (CAMHS) services (walk-in, day hospital, intensive community treatment). We fit ordered-categorical confirmatory factor analysis (CFA) to the canonical four-domain model and a theory-refined variant with targeted cross-loadings. We then examined multi-group measurement invariance (configural, metric, scalar) across service streams, diagnosis, gender, race/ethnicity (White vs. racialised).) Finally, we assessed item-level bias (i.e., differential item functioning; DIF) with an ordinal logistic approach using an observed-score nested model sequence. RESULTS: For the CFA, we found that the four-domain structure fit well and that allowing two theory-guided cross-loadings-Physical items 7 and 8 onto the Emotional domain yielded a strong fit. We found full scalar invariance across all groups tested. For DIF testing, no items exhibited meaningful uniform or non-uniform DIF. CONCLUSIONS: PedsQL domain scores demonstrate evidence of structural validity and preliminary evidence of measurement invariance across the CAMHS subgroups evaluated. This provides support for the use of PedsQL scores in CAMHS.

Major depressive disorder (MDD) is associated with alterations in large-scale brain networks, and variability in transcutaneous auricular vagus nerve stimulation (taVNS) parameters, particularly stimulation frequency, limits reproducibility and comparability across studies. Standardized strategies for systematic parameter selection are therefore needed. This protocol presents a reproducible, neuroimaging-guided workflow for mapping individual cortical responses to multiple taVNS frequencies using functional near-infrared spectroscopy (fNIRS). The approach combines continuous fNIRS acquisition with within-session delivery of multiple stimulation frequencies and network-level analysis of default mode network activity. Frequency-specific responses are quantified using distance-based metrics, followed by algorithmic ranking to identify candidate stimulation parameters within each participant. The workflow enables direct within-subject comparison of stimulation conditions and provides a structured framework for exploratory parameter mapping based on network-level responses rather than fixed-frequency designs. Representative results demonstrate the feasibility of acquiring stable fNIRS signals across conditions and generating interpretable participant-specific frequency rankings. Although demonstrated in MDD, this protocol is adaptable to other neuromodulation paradigms and disorders involving network-level dysfunction and may support future studies aimed at individualized parameter selection.

BACKGROUND: Adolescence represents a critical developmental stage characterized by complex stressors, including academic pressure and interpersonal challenges, which significantly elevate the risk of depressive symptoms. While conventional research predominantly relies on linear methodologies focusing on isolated environmental determinants, the multi-level interactive effects of ecological environments on adolescent depressive symptoms remain under-explored. METHODS: Utilizing longitudinal data from the 2020 and 2022 China Family Panel Studies (CFPS), this study included a sample of 971 adolescents (aged 10-15). Baseline ecological variables and covariates were measured in 2020, while the outcome-depressive symptoms-was assessed in 2022 using the 8-item Center for Epidemiologic Studies Depression Scale (CES-D8). We integrated a machine learning framework (Random Forest, RF) to predict continuous CES-D8 scores and a nomogram model to predict binary depression risk (CES-D8 ≥ 9). The nomogram was internally validated using 1000 bootstrap resamples. RESULTS: Ecological environments demonstrated significant associations with adolescent depressive symptoms. In the RF model (Out-of-Bag Mean Squared Error = 12.72), the predictor s ranked in descending order of their contribution were social trust, interpersonal relationships, parent-child conflict, teacher satisfaction, and age. The developed visual nomogram demonstrated modest discrimination (AUC = 0.614) but excellent calibration (Mean Absolute Error = 0.011) for quantifying individualized risk probabilities. CONCLUSION: These findings highlight specific environmental correlates and underscore the necessity of transitioning from single-factor management to integrated, multi-systemic approaches. While the predictive model requires further external validation before clinical application, it offers a preliminary epidemiological tool to identify potential intervention targets and facilitate coordinated family, school, community, and governmental interventions.

BACKGROUND: Chronic obstructive pulmonary disease (COPD) is frequently accompanied by depression and anxiety, which may exacerbate disease outcomes, reduce treatment adherence, and impair quality of life. Despite their clinical significance, these comorbidities remain frequently underdiagnosed and undertreated. This study examined the diagnosed prevalence of depression and anxiety, as well as the patterns of psychotropic medication use among patients with COPD in Lithuania. MATERIALS AND METHODS: A retrospective observational study was conducted using anonymized outpatient administrative data from the Lithuanian State Data Agency, comprising adult patients with COPD (ICD-10 J44.x) between 2020 and 2024. Mental health comorbidities were identified according to ICD-10 codes for anxiety disorders (F41.x), depressive episodes (F32.x), and recurrent depressive disorders (F33.x). Associations between categorical variables and sex differences were analyzed using contingency tables. Crude odds ratios (ORs) and adjusted odds ratios (aORs) from multivariable logistic regression analyses were calculated. RESULTS: Among 64,246 unique patients with COPD, 18.1% had a diagnosed psychiatric disorder, with a higher diagnosed prevalence among women than men (26.8% vs 12.1%; aOR = 2.40, 95% CI 2.32-2.48, p < 0.001). Anxiety disorders were identified in 15.0% of patients, and depressive disorders in 4.6%; women had significantly higher odds of depressive disorders compared with men (aOR = 3.53, 95% CI 3.36-3.72, p < 0.001). Psychotropic medications were prescribed to 61.9% of affected individuals, with women being more likely to receive any psychotropic medication than men (aOR = 0.687 for men vs women, 95% CI 0.644-0.732, p < 0.001). Anxiolytics represented 89.9% of all psychotropic prescriptions, with benzodiazepines accounting for 85.0% of this category. Family physicians were significantly more likely to prescribe anxiolytics than psychiatrists (OR = 10.66, p < 0.001). Antidepressant and neuroleptic prescribing showed statistically significant increasing trends over the study period (p = 0.007 and p = 0.005, respectively), whereas benzodiazepine prescribing rates also increased significantly (p = 0.004). CONCLUSION: Anxiety and depression are common psychiatric comorbidities among patients with COPD in Lithuania and exhibit notable gender differences. Psychotropic medications were predominantly prescribed in primary care, with benzodiazepines accounting for the majority of anxiolytic treatments. These findings provide updated nationwide data on psychiatric comorbidity and psychotropic prescribing patterns among patients with COPD in Lithuania.

OBJECTIVE: To investigate the association between preoperative serum CX3CL1 and TSLP levels and postoperative pain severity in patients with acute calculous cholecystitis undergoing laparoscopic cholecystectomy (LC). METHODS: We prospectively enrolled 379 patients with acute calculous cholecystitis undergoing LC. According to the 24-hour postoperative visual analog scale (VAS) score, patients were classified into mild pain (MP, n=261) and moderate-to-severe pain (MSP, n=118) groups. Preoperative serum CX3CL1 and TSLP were measured by enzyme-linked immunosorbent assay (ELISA). Receiver operating characteristic (ROC) curves were constructed to evaluate their predictive value, alone and in combination. Multivariable logistic regression identified independent risk factors. A nomogram was developed and internally validated using a 7:3 split. RESULTS: Preoperative serum CX3CL1 and TSLP levels were significantly higher in the MSP group (both P<0.001). Both showed moderate positive correlations with C-reactive protein (CRP) and postoperative VAS scores (r=0.410-0.456). The combined biomarker model (CX3CL1 + TSLP) achieved an area under the curve (AUC) of 0.860 (95% confidence interval [CI], 0.819-0.900). Multivariable logistic regression identified gallbladder wall thickness, onset-to-surgery time, intraoperative drainage tube placement, Tokyo Guidelines 2018 (TG18) grade, Generalized Anxiety Disorder-7 (GAD-7) score, Patient Health Questionnaire-9 (PHQ-9) score, Athens Insomnia Scale (AIS) score, CRP, CX3CL1, and TSLP as independent risk factors. The nomogram demonstrated AUCs of 0.859 and 0.892 in the training and validation sets, with good calibration and clinical net benefit. CONCLUSION: Elevated preoperative serum CX3CL1 and TSLP levels are independently associated with moderate-to-severe pain following LC, and their combined detection may help identify high-risk patients. The nomogram integrating these biomarkers with clinical risk factors shows favorable predictive performance; however, external multicenter validation is required before clinical application.

Endometriosis (EM) is a severe chronic inflammatory disease characterized by the presence of endometrium-like tissue outside the uterine cavity, causing pain and significantly reducing quality of life. Worldwide, around 10% of women of reproductive age are affected and there is no cure as of now. The limited treatment options focus on hormone therapy, surgery and pain management--without satisfactory long-term effects. Nutritional strategies might support the prevention and treatment of EM-associated pain as nutrients and phytochemicals exert anti-inflammatory and antioxidant effects, modulate the immune system and hormonal balance. In addition, diet is a key determinant of the composition, health, and function of the gut microbiome. To identify the multitude of potential nutrition-related factors that influence the clinical picture of EM, we conducted a targeted literature search in PubMed, Web of Science, and Google Scholar in 2025. This narrative review examines the association of thirteen areas-including macro- and micronutrients, dietary patterns, contaminants, allergens, and food intolerances-with the risk of EM and therapeutic options. At present, there is only limited scientific evidence regarding the therapeutic benefits of dietary strategies. There are promising indications for the supportive potential of an anti-inflammatory diet, based on elements of the MedD resulting in a regular intake of long-chain n-3 polyunsaturated fatty acids, secondary plant compounds, dietary fibers, vitamins, minerals and trace elements. Certain foods (or food groups) may contribute to a worsening of symptoms in individual patients with EM (eg, cruciferous vegetables, foods containing histamine, gluten, FODMAPs). Since these foods usually provide important nutrients, avoiding them as a preventive measure can lead to nutrient deficiencies. Therefore, individual assessment is required to determine the extent to which these foods are tolerated by women diagnosed with EM. To clarify the supportive role of personalized nutritional concepts to support therapy of EM, there is an urgent need for further high-quality studies.

Cyber victimization is among the most consistent predictors of depression (DEP) in adolescence, yet research has largely treated both constructs as unidimensional totals, obscuring which specific victimization experiences activate which depressive symptoms and for whom. This study applied a person-centered and network psychometric approach to map these pathways in a cross-sectional community sample of 622 Turkish adolescents (55.0% female;  = 13.90 years). Latent profile analysis (LPA) identified three distinct subgroups based on self-esteem (SE), family affluence, and social media (SM) use: a low SE/moderate SM group ( = 395, 63.5%), a high SE/high DEP group ( = 115, 18.5%), and a high SM use group ( = 112, 18.0%). Depressive symptom networks differed significantly in global strength across profiles; the high SM use group showed the densest intersymptom connections. A bipartite bridge network analysis revealed that self-harm/suicidal ideation was the strongest cross-community bridge node (bridge expected influence = 0.143), despite being the most peripheral symptom within the DEP network itself. This dissociation suggests that the symptom is linked mainly to cyber victimization rather than to other depressive symptoms. Embarrassing messages was the strongest victimization-side bridge node (EI = 0.095). These findings challenge the assumption that intranetwork centrality predicts intervention priority: Peripheral symptoms may function as critical entry points when external stressors drive activation.

BACKGROUND: Chronic musculoskeletal pain (CMP) is a prevalent and disabling condition associated with impaired physical function and reduced quality of life. Graded exposure therapy (GEP), a cognitive-behavioral intervention targeting pain-related fear and avoidance, has been proposed as a non-pharmacological approach for CMP management. OBJECTIVE: To evaluate the effects of GEP compared with non-GEP interventions in individuals with CMP. METHODS: We searched electronic databases from inception to February 2025 for randomized controlled trials (RCTs) comparing GEP and non-GEP interventions in individuals with CMP. Primary outcomes included pain intensity and pain-related disability. Secondary outcomes included pain-related fear and cognition, health-related quality of life, psychological outcomes, sleep-related outcomes, behavioral adaptation, self-efficacy, and physical functioning. The certainty of evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. RESULTS: Eight RCTs involving 554 participants were included. Compared with non-GEP interventions, GEP was associated with improvements in pain-related disability and pain-related fear and cognition, including pain catastrophizing (Pain Catastrophizing Scale [PCS]: mean difference [MD] = -4.45, 95% confidence interval [CI] -7.20 to -1.69) and kinesiophobia (Tampa Scale of Kinesiophobia [TSK]: MD = -4.57, 95% CI -7.11 to -2.03). Disability outcomes have showen beneficial effects across several instruments, although many estimates are based on individual studies. Effects on pain intensity were inconsistent, with significant reductions observed for Neuropathic Pain Scale (NPS) (MD = -2.66, 95% CI -4.09 to -1.23) and Fibromyalgia Impact Questionnaire Pain subscale (FIQ-Pain) (MD = -2.51, 95% CI -3.48 to -1.54). The certainty of evidence ranged from very low to moderate, with most outcomes being downgraded owing to the risk of bias and imprecision. CONCLUSION: GEP may improve pain-related disability and pain-related fear and cognition in individuals with CMP. However, the limited certainty of evidence and variability across populations, interventions, and outcome measures warrant cautious interpretation. Further high-quality trials with standardized outcomes and longer-term follow-up are needed.

OBJECTIVE: Traditional Chinese Medicine (TCM) constitution theory underpins personalized health management, but most studies examine constitution types in isolation, whereas overlapping constitutions are the rule rather than the exception in practice. This study examined how combinations of TCM constitution subscale scores were related to health-related quality of life (QoL) over six months of constitution-based comprehensive intervention. METHODS: In a single-arm prospective study, 509 adults aged 19-84 years completed a 6-month constitution-based self-management programme. Constitution was assessed with the 60-item Constitution in Chinese Medicine Questionnaire (CCMQ-60), which yields a Gentleness (Type A) score and scores on eight biased types (Qi-Deficiency, Yang-Deficiency, Yin-Deficiency, Phlegm-Dampness, Damp-Heat, Blood-Stasis, Qi-Depression, Special-Diathesis). QoL was measured with the 36-Item Short Form Health Survey (SF-36) at baseline, 3 months, and 6 months. Dynamic (panel) and "bottom-up" fuzzy-set qualitative comparative analysis (fsQCA) were used to identify constitution configurations associated with high QoL at each time point. RESULTS: The mean SF-36 total score rose from 72.7 ± 16.1 at baseline to 75.1 ± 14.6 at 3 months and 75.6 ± 15.5 at 6 months (mean change 2.9 points, 95% CI 1.7 to 4.1; standardized change 0.21). No single constitution subscale was a necessary condition for high QoL (pooled consistency < 0.90). Dynamic fsQCA identified 5 overlapping configurations (consistency 0.946-0.953; solution coverage 0.540), each characterized by a high Gentleness score combined with low scores on most biased constitutions; unique coverage of individual configurations was small (0.006-0.049). Bottom-up analysis at a PRI threshold of 0.75 retained low Yang-Deficiency or low Blood-Stasis together with low Qi-Depression at baseline and 3 months (consistency 0.867-0.873), whereas at 6 months the retained pairs were low Qi-Deficiency with low Yang-Deficiency or low Blood-Stasis, and low Yang-Deficiency with low Phlegm-Dampness (consistency 0.856-0.866). Consistency of the configurations exceeded 0.90 in every age and sex stratum. CONCLUSION: During the programme, high QoL was associated with a high Gentleness score combined with low scores on several biased constitutions rather than with any single constitution type, and the pairs of biased constitutions that distinguished high QoL at 6 months differed from those at baseline and 3 months. Because the study had no control group, these configurational patterns are descriptive and hypothesis-generating; they point to combinations of constitutions that could be prioritized and tested in controlled evaluations of constitution-based personalized health management.

The evolution of alternative migratory strategies can lead to the establishment of ecologically and genetically distinct morphs; however, the forces that maintain these differences are often unclear. Here we assessed how migratory strategy may affect gene flow and adaptation in Atlantic Salmon () in a setting where a migratory barrier was removed, and migratory and non-migratory salmon have been brought into contact through a program to initiate a migratory population. We used whole genome sequencing to characterize genetic variation in resident and anadromous salmon in this experimental system, as well as in the original source of the migratory individuals and a proximate source of strays into the system. Our results suggest that resident and anadromous salmon populations are highly divergent genetically, but that introgression from the resident population into the introduced migratory morph is widespread. However, despite a general trend of introgression into the migratory form, localized genomic regions appear resistant to gene flow, potentially highlighting adaptive divergence between resident and anadromous salmon. Additionally, we compared how the proportion of ancestry associated with migratory type changed between out migrating smolts and returning adults across two cohorts. Our results show a significant reduction in resident ancestry consistent with outbreeding depression during the marine migratory phase. Genomic comparisons between smolts and adults also identify several localized regions potentially under selection in the marine environment, possibly related to immune function. Together, these results suggest that introgression between divergent migratory forms in this system is unidirectional and is resulting in outbreeding depression and reduced migratory success. In the context of supplementation, our results suggest that enhancement activities aimed at boosting anadromous Atlantic Salmon populations could be impacted by introgression with resident populations. Additionally, interbreeding may present a demographic threat to resident populations, as anadromous-resident hybrids appear to follow a migratory life history.

[This corrects the article DOI: 10.1002/hsr2.2235.].

BACKGROUND: Children of mentally ill parents (CHIMPS) experience a variety of negative outcomes and have an increased risk for mental illness. Nevertheless, no routine screenings or therapies for CHIMPS exist in the German healthcare system. The CHIMPS program was developed as a psychodynamic, transdiagnostic family intervention for affected children and adolescents (CA). Its effectiveness on mental health and health-related quality of life was evaluated in a prospective, two-arm, cluster-randomized, controlled, open, multicentric trial. METHODS: Data from families with mentally ill parents were collected at seven sites in Germany and Switzerland at four measurement points. Group allocation was randomized. The intervention group (IG) received the CHIMPS intervention, while the control group (CG) received Treatment-As-Usual. The primary outcome was the mental health of CA with an initial psychiatric diagnosis according to the Schedule for Affective Disorders and Schizophrenia for School Aged Children, Lifetime Version (applied by blinded external raters) 18 months after baseline. Secondary outcomes comprised mental health assessed with the parent-rated Child Behavior Checklist and the self-rated Youth Self Report, and health-related quality of life assessed with the KIDSCREEN-27 (parent- and self-rated). Multilevel models were used for analysis. RESULTS: Two hundred fifteen families (109 in IG, 106 in CG) were included in the trial. Data from 43 CA in both the IG and CG were used in the primary analysis. An odds ratio of 0.52 (95% CI: 0.25; 1.09) indicated a statistically not significant advantage of the IG over the CG. No clinically relevant advantage of the IG in any secondary outcome was found. CONCLUSIONS: The CHIMPS program will be revised to provide families with more needs-based assistance. A diagnostic evaluation, which was delivered to both IG and CG families, may have had a therapeutic effect. Future trials should place particular emphasis on improving accessibility and adherence among CHIMPS and their families, as the target group proved difficult to reach and retain. Above all, interdisciplinary structures that enable CHIMPS and their families to receive low-threshold care must be created. CLINICALTRIALS: gov NCT0230846 (December 4, 2014). German Clinical Trials Register DRKS00006806 (October 7, 2014).

BACKGROUND: Emotion regulation (ER) plays a crucial role in adolescent mental health, yet its complexity is often overlooked. ER involves the use of multiple strategies, and individuals frequently combine several strategies to manage their emotions. To better capture this complexity, person-centred approaches have increasingly been used to identify ER strategy profiles. However, research on ER profiles among adolescents remains limited. The present study therefore adopted a person-centred approach to identify ER strategy profiles in adolescents and examine their associations with mental health outcomes. METHODS: Survey data were collected from a community sample of Swedish adolescents (n = 759; M = 13.9 years; 48.6% girls). The survey included measures of six ER strategies, including rumination/negative thinking, positive reorientation, social support, aggressive outlet, creative expression, and distraction, as well as measures of life satisfaction, anxiety, depression, and non-suicidal self-injury (NSSI). Latent profile analysis was used to identify distinct ER strategy profiles. RESULTS: Five ER profiles were identified: Positive Reorientation-Focused, Minimal Strategy, Multiple Strategy, Rumination-Focused, and Creative Rumination-Aggression. The profiles differed significantly across all mental health outcomes, with large effect sizes. The Positive Reorientation-Focused and Minimal Strategy profiles showed the most favourable mental health, whereas the Multiple Strategy profile showed intermediate outcomes. The Rumination-Focused and Creative Rumination-Aggression profiles showed the poorest mental health. Notably, the Minimal Strategy profile, comprising primarily boys, was associated with favourable outcomes despite limited strategy use. The Creative Rumination-Aggression profile, which consisted predominantly of girls, showed the most severe pattern, with nearly half of its members scoring within the clinical range for anxiety and 75.5% reporting repetitive NSSI. Creative expression occurred in profiles characterized by both favourable and poorer mental health, suggesting that its associations with mental health may vary depending on the broader ER configuration in which it occurrs. CONCLUSIONS: The findings suggest that favourable mental health outcomes are associated with multiple ER strategy configurations rather than a single optimal pattern, and that the associations between individual strategies and mental health may depend on the broader regulatory repertoire in which they are embedded. Longitudinal research is needed to clarify whether minimal strategy use reflects an adaptive pattern or a potential vulnerability over time, and to evaluate the relative stability and developmental relevance of the five- and six-profile solutions.

BACKGROUND: Prevalences of psychological distress among young women are high and rising. Despite a vast number of potentially helpful mental health apps (MHA), dissemination is limited. The current study aims to inform user-centered development and implementation of mental health apps for young women by examining mental health problems in the target population, existing help-seeking patterns and their gaps, perceived barriers to both conventional and digital care, and preferred MHA characteristics. METHODS: 521 women between the ages of 18 and 35 participated in a cross-sectional online survey. Alongside descriptive data on psychological distress, help-seeking behaviour, and barriers to mental health app use, associations between indicators of psychological distress and MHA use were examined using binary logistic regression. Thematic analysis was used to reveal attributes of MHA that are considered professional and most helpful by this group. RESULTS: The most common psychological distress symptoms were fatigue (79%), worry (79%), and tension (74%). Frequently used support sources included self-help books (60%), primary care (51%), and psychotherapy (51%); 31% had ever used MHA. Barriers to MHA use were mainly a lack of knowledge (32.5%), concerns about effectiveness (9.8%), and financial costs (9.6%). General psychological distress (OR = 1.03 [1.01-1.06], p = .012), anxiety and appetite/weight problems (ORs between 1.95 and 1.99, ps ≤ .004) were most strongly associated with MHA use. Thematic analysis showed that young women view professional appearance and helpfulness in MHA as multifaceted, emphasizing usability, security, as well as personal and technical support as relevant aspects. CONCLUSIONS: Although psychological distress is common among young women, only a minority uses MHA. Use is associated with the type of symptoms, symptom burden, knowledge of and expectations toward these tools. Improving awareness and accessibility, ensuring app quality, credibility, and data security may represent key factors for strengthening uptake and sustained use in this population.

Previous research has shown that despite higher rates of poverty and race-based discrimination, Black Americans tend to report better mental health outcomes than their non-Hispanic White counterparts. This black-white mental health paradox has been attributed to greater religious involvement and associated health benefits among Black Americans. Data for this study come from a U.S. national sample (n = 1,259) who reported being sick in the past twelve months. Regression analysis indicates that Black American and Hispanic/Latino respondents reported lower levels of depressive symptoms. Frequent attendance at religious services and meetings is associated with lower levels of depressive symptoms, but only for Black Americans and Hispanics/Latinos. Interestingly, the public and private dimensions of religion are positively associated with increased levels of depressive symptoms.

OBJECTIVES: The Alzheimer's Association has reported a 746% increase in dementia-related deaths in Asian American populations between 2000 and 2018, the most significant rise compared to all other racial groups. Asian Americans face a unique myriad of obstacles and factors contributing to significant health disparities, including those in dementia. Our aim is to compare determinants and outcomes of dementia between US-born and foreign-born Asian Americans. METHODS: Data from the 2019-2022 National Health Interview Survey was analyzed to examine the relationship between nativity and dementia. Other life course risk factors and outcomes of having dementia were also included in the analysis. The study sample included 16,331 US-born and 126,978 foreign-born Asian Americans. RESULTS: Foreign-born Asian Americans were found to have a higher proportion of dementia compared to US-born Asian Americans (1.1%>0.4%, p = 0.0140). Risk factors that were found to significantly explain the relationship between nativity and dementia included age > 65, ever being married, having some college education, and having Medicaid coverage. Foreign-born Asian Americans with dementia are more likely to suffer from depression (p < 0.001) and experience/have difficulty in social involvement (p < 0.001) compared to US-born Asian Americans with dementia. CONCLUSION: Our findings reaffirm that nativity contributes to the heterogeneous risk and outcomes of dementia in Asian Americans and the likelihood of having dementia is further impacted by life course factors. Interventions to support Asian American immigrants are needed to reduce the burden of dementia. More studies that identify nativity variations are also recommended to address health disparities that disproportionately affect older immigrants.

By observing others' experiences, humans learn about threats while avoiding firsthand dangers. Yet, previous neuroscience research has focused on observational threats that are predictable. In firsthand learning, temporally predictable and unpredictable threats can be mechanistically discerned. In this study, we developed a novel observational paradigm in which participants learned from predictable and unpredictable observational threats, as well as a no-threat condition. Participants encountered the same conditions during an expression phase to investigate how the brain encodes predictive and unpredictive threat cues observed in others. Participants in Experiment 1 (n = 20, 14 female, 6 male) and Experiment 2 (n = 23, 9 female, 1 non-binary, 13 male) successfully learned threat contingencies, showing heightened threat expectations for predictive cues and unpredictable condition-onsets. Behavioral findings converged with neural (fMRI, Experiment 2) responses in the anterior insula during the expression phase. Reflecting the dynamic process of learning, amygdala activation in response to predictive threat cues displayed a linear decrease across trials. Interestingly, BOLD responses to others' pain that was predictable, were enhanced within the amygdala, insula and hippocampus, compared to unpredictable conditions. Our findings suggest that humans can learn to resolve temporal threat uncertainty, through the observation of others. The present work thereby contributes to understanding the social aspects of fear and anxiety disorders.