Acta Neuropsychiatrica

IntroductionSepsis is a life-threatening ailment caused by an exaggerated immune response to infection that poses a major health problem, with increasing prevalence, high costs, and poor outcomes. Improved outcomes are seen in patients when providers follow the Surviving Sepsis Campaign recommended clinical practice guidelines for identifying and treating sepsis using a 3-hour and 6-hour bundle after sepsis is suspected. Previous research has shown patients with mental health issues receive worse quality of diabetes and cardiac care and have poorer outcomes compared with those without mental health issues. Similarly, patients with mental health issues may receive worse sepsis care due to inability to explain symptoms, agitation, etc. This study explores sepsis quality of care among patients with vs. without an acute mental health crisis, and whether patients with certain mental health issues were more likely to receive sepsis bundle care than others. MethodsUsing data extracted from 2018-2019 at the Long Island Jewish Medical Center Emergency Department (ED), patients who met sepsis inclusion criteria were grouped into either having, or not having, a severe mental illness crisis on the basis of whether physical or chemical restraints were used in the ED. Patients with a history of a severe mental illness, but who were not in a severe mental health crisis, were grouped with the patients without mental health illness, as, in the absence of an acute psychiatric problem, their mental health issue unlikely affected sepsis care. We describe demographic characteristics of both groups and performed a univariate analysis using Students T-test to compare the percent of those with vs. without acute mental health crisis who received full 3- and 6-hour sepsis bundle care. Patients with an acute mental health crisis were grouped according to "cognitive" (eg, dementia) vs. "non-cognitive" (eg, schizophrenia) disorders. ResultsComparing those with vs. without acute mental health crisis, there was no difference in the percent of patients who received 3-hour sepsis bundle care (80.7% vs 74.9%, p = 0.1456). However, among patients who received the 3-hour bundle, a significantly-greater percent of those with an acute mental health crisis received the 6-hour sepsis bundle (51.0% vs. 30.7%, p <0.0001). There was no difference between different groups of patients with mental health issues (eg, "cognitive" vs. "non-cognitive") with respect to receiving 3- or 6-hour sepsis bundle care. DiscussionSurprisingly, although there was no significant difference in likelihood to receive a 3-hour sepsis bundle among patients with vs. without an acute mental health crisis, those with an acute mental health crisis were more-likely to receive 6-hour care. We suspect this difference might be due to increased attention paid to patients with an acute mental health crisis, including more-frequent room visits by hospital staff or more concerns among family members. No particular set of mental health conditions was associated with receiving or not receiving appropriate care. Future research could address possible confounding factors, go into more detail about the specific component of the sepsis protocol that patients failed to receive, and specify what aspects of a mental health crisis affected treatment plans. Future studies are needed to assess possible associations between severe mental illness crisis, bundle care, and mortality in relation to ED, Intensive Care Unit (ICU), or hospital length-of-stay (LOS).

Background and HypothesisSchizophrenia is a disease characterized by various symptoms and has severe lifelong impacts on patients and their families. Despite various hypotheses and associated studies, the key mechanism in schizophrenia is not fully elucidated. In the present study, we focused on adropin, a peptide regulating energy metabolism, antioxidation, and neuroprotection. Study DesignIn both the group of healthy volunteers (HV) and the group of patients with some schizophrenia spectrum and other psychotic disorders (SZ), we evaluated adropin along with other variables such as anthropological factors, psychological well-being indicators, and laboratory test results. Study ResultsThe adropin levels in SZ were not significantly different from those in HV. Correlation analysis indicated five significant correlations beyond various natural correlations arising from fundamental proportional relationships and multifaceted psychological well-being indicators: (1) adropin versus right handgrip strength in the SZ group ({tau} = -0.82, P = 0.066); (2) adropin versus selenium in the total group ({tau} = 0.44, P = 0.053); (3) ferritin versus perceived stress in the total group ({tau} = -0.44, P = 0.053); (4) right versus left handgrip strength in the total group ({tau} = 0.70, P = 0.001) and in the SZ group ({tau} = 0.82, P = 0.075); and (5) selenium versus state anxiety in the total group ({tau} = 0.44, P = 0.053) and the SZ group ({tau} = 0.84, P = 0.066). ConclusionsThe present study provides a foundation for future studies and sheds light on the role of adropin in schizophrenia.

BackgroundGlaucoma is identified as one of the leading causes of blindness worldwide. Its chronic nature and the potential for irreversible vision loss contribute to significant distress among affected individuals. Around 25% of individuals with glaucoma are estimated to experience depression, negatively impacting their quality of life and treatment adherence. However, data on the prevalence of depression among people with glaucoma in Tanzania is limited. This study aimed to determine the prevalence and factors associated with depressive symptoms among adults with glaucoma at Muhimbili National Hospital. Materials and methodsA cross-sectional study was conducted involving 297 adults with glaucoma, who were recruited consecutively from the ophthalmology clinic at Muhimbili National Hospital between July and November 2024. Data on biopsychosocial factors were collected using interviewer-administered questionnaires and medical records. Patient Health Questionnaire-9 and Oslo Social Support Scale assessed depressive symptoms and social support, respectively. Data were analyzed using STATA version 16. Logistic regression analyses identified factors associated with probable depression, with statistical significance set at p-value<0.05. ResultsThe mean age of participants was 63.6 years (SD{+/-}12.8), with 159 (53.5%) being female. Prevalence of probable depression was 11.1%, with 8.7% moderate, 2.4% moderately severe, and none reporting severe depressive symptoms. Having moderate social support (AOR 0.14; CI: 0.04-0.47; P=0.001) and strong social support (AOR 0.08; CI: 0.03-0.25; P<0.000) were significantly associated with lower odds of probable depression. ConclusionApproximately 1 in 10 individuals with glaucoma experience depression. Having good social support was identified as a protective factor against depression in people with glaucoma. These findings underscore the need for a multidisciplinary approach integrating psychosocial services into ophthalmology clinics.

ObjectiveTo analyze the structure of mental disorders in children in the outpatient practice of a specialized mental health center for optimization of care organization for this patient category. MethodsA retrospective analysis of medical records of 23 children (out of 44 patients) at the Insight Mental Health Center (Dushanbe, Tajikistan) was conducted for the period from December 9, 2025, to January 8, 2026. Diagnosis was performed according to ICD-10 criteria using standardized instruments: M-CHAT-R, ADOS-2, and ADI-R for autism spectrum disorder (ASD); SNAP-IV for attention deficit hyperactivity disorder (ADHD); CGI; and pediatric versions of PHQ and GAD. ResultsChildren accounted for 52% of all patients. Primary school-age children (7-12 years) predominated at 43.5%. Disorders of psychological development (F80-F89) dominated the nosological structure at 82.6%, with ASD comprising 56.5%. ADHD was diagnosed in 30.4% of cases. Comorbidity was registered in 47.7% of patients. ConclusionThe structure of pediatric psychiatric pathology is characterized by a predominance of developmental disorders and high comorbidity levels, justifying the need for a multidisciplinary approach.

The COVID-19 pandemic had substantial impact on healthcare systems across the globe, including psychiatric services. Use of electroconvulsive therapy (ECT), a lifesaving intervention for severe mental illness, was reported to have declined during the pandemic in several countries, but nationwide data remain scarce. Using nationwide data from the Danish National Patient Register, we examined all ECT treatments administered in Denmark from September 2019 to May 2025. Weekly treatment numbers were visualized across the three national COVID-19 lockdowns to descriptively assess changes in ECT use. A notable reduction in ECT treatments was observed in the weeks preceding and during the first lockdown (March 11 to May 18, 2020). A post-hoc estimation indicated approximately 1,366 "missed" treatments during the initial pandemic phase in 2020. When these were added to the 27,033 treatments delivered in 2020, the adjusted total approximated annual treatment volumes in 2019 and 2022, suggesting a temporary disruption rather than sustained decline. In contrast, ECT activity during the second and third lockdowns appeared largely unaffected. These findings suggest that ECT provision in Denmark was temporarily reduced during the initial phase of the pandemic but remained resilient thereafter. In the case of a future pandemic, safeguarding timely access to ECT--particularly in early phases-- should be prioritized given its critical role in the treatment of severe mental illness.

Burnout, a state of chronic exhaustion often characterized by feelings of emotional exhaustion, cognitive and emotional dysregulation, and psychological distancing, is an increasingly recognized issue within most professions. This syndrome results in diminished job satisfaction, strained interpersonal relationships, and decreased well-being. Socio-demographic factors have been shown to play a role in burnout risk, while trait mindfulness has been identified as an effective method to mitigate it. This study aimed to identify the prevalence of burnout risk and its relationship with mindfulness and socio-demographics among medical researchers. An anonymous, online, cross-sectional survey was administered to corresponding authors published in MEDLINE. The survey consisted of screening and socio-demographic questions, as well as validated assessment tools (i.e., shortened work-related Burnout Assessment Tool [BAT-12] and shortened Freiburg Mindfulness Inventory [FMI-14]). Responses were analysed according to the BAT and FMI guidelines, alongside regression analyses. A total of 1,732 participants completed the survey, yielding a response rate of 1.88%. Overall, 38.8% of participants were at risk or at very high risk of burnout, and the mean mindfulness score was 37.51. Multiple linear regression analysis indicated that sex, age, and employment status were significant predictors of burnout risk, while age and region significantly predicted mindfulness. Hierarchical regression analysis showed that, after controlling for socio-demographic variables, mindfulness was a strong and independent negative predictor of burnout risk. These findings on burnout risk and the influence of mindfulness and socio-demographics could guide future research in developing tailored interventions and policies that improve the well-being of medical researchers.

Numerous studies have shown that adults with depression have distinct oculomotor alterations during saccade tasks, but whether similar alterations occur in adolescents is largely unknown. The purpose of this study was to test if eye-tracking during a structured saccade task could distinguish a group of adolescents with depression from healthy controls. We hypothesized that, due to overlapping circuitry between depression pathology and the oculomotor system, adolescents with depression would show alterations in fixation, saccade, and pupil behaviour. 51 adolescents with depression and 66 age-matched healthy controls completed the Interleaved Pro- and Anti-Saccade Task (IPAST) and several self-reported questionnaires for psychiatric symptoms. Oculomotor outcomes included fixation acquisition, fixation breaks, correct rate, saccadic reaction time, rate of correct express-latency pro-saccades, rate of express- and regular-latency anti-saccade errors, baseline pupil size, as well as pupil constriction and dilation sizes following task instruction. In comparison to healthy controls, adolescents with depression displayed impairments acquiring fixation (p<.001), made more fixation breaks in pro- (p=.023) and anti-saccade trials (p=.005), more anti-saccade errors (p=.013), more express-latency saccades overall (ps=.016), had a smaller pupil constriction in pro-saccade trials (p=.047) and had a smaller pupil dilation in pro- (p=.011) and anti-saccade trials (p=.041). No differences were found for saccadic reaction time, rate of correct pro-saccades, rate of regular-latency anti-saccade errors, pupil constriction size during anti-saccade trials, or baseline pupil size. Patients had psychiatric comorbidities and were using psychotropic medication. While this reflected clinical reality, these factors may have influenced oculomotor behaviour. Adolescents with depression had altered fixation, saccade, and pupil behaviour during IPAST. Given that many cases of adolescent depression remain undetected, accessible and objective screening approaches are highly needed. This oculomotor phenotype may be used in the development of such a screening tool to detect those at risk.

BackgroundEarly detection of individuals at risk for clinical deterioration in first-episode psychosis (FEP) remains a vital challenge in psychiatric care. Emerging evidence indicates that immune dysregulation might play a crucial role in the pathophysiology and progression of psychotic disorders. AimsThis study examined the predictive potential of a plasma cytokine and chemokine panel in anticipating clinical stage transition of FEP patients. MethodUsing multiplex immunoassays, plasma samples from a cohort of 35 FEP patients were screened for the quantification of 21 analytes. Participants were clinically assessed at baseline and follow-up and classified according to a validated staging model. Data was used to predict clinical stability over a 12-month follow-up period. ResultsIL-17A was found to be significantly increased in transitioning patients (p = 0.045), with a medium standardized effect size and wide confidence interval (Hedges g = - 0.687, 95% CI [-1.379, 0.004]). A logistic regression model was determined, which revealed that higher baseline levels of IL-17A were significantly linked to progression to a more advanced clinical stage, while higher baseline levels of MIP-3 and IFN-{gamma} were associated with clinical stability. This combined cytokine model exhibited strong predictive capacity (AUC = 0.853), indicating its potential as a biomarker panel for early risk assessment. ConclusionsThese findings highlight the importance of neuroimmune mechanisms in the development of psychotic disorders and advocate for the inclusion of immunological markers within staging-based models of care. Incorporating cytokine profiling into clinical practice could improve personalised treatment strategies and lead to better long-term outcomes for individuals with FEP.

Armed conflict in Sub-Saharan Africa has exposed millions of civilians to repeated and severe traumatic events, yet the prevalence of posttraumatic stress disorder (PTSD) and its associated determinants across the region have not been comprehensively synthesised. This study aimed to estimate the prevalence of PTSD and examine its associated factors among conflict-affected adult populations in Sub-Saharan Africa. Methodological quality was assessed using the Joanna Briggs Institute (JBI) criteria for cross-sectional and epidemiological studies A systematic search of PubMed, MEDLINE, Embase, Scopus, CINAHL, APA PsycINFO, the Cochrane Library, and the WHO Global Index Medicus (including African Index Medicus) was conducted for studies published between January 1, 2000, and May 31, 2025. Observational studies reporting PTSD prevalence among adults aged 18 years or older exposed to armed conflict were included. Study selection followed PRISMA 2020 guidelines, with independent screening by two reviewers. Random-effects meta-analyses with logit transformation were used to pool prevalence estimates, and determinants were synthesised narratively with emphasis on adjusted effect estimates. Heterogeneity was assessed using the I{superscript 2} statistic. Sixty-eight studies comprising 82,021 participants from 13 countries met inclusion criteria. The pooled prevalence of PTSD was 43% (95% CI, 35.9%-50.0%), with substantial heterogeneity (I{superscript 2} = 99.9%). Prevalence was highest among refugees (79%), followed by internally displaced persons (48%) and residents of conflict-affected communities (34%). Female sex was consistently associated with increased odds of PTSD (pooled adjusted odds ratio approximately 2.0), as were comorbid depression or depressive symptoms (AOR range 4.2-9.5). Additional correlates included cumulative trauma exposure, displacement, poor social support, and substance use. Overall, PTSD is highly prevalent among conflict-affected adults in Sub-Saharan Africa, underscoring the need for integrated, context-sensitive mental health strategies to address the enduring psychological consequences of armed conflict in the region.

BackgroundWhile commonly accepted depressive subtypes reflect phenotypic differences, there has been minimal progress in identifying discrete pathophysiological pathways, biomarkers or differential therapeutic approaches which effectively guide clinical management. AimsTo test the biological validity and clinical utility of a circadian subtype of depression on the basis of clinical course, differential medication response (self-reported) and genetic risk profile. MethodsCross-sectional data were drawn from the nationwide, genetically-informative Australian Genetics of Depression Study. Participants were classified as having a "circadian" versus "non-circadian" subtype of depression on the basis of meeting criteria for at least three binary circadian features: social jetlag, seasonality, delayed sleep midpoint, evening chronotype, sleep inertia, and hypersomnia. Clinical course characteristics were compared. Associations with response to commonly prescribed antidepressants and polygenic risk scores (PGS) for mental disorders and sleep, circadian, metabolic and inflammatory traits, were investigated using logistic regression models. Results2,604 participants (23%; 80% females; mean age=37.87{+/-}13.62) had a circadian subtype. These cases reported an earlier age of onset (p<0.001), more severe clinical features including hypo/manic-like and psychotic-like experiences, suicidality, psychological distress and somatic complaints (ps<0.001), weight gain during depressive episodes (p<0.001), poorer response to SSRIs (OR=0.88 [0.82, 0.94]) and SNRIs (OR=0.89 [0.83, 0.97]) and more side-effects, compared to those with a non-circadian subtype. Having a circadian subtype was associated with higher PGS for attention-deficit/hyperactivity disorder (OR=1.11 [1.06, 1.17]), major depression (OR=1.11 [1.06, 1.16]), bipolar disorder (OR=1.09 [1.04, 1.14]), body mass index (OR=1.09 [1.05, 1.14]), triglycerides (OR=1.10 [1.06, 1.16]), interleukin-6 (OR=1.08 [1.03, 1.13]), higher insulin resistance (OR=1.08 [1.04, 1.13]), later sleep midpoint (OR=1.15 [1.10, 1.21]), insomnia (OR=1.08 [1.03, 1.13]), and later chronotype (OR=0.68 [0.65, 0.71]). ConclusionThese findings support the face validity and potential clinical utility of circadian subtype of depression as a clinical profile. Pending independent replication, investigation of its biology and predictive utility are warranted.

Objective: Posttraumatic stress disorder (PTSD) after a traumatic birth is a serious but overlooked maternal morbidity, affecting ~20% of women following medically complicated deliveries. PTSD can undermine maternal caregiving. Rapid screening tools suited to busy obstetric settings are lacking. We developed and evaluated a brief screener, derived from the 20-item PTSD Checklist for DSM-5 (PCL-5), to identify PTSD related to childbirth. Study Design: We enrolled 107 women with traumatic childbirth. Participants completed the PCL-5 and the gold-standard clinician diagnostic interview for PTSD (CAPS-5); depression was measured with the Edinburgh Postnatal Depression Scale (EPDS). Bootstrap resampling with LASSO regression identified PCL-5 items most associated with PTSD. Firth logistic regression models estimated diagnostic accuracy. Sensitivity, specificity, area under the ROC curve (AUC), and Youden's J statistic determined performance and optimal cut-off. Results: A six-item version of the PCL-5 (PCL-5 R6), statistically derived from the full scale, showed excellent discrimination for PTSD compared with clinician evaluation (AUC = 0.95; 95% CI, 0.89-1.00). A cut-off score of 7 yielded high sensitivity (0.96) and good specificity (0.83), with an overall diagnostic efficiency of 0.86, detecting most PTSD cases while minimizing false positives. The PCL-5 R6 correlated moderately with the EPDS (rho = 0.53), showing that a depression screen alone cannot reliably detect PTSD. Conclusions: A short, 6-item PCL-5 provides a valid, efficient tool for detecting childbirth PTSD. Its brevity and accuracy make it practical for integration into routine postpartum care, enabling timely mental health screening.

ObjectiveGiven the episodic nature of bipolar disorder (BD) and the variability in mood episode recurrence across individuals, accurate recurrence prediction is critical. The original COBY recurrence risk calculator (RC) was developed in a longitudinal youth cohort to estimate threshold recurrence risk. However, its accuracy for predicting subthreshold recurrences had not been fully evaluated. The objective of this study was to extend the previously developed COBY mood recurrence RC to predict both threshold and subthreshold mood recurrences and evaluate its performance in an independent sample. MethodAdolescents and young adults with BD-I/II (N= 51; BD-I: 38, BD-II: 13; 14-24 years old) were interviewed with standard instruments at intake and during the follow-up on average every 6 months for a median of 54 weeks. We assessed the degree to which the COBY RC predicted mood recurrence (threshold or subthreshold) in this independent sample. Discrimination was measured using the area under the receiver operating characteristic curves (AUC); calibration and variable importance were also assessed. ResultsThe model demonstrated good prediction of any recurrence within the next six months (any threshold recurrence AUC = 0.72, any subthreshold or worse recurrence AUC = 0.77). Calibration analysis demonstrated the model tended to overestimate risk in the external sample, plausibly attributable to differences in recurrence ascertainment strategy (prospective vs retrospective) or the significant difference in prior remission length, a key predictor. Recalibration greatly improved calibration without loss of discrimination. ConclusionThe mood recurrence RC demonstrated good discrimination for both threshold and subthreshold mood recurrences in an independent young adult cohort, consistent with prior youth and adult validations. Validation now spans across developmental stages and different degrees of severity of mood symptoms opening the opportunity for clinical implementation to provide personalized monitoring and early intervention for people with BD.

BackgroundIn 2020, Oregon became the first U.S. state to establish a regulated framework for adults to access psilocybin services using naturally-derived mushroom products. No studies have examined mental health outcomes among individuals receiving psilocybin in this context. AimsTo evaluate changes in self-reported symptoms of depression, anxiety, and well-being 30-days post-psilocybin session under the Oregon state-regulated model , and document session-related adverse events and doses consumed. MethodsThis was a naturalistic study (March 2024-April 2025) among adults [&ge;]21 years participating in a legal psilocybin services program. Online surveys were completed pre-session, 1-day, and 30-days post-session. Primary outcomes were change in depression, anxiety, and well-being symptoms pre-session to 30-days post-session evaluated using linear mixed-effects models (random effect: timepoint; fixed effects: sex, concurrent psychiatric medication use, age, session dose [total psilocybin equivalents, TPE, mg: psilocybin mg + 1.39 * psilocin mg]). Adverse events (e.g., hallucinogen persisting perception disorder [HPPD]) were assessed at 1-day and 30-days post-session. ResultsParticipants (n=88; median age 43 years; 52% male) were predominantly Oregon residents (53.4%), psychedelic-experienced (64.8%), and concurrently using psychiatric medication (46.6%). All outcomes improved significantly at 30-days post-session (p<0.001), including in sensitivity analyses stratified by concurrent psychiatric medication usage (p<0.001 all outcomes, both groups). Two participants (2.3%) reported symptoms consistent with HPPD at 1-day post-session, but none at 30-days. Mean dose was 27.8 mg (SD 8.2) TPE. ConclusionsPsilocybin sessions delivered under the Oregon regulatory model were associated with clinically meaningful improvements in depression, anxiety, and well-being 30-days post-session, supporting therapeutic effectiveness of legal psilocybin services.

Depression is a common and clinically significant mental health condition among university students, particularly those experiencing academic failure and course repetition, and is associated with adverse effects on cognitive functioning, emotional regulation, and academic performance. This study evaluated the efficacy of an internet-based cognitive behavioural therapy (iCBT) intervention, MoodGYM, in reducing depressive symptoms among repeating undergraduate students at the University of Zambia Ridgeway Campus. A quasi-experimental quantitative study design was employed. Seventy-five repeating undergraduate students with depressive symptoms were enrolled, with 33 assigned to the MoodGYM intervention group and 42 to a control group. Depressive symptom severity was assessed using the Beck Depression Inventory (BDI) at baseline and after an eight-week intervention period. Statistical analyses included within-group and between-group comparisons, difference-in-differences estimation, and fixed-effects regression modelling. At baseline, participants exhibited predominantly moderate to severe depressive symptoms, with no statistically significant differences between the intervention and control groups. Following the eight-week intervention, the MoodGYM group demonstrated a statistically and clinically significant reduction in depressive symptoms, with median BDI scores decreasing from 22 to 16 (p < 0.001), representing a large effect size (Cohens d = 1.02). In contrast, the control group showed persistence or worsening of depressive symptoms over the same period. Difference-in-differences analysis confirmed a robust intervention effect, with an approximately 10-point greater reduction in depression scores among MoodGYM participants compared with controls (p < 0.001). These findings indicate that MoodGYM is an effective internet-based intervention for reducing depressive symptoms among repeating undergraduate students and offers a feasible and scalable approach to addressing student mental health needs in low-resource university settings.

BackgroundMental well-being encompasses positive psychological functioning, life satisfaction, and engagement with daily activities. It is influenced by multiple interrelated factors, including symptoms of stress, anxiety, depression, and psychological inflexibility. Network analysis provides a data-driven framework for examining the complex interconnections between these components and for identifying elements that may play a central role in the mental well-being system. The present study aimed to identify key elements related to stress, anxiety, depression, and psychological inflexibility associated with mental well-being in individuals seeking online psychological support. MethodsThis cross-sectional study analyzed data drawn from the Online Well-being intervention. A total of 967 Mexican participants were included. A psychological network comprising seventy-four items was estimated, and centrality indices (strength, closeness, and betweenness) were computed to determine the relative importance of individual elements within the network. Network comparisons by gender were conducted to evaluate global and local differences. ResultsThe network revealed multiple inter-domain associations, particularly negative relationships between mental well-being and symptoms of depression, anxiety, negative stress, and psychological inflexibility. Items reflecting self-evaluation and emotional well-being consistently emerged as the most central elements in the network across centrality metrics. Gender-based comparisons indicated overall structural similarity between networks, although differences were observed in the strength of specific connections. ConclusionsNetwork analysis identified central elements linking mental well-being with psychological distress and inflexibility in a population seeking online psychological support. These findings contribute to a systems-level understanding of mental well-being and highlight potential targets for psychological interventions to enhance well-being and reduce distress.

There is a predicted increase in older adults presenting with mild to severe cognitive impairment. Screening tools with high sensitivity are the first frontier in identifying a cognitive pathology; however, to ensure that they are measuring the intended concept or criterion, thorough psychometric procedures should be followed. In this study, convergent criterion validity of Riga Cognitive Screening Task was measured, using cortical thickness of regions of interest as the criterion. 106 older adults (Mage = 70.49, SD =8.08, 35.8% male) with varying levels of cognitive functioning were involved in the study. All participants underwent cognitive assessment with the screening task and a 3T MRI. Cortical thickness of selected temporal and parietal regions was used as a brain measure. Behavioural Partial Least Squares Correlation was conducted and one latent variable was extracted. The results confirmed that Riga Cognitive Screening Task shows good criterion validity, suggesting successful use for screening.

Schizophrenia is a severe neuropsychiatric disorder characterized by positive and negative symptoms and cognitive impairments. The present study aimed to investigate the potential interference of ambient noise on the performance of executive function (EF) tasks in individuals with schizophrenia. The sample consisted of 40 participants, divided equally into two groups: a group of individuals with schizophrenia (SchG) and a healthy control group without neuropsychiatric disorders (HC). All participants did three EF assessment instruments: Trail Making Test, Corsi Block Test, and Maze Test. The experimental design included a test-retest procedure with order counterbalancing: half of the sample began the assessment in the noise condition and the other half in the no-noise condition, to control for order and learning effects. The results indicate that ambient noise has a negative impact on the cognitive performance of individuals with schizophrenia. Specifically, the SchG group performed significantly worse on the Maze Test in the noise condition compared to the no-noise condition. These findings contribute to the understanding of the interactions between sensory and cognitive processes underlying the symptoms of schizophrenia. In addition to their theoretical potential, the results have practical implications, as they support the development of intervention strategies and ambiental adaptations that can improve the functionality and quality of life of people with the disorder.

Background At present, there are no approved pharmacological treatments for people at clinical high risk for psychosis (CHR-P). We sought to assess the acceptability of cannabidiol (CBD): a promising candidate treatment for this population. Methods CHR-P individuals completed a survey which assessed their views on the acceptability of CBD, its expected effectiveness and side effects, and on formulation preferences. Results The sample comprised 55 CHR-P individuals (24.3 years and 69% female). Most (91%) were familiar with CBD, and had previously used cannabis (64%), and around half (42%) had tried over-the-counter CBD. 75% were willing to take CBD as an intervention for mental health problems. Most participants anticipated fewer side effects with CBD than with existing medications, and preferred tablet or capsule formulations over liquids. Discussion CBD is perceived as a highly acceptable treatment among CHR-P individuals.

Background and HypothesisClozapine is the only antipsychotic with protective effects against suicide in schizophrenia (SCZ). Newer third-generation antipsychotics (TGA) have better tolerability and modulate serotonin, dopamine, and N-methyl-d-aspartate neurotransmission pathways implicated in suicide. We aimed to investigate the effects of TGAs on suicide in SCZ. MethodsWe searched seven databases up to December 2023 for SCZ studies that reported suicide data. The primary outcome was suicide deaths and attempts; suicidal ideation was added as a secondary outcome. Random effects meta-analyses quantified suicide risk in randomized controlled trials (RCT) while single proportion meta-analyses assessed longitudinal suicide risk in open label extension trials (OLE). For RCTs, sensitivity analyses were conducted and subgroup analyses explored the impact of dose, drug type, and comparator arm. Study ResultsTwenty articles were included; thirteen excluded higher suicide risk participants. Compared to placebo control, TGAs did not significantly change the risk of primary [RR = 0.65, p = 0.38] or secondary [RR = 0.63, p = 0.15] suicide outcomes. Subgroup and sensitivity analyses were not statistically significant. For OLEs, there was a significant increase in the incidence of primary [Ip = 0.004, p = 0.048] and secondary [Ip = 0.024, p = 0.0013] suicide outcomes, but there was marked study heterogeneity. ConclusionThere is no current trial evidence to show that TGAs significantly impact suicide outcomes in SCZ. The signal from OLEs should be interpreted cautiously due to heterogeneity and requires replication. An effective clozapine alternative is needed for suicide prevention in SCZ.

BackgroundUp to one-third of medical inpatients experience clinically relevant mental distress, yet many remain untreated. Stepped and collaborative care (SCC) models may improve access to mental health care, but predictors of service uptake are unclear. We examined patient- and ward-level predictors of psychosomatic-psychiatric consultation (PPC). MethodsWe analyzed data from SomPsyNet, a stepped-wedge cluster randomized trial targeting SOMatic inpatients across three Swiss tertiary hospitals, to prevent PSYchosocial distress by a care NETwork. Analyses focused on inpatients screening positive for mental distress. Multiple-imputed logistic regressions assessed predictors of four sequential service-use stages: PPC considered, offered, accepted, and received. ResultsAmong 589 distressed patients, 93.9% were offered PPC, 63.1% accepted, and 83.9% of acceptors received PPC, yielding a 50% overall receipt rate. Patients without Swiss citizenship showed higher odds of acceptance (odds ratio [OR]=1.82 [1.10, 3.00]) and eventual receipt (OR=1.62 [1.01, 2.62]). Being in a Geriatric ward facilitated PCC uptake, while patients from gynecology showed reduced progression through the care pathway. Age, gender, income, education, marital status, and living arrangement showed no statistically robust associations. ConclusionsAlmost two-thirds of mentally distressed medical hospital inpatients accepted an offered PPC, indicating high acceptability. About half ultimately received a consultation, highlighting substantial attrition along the SCC pathway. Ward specialty and nationality were key determinants of PPC uptake. These findings suggest that proactive, ward-oriented consultation-liaison models embedded in routine inpatient care may improve timely and equitable access to mental healthcare, including for migrant and minority patients who are otherwise less likely to access such care. HighlightsO_LIPsychosomatic-psychiatric consultation pathway of medically hospitalized inpatients C_LIO_LI63% accepted such a consultation when offered; overall 50% reached receipt. C_LIO_LINon-Swiss nationality increased odds of acceptance (OR 1.8) and receipt (OR 1.6). C_LIO_LIPatients at geriatrics wards showed higher, at gynecology wards lower transitions. C_LIO_LIResults support low-threshold, ward-oriented consultation-liaison models. C_LI