The contributors to Actas Españolas de Psiquiatría include leading professionals whose work is known both nationally and internationally. The topics covered are diverse and fall within the fields of psychiatry, clinical psychology, and mental health. Most of the contributions are original articles, although we also publish scientific reviews. Our exhaustive selection process takes the utmost care to guarantee the quality that has become the hallmark of the Journal, whose reputation is based on more than 70 years of history. Actas Españolas de Psiquiatría indexes in: EMBASE, MEDLINE, PMC, PsycINFO, SCI, SCOPUS, EBSICO, IBECS.
Development and Validation of the Resilience in Eating Disorders Scale (RED-5)
Background: A resilience scale tailored for individuals with eating disorders (EDs) could significantly enhance our understanding and treatment of EDs. Therefore, we developed and psychometrically evaluated a new Resilience in Eating Disorders scale (RED) following COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) guidelines. Method: Informed by prior qualitative interviews, the new RED scale underwent an initial pilot test among patients with EDs (n = 52) and field tests among patients with EDs (n = 169), ED-recovered individuals (n = 61), and a normative sample of the general population (n = 349), all aged between 27.9 and 29.8 years and residing in Spain. In this study, the participants completed the RED scale, Resilience Scale-25 (RS-25), Eating Attitudes Test-26 (EAT-26), World Health Organisation Quality of Life Scale – Brief Version (WHOQOL-BREF), and Hospital Anxiety and Depression Scale (HADS). Data were collected at baseline and after 1 year. Alongside machine learning techniques, exploratory and confirmatory analyses were employed to evaluate the reliability, construct validity, convergent validity, known-groups validity, predictive validity and responsiveness of the RED scale. Results: The original 52-item version of the RED scale was refined to 44 items following the pilot phase, and ultimately reduced to a 5-item version (RED-5) after field testing and psychometric evaluation. The RED-5 demonstrated strong psychometric properties, with excellent model fit indices (Root Mean Square Error of Approximation (RMSEA) = 0.03, and Comparative Fit Index (CFI) = 0.99) and acceptable internal consistency (Cronbach's alpha = 0.71). Additionally, the RED-5 scale effectively predicted quality of life, anxiety, depression, and ED symptomatology over a 1-year period. Conclusions: The RED-5 is a concise, psychometrically robust scale specifically developed to assess resilience in patients with EDs. It significantly predicts ED symptoms and quality-of-life outcomes, making it a valuable tool for both clinical practice and research. The RED-5 allows for quick administration and easy scoring. It provides mental health professionals with a tool to guide resilience-informed assessment and more personalized treatment planning.
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Association Between Postpartum Depression Symptoms of Primiparas and Uterine Recovery, Sleep Quality and Postpartum Stress
Background: To investigate the relationship between postpartum depression (PPD) symptoms in primiparous women and uterine recovery, sleep quality and postpartum stress. Methods: This retrospective study enrolled 194 postpartum women who underwent 42-day postpartum examinations in our hospital from February 2024 to February 2025. General demographic information, uterine recovery (including uterine fundal height decline, lochia volume and pelvic floor muscle recovery), sleep quality (determined using the Pittsburgh Sleep Quality Index [PSQI]) and postnatal stress levels (measured using the Maternal Postpartum Stress Scale [MPSS]) were collected through the electronic medical record system. PPD was assessed using the Edinburgh Postnatal Depression Scale (EPDS). Mothers with an EPDS score ≥10 were classified into the PPD group, and those with <10 were classified into the non-PPD group. Univariate and multivariate logistic regression analyses were performed to assess the factors influencing PPD. Results: A total of 194 primiparous women were included, 56 in the PPD group and 138 in the non-PPD group. The PPD group showed significantly higher percentage of high school education and below, discordant relationship with husband, lack of regular maternity check-ups, illness during pregnancy and poor health of newborn than the non-PPD group (p < 0.05). PSQI (p = 0.001) and MPSS (p < 0.001) scores were significantly higher in the PPD group than in the non-PPD group. In terms of uterine recovery, the PPD group had a significantly lower lochia volume at 24 and 48 h postpartum than the non-PPD group (p < 0.001) and poorer recovery of pelvic floor muscle strength (p < 0.05). Logistic regression analysis showed that high school education or less, illness during pregnancy, PSQI and MPSS scores were independent risk factors for PPD, whereas higher lochia volume at 24 and 48 h postpartum and pelvic floor muscle strength ≥grade III were protective factors. Conclusions: This study identified several specific independent risk factors (lower education level, illness during pregnancy, poor sleep quality and high postpartum stress) and protective factors (adequate lochia volume and good pelvic floor muscle recovery) for PPD. Clinical practice should strengthen the identification and intervention of high-risk groups and pay attention to the integrated management of postpartum physiological recovery and mental health.
Exploring the Effect of Genetic Testing on Personalised Treatment Plans for Depression
Background: As a result of individual genetic variations, some patients show no response to initial antidepressant medications. This study aims to investigate the association between specific genetic polymorphisms and the efficacy of antidepressant drugs and to improve the accuracy and effectiveness of treatment under the guidance of genetic testing. Methods: A retrospective screening was conducted on medical records from, Suixian People's Hospital between January 2022 and December 2024. A total 202 patients with depression carrying the CYP2C19 gene were selected after the application of exclusion criteria. They were assigned to three groups in accordance with their genetic metabolism types: the rapid metabolism group (Group A, n = 65), the intermediate metabolism group (Group B, n = 94) and the poor metabolism group (Group C, n = 43). All three groups were treated with sertraline for a six-week treatment cycle. The observation indicators included scores on the Hamilton Depression Scale (HAMD); onset time of drug effect; rates of response and remission; scores on the Clinical Global Impression–Improvement (CGI–I) scale; levels of the neurotransmitter factors 5-hydroxytryptamine (5-HT), γ-aminobutyric acid (GABA) and brain-derived neurotrophic factor (BDNF); incidence of adverse events; and scores on the Morisky Medication Adherence Scale-8 (MMAS-8). Results: The baseline data of the three groups of patients were comparable before medication (p > 0.05). Compared with those in Groups A and B, patients in Group C showed a significantly greater reduction in HAMD scores (all p < 0.05), along with higher response rates (all p < 0.05) and remission rates (all p < 0.05). Amongst the three groups, Group C had a shorter onset time of drug effect (all p < 0.05); more significant improvement in CGI–I scores (all p < 0.05); and more prominent upregulation of neurotransmitter factors, namely, 5-HT (all p < 0.05), GABA (all p < 0.05) and BDNF (all p < 0.05). Regarding the incidence of adverse events, Group C had the highest rate, whereas Group A had the lowest (10.8% vs. 24.5% vs. 41.9%). Compared with other groups, Group B exhibited a more significant increase in MMAS-8 scores (all p < 0.05). Conclusions: Metabolic phenotype exerts substantial effects on the therapeutic outcome of sertraline in patients with depression carrying the CYP2C19 gene. Amongst groups, Group C showed better therapeutic efficacy but an elevated incidence of adverse events and lower medication adherence; Group A had relatively poor efficacy; and Group B demonstrated superior adherence. In clinical practice, individualised treatment can be implemented on the basis of CYP2C19 metabolic typing to improve therapeutic efficacy and reduce adverse events and medical burden.
Maternal Anxiety and Psychosocial Burden in Childhood Atopic Dermatitis: A Comparative Study
Background: Atopic dermatitis (AD) is among the most prevalent chronic pediatric skin diseases. Beyond its cutaneous manifestations, AD imposes substantial psychosocial and economic strain on families. We quantified this burden—i.e., maternal anxiety and quality of life (QoL)—and identified its clinical and sociodemographic determinants, comparing families of children with AD to those of healthy peers. Methods: This cross-sectional study enrolled 84 mothers of physician-diagnosed patients with AD aged 3–144 months and 90 mothers of age-matched healthy children attending routine visits. Disease severity was graded with the Scoring Atopic Dermatitis (SCORAD) index. Mothers completed the State-Trait Anxiety Inventory (STAI) and the 8-item European Health Impact Scale (EUROHIS-QoL). Additionally, the Dermatological Family Impact Scale (DeFIS) was administered to the AD group. Results: EUROHIS-QoL scores were lower in the AD group than in controls (p = 0.016), whereas The State-Anxiety Inventory (STAI-S) scores were higher (p < 0.001); the Trait-Anxiety Inventory (STAI-T) scores did not differ (p = 0.125). In multivariable models, patient status (p = 0.006), higher STAI-T (p = 0.002), and greater income (USD 750–1500: p = 0.014; >USD 1500: p = 0.010) were independently associated with QoL. Anxiety was driven by patient status, lower QoL, and higher STAI-T, while trait anxiety was driven by lower QoL and higher STAI-S. SCORAD correlated negatively with QoL (ρ = –0.225; p = 0.040) and positively with STAI-S and DeFIS. Conclusions: Pediatric AD significantly impairs mothers' QoL and heightens maternal situational anxiety and these effects intensify with increasing disease severity and financial strain. Multidisciplinary, family-centered care, including psychological screening and targeted support for low-income households, is essential for comprehensive AD management.
Hospice Care's Influence on Pain, Sleep, Anxiety, and Depression: A Focus on Elderly Survivors of Cancer Chemotherapy
Background: With population ageing, the number of elderly cancer chemotherapy survivors has been increasing. In addition, the elderly often face problems, such as pain, sleep disorders, anxiety and depression, which seriously affect their quality of life. We explored the effects of hospice care on pain, sleep quality, anxiety, depression, quality of life, chemotherapy-related adverse reactions and readmission rate in elderly cancer survivors after chemotherapy to supply evidence for the clinical promotion of this nursing model. Methods: A total of 240 elderly cancer survivors who completed at least 4 cycles of chemotherapy (January 2022–June 2024) and had a 3-month follow-up were retrospectively enrolled. They were divided into the observation (hospice care + routine nursing, n = 124) and control (routine nursing, n = 116) groups. After 1:1 propensity score matching, 98 cases per group were analysed. Core (Visual Analogue Scale (VAS), Pittsburgh Sleep Quality Index (PSQI), Self-rating Anxiety Scale (SAS), Self-rating Depression Scale (SDS) and Short Form-36 Health Survey (SF-36)) and extended indicators (chemotherapy-related adverse reactions, 3-month readmission rate and nursing satisfaction) were compared pre- and postintervention. Results: Pre-intervention, no significant differences were found between groups (p > 0.05). Post-intervention, the observation group had significantly lower VAS (2.08 ± 0.85), PSQI (5.25 ± 1.32), SAS (38.15 ± 4.15) and SDS (38.86 ± 4.40) scores than the control group (4.68 ± 1.33, 8.92 ± 1.65, 49.32 ± 5.40 and 50.65 ± 5.80, respectively; all p < 0.05). The observation group showed significant improvements in all eight dimensions of SF-36 (p < 0.05), with a larger improvement range than the control group. In addition, the observation group had lower incidence of chemotherapy-related adverse reactions (nausea and vomiting: 8.16%, fatigue: 16.33%), lower readmission rate (7.14%) and higher nursing satisfaction (95.92%) than the control group (24.49%, 31.63%, 19.39% and 82.65%, respectively; all p < 0.05). Conclusions: Hospice care can effectively alleviate pain, sleep disorders, anxiety and depression in elderly cancer chemotherapy survivors, improve their quality of life, reduce adverse reactions and readmission rate and enhance nursing satisfaction and is thus worthy of clinical promotion.
Analysis of Anxiety and Depression Status and Risk Factors in Postmenopausal Women With Diabetes Mellitus Complicated by Hypothyroidism
Background: This study aimed to investigate the prevalence of anxiety and depression symptoms and analyse the associated risk factors in postmenopausal women with type 2 diabetes mellitus (T2DM) and comorbid hypothyroidism. Methods: A cross-sectional study design was employed, enrolling 152 postmenopausal women with T2DM and hypothyroidism who attended Huainan Chaoyang Hospital between February 2024 and August 2025. Psychological status was assessed using the Hamilton Depression Rating Scale and the Hamilton Anxiety Rating Scale. Demographic characteristics, clinical features and laboratory parameters were collected. Results: Amongst the 152 patients, the prevalence rates of depressive and anxiety symptoms were 26.97% and 34.87%, respectively. Between-group analyses showed that the depression group had significantly longer durations of T2DM and hypothyroidism and higher glycosylated haemoglobin (HbA1c) and thyroid-stimulating hormone (TSH) levels than the non-depression group. The anxiety group was significantly younger than the non-anxiety group, with longer T2DM duration and higher TSH levels (p < 0.05). Multivariate logistic regression analysis identified increased HbA1c level (Odds Ratio [OR] = 1.43), increased TSH level (OR = 1.36) and longer T2DM duration (OR = 1.21) as independent risk factors for depressive symptoms, whereas higher income served as a protective factor (OR = 0.19). For anxiety symptoms, younger age (OR = 0.88), longer T2DM duration (OR = 1.19) and increased TSH (OR = 1.23) were independent risk factors. Conclusions: Anxiety and depressive symptoms are prevalent amongst postmenopausal women with T2DM and hypothyroidism. Poor glycaemic control, thyroid dysfunction and longer diabetes duration are primary risk factors.
Stress, Anxiety, and Depression Among Spanish University Professors: Associations With Lifestyle Habits and Physical and Mental Health Indicators
Background: Professors play a crucial role in the educational process, making their well-being a key area of interest in research on universities as health-promoting settings. The scientific literature emphasizes that various contextual, personal, and behavioral factors have a direct impact on faculty health. To estimate the prevalence of stress, anxiety, and depression among Spanish university professors, and to examine their associations with lifestyle habits and indicators of physical and mental health. Methods: A cross-sectional study was conducted with 1560 participants (mean age 47.39 ± 11.29 years) from thirteen universities that are part of the Spanish Network of Health-Promoting Universities. The variables assessed included stress, anxiety, depression, burnout, health-related quality of life, physical activity, sedentary behaviour, dietary patterns, sleep quality, and vocal fatigue. Results: Regression analyses revealed that, across all three outcomes, lower mental well-being, greater emotional exhaustion, and more frequent sleep disturbances were significant predictors of psychological distress. For stress and anxiety, being female and younger also emerged as significant demographic predictors. Stress was additionally associated with increased emotional eating and reduced vocal recovery, whereas anxiety was linked to greater physical vocal discomfort. Depression was predicted exclusively by lower mental well-being, higher emotional exhaustion, and more sleep problems. Conclusions: The psychological health of university faculty is influenced by a complex interplay of well-being, occupational, and lifestyle factors. Interventions aimed at enhancing emotional regulation, promoting sleep hygiene, ensuring balanced workloads, and providing psychosocial support, along with institutional measures that address early-career vulnerabilities and gender disparities, may help mitigate stress, anxiety, and depression among university professors.
Bidirectional Mendelian Randomisation Analysis of Gastric Cancer and Depression: Evidence for the Causal Effect of Cancer on Depression
Background: The relationship between gastric cancer and depression is an area of active investigation, and recent studies suggests a bidirectional association. Understanding this relationship is crucial for improving treatment approaches and mental well-being in patients with gastric cancer. Methods: We analysed the correlation between gastric cancer and depression, using data from Genome-Wide Association Studies. Causal links were explored using Mendelian randomisation (MR) and Gene Expression Omnibus. Results: Forward MR analysis identified 24 single nucleotide polymorphisms (SNPs) meeting the criteria for instrumental variables. The analysis provided evidence of a causal effect of gastric cancer on depression (odds ratio [OR]: 1.132, 95% confidence interval [CI]: 1.032–1.231). The reverse MR analysis, examining the potential causal effect in the opposite direction, identified 15 SNPs; however, no significant causal effect of depression on gastric cancer was detected (OR: 0.834, 95% CI: 0.504–1.380). Cross-pathway analysis identified 23 genes common to both conditions. Protein interaction network analysis of these shared genes revealed that lactoferrin, lipocalin-2 and matrix metalloproteinase-9 are potential key genes in the shared pathophysiology of both diseases. Conclusions: Our study demonstrates a causal effect of gastric cancer on depression, whereas depression does not exert a causal effect on gastric cancer. These findings provide evidence for targeted depression prevention strategies for patients with gastric cancer.
Associations Between Depression Severity, Antidepressant Use, and Metabolic Syndrome Components Among Chinese Adults: A Cross-Sectional Study Based on Historical Medical Records
Background: Depression affects approximately 280 million people globally and often co-occurs with metabolic syndrome (MetS), a cluster of cardiometabolic risks that increase cardiovascular and diabetes events. This study investigates the associations among depression severity, antidepressant use and MetS components in Chinese adults. Methods: In this cross-sectional study from a Chinese hospital (2018–2025), electronic medical records of 585 adults (aged ≥18 years, 61.54% female) were analysed using convenience sampling. Depression severity was assessed via Patient Health Questionnaire-9 (PHQ-9) scores (normal: 0–4; mild: 5–9; moderate: 10–14; severe: 15–27). MetS was defined in accordance with the National Cholesterol Education Program Adult Treatment Panel III criteria (≥three components: hypertension ≥130/85 mmHg, triglycerides >150 mg/dL, high-density lipoprotein cholesterol (HDL-C) <40/50 mg/dL, waist circumference >102/88 cm for men/women and glucose ≥100 mg/dL). Logistic regression was applied to evaluate associations, including serotonin reuptake inhibitors (SSRIs) versus serotonin-norepinephrine reuptake inhibitors (SNRIs). Results: In this hospital-based cohort, patients with severe depression exhibited a substantially increased odds for clustered MetS (adjusted odds ratio [OR] = 13.461, 95% confidence interval [CI]: 2.461–253.037, p = 0.015 for one MetS component and OR = 2.129, 95% CI: 1.080–4.130, p = 0.027 for two components). Severe depressive symptoms were significantly associated with multiple MetS components, specifically hyperglycaemia (adjusted OR = 2.022, 95% CI: 1.033–4.068, p = 0.043), increased triglycerides (adjusted OR = 2.460, 95% CI: 1.304–4.661, p = 0.005) and reduced HDL-C (adjusted OR = 2.653, 95% CI: 1.397–5.102, p = 0.003). Antidepressant use increased MetS odds (central obesity OR = 3.098, 95% CI: 2.098–4.614, p < 0.001; hyperglycaemia OR = 2.312, 95% CI: 1.566–3.446, p < 0.001), with SSRIs (95.2%, n = 317) being predominant over SNRIs (4.8%, n = 16) but having similar metabolic impacts in subgroups. Conclusions: Depression severity and antidepressant use are significantly associated with individual components of MetS and their clustering, underscoring the need for personalised metabolic screening in affected patients. Recognising and addressing metabolic abnormalities in individuals with depression are essential to optimise treatment outcomes and mitigate long-term cardiometabolic risks.
Dysbiosis in the Family nucleus of Children Diagnosed With Autism Spectrumin Mexico City
Background: The relationship between the gut microbiome and Autism Spectrum Disorder (ASD) has been the subject of growing interest in scientific research. Research into the relationship between the gut microbiome and ASD has gained relevance in recent years as recent studies have identified significant differences in the gut microbiome abundance and composition in ASD children compared to neurotypical ones. However, little is known about the microbiome interplay, changes and relationship in parents and children with ASD, considering that they share a consistent environment. Charactering the microbiota of trio-type families with a child diagnosed with autism. Methods: The hypervariable region of the 16s ribosomal gene was sequenced from stool samples from adolescents with ASD and their parents. The analysis was performed using various software programs, including QIIME2 and DADA2. Results: In this paper, we discuss this relationship in three families, and observed that the gut microbiome of the offspring with ASD is more similar to the mother's than the father's microbiome. Conclusions: These observations could lead to the understanding of the potential heritability of the disorder through parental connectedness of the gut microbiome and eventually to the development of interventions aimed at modulating the gut microbiota to improve symptoms associated with ASD.
Autism and Schizotypal Traits in Relation to Thought-Action Fusion in Obsessive-Compulsive Disorder
Background: Thought-Action Fusion (TAF) is one of the cognitive variables and thought misinterpretations that have been extensively studied in Obsessive-Compulsive Disorder (OCD). However, further research is needed on the specific factors contributing to the development of TAF in patients with OCD. Since autistic traits and TAF are related to cognitive processes, we hypothesized in this study that autistic traits as well as schizotypal traits and obsessive-compulsive symptoms may be associated with TAF severity in OCD patients. Methods: In this cross-sectional study, eighty-three patients (aged 18 to 65) with OCD were assessed using the Yale Brown Obsessive-Compulsive Scale (Y-BOCS), Schizotypal Personality Questionnaire (SPQ), Autism Spectrum Quotient (AQ), Thought-Action Fusion Scale (TAFS), Beck Depression Inventory (BDI), and Beck Anxiety Inventory (BAI). Results: We found that attention switching, attention to detail, and communication dimensions of the AQ were associated with higher TAF-Likelihood/Self. There was a significant association between attention shifting and TAF-Moral, while attention to detail was significantly associated with TAF Likelihood/Others. Y-BOCS-Total (β = 0.338, p = 0.001), and cognitive-perceptual traits (β = 0.295, p = 0.018) were significantly associated with TAF-Moral. Likelihood/Self dimension of TAF was significantly associated with Y-BOCS-total (β = 0.386, p < 0.001), BDI (β = –0.333, p = 0.017), AQ-Total (β = 0.250, p < 0.001) and Cognitive-Perceptual schizotypal traits (β = 0.289, p = 0.016). The severity of TAF-Likelihood/Others was significantly associated with Y-BOCS-Total (β = 0.279, p = 0.012). Conclusions: We suggest that in addition to the severity of OCD and cognitive-perceptual traits, higher autistic traits may also contribute to increased levels of TAF-Likelihood/Self.
Influencing Factors, Construction and Verification of a Nomogram Model for Adolescent Depression With Nonsuicidal Self-Injury Behaviour
Background: Adolescent depression with nonsuicidal self-injury (NSSI) is a serious public health issue. NSSI involves intentional self-harm without suicidal intent and is common amongst depressed teens, leading to considerable psychological and physical risks. Early detection and intervention are essential to reduce these risks. To explore the influencing factors of adolescent depression with NSSI behaviour and construct a nomogram prediction model and verify its clinical application value. Methods: From January 2023 to April 2025, 136 cases of adolescent depression admitted to our hospital were selected. Patients were randomly divided into training (n = 95) and verification (n = 41) sets in a 7:3 ratio. Multivariate logistic regression was used to analyse the risk factors of NSSI behaviour in the training set, and a nomogram prediction model was constructed. Receiver operating characteristic (ROC) and calibration curves were drawn to evaluate the prediction efficiency of the nomogram model, and verification was conducted on the basis of the verification set. Decision curve analysis was applied to assess the clinical application value of the nomogram model for the prediction of NSSI behaviour. Results: The training and verification sets included 38 (40.00%) and 15 (36.59%) of cases of NSSI behaviour, respectively. No statistically significant differences in the incidence and clinical characteristics of NSSI behaviour were found between the training and verification sets (p > 0.05). Multivariate logistic regression analysis on the training set indicated that tense parental relationship, long depression duration, co-occurring physical diseases, high depression severity, high anxiety levels, childhood trauma, Electroencephalogram (EEG) frontal α power, functional Magnetic Resonance Imaging (fMRI) dorsolateral prefrontal cortex activation and negative life events were factors associated with NSSI behaviour (p < 0.05). The nomogram model showed good calibration and fit between prediction and reality on the training and verification sets with C-index values of 0.936 and 0.923, respectively. average absolute errors between predicted and actual values of 0.092 and 0.105, respectively. and Hosmer–Lemeshow test p values of 0.452 and 0.523, respectively. ROC curves indicated that the areas under the curve of the nomogram model for predicting the NSSI behaviour of patients with adolescent depression in the training and verification sets were 0.941 (95% CI: 0.887–0.995) and 0.928 (95% CI: 0.834–1.000), respectively, with the sensitivity of 0.929 and 0.846, respectively, and specificity of 1.000 and 0.667, respectively. Conclusion: The nomogram prediction model based on risk factors for depression with NSSI behaviour is beneficial for the early prediction of such behaviour in adolescents with depression, guiding appropriate clinical decisions and minimising the risk of NSSI behaviour, thereby safeguarding adolescent mental health.
Efficacy of Sertraline Combined With Intestinal Microecological Therapy in Adolescents With Moderate Depression and Suicidal Ideation and Its Effects on Serum Inflammatory Factors
Background: Adolescents with moderate depression and suicidal ideation constitute a high-risk psychiatric population. Major depressive disorder with suicidal ideation in this age group is a disabling psychiatric disorder. Current selective serotonin reuptake inhibitor treatments are limited by their low efficacy rates (approximately 50%–60%) and delayed onset of action. Informed by the gut–brain axis theory, this study aimed to evaluate the synergistic efficacy and anti-inflammatory mechanisms of sertraline combined with a Bacillus subtilis probiotic preparation in this high-risk population. Methods: This retrospective cohort study included 160 adolescents meeting International Classification of Diseases 10th Revision diagnostic criteria were identified and categorised into either monotherapy (sertraline) or combination therapy (sertraline + probiotics) groups. Over a 12-week treatment period, clinical symptoms were assessed using the Hamilton Depression Rating Scale, Hamilton Anxiety Rating Scale and Beck Scale for Suicide Ideation-Chinese Version, and serum inflammatory factors, namely, interleukin-6 (IL-6), interleukin-1β (IL-1β), tumour necrosis factor-α (TNF-α) and C-reactive protein (CRP) and peripheral blood inflammatory ratios, namely, platelet-to-lymphocyte, neutrophil-to-lymphocyte and monocyte-to-lymphocyte ratios, were measured. Results: The proportion of patients with severe depression was significantly reduced in the combination group (1.25% vs. 7.5%, p = 0.004), and anxiety symptoms showed significant improvement (severe anxiety proportion: 1.25% vs. 11.25%, p = 0.008). Biomarker analysis revealed significantly reduced levels of IL-6 (p = 0.007), IL-1β (p = 0.002), TNF-α (p = 0.005) and CRP (p = 0.001) in the combination group, and IL-6 and CRP showed strong positive correlations with depression scores (r = 0.35–0.39). Conclusions: This study confirms that modulating the intestinal smicroecology can enhance antidepressant efficacy by reducing neuroinflammation.
Diagnostic Trends of Minors in Psychiatric Emergency Care: An Observational Study
Background: Diagnostic stability in child and adolescent psychiatry is a key indicator of validity and essential for clinical decision-making. Few longitudinal studies have examined diagnostic trajectories after a first emergency psychiatric contact. Methods: We conducted a retrospective observational cohort study at Santa Maria University Hospital (Lleida, Spain). A total of 583 patients aged 4–18 years presenting for their first psychiatric emergency visit between 2017 and 2023 were included, with 24-month follow-up. Sociodemographic and clinical data were extracted from Electronic Health Records. Diagnostic transitions were summarized using transition matrices. An exploratory association analysis (Apriori algorithm) identified frequent T1→T2 patterns, reported with confidence and lift. Diagnostic stability was defined as the proportion of patients retaining the same diagnosis at follow-up. Results: Median age at baseline 14.9 years (interquartile range [13–16]); 54.55% were female. Schizophrenia/psychosis showed the highest stability (71%), followed by intellectual disability with gender identity disorder (67%). Mood disorders showed moderate stability (~44%), while others such as eating disorders (26%) or conduct disorders (17%) had lower stability. The strongest associations were “no prior diagnosis → eating disorder” (confidence = 1.00; lift = 12.76) and “autism spectrum disorder + attention-deficit/hyperactivity disorder (ADHD) → conduct disorders” (confidence = 0.66; lift = 2.55). Conclusions: Diagnostic stability is heterogeneous, with high persistence in schizophrenia/psychosis and low in eating disorders and ADHD. Association analysis identified specific trajectories that may help anticipate clinical evolution. Findings highlight the importance of longitudinal evaluation in early psychiatric care.
Transdiagnostic Factors and Their Relationship to Post-Traumatic Stress and Psychopathology in Clinical Populations
Background: High comorbidity among mental disorders challenges the utility of categorical classifications. The transdiagnostic perspective focuses on common psychological processes, potentially overcoming these limitations. The aim of this study was to explore transdiagnostic factors related to post-traumatic stress and psychopathology in a clinical sample. Methods: Sixty-one patients (73.8% women; aged 20–66 years, M = 43.79, standard deviation (SD) = 12.75) from the Adult Mental Health Unit of the Hospital Clínico Universitario of Valencia were assessed on symptomatology (post-traumatic stress and psychopathology) and psychological variables (emotional dysregulation, resilience, personality, social support, and stressful life events). Results: Our results indicated elevated post-traumatic stress scores (M = 70.49, SD = 20.33), suggesting clinically significant distress, together with low exposure to stressful life events (Median (Mdn) = 2.00; interquartile range (IQR) = 2.00). Post-traumatic stress and psychopathology were positively correlated with emotional dysregulation and negatively with resilience, social support, extraversion, and conscientiousness. Higher post-traumatic stress and psychopathology were linked to low social support, low extraversion, and high emotional dysregulation. Emotional dysregulation emerged as a key moderating variable, potentially diminishing the protective effects of resilience on post-traumatic stress. Conclusions: Overall, findings support the transdiagnostic approach, highlighting that factors like emotion regulation contribute not only to symptom development but also critically influence how risk and protective factors affect mental health outcomes, emphasizing the importance of targeting these processes in clinical intervention and prevention efforts.
Effect of Continuity of Care Combined With Family Supportive Care on Cognitive Function and Self-Care Ability in Patients With Alzheimer's Disease
Background: This study aimed to investigate the effects of a combined approach of continuity of care and family supportive care on cognitive function and self-care ability in patients with Alzheimer's disease (AD). Methods: The clinical data of 135 patients with AD, who presented to China-Japan Friendship Hospital from April 2021 to April 2023, were retrospectively analysed. On the basis of the sequential introduction of different care protocols at China-Japan Friendship Hospital, the patients were categorised into three groups: the conventional group (n = 42, receiving conventional care), the continuity group (n = 49, receiving conventional care plus continuity of care) and the family group (n = 44, receiving conventional care, continuity of care, and family supportive care). Cognitive function (assessed using the Mini-Mental State Examination and Montreal Cognitive Assessment), self-care ability measured using the Barthel Index (BI), family support evaluated using the Perceived Social Support from Family Scale (PSS-Fa), and quality of life assessed via the Quality of Life in Alzheimer's Disease scale (QOL-AD) were compared across the three groups before and 3 months after the implementation of the respective care protocols. Results: At the 3-month mark, the family group demonstrated significantly higher BI, PSS-Fa and QOL-AD scores than the continuity and conventional groups, and the continuity group's scores on these measures were significantly higher than those of the conventional group (p < 0.05). Conclusions: The application of continuity of care combined with family supportive care in patients with AD is associated with positive effects on cognitive function, self-care ability, family support and quality of life. This finding suggests that this integrated care model may represent a superior option for the management of patients with AD. However, given the inherent limitations of retrospective designs in fully controlling for confounding variables, further validation through prospective, large-sample studies is warranted to confirm its efficacy and generalisability.
Affective and Cognitive Vulnerability Under Chronic Stress: Insights From Patients With Left Temporal Lobe Epilepsy and Caregivers
Background: Temporal lobe epilepsy (TLE) is a chronic stress condition characterized by affective and cognitive deficits. This study analyzed differences in affective and cognitive functioning between patients with TLE and another chronically stressed population — caregivers of patients with epilepsy — as well as the relationships between affective and cognitive outcomes. Methods: In this cross-sectional study, 40 adults (20 with left TLE and 20 caregivers; mean age 48.43 ± 8.86 years) underwent a neuropsychological assessment evaluating affectivity, attention, executive function, language, and memory. Results: Patients with TLE and caregivers did not differ in anxiety, depression, attention, executive functions, or visual memory. However, patients with TLE had poorer semantic verbal fluency (p = 0.02), naming (p < 0.0001), short-term verbal recall (p = 0.027), long-term verbal recall with semantic cues (p = 0.005), long-term verbal recognition (p = 0.017), and verbal discriminability (p = 0.001). The group (epilepsy vs. caregiver) significantly moderated the association between depression and long-term verbal recognition (B = –0.12, standard error (SE) = 0.05, p = 0.03, 95% confidence interval (CI) [–0.23, –0.01]), with higher depression scores being associated with poorer verbal recognition in patients with epilepsy (p = 0.001) but not in caregivers (p = 0.74). Conclusions: These findings suggest a specific pattern of verbal dysfunction and increased cognitive vulnerability to depression in patients with TLE, compared to another chronically stressed group. Although the present study cannot determine the mechanisms underlying these associations, the results underscore the clinical relevance of assessing these variables together and may inform the development of tailored interventions.
Predictors of Quality of Life in Parkinson's Disease: The Role of Mental Health and Internalized Stigma
Background: Parkinson's disease (PD) is a progressive neurodegenerative disorder that negatively affects the well-being of both patients and their caregivers. Therefore, the aim of the present study was to identify factors associated with quality of life (QoL) in patients with Parkinson's disease (PPD) and caregiver burden in their primary caregivers (PCG). Methods: We conducted a cross-sectional study at a tertiary neurological center in Mexico. Assessments included the Parkinson's Disease Questionnaire (PDQ-39); motor severity with the Movement Disorder Society–Unified Parkinson's Disease Rating Scale Part III (MDS-UPDRS III); cognition with the Montreal Cognitive Assessment (MoCA); depressive and anxiety symptoms with the Patient Health Questionnaire-9 (PHQ-9) and the Generalized Anxiety Disorder-7 (GAD-7); and internalized stigma with the King Internalized Stigma Scale (ISS). Caregiver burden was measured with the Zarit Burden Interview (ZBI). Results: We included 48 PPD (58.3% male) and 38 PCG (55.3% female). Mean disease duration was 7.3 years [standard deviations (SD) = 4.6; range 1–26 years]. Among PPD, 97.9% were on dopaminergic replacement therapy and 43.8% reported comorbidities. Anxiety severity differed between groups (χ2 = 11.7, p = 0.008). No between-group differences were observed in internalized stigma (ISS total score and subdomains). A significant discrepancy emerged regarding assistance with activities of daily living (ADLs), reported by 63.2% of PCG versus 20.8% of PPD (p < 0.001). Linear regression models showed that poorer QoL in PPD was associated with depressive and anxiety symptoms and motor severity (MDS-UPDRS III) (R2 = 0.47). Caregiver burden in PCG was associated with depressive symptoms and perceived discrimination (ISS subdomain) (R2 = 0.53). Conclusions: Comprehensive PD management, beyond motor control, should incorporate the evaluation and support of mental health, alongside stigma-reduction strategies, to enhance the well-being of both PPD and their PCG.
The Effects of Gut Microbiota, Plasma Metabolites, Immune Cells, Blood Cells and Cytokines on Schizophrenia: A Bidirectional Two-Sample Mendelian Randomisation Study
Background: The aberrant traits of the gut–metabolite–immune network in schizophrenia imply a crucial interrelationship among them. The exploration of the association between the gut–metabolite–immune network and schizophrenia will create novel opportunities for future studies on the disorder. Methods: This study utilised the Mendelian randomisation (MR) method to examine the causal relationships among gut microbiota, plasma metabolites, immune cells, blood cells, cytokines and schizophrenia. Additionally, mediation analysis was performed to identify and verify potential mediators involved in the pathway linking gut microbiota to schizophrenia. Results: A total of 62 traits with causal connections to schizophrenia were identified from the gut microbiota, plasma metabolites, immune cells, blood cells and cytokines (11 traits from the gut microbiota [odds ratio (OR) = 0.683–2.104, p = 0.005–0.047], 35 traits from plasma metabolites [OR = 0.596–1.597, p = 0.005–0.049], 14 traits from immune cells [OR = 0.813–1.105, p = 0.005–0.049], 1 trait from blood cells [OR = 1.112, p = 0.038] and 1 trait from cytokines [OR = 0.864, p = 0.041]). Among them, 30 traits were classified as risk factors for schizophrenia. Additionally, we determined nine pathways by which gut microbiota influences schizophrenia (via 7 plasma metabolites and 2 immune cells). Moreover, in our MR analyses, several sensitivity analyses were employed to eliminate heterogeneity and horizontal pleiotropy, ensuring reliable MR results. Meanwhile, the outcomes of various analyses revealed that the gut microbiota most significantly associated with schizophrenia belonged to the Firmicutes phylum. Conclusions: These discoveries not only deepen our understanding of the pathogenic mechanism of schizophrenia but also offer significant impetus for the development of future diagnostic studies and therapeutic strategies.
A Systematic Review and Meta-Analysis of Executive Function Outcomes in Pediatric Central Nervous System Tumor Survivors
Background: This review aimed to determine whether executive dysfunction is a characteristic of survivors of central nervous system tumors in children and adolescents, including Astrocytoma, Neurofibromatosis-1, Medulloblastoma, and Pilocytic Astrocytoma. Methods: A review and meta-analysis of executive function assessed with Behavior Rating Inventory of Executive Function (BRIEF) in individuals with these tumor types. Results: The main findings of the meta-analyses can be summarized as follows: (i) Neurofibromatosis type 1 (NF1) – BRIEF (parents): Children with NF1 show significant deficits in executive functions according to the parent-rated BRIEF, with an overall model effect size of d = 0.81 (p < 0.001). The most affected areas are working memory, monitoring, and metacognition, indicating that these deficits are consistent and clinically relevant. (ii) NF1 – BRIEF-P (parents and teachers): In this meta-analysis, the overall model effect size was d = 0.37 (p < 0.001), showing moderate but significant difficulties in executive functions. Both parents and teachers report problems in working memory and emerging metacognition, reflecting a consistent pattern across different observational contexts. (iii) Medulloblastoma vs. other tumors: Patients with medulloblastoma exhibit marked deficits in executive functions compared to other brain tumors, with an overall model effect size of d = –0.74 (p < 0.001). The most affected areas include inhibition, initiation, regulation, and metacognition, with consistent findings across the included studies. Conclusions: Executive deficits are observed in individuals with brain tumors or survivors, significantly affecting their academic, social, and emotional lives. Early identification, along with educational and neuropsychological support, is essential to preventing these deficits from interfering with academic, personal, and professional functioning.