Open Dialogue has been linked to better outcomes and reduced hospital admissions amongst patients with mental health problems. Yet, information on associated health care costs is scarce.

To conduct an evaluation of downstream health care costs of Open Dialogue provided to young patients in acute psychiatric crises and compared with treatment as usual.

Matched case-cohort study based on clinical and register data.

Open Dialogue was offered between 2000 and 2019 as standard care to adolescents in acute psychiatric crisis in four municipalities in Region Southern Denmark.

355 individuals between 14 and 19 years received treatment with Open Dialogue and were compared to 979 peers who had received standard acute psychiatric treatment in two other Danish Regions (Central Denmark Region and North Denmark Region) where Open Dialogue was not implemented.

Health care cost data (including primary care, psychiatric and somatic care) was available during 2005-2018. We matched controls to the cases based on a X-factor propensity score and a 3:1 ratio. The statistical analysis took a double-robust approach combining matching with Difference-in-Difference analysis over 12-year follow-up. Graphical inspection and placebo tests were used to test parallel trends assumption, and generalized estimation equations were applied as a robustness check to validate the results.

In the intervention group, the unadjusted yearly mean health care costs were €299 the year before receiving Open Dialogue. In the subsequent year, it was €1523, equivalent of a €1224 increase. In corresponding years, the respective health care costs were €208 and €1813 for members of the control group, implying an increase of €1605. The increase in health care costs was driven by psychiatric costs in both groups. Follow-up up to 12 years showed a decrease in total health care costs to €457 in the Open Dialogue group and €938 in the control group. The difference between the groups was not statistically significant.

This evaluation did not find statistically significant differences in total health care costs between patients receiving Open Dialogue and controls over 12-year follow-up.

Young patients in treatment with Open Dialogue during acute psychiatric crisis did not have higher total health care costs up to 12-year follow-up compared to controls.

Empathy is essential in mental health nursing, as nurses serve as the first point of contact for individuals and families, playing a key role in building therapeutic relationships and providing culturally safe care. Despite its importance, empathy remains a complex and underexplored concept, particularly in culturally diverse contexts.

The current study subjectively explored the cultural factors influencing nursing students' empathy toward people with mental illness.

Q-methodology was used to investigate the subjective perspectives of nursing students on empathy.

Nursing students were recruited to represent culturally diverse backgrounds. The sample included 23 undergraduate nursing students residing in Australia.

Participants ranked 40 statements derived from a literature review on cultural tightness, relational mobility, and causal attributions of mental illness. Participants shared their subjective viewpoints by arranging the statements onto a quasi-normal distribution grid (Q-sort). The completed Q sorts were analysed using by-person factor analysis, and responses to follow-up open questions were used to enrich the interpretations of the factors.

Two viewpoints explaining 49% of the variance were identified by the nursing students: "The Role of Internal Attributions and Intentional Relationships" and "The Role of External Attributions and Biological Scepticism" in empathising with people with mental illness.

This study underscores the importance of understanding nursing students' socio-cultural norms, particularly as they may reflect Westernised or acculturated perspectives. The findings from this study can help inform clinical practices and interventions aimed at addressing knowledge gaps in understanding mental illness symptoms. This support is especially important as nursing students prepare for roles in mental health care settings.

For adolescents with Anorexia Nervosa (AN) or Atypical Anorexia Nervosa (AAN), Family Based Treatment (FBT) is an effective treatment. However, outcomes remain suboptimal, making investigations into predictors of outcome important. Most prior research into FBT has focussed on parental and family factors as predictors.

The current study aimed to identify predictors of FBT for adolescents with AN and AAN in a real-world setting, specifically focussed on comorbid patient psychopathology as a predictor of outcome.

A prospective cohort of 135 young people engaging in manualised FBT (female = 92.6%, age = 14.33 years, SD = 1.54, range 11-17) at a public outpatient child and youth eating disorder (ED) service were evaluated. Measures of ED and comorbid psychopathology and BMI outcomes were evaluated pre- and post-treatment.

Results showed that age was a predictor of drop-out and weight gain, with older age associated with higher chance of drop-out and less weight gain. No comorbid psychopathology measure predicted drop-out or treatment outcomes.

Findings highlight the potential role of age in treatment non-completion and weight regain in FBT, suggesting the potential need for developmental considerations to FBT among this group.

Recent reports indicate that sustained interaction with conversational artificial intelligence (AI) systems can, in a small subset of users, contribute to the emergence or stabilisation of delusional experience. Existing accounts typically attribute such cases either to individual vulnerability or to failures of safety engineering. These explanations are incomplete. Drawing on phenomenology, psychiatry, and cognitive neuroscience, this paper argues that the risk arises from the relational and ontological structure of the interaction itself. Conversational AI generates ontological dissonance: a conflict between the appearance of relational presence and the absence of any subject capable of sustaining it. Maintained through a communicative double bind and amplified by attentional asymmetries, this dissonance tends, under conditions of affective vulnerability, to stabilise into a technologically mediated analogue of folie à deux. This account explains why explicit disclaimers often fail to disrupt delusional involvement and clarifies the ethical and clinical implications for the design and use of conversational AI.

Given theoretical and methodological criticisms surrounding coping strategies, this study examines coping profiles and differences between mothers and fathers at the time of their child's autism diagnosis.

Multi-group confirmatory factor analyses (MG-CFAs) were conducted to improve construct validity of the French Ways of Coping Checklist-Revised in 554 parents in France and to test measurement invariance between mothers and fathers. Linear mixed models were performed to examine parental status (mother vs. father) differences in coping strategies. Dyadic latent profile analysis (LPA) was used to identify distinct coping profiles and the R3STEP approach to examine differences in latent profile membership by parental status.

MG-CFAs supported four coping dimensions (problem solving-positive reappraisal, seeking social support, wishful thinking, and self-blame) and demonstrated configural and metric invariances, with partial scalar invariance between mothers and fathers. Fathers reported a significantly lower use of all coping strategies except wishful thinking. LPA identified three coping profiles -Varied Coping, Adaptive-Dominant Coping, and Maladaptive-Dominant Coping-with no significant differences in latent profile membership between mothers and fathers. In both parents, coping profiles differed by anxiety symptoms; additionally, maternal profiles were associated with socio-economic status, stress levels, and the child's internalizing difficulties, and paternal profiles with depressive symptoms.

These findings provide a more nuanced understanding of mother-father differences in coping among parents of autistic children and underscore the need for tailored, profile-based interventions in clinical practice and future research.

Life's Essential 8 (LE8) provides a multidimensional framework to assess cardiovascular health (CVH) in aging populations. The objective of this study was to describe LE8 component scores and their variation by age, sex, and psychosocial factors in middle-aged and older adults from Cádiz, Spain. Cross-sectional data were analyzed from 495 adults aged 50-79 years (59.4% women; 34.7% ≥ 65 years). LE8 scores were calculated following American Heart Association guidelines. Group comparisons used t-tests, ANOVA, and chi-square tests to explore differences across demographic and psychosocial variables. Age- and sex-adjusted linear regressions were fitted for CVH, health behaviors (HB), and health factors (HF). Most participants showed moderate CVH, HB, and HF scores (76.6%; 53.1%; 62.2%). Diet quality had the lowest mean (40.8 ± 31.7), while physical activity and sleep health were the highest (88.3 ± 30.6 and 85.0 ± 22.2). Middle-aged adults presented higher CVH and HF scores (mean differences [MD]: 2.5 ± 0.3; 7.8 ± 1.5), whereas older adults scored better in HB (MD: 2.8 ± 1.4). Women exhibited higher CVH, HB, and HF scores than men (MD: 3.6 ± 0.3; 2.8 ± 0.4; 4.4 ± 0.4), with middle-aged women showing the most favorable CVH profile (73.0 ± 10.5) and older men the least favorable (66.4 ± 11.0). Higher self-rated health (β = 0.240; R2 = 0.096) and educational attainment (β = 0.235; R2 = 0.090) were the strongest correlates of CVH (both P < 0.001). LE8 scoring revealed an intermediate CVH profile, with disparities by age, sex, and psychosocial context. Middle-aged women showed the most favorable profiles, while self-rated health and educational attainment emerged as key psychosocial markers for CVH assessment.

Adolescent idiopathic scoliosis (AIS) affects 1-3% of children in the United States, with approximately 38,000 patients undergoing posterior spinal fusion (PSF) annually. The relationship between preoperative patient-reported outcomes, postoperative recovery, and long-term clinical significance remains unclear. This study assesses longitudinal changes in Scoliosis Research Society-22r (SRS-22r) scores. It evaluates clinical significance using the Minimum Clinically Important Difference (MCID) in AIS patients undergoing PSF.

Retrospective study using prospectively collected data.

A retrospective study was conducted using prospectively collected data on AIS patients who underwent PSF at a single academic institution between 2012 and 2022. Patient-reported outcomes were assessed using the SRS-22r questionnaire at preoperative, 6-month, 1-year, and ≥ 2 years postoperative time points. MCID threshold achievements were determined using anchor-based criteria from Bago et al. The percentage of patients achieving MCID and predictors of MCID achievement were analyzed using logistic regression.

A total of 161 patients (mean age 15.26 ± 2.15 years; 65.8% female) were included. At 1 year, MCID achievement ranged from 30.1% (Self-Image) to 43.4% (Mental Health). By ≥ 2 years, MCID rates declined in Pain (25.9%) and Self-Image (22.8%) but increased in Function/Activity (44.1%). Lower preoperative SRS-22r scores consistently predicted MCID achievement across all domains. A documented mental-health history reduced the likelihood of Pain MCID at 1 year, and larger postoperative Cobb angles independently decreased the odds of achieving Self-Image MCID at both follow-up points. Neighborhood opportunity (Child Opportunity Index) was not associated with outcomes. Sensitivity analyses demonstrated that complete-case ≥ 2 year MCID rates were consistently bounded by best- and worst-case values and closely approximated LOCF estimates, supporting robustness despite attrition.

Meaningful postoperative improvement after PSF varies substantially by SRS-22r domain. Pain and mental-health gains occurred early and stabilized, whereas function demonstrated ongoing recovery, and self-image improved rapidly and remained stable. MCID achievement was most likely in patients with greater preoperative symptom burden, while mental-health history and residual postoperative deformity diminished domain-specific improvements. The stability of MCID patterns across sensitivity analyses reinforces the reliability of long-term findings. These results highlight the importance of incorporating psychological assessment, expectation management, and attention to postoperative alignment into perioperative care for AIS patients.

Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) represent a major advancement in obesity treatment, offering robust efficacy in weight loss and metabolic regulation. Beyond these effects, emerging evidence indicates that GLP-1 RAs also modulate appetite, reward sensitivity, and self-regulation, domains that intersect with behavioral and psychological functioning. This review adopts a biopsychosocial perspective to examine how GLP-1 RAs interact with eating behavior, mood, identity, and self-regulation, particularly in individuals with binge eating disorder (BED) or other psychiatric comorbidities. A clinical framework is proposed to integrate pharmacotherapy with lifestyle and psychological interventions. The temporary reduction in appetite and food reward may create a "low-drive window" in which behavioral strategies such as self-monitoring or stimulus control become more effective. However, high emotional eating, mood symptoms, or identity conflicts may moderate treatment response. Given the high prevalence of psychiatric comorbidities, structured screening using tools like the Patient Health Questionnaire-9 (PHQ-9) or Binge Eating Scale (BES) is recommended. A stepped-care approach from brief digital interventions to formal psychotherapy may help address varying support needs. Crucially, weight regain after discontinuation is common. The review discusses behavioral, psychological, and social mechanisms of relapse and highlights strategies for long-term stabilization. These include emotion regulation, body image work, and maintenance-focused behavioral interventions. GLP-1 RAs should therefore be seen not as standalone treatments but as facilitators of self-directed, sustainable change within integrated care models. Future research should define composite outcomes, explore digital tools for relapse prevention, and develop adaptive pathways tailored to individual psychological profiles.

Obesity and binge eating disorder (BED) are global health concerns that share overlapping neural mechanisms. These include alterations in the brain's reward and control systems leading to heightened sensitivity to food cues and impaired self-regulation, which underpin overeating. Identifying neuroimaging-based biomarkers that index these mechanisms could advance individualised treatments. This scoping review examined evidence on fMRI food cue reactivity as a potential approach for developing predictive and response biomarkers relevant to the treatment of obesity and BED. A systematic search of MEDLINE, Scopus, PsycINFO, and Embase (to July 2025) identified 57 eligible studies incorporating fMRI cue reactivity measures in the context of pharmacological, surgical, psychological, and lifestyle interventions. Of these, 7 reported predictive outcomes only (6 for adults with obesity and 1 for children and adolescents with obesity), 41 reported response outcomes only (36 for adults with obesity, 3 for children and adolescents with obesity and 2 for adults with binge eating), and 9 reported both predictive and response outcomes (8 for adults with obesity and 1 for adults with binge eating). Across paradigms and intervention modalities, there was consistent involvement of reward (striatum, insula, orbitofrontal and ventromedial prefrontal cortex) and cognitive control regions (dorsolateral and dorsomedial prefrontal cortex) as response outcomes from successful treatment. Reductions in reward-system reactivity following interventions were consistently associated with improved clinical outcomes, supporting the potential of fMRI food cue reactivity as a candidate biomarker of treatment response. However, this finding is highly skewed towards obesity, given the limited number of studies that report results for BED (3 studies). Furthermore, consistent evidence for reliable predictive biomarkers was also limited, likely due to methodological variability and small sample sizes. Overall, this review supports the potential of response outcomes from fMRI food cue reactivity as an indicator of treatment efficacy in obesity and highlights the limited evidence in BED. We also emphasise the need for further standardisation of paradigms and biomarker validation efforts.