Rupture of a cerebral aneurysm and the resulting subarachnoid hemorrhage often lead to early and long-term neurological deficits. These impairments significantly limit daily functioning and hinder return to work. The ability and timing of return to work after interventional treatment depend on multiple clinical and individual factors. The aim of the study was to review evidence on return to work among patients following surgical and endovascular treatment of ruptured cerebral aneurysms. The review included 27 publications from 1999-2025 on return to work after aneurysmal subarachnoid hemorrhage. The findings indicate that neurological outcomes, severity of persistent symptoms, age, and mental health are the main factors determining return to work. Type of occupation also play a significant role. Systematic monitoring of return-to-work outcomes after treatment of ruptured cerebral aneurysms appears to be an important component of treatment evaluation. It may facilitate identification of barriers that hinder the return to work and support the development of more targeted and effective therapeutic interventions. Med Pr Work Health Saf. 2026;77(6).

The increasing proportion of older adults in the population, along with changes in their occupational engagement, has made loneliness a growing concern across Europe. Due to the unclear relationship between work and loneliness, this study aimed to examine the association between occupational activity and loneliness among adults aged ≥60 years, considering factors that may influence this relationship.

The study was conducted among 1090 respondents aged ≥60 years in September-November 2025 using computer-assisted telephone interviews (CATI). Loneliness was assessed using the Revised UCLA Loneliness Scale (R-UCLA), and life satisfaction was measured with the World Health Organization Quality of Life - Brief Version (WHOQOL-BREF) questionnaire. Participants were categorized into 3 groups: occupationally and socially active, socially active but not occupationally active, and neither occupationally nor socially active. Logistic regression (odds ratio, 95% CI) was applied to identify factors associated with occupational activity, Mann-Whitney U tests were used for comparisons between working and non-working participants, and Kruskal-Wallis tests were employed for analyses across the 3 activity profiles.

Engagement in occupational activity among adults aged ≥60 years was limited (17.2%). It was most common among individuals aged 60-69 years, who have higher education, are more satisfied with their lives, but are also divorced, rate their mental health more poorly, and are in a more difficult financial situation (p < 0.05). Non-working participants exhibited significantly higher loneliness, lower social connectedness, and poorer quality of life (p < 0.001). Occupationally active individuals showed the highest quality of life and lowest loneliness, whereas those inactive both socially and professionally displayed the lowest quality of life and highest loneliness levels.

Occupational activity may reduce loneliness and enhance quality of life among older adults, highlighting the importance of systemic and institutional support. There is a need to develop and expand access to age-friendly and flexible employment opportunities for seniors to promote active and healthy aging. Med Pr Work Health Saf. 2026;77(5).

Co-occurring psychiatric conditions are common in opioid use disorder (OUD). This review summarizes findings on the effects of co-occurring conditions on OUD outcomes and changes in psychiatric symptoms during medication treatment for OUD.

The initial search yielded 6,419 articles from PubMed, Embase, Health & Medical Collection, CINAHL, APA PsycINFO, and Medline databases, and 76 of which were eligible for study inclusion. All articles were coded by independent raters, and consensus was used for the final results.

Most of the identified studies reported no effect of baseline mental health diagnoses or symptoms on substance use or treatment retention. Studies that examined changes in psychiatric symptoms over time largely reported improvement in mental health during medication treatment.

While there is some evidence that mental health symptoms improve during treatment, medications for OUD are likely insufficient on their own for addressing co-occurring mental health conditions.

There is a significantly higher prevalence of tobacco use disorder (TUD) among individuals with mental health conditions, and they account for nearly 40% of cigarettes smoked in the United States. Although the DSM-5 notes the high prevalence of co-occurring mental health conditions with TUD and that nicotine withdrawal symptoms mimic the symptoms of other mental health conditions such as anxiety, depressive, and bipolar disorders, the discussion of co-occurring mental health conditions in relation to TUD is limited. DSM-6 presents an important opportunity to expand diagnostic guidance, recognize shared and bidirectional etiological mechanisms, and recommend systematic screening and intervention approaches for TUD in the context of mental health treatment. Expanded guidance for differential diagnosis and treatment in DSM-6 could promote tobacco cessation as an essential component of mental health care, thereby improving clinical outcomes for people with TUD and co-occurring mental health conditions.

Since 1952, psychiatry has grappled with the concept of addiction in terms of diagnosis, treatment, and research; this work has been particularly complex given the common co-occurrence of other mental health concerns. Tracing the history of substance use disorder (SUD) comorbidity and exploring related concepts of dual diagnosis, co-occurring disorders, and multimorbidity highlights the necessity for a strong addiction comorbidity framework. In this commentary, we contend that to continue advancing our understanding of addiction comorbidities, a more nuanced and explicit framework is needed. Specifically, one that moves beyond the limitations of dual diagnosis and multimorbidity, and embraces a more integrative, biopsychosocial approach. The DSM offers a critical opportunity for dialogue and development of psychiatric comorbidity frameworks to guide future research, clinical practice, and educational initiatives in the field of addiction and mental health.

Post-9/11 Veterans experience a disproportionate burden of mental health conditions. Major depressive disorder (MDD) frequently co-occurs with trauma-related conditions, contributing to clinical heterogeneity. Clarifying how categorical and dimensional representations of depression relate to cognition while accounting for clinical comorbidity may improve understanding of depression and inform targeted interventions in Veterans.

To assess how categorical and dimensional measures of depression relate to cognitive performance and clinical characteristics in post-9/11 Veterans.

This cross-sectional analysis included 970 U.S. post-9/11 Veterans (ages 18-67) from the Translational Research Center for TBI and Stress Disorders (TRACTS), a multisite longitudinal cohort. Depression was classified via structured clinical interviews as No, Lifetime, or Current Depression. Dimensional measures incorporated recent self-reported, current, and lifetime depression symptom severity. Age-standardized cognitive composites (Global, Memory, Attention, Processing Speed, Executive) were examined in multivariable models adjusting for demographics, estimated premorbid IQ, and clinical and trauma-related symptom burden.

Clinical and trauma-related burden increased progressively from No to Lifetime to Current Depression. Veterans with depression showed no evidence of reduced cognition compared with the non-depressed group. Modest depression-related differences were observed for processing speed, with slower performance in the Current Depression group. Military blast burden significantly moderated the association between depression and processing speed, with slower processing speed in Current Depression most evident at greater military blast burden.

These findings suggest that depression is not characterized by broad cognitive impairment in post-9/11 Veterans but that the combination of military blast exposure and depression may subtly affect processing speed.

STAGES trial was a triple-blind noninferiority trial that investigated intensive psychosocial treatment with or without low-dose antipsychotics in young people with first-episode psychosis with a short duration of untreated psychosis, who were low-risk and had stable family support. Participants received cognitive behavioural case management combined with either low-dose risperidone/paliperidone or placebo. Only 7% of the screened individuals were included (N = 90), with just 30% completing the protocol, reflecting trial challenges. Both groups showed significant improvements in social and occupational functioning (primary outcome) and symptoms at 6 months, with placebo demonstrating noninferior outcomes. At 24 months, the groups did not significantly differ, though noninferiority could not be confirmed. Neuroimaging findings revealed that placebo recipients showed reduced basal ganglia volume and widespread cortical thinning relative to healthy controls, while antipsychotics increased basal ganglia volume and attenuated cortical thinning. This demonstrates that antipsychotics do not cause tissue loss early in treatment, and delaying medication may hasten illness-related brain volume loss. Metabolic analyses showed that antipsychotics contributed to greater weight gain and metabolic changes, though some risk existed without medication. Cognitive analyses revealed baseline illness-associated cognitive impairment, with verbal learning/memory decline over 6 months in the medication group only, suggesting early cognitive side effects. STAGES trial findings demonstrate that carefully selected low-risk first-episode psychosis patients can achieve clinical improvement through psychosocial interventions alone while minimising potential negative metabolic and cognitive effects. However, delaying medication may result in adverse structural brain changes. The results support integrated treatment and shared decision-making approaches that balance symptom management, functional recovery and preservation of physical, cognitive and brain health.

Methods are needed to evaluate the influence of risk factors on post-injury brain health among those with mild traumatic brain injury (mTBI). We employed an existing model, the LIfestyle for BRAin Health (LIBRA), to demonstrate feasibility and establish initial validation with mTBI cohorts.

Analyses of data from 17 civilians with acute mTBI (longitudinal) and 92 male United States Veterans with historical mTBI (cross-sectional). LIBRA scores were constructed; a higher score indicates greater risk to brain health. We also evaluated score distributions, the prevalence of LIBRA factors, and associations with non-LIBRA risk factors (initial validation).

Among those with acute mTBI (longitudinal), the mean ± standard deviation LIBRA score across all time points was 2.34 ± 3.19 (range -1.0 to +11.1). Individual scores were relatively stable across time, with some variability in physical activity and alcohol use. In Veterans with historical mTBI (cross-sectional), the mean LIBRA score was 3.92 ± 2.64 (range -1.0 to +10.3). The most prevalent risk factors were obesity and lifetime history of smoking followed by current depression. Initial validation findings were mixed.

Differences in LIBRA scores and other drivers of risk (non-LIBRA) across two mTBI cohorts (acute, historical) support the feasibility of implementation among those with a history of mTBI.

ObjectiveTo quantify Hepatitis C virus (HCV) testing, positivity rates and risk factor prevalence in mental health service consumers.MethodThis retrospective study (March 2019-April 2020) included consumers accessing mental health services at a public metropolitan hospital network. HCV testing was determined by data linkage with pathology results. Demographic characteristics, type of mental health care and assessment of HCV risk factors were analysed to investigate predictors of HCV positivity.ResultsEleven percent (n = 2065) of consumers had HCV testing; most commonly among inpatient-only consumers (22.6%; n = 513) and least common among community-only consumers (5.3%; n = 1,040). HCV antibody (Ab) positivity was observed in 31.2% of consumers (n = 215). Among those who underwent PCR testing (n = 42), 33.3% were PCR-positive.Predictors of active HCV infection were persons who injected drugs (PWID), evidence of liver disease and recent contact with custodial settings. Forty-three percent of consumers without HCV testing had at least one known HCV risk factor.ConclusionThe high HCV (Ab and RNA) positivity rate and prevalence of risk factors support consideration for increased screening in mental health services as a public health strategy to meet Australia's target of HCV eradication by 2030.

According to attachment theory, loneliness may be a cause of hoarding symptoms. However, due to mixed findings, it is unclear whether people with hoarding disorder (HD) are lonelier than healthy and clinical controls, whether there is a significant positive association between loneliness and hoarding, and whether loneliness causes more severe hoarding.

We conducted a systematic review and included peer-reviewed quantitative cross-sectional, longitudinal, experimental and intervention research that measured hoarding and loneliness. We excluded hoarding due to other conditions and qualitative, review, and case study research. The final search was conducted on 16 May 2025 on PsycINFO, Medline, and Web of Science. We used the Quality Assessment with Diverse Studies to evaluate study quality and conducted a random effects meta-analysis to examine loneliness-hoarding correlations.

Eleven papers with 13 studies (n = 2715) were included. Four studies compared loneliness in HD relative to controls. Ten studies examined the association between hoarding and loneliness. Only one experimental study examined the causal link. Results showed significantly higher loneliness in HD relative to healthy controls, but findings were mixed when compared with clinical controls. The meta-analysis showed a significant association between loneliness and hoarding, r = .38 [95% CI .33, .44].

Our findings confirm that loneliness is a significant issue in HD. Due to its wide-ranging effects, we recommend that clinicians should assess and address loneliness in HD. Although we are confident that loneliness is positively associated with hoarding, further research is required to establish a causal link.