Affiliative social behaviour is critical for survival and well-being and is shaped by complex neurobiological systems, including the endocannabinoid system (ECS). Δ⁹-tetrahydrocannabinol (THC), the primary psychoactive compound in cannabis, is a partial agonist at cannabinoid receptors and directly modulates ECS signaling. Given increasing cannabis use globally, understanding the effects of THC on social functioning is essential.

We conducted a systematic review of preclinical studies indexed in MEDLINE and PsycINFO to examine the effects of THC on social behaviour in wild-type (WT) rodents and rodent social impairment models (SIM). Forty-nine studies encompassing 146 experiments were included. Risk of bias (RoB) was assessed using SYRCLE's tool.

In WT rodents, THC generally reduced social behaviour, particularly following acute or adolescent exposure at moderate-to-high doses. SIM results were mixed: while low-dose THC sometimes improved social behaviour in schizophrenia-related models, higher doses often worsened deficits or had no effect. Outcomes varied by dose, sex, developmental timing, and experimental model. RoB assessment revealed insufficient reporting for nearly half of the included studies.

These findings highlight the complexity of THC's behavioural effects and suggest a need for more rigorous, sex-balanced preclinical research. Moreover, suboptimal methodological quality across studies hinders replicability and generalizability. More thorough and streamlined reporting is needed to support the translational validity of this area of research. As interest grows in ECS-targeted therapies for psychiatric disorders, understanding how THC modulates affiliative social behaviour under different conditions will be essential to inform safe and effective clinical strategies.

Child and adolescent psychiatric disorders are common, now affecting at least one in eight children. Evidence points towards an increase in prevalence over time, but very few studies have tested whether longitudinal outcomes for children with mental health problems have changed. This study is the first to test whether mental health and functional outcomes for children with a diagnosed psychiatric disorder have improved or worsened across time in England.

Three national probability surveys were undertaken in England in 1999, 2004, and 2017, each with respective 3-year follow-ups in 2002, 2007, and 2020. We include children at baseline aged 5-13 years and compare outcomes for those with baseline psychiatric diagnosis (mental health disorder or ADHD). Three-year mental health symptom severity and functional impairment were assessed using the parent- and self-rated total difficulties score and impact supplement from the Strengths and Difficulties Questionnaire.

Across all surveys, having a psychiatric disorder at baseline predicted greater difficulty and impact scores at follow-up. The magnitude of these associations increased sequentially over time, such that having a disorder at baseline was more strongly associated with parent- and self-rated difficulties in the 2017 survey compared with the 1999 and 2004 surveys. Children in the 2017 survey were also more likely to report a greater impact of problems. Patterns of individual change also showed a temporal gradient. For children with a psychiatric disorder in 1999, 34% experienced deterioration in mental health at the three-year follow-up, compared to 52% of those with a disorder in 2017. The proportion of those who improved decreased correspondingly.

Children with a psychiatric condition are experiencing increased difficulties in their daily lives compared to previous generations. Understanding why children are now more likely to experience impaired functioning is a major public concern.

One third of patients who undergo definitive chemoradiotherapy for locally advanced cervical cancer develop disease recurrence. Salvage surgery in the form of pelvic exenteration (PE) may offer improved survival and possibly cure in carefully selected patients, however robust data is scarce. This study aimed to describe margin status, morbidity, survival and quality of life (QOL) outcomes following PE for cervical cancer at a high-volume center. Primary outcome was histological margin clearance; secondary outcomes were postoperative complications, overall survival (OS) and QOL.

Retrospective review of prospectively collected data for all adult patients undergoing PE for cervical cancer at Royal Prince Alfred Hospital, Sydney, between 1994 and 2024. Physical and mental QOL were measured quantitatively at 6-monthly intervals using the SF-36, FACT-G and FACT-C scores.

A total of 24 exenterations were performed for persistent or recurrent cervical cancer, median age 44 years, 87.5% curative intent. Total PE performed in 58.3%; bone resection in 29.2%; common and/or external iliac vascular resection in 20.8%; major nerve resection in 33.3%. Clavien-Dindo III-IV complications occurred in 37.5%, including unplanned return to theatre in 25.0%. R0 resection was achieved in 81% of curative intent PE. Median OS was 45.6 months; 1-year, 3-year and 5-year OS 74%, 62% and 48%, respectively. Survival after palliative PE ranged from 5.6 to 9.0 months. Improved QOL was demonstrated at 6 months and sustained until 30 months post-operatively.

PE for carefully selected patients with cervical cancer can offer encouraging R0 resection rates, acceptable QOL, and the potential for long-term survival. Morbidity and oncological outcomes are comparable to international data.

The use of compulsory community treatment in Australia varies widely within, and across, jurisdictions for reasons that are not fully understood. This study, therefore, used meta-regression to explore possible explanations for this variation in the following four Australian states: Queensland, South Australia, New South Wales and Victoria.

Aggregated administrative data from the Australian Institute of Health and Welfare for 2018 were analysed, encompassing 402,060 individuals in contact with community mental health services. Meta-regression using logit-transformed proportions was employed to assess associations between compulsory community treatment rates and district-level sociodemographic variables, including age, sex, marital status, region of birth and metropolitan residence. Workforce data were also examined in New South Wales.

Compulsory community treatment use varied significantly by jurisdiction and by health district within jurisdictions. Higher rates were associated with districts having more individuals aged 25-44 years, males (in South Australia), metropolitan residents, and those born outside Oceania. These associations persisted after adjustment. There was no statistically significant association between workforce levels and compulsory community treatment use in New South Wales.

Our findings suggest that sociodemographic factors such as age, sex and place of residence or birth may explain some of the variation in compulsory community treatment use between health districts. The influence of sociodemographic variables and geographical location in influencing compulsory community treatment use at the health district level needs further investigation.

Australian and New Zealand Clinical Trials Registry (https://www.anzctr.org.au/; ACTRN12624000153516).

Family communication dysfunction significantly impacts HIV medication adherence and mental health outcomes among adolescents in sub-Saharan Africa, yet evidence-based family interventions remain scarce in resource-limited settings. This qualitative descriptive study examined family communication transformation following culturally adapted Multiple Family Group Therapy (MFGT) for adolescents living with HIV and their families in rural Ghana. Focus group discussions were conducted with 20 caregivers and 19 adolescents who completed the 11-session intervention. All core therapeutic content was delivered across sessions 1 through 10; the 11th session comprised a graduation ceremony and sustainability planning. Reflexive thematic analysis revealed four major themes: preintervention dysfunction (public shaming, adolescent defiance, spousal teknonymy, extended family triangulation); MFGT-facilitated skills (tone modulation, privacy-preserving correction, active listening); postintervention transformation (caregiver behavioral consolidation, adolescent reciprocal adaptation, spousal reconnection); and sustaining mechanisms (observational learning, metacognitive awareness, positive reinforcement, peer accountability). Communication improvements occurred bidirectionally, with caregiver changes catalyzing adolescent adaptations. Findings are theoretically interpreted through family systems theory, communication accommodation theory, social cognitive theory, and self-determination theory. Culturally adapted MFGT successfully transformed communication patterns while preserving traditional authority structures, suggesting potential for integration within HIV care systems in resource-limited settings.

Dementia is a growing public health challenge, approximately 130,000 to 150,000 people were living with the condition in Sweden in 2023. Dementia is generally associated with psychological symptoms such as depression, anxiety, apathy, and reduced quality of life. Treatment generally consists of a combination of pharmacological and non-pharmacological nursing interventions. Mental health nurses play a central role in promoting person-centred care and applying evidence-based nursing practices, where dog-assisted interventions may represent a potential component of care. The aim of the study was to describe experiences of dog-assisted interventions for people with dementia. The study was carried out as a mixed methods systematic review based on a total of 14 quantitative and qualitative scientific articles. Three categories were identified: psychological and emotional well-being, social interaction and relational significance, and increased ability and independence in daily life. Dog-assisted interventions may constitute a valuable complement to nursing care in dementia care by promoting well-being and participation among people with dementia. There is a need for increased knowledge in form of larger studies focusing on qualitative methodology, to strengthen the evidence and thereby promote implementation in clinical practice.

To investigate the association between loneliness, living alone and mental well-being among Swedish adults.

The study is based on 6315 men and women aged 18 years or older responding to a population survey in 2022 (overall response rate 45%). A short version of the Warwick Edinburgh Mental Well Being Scale was used to measure mental well-being. The associations between loneliness, living alone and mental well-being were analysed using multiple logistic regression, adjusting for gender, age group, educational level, economic difficulties, social support, risk consumption of alcohol and longstanding illness.

Overall, the majority of the study population did not feel lonely, with 63.5% living with someone and 16.1% living alone. The proportion reporting loneliness, in total 20.4%, was about the same irrespective of whether the respondent lived with someone (10.7%) or was living alone (9.7%). More women than men reported loneliness, living alone and poor mental well-being. The youngest age group, 18-29 years, reported the highest levels of loneliness and poor mental well-being. Loneliness was independently associated with poor mental well-being, and the association was as strong among those who lived alone as among those who lived with someone.

Loneliness was associated with poor mental well-being irrespective of living alone or not. Public health actions aiming to reduce loneliness and strengthen mental well-being in the general population need to address all age groups, in particular young adults and those who live with someone but still feel lonely.

Characterizing dolutegravir penetration into the central nervous system is important for optimizing human immunodeficiency virus treatment outcomes, yet population-specific pharmacokinetic data describing cerebrospinal fluid disposition and equilibration kinetics remain lacking. This study characterizes dolutegravir pharmacokinetics in plasma and cerebrospinal fluid to describe the plasma-to-cerebrospinal fluid equilibration rate constant and cerebrospinal fluid-to-plasma pseudo-partition coefficient. Sparse pharmacokinetics samples were collected from 121 antiretroviral therapy-experienced adults who are predominantly overweight or obese (body mass index: 32.2 ± 8.7 kg/m²) receiving daily dolutegravir (50 mg)-based therapy. The model was developed using nonlinear mixed-effects modeling in NONMEM. Plasma dolutegravir pharmacokinetics were best described by a one-compartment model with first-order absorption and elimination. The population estimate for apparent oral clearance was 1.38 L/h/70 kg. Cerebrospinal fluid data were modeled using a sequential approach with a hypothetical effect compartment linked to plasma to estimate equilibration kinetics and relative cerebrospinal fluid exposure at steady-state. Key cerebrospinal fluid penetration parameters included a plasma-to-cerebrospinal fluid equilibration rate constant of 0.38 h^-1, corresponding to an equilibration half-life of 1.82 h, and a cerebrospinal fluid-to-plasma pseudo-partition coefficient of 0.0015, indicating 0.15% cerebrospinal fluid penetration relative to plasma. Post hoc estimated area under the concentration-time curve (0-24) demonstrated a moderate inverse correlation with body mass index (r = -0.34), indicating that dolutegravir exposure decreases with increasing body mass index. The model revealed rapid plasma-to-cerebrospinal fluid equilibration kinetics with low steady-state cerebrospinal fluid penetration in this predominantly overweight and obese population.

Objective: Almost half of patients diagnosed with borderline personality disorder (BPD) have a co-occurring substance use disorder (SUD). Patients with co-occurring BPD and SUD have poorer treatment outcomes, including lower rates of BPD remission and higher rates of substance-related harms. This systematic review aimed to evaluate existing treatments for co-occurring BPD and SUD. Methods: A systematic search was conducted using PsycINFO, Medline, PubMed, and Embase from inception to December 5, 2023. Selected studies assessed psychological or pharmacological interventions for patients with co-occurring BPD and SUDs. The impact of treatment on SUD and BPD symptoms was assessed. As an exploratory outcome, we examined the effects of interventions on emotion regulation. Results: Seventeen studies met our eligibility criteria. The most commonly studied intervention was dialectical behavior therapy (DBT; k = 9); most other interventions were evaluated by single studies. Treatment with DBT reduced SUD symptoms in some but not all studies. Overall, three psychotherapy studies assessed emotion regulation and found improvements following treatment. There were few pharmacotherapy trials in patients with BPD and SUD. There is evidence from these studies to suggest that specific pharmacotherapies for SUDs reduce substance use in patients with concurrent BPD. Conclusions: There is evidence that DBT improves emotion regulation for patients with co-occurring BPD and SUDs and some evidence that it reduces substance use. Future studies should systematically assess both BPD and SUD outcomes using larger samples and evaluate integrated treatments for BPD and SUDs.

Major depressive disorder (MDD) is biologically heterogeneous and encompasses diverse symptom presentations. The authors used large-scale plasma proteomics to examine proteomic associations with categorical MDD status, continuous depression symptom severity, and DSM-IV-defined melancholic and atypical symptom dimensions.

Using the SomaScan platform, the authors conducted plasma proteomic profiling of 7,289 analytes in 1,881 participants from the Netherlands Study of Depression and Anxiety, including individuals with current MDD (N=469), individuals with remitted MDD (N=918), and healthy control subjects (N=494). They evaluated associations with diagnostic status, symptom severity, and melancholic and atypical symptom dimensions, followed by pathway enrichment analyses.

Eight aptamers, representing seven unique proteins, differed significantly between the current MDD and healthy control groups after false discovery rate (FDR) correction. Overall depression symptom severity was associated with 18 significant aptamers corresponding to 18 unique proteins, whereas atypical symptoms were associated with 58 significant aptamers corresponding to 57 unique proteins. In contrast, no individual proteins reached FDR significance for melancholic symptoms. Pathway analyses showed enrichment for extracellular matrix organization, collagen formation, complement cascade signaling, platelet activation, and hemostasis in relation to overall depression symptom severity. Gene set enrichment analysis of proteins ranked by association with melancholic symptoms identified pathway-level enrichment despite the absence of FDR-significant individual proteins, including mitochondrial stress response, protein translation, complement signaling, and nervous system development. Atypical symptoms showed enrichment of extracellular matrix organization, collagen formation, complement cascade signaling, insulin-like growth factor transport, and chromatin regulatory processes.

These findings support biological heterogeneity within MDD and suggest that peripheral proteomic alterations are more strongly represented for specific symptom dimensions than for categorical diagnosis alone. Atypical symptoms showed pathway-level enrichment with significant individual protein associations. A dimensional framework may improve biological stratification of depression and refine biomarker-informed approaches to clinical symptom profiles.