Children of parents with depression, hereafter referred to as high-risk youth, are at elevated risk for mental illness, yet the mechanisms underlying this vulnerability remain unclear. Biased interpretation of ambiguous information and altered stress responses in this population have been proposed as potential pathways. As no previous study has examined these factors together, we investigated interpretation bias and endocrinological and affective stress responses as potential markers of depression vulnerability in high-risk children. We hypothesised that children of parents with depression would show more negative interpretation bias, altered cortisol stress responses and greater affective reactivity and prolonged recovery compared to children of parents with no mental illness. Across the sample, associations between interpretation bias and stress responses were expected.

Participants were 80 high-risk (parental depression) and 77 low-risk (no parental mental illness) youth aged 10 to 14 years. Mental health was assessed using structured clinical interviews. Interpretation bias was measured using the Scrambled Sentences Task, and stress reactivity and recovery were indexed by salivary cortisol and self-reported affect across six time points. Group differences were tested with t-tests and analyses of covariance. Regressions examined the unique contribution of familial risk status beyond other relevant factors, including depression, anxiety, childhood trauma, pubertal status, and sex. Correlations examined associations between interpretation bias and cortisol and affective stress indices.

Groups did not differ in interpretation bias, or cortisol or affective stress responses. Children's own symptoms of psychopathology (depression slightly more so than anxiety) positively predicted their interpretation bias but not their cortisol or affective stress responses. Exploratory moderation analyses showed that higher baseline cortisol strengthened the relationship between depression and interpretation bias. Interpretation bias correlated with cortisol reactivity and recovery within the high-risk but not the low-risk group.

Contrary to theoretical accounts, high-risk youth did not exhibit cognitive, affective, or endocrinological vulnerabilities relative to low-risk peers. Interpretation bias was found to be a promising target, robustly linked to clinical outcomes and tentatively to cortisol stress responses, though its absence in high-risk youth is in support of a more selective intervention approach.

The study was preregistered under the Deutsches Register Klinischer Studien DRKS00028842 on August 19, 2022.

The treatment of neuromyelitis optica spectrum disorder (NMOSD) has entered the era of targeted biological agents. While relapse control has improved substantially, patient-reported outcomes (PROs) remain understudied. This study aimed to explore real-world patient-reported perceptions of inebilizumab therapy in AQP4-IgG-positive NMOSD.

We conducted a nationwide cross-sectional survey of AQP4-IgG-positive NMOSD patients receiving inebilizumab using an anonymous online questionnaire (April-September 2025). Data collected included demographics, medication history, and multidimensional quality-of-life changes following inebilizumab initiation. Descriptive statistics and correlation analyses were performed. Key outcomes were patient-reported without objective validation.

A total of 275 valid questionnaires were analyzed. Respondents were predominantly female (90.5%) with a mean age of 39.7 ± 11.8 years. Mean inebilizumab treatment duration was 14.5 ± 8.4 months. Of all patients, 33.1% received inebilizumab as initial maintenance therapy, 42.9% had previously used conventional immunosuppressants, and 24.0% had switched from other biologics. Among respondents, 92.4% reported meaningful symptom improvement across multiple domains including bodily pain and mental health. Overall, 96.4% expressed willingness to continue therapy, with symptom improvement cited as the predominant reason (91.7%). Correlation analysis revealed weak associations between treatment duration and satisfaction (r = 0.12, p < 0.05) and between medication cost burden and satisfaction (r = - 0.24, p < 0.01).

In this cross-sectional survey, Chinese patients with AQP4-IgG-positive NMOSD receiving inebilizumab reported high satisfaction, perceived multidimensional benefit, and strong treatment continuation willingness. These findings provide exploratory patient-reported evidence regarding the acceptability of inebilizumab in routine practice. However, the observed improvements are self-reported and associative rather than causal; interpretation should account for the cross-sectional, non-comparative design, potential selection and recall biases, and lack of objective outcome validation. Prospective controlled studies are required to confirm these preliminary findings.

Individuals with psychosis and depression show widespread alterations in brain resting-state functional connectivity (rs-FC), affecting both sensory and higher-order brain regions. In this study, we investigate disruptions in the hierarchical organization of brain functional networks in individuals with psychotic and affective disorders. We derived functional brain gradients, low dimensional representations of rs-FC that capture cortical hierarchy, in a sample of 1071 (56.3% female) participants, including clinical high-risk for psychosis (CHR-P) individuals, recent-onset psychosis (ROP) patients, recent-onset depression (ROD) patients, and healthy controls (HC). We examined regional alterations, network-level alterations and functional differentiation and their relationship to clinical symptoms. In addition, we linked case-control differences to receptor expression maps to explore underlying neurobiological mechanisms. All clinical groups exhibited alterations in the visual-to-sensorimotor gradient, while only ROP patients showed alterations in the sensory-to-association gradient. CHR-P and ROP individuals exhibited lower values in the ventral attention network. Clinical groups combined showed higher values in the somatomotor network, a reduced gradient range and altered between-network dispersion. ROD patients showed reduced within-network dispersion in the attentional networks and a reduced range. Correlational analysis revealed weak associations of gradient measures with functioning, visual dysfunctions and cognition. Case-control differences showed associations to receptor expression maps, suggesting the involvement of neurotransmitter systems in these disruptions. Our findings reveal transdiagnostic and disease-specific alterations of hierarchical brain organization. These alterations indicate deficits in functional integration across psychiatric diseases, highlighting the role of attentional and sensory networks in disease processes.

Substance use severely harms health, mental health, and is a leading cause of preventable morbidity and mortality. To help prevent substance use, developmentally appropriate educational interventions during elementary school are much needed.

An evidence-based and age-appropriate substance use prevention curriculum targeted at upper elementary school students (4th and 5th grades) was developed by a multidisciplinary educational committee. The curriculum was administered to 514 upper elementary over the 2023-2024 school year.

A pre-curriculum baseline knowledge survey was administered to 274 students in 4th grade and 240 students in 5th grade over the 2023-2024 school year. At the end of the school year, following instruction of the curriculum, the survey was re-administered post-curriculum (n=158 in 4th grade; n=162 in 5th grade) with student retention rates of 58% and 68%, respectively. This pilot study demonstrated increased knowledge, changes in attitude, and improved perceptions about health promotion and substance use prevention in both 4th and 5th grade students.

These results support well-designed and age-appropriate curriculum as effective prevention programs that would ideally mitigate risk and reinforce protective factors. It further suggests that elementary school-based prevention programs are likely to be successful, which could help reduce exposure to substances during middle and high school.

Sexual health is a fundamental aspect of wellbeing, encompassing physical, emotional, mental, and social dimensions. However, sex-positive approaches often focus on younger populations, neglecting middle-aged and older adults (aged 45 years and above). Sex positivity treats sexuality as natural and healthy, emphasizing consensual, respectful, non-judgmental expression, and promoting autonomy, inclusivity, and access to accurate sexual health information and services. This study explored how sex-positive frameworks can promote pleasurable, healthy sexual lives among middle-aged and older adults.

A co-creation workshop was organized at the STI & HIV World Congress 2025 in Montreal, Canada, inviting selected participants to small-group discussions on what a sex-positive approach might look like. This was followed by participatory discussions between co-authors and adults aged over 45 years, exploring perceptions, experiences, and barriers related to a sex-positive approach among middle-aged and older adults. Data were analyzed thematically to identify key influences on sexual health and pleasure.

Participants highlighted that stigma, silence, and cultural norms shape understanding of sexuality in middle and later life. These were reinforced by the discomfort of healthcare providers in discussing sexual issues and widespread misconceptions that sexual desire inevitably declines with age. Such barriers limited access to accurate information and supportive care. Despite this, participants expressed enthusiasm for inclusive, age-appropriate campaigns and health services that affirm pleasure, intimacy, and connection as vital components of well-being.

Findings underscore the need to integrate sexual health into aging policies, clinical training, and public health advocacy. Embedding sex-positive principles across the life span ensures that desire and intimacy remain recognized, supported, and celebrated throughout life.

Depression is common among adolescents and young people living with HIV (AYPLHIV) in sub-Saharan Africa, and is associated with poor antiretroviral therapy adherence, reduced retention in care and poorer health outcomes. In Uganda, routine depression screening using brief tools, such as the Patient Health Questionnaire-2, is recommended, but inconsistently implemented due to overburdened healthcare workers and limited mental health workforce capacity. Scalable approaches to improve early identification of depression among AYPLHIV are needed to bridge this implementation gap. We describe a protocol for a formative mixed-methods study designed to generate the contextual, user-level and health-system evidence needed to inform the design, feasibility and acceptability of an interactive voice response (IVR)-based depression-screening intervention for AYPLHIV in Uganda.

We will conduct a convergent parallel mixed-methods study at Makerere University Walter Reed Program (MUWRP) HIV clinics in Central Uganda. The quantitative arm will survey 133 AYPLHIV aged 18-24 years on mobile phone access, digital habits and IVR preferences; the qualitative arm will run focus group discussions with healthcare workers to probe barriers to depression screening, whether the system can absorb the extra cases screening would find and how IVR could fit existing HIV care. The two strands will be triangulated to guide IVR design and implementation.

The study will generate context-specific evidence on user-level access and preferences, health-system readiness, and referral pathway capacity to support a future IVR-based depression-screening intervention for AYPLHIV. These findings inform tailoring of a youth-centered IVR intervention aligned with national HIV and mental health guidelines.

To evaluate the integration of Indigenous healing practices within an interprofessional team-based primary care clinic.

Guided by the Two-Eyed Seeing and Eco-Normalization frameworks, a developmental evaluation was conducted from November 2023 to July 2024, and included surveys, semistructured interviews, and a facilitated sharing circle. Quantitative data were analyzed descriptively. Deductive content analysis-using the Eco-Normalization Framework and the Empathy Map analysis-was used for qualitative data analysis.

An interprofessional team-based primary care clinic in Winnipeg, Man, in Canada.

Indigenous and non-Indigenous patients (n=9) and health care providers (n=14).

An Indigenous Elder, Knowledge Keeper, and mental health counsellor were integrated into the study to embed Indigenous ways of knowing into care. Perspectives of patients and health care providers regarding the perceived value of integrating Indigenous ways of knowing and healing were explored.

Nine themes emerged: valuing Indigenous ways of knowing and healing; culturally relevant, holistic care; incorporating Indigenous healing practices; whole-person care; collaboration within a team-based model; relationship building; barriers to health care access; lost traditional knowledge and continuation of intergenerational trauma; and centrality of emotional health. Patients and providers reported improved cultural safety, enhanced trust, and deeper engagement. Key facilitators included interdisciplinary collaboration, community partnerships, and integration of ceremony and land-based healing. Challenges included systemic barriers beyond the clinic and sustainability concerns.

Integrating Indigenous knowledge into team-based primary care can advance culturally safe, holistic, and equity-oriented health services. Structural transformation, sustainable funding, Indigenous governance, and embedding Indigenous ways of knowing into health professional education are critical for scaling and sustaining such models. Our findings support the Truth and Reconciliation Commission of Canada's Calls to Action.

This naturalistic study characterized clinical profiles of outpatient young adults with concurrent substance use and nonsubstance mental health symptoms in addition to evaluating reach and outcomes of a dialectical behaviour therapy skills training group.

Descriptive statistics were generated to characterize demographic and clinical profiles of young adults (N = 612) who initiated services at a psychiatric specialty clinic between June 2016 and January 2020. Chi-square, independent t-tests and logistic regression models were used to examine factors associated with engagement with dialectical behaviour therapy skills training group. Paired samples t-tests were utilized to evaluate psychiatric symptom and functional impairment outcomes associated with group completion.

Self-report measures indicated a high rate of substance use and co-occurring nonsubstance mental health concerns in the sample as a whole. Young adults who engaged in group programming differed significantly from those who did not on several clinical and demographic variables; however, no variables were significantly associated with group engagement in regression models. While referral and attendance rates were relatively low (30.6% and 15.4% of total sample), for those completing dialectical behaviour therapy skills training group we observed positive pre-post change outcomes on measures of psychiatric symptoms and functioning (d = 0.35-0.69).

Taken together, these findings provide initial support for offering dialectical behaviour therapy skills training as an adjunctive intervention for young adults with concurrent disorders. Future research identifying factors for enhancing engagement and examining outcome with more controlled conditions are warranted.

Medical residents frequently experience anxiety, depression, burnout and suicidal ideation. Existing support strategies have shown limited benefit. The Impact de la Pair-Aidance Étudiante sur la Santé Mentale des internes de Médecine de première année (PAESSM) study will evaluate whether embedding Mental Health First Aid (MHFA)-trained peer supporters within a first-year residency cohort is associated with improved mental well-being and reduced psychological distress over 12 months.

PAESSM is a non-randomised controlled mixed-methods quasi-experimental study in Lyon, France involving the two Lyon medical schools. Two contemporaneous cohorts will be followed for 12 months: first-year residents exposed to a structured peer-support programme and second-year residents receiving usual support resources without a structured peer-support network. About 430 residents are eligible in each cohort, with anticipated enrolment of approximately 260 per group. In the intervention cohort, around 10% of first-year residents will complete certified MHFA training and act as peer supporters. Online questionnaires will be administered at baseline and at 3, 6, 9 and 12 months. The primary outcome is 12-month mental well-being measured by the Warwick-Edinburgh Mental Well-Being Scale. Secondary outcomes include anxiety and depression symptoms, suicidal ideation, job strain and help-seeking behaviours. The primary analysis will use longitudinal targeted maximum likelihood estimation adjusted for prespecified baseline covariates and informative censoring. Sensitivity analyses will include mixed-effects models and complete-case analyses. A qualitative sub-study will explore peer supporters' experiences and implementation processes.

Ethical approval was obtained from the Comité de Protection des Personnes Nord-Ouest IV (Ref: 2025-A01549-40). In accordance with French legislation applicable to minimal-risk research, formal written informed consent was waived and participants will provide documented non-opposition before inclusion. Findings will be disseminated through peer-reviewed publications, conference presentations and communication with institutional stakeholders and residents.

NCT07161284.

The mental health of medical students has been widely discussed, with studies reporting a high prevalence of mental health issues, including depression, anxiety, suicidal ideation and burnout. Yet, few have explored the relationship between material, social and health deprivation and these outcomes in medical students, despite the higher risk of psychological disorders when exposed to precarious living conditions.

Our study aimed to explore longitudinal associations between experiencing deprivation and mental health outcomes among Swiss medical students while adjusting for protective factors.

Data were collected from hour-long online surveys at two time points (November-December 2022 and November-December 2023) of an open cohort study of medical students from the University of Lausanne, Switzerland (UNIL). Data were analysed using hierarchical multiple regression models.

This study was carried out by Lausanne University Hospital (Centre Hospitalier Universitaire Vaudois (CHUV)) and the Centre for Primary Care and Public Health, UNIL.

Our sample included medical students enrolled in any year of medical school studies, excluding those enrolled as part of an exchange programme. At time points T3 and T4, there were, respectively, 1941 and 1267 eligible students for participation; the final sample consisted of 631 medical students having participated at both time points (67.5% female, mean age 22.11).

Deprivation was evaluated with the Deprivation in Primary Care Questionnaire (DIPCare-Q) index. Mental health variables included depression symptoms, anxiety symptoms, suicidal ideations and burnout symptoms (emotional exhaustion, cynicism, academic efficacy). Protective factors included coping skills (emotion-focused, problem-focused and help-seeking) and social support (practical and emotional support).

In our final regression model, controlling for demographics (ie, age, gender, year of study and mother tongue), protective factors and baseline mental health scores, a higher overall baseline deprivation index was predictive of increased depression (β=0.14, p<0.001) and anxiety (β=0.06, p=0.046) symptoms over time, but not for suicidal ideation or burnout symptoms.

Results demonstrated a significant association between deprivation and mental health longitudinally. Findings suggested that social support was protective from an increase in suicidal ideations over time. The implementation of interventions that provide material and social support may help promote improved mental health and health equity among medical students.