Family caregivers play critical roles in supporting the home-based recovery of patients with schizophrenia, but they often encounter substantial challenges and receive insufficient systemic support. Understanding caregivers' involvement in home-based recovery is essential for aligning community mental health services with families' capacities and needs. This study aimed to explore family caregivers' involvement and adaptive processes in supporting home-based recovery of patients with schizophrenia in China.

A qualitative study using interpretative phenomenological analysis was conducted through semi-structured interviews. Family caregivers were purposively recruited from four community health service centers (CHSCs) across urban and rural areas of Beijing. All interviews were audio-recorded, transcribed verbatim, anonymized, and analyzed iteratively to identify themes and subthemes.

A total of 20 family caregivers were recruited, including 11 from two urban districts and 9 from a rural district in Beijing. Five themes were identified: Caregivers' redefinition of recovery as stability rather than cure; Routine recovery involvement in medication management and symptom monitoring; Experienced tensions between the patient's independence and relapse prevention; Bearing family obligation and personal strain in sustained caregiving involvement; and Uncertainty in sustaining caregiving and the patients' future stability. Caregivers reported persistent challenges in supporting patients' independent living, participation in family activities, communication, and social interaction.

Family caregivers gradually develop their capacity to support home-based recovery, but continue to encounter complex challenges while receiving limited support from CHSCs. Strengthening recovery-oriented family support within community mental health services, particularly through accessible psychoeducation and rehabilitation guidance, may enhance caregivers' capacity to support patients' independence and social participation, thereby promoting sustainable home-based care and long-term functional recovery.

Current psychiatric models, while clinically valuable, remain limited in their ability to account for the complexity, variability, and context dependence of mental disorders. Converging evidence from neuroscience, complexity science, and psychedelic research suggests that psychiatric symptoms may be better understood as stable patterns of organization within dynamic, multilevel systems rather than as outputs of isolated biological dysfunction. This paper proposes a systems-based framework in which therapeutic change is conceptualized as a phased process of perturbation, reorganization, and consolidation. Within this model, interventions act by modulating system stability and plasticity, with outcomes determined by interactions among biological, psychological, relational, and environmental factors over time. Psychedelic-assisted therapies provide a particularly revealing case, as they reliably induce transient destabilization of entrenched patterns, increasing flexibility and enabling reorganization under supportive conditions. This formulation suggests a generalizable mechanism of healing across modalities: the strategic destabilization of rigid system states followed by the consolidation of more adaptive configurations. Accordingly, recovery is reframed not as symptom reduction alone, but as increased coherence, flexibility, and adaptive capacity across domains of functioning. This perspective has implications for assessment, ethics, clinical implementation, and research design, including the need for longitudinal, context-sensitive outcome measures and hybrid methodologies. A systems-based psychiatry does not replace mechanistic models but reorganizes them within a framework that accommodates emergence, temporal dynamics, and context, offering a foundation for more integrative and preventive approaches to mental health care.

Pyoderma gangrenosum is a rare neutrophilic dermatosis characterized by painful ulcerative skin lesions and a lack of definitive diagnostic tests. It is frequently mistaken for infectious conditions, often resulting in inappropriate antibiotic use and delayed immunosuppressive therapy. To describe the clinical and demographic characteristics of patients with pyoderma gangrenosum initially assessed in an infectious diseases setting and identify patterns that may aid in earlier diagnosis and management. A retrospective case series was conducted at a Cellulitis Clinic. Patients with a PARACELSUS score ⩾10 were included. Ten patients met inclusion criteria. Median age was 61.5 years; 60% were female and 90% Caucasian. Autoimmune diseases were present in 90%, mental health disorders in 50%, and endocrine abnormalities in 60%. Notably, 20% developed pyoderma gangrenosum at sites of healed scars-a rare presentation. Early recognition and multidisciplinary management are essential for timely treatment and improved outcomes.

[This corrects the article DOI: 10.3389/fpubh.2026.1833997.].

Ultra-processed food (UPF) exposure has increased markedly worldwide and is now a major contributor to total energy intake in many countries. Evidence from large prospective cohort studies suggests that higher UPF exposure is associated with adverse health outcomes, including overweight and obesity, type 2 diabetes, cardiovascular disease, selected cancers, depression, and increased all-cause mortality. Short-term experimental studies further indicate that diets rich in UPFs can promote excess energy intake and weight gain, supporting biological plausibility. Several mechanisms have been proposed, including poor nutrient quality, high glycemic load, altered food structure and satiety signaling, exposure to additives and contaminants, gut microbiome perturbations, and displacement of minimally processed foods. Nevertheless, the field remains debated. Major controversies concern the Nova classification system, substantial heterogeneity within the UPF category, challenges in reproducible classification, and the extent to which observed associations reflect processing itself rather than nutrient profile, dietary patterns, or broader food environments. These issues hinder causal inference and sustain ongoing debate over whether UPFs act as independent etiological factors or function as markers of unhealthy diets. Policy responses vary internationally, ranging from explicit inclusion of UPFs in dietary guidelines to predominantly nutrient-based or hybrid frameworks. This narrative review summarizes current evidence linking UPF exposure to health outcomes, critically examines methodological and conceptual limitations, and discusses implications for future research and public health policy. See also the graphical abstract(Fig. 1).

Migration is a well-established risk factor for psychosis, yet limited research has examined long-term clinical trajectories following first-episode psychosis (FEP) in migrant populations within Southern European settings. This study investigates how country of origin and time since migration influence psychiatric outcomes in a naturalistic FEP cohort.

A 5-year longitudinal study was conducted on 184 patients with FEP attending the Early Intervention Service from Hospital Universitari de Mataró. Patients were grouped by geographic origin (Spanish, Latin American, Maghrebi, Sub-Saharan) and migration recency (≤5 years vs. >5 years). Primary outcomes included treatment adherence, use of long-acting injectable (LAI) antipsychotics, relapse, and service disengagement. Logistic regression and survival analyses were used to identify associations.

Maghrebi origin was associated with lower treatment adherence (OR = 0.32, 95% CI [0.12-0.89], p = 0.030). In time-to-event analyses, Maghrebi patients showed a higher hazard of service disengagement compared with Spanish-born patients (HR = 2.42, 95% CI [1.10-5.34], p = 0. 028). Recent migrants (≤5 years in Spain) also had a significantly increased hazard of disengagement (HR = 2.89, 95% CI [1.30-6.40], p = 0.009). Sub-Saharan origin was strongly associated with earlier initiation of long-acting injectable antipsychotics (HR = 3.40, 95% CI [1.58-7.32], p = 0.002), alongside higher overall odds of LAI use. No significant differences were observed in relapse rates across groups.

Both migrant origin and recent arrival were associated with differences in psychiatric care trajectories following FEP. These findings highlight the need to consider adaptation of treatment approaches for migrant populations according to their origin and migration context in order to improve long-term outcomes.

The use of generative artificial intelligence (AI) based chatbots in mental health interventions is rapidly evolving, but evidence of their efficacy and safety is scarce. This randomized pilot trial investigated the feasibility, efficacy, mechanisms, and unwanted effects of a generative AI chatbot (ChatGPT-4) vs. human conversational agent as a cognitive behavioral micro-intervention for procrastination.

62 university students (M_age 23.60 years, 93.5% female) were analyzed and assigned (concealed) to a three-session chat-based intervention with either the chatbot or human conversional agent. Outcomes were assessed using questionnaires at baseline, post-intervention, and 6-month follow-up. The primary outcome was self-reported procrastination. Secondary outcomes included depression, anxiety, worry, and rumination. Additionally, unwanted negative effects and common factors of therapeutic change were assessed.

Intention-to-treat analyses revealed a non-significant group × time interaction effect (p = .117, η² _p = 0.05). Unwanted negative effects at post-assessment were reported by 43.1% of participants, with no significant group difference. Common factors were rated similarly across groups and did not mediate change in procrastination.

Our findings do not indicate superiority of either conversational agent and both interventions had comparable, rather high rates of unwanted effects, indicating that more research in larger, clinically meaningful samples is needed to confirm the efficacy and safety of AI-based (micro-)interventions.

Early detection of cognitive impairments is crucial for preventing progression to dementia. An effective diagnosis necessitates a tool with robust diagnostic characteristics. The Saint Louis University Mental Status (SLUMS) exam is a widely utilized instrument for diagnosing neurocognitive disorders. This study assessed the psychometric properties of its Persian version (P-SLUMS) among Iranian community.

This cross-sectional study was conducted with 450 community-dwelling older adults who were referred to one of the Tehran Municipality centers and participated in a cultural program from March to November 2021. Data collection tools included a demographic questionnaire, the Mini-Mental State Examination (MMSE) for concurrent validity, and the SLUMS exam. Dementia was assessed using the Persian version of the Global Deterioration Scale (GDS), while depression was evaluated with the Persian version of the Patient Health Questionnaire-9 (PHQ-9). The SLUMS exam was translated into Persian in accordance with the World Health Organization's protocol. Participants were recruited through convenience sampling based on the inclusion criteria. The P-SLUMS exam was evaluated for content validity, face validity, concurrent validity, and construct validity using Confirmatory Factor Analysis (CFA), as well as reliability, which was assessed over a two-week interval among 20 participants.

CFA indicated acceptable model fit indices. The goodness-of-fit indices for the model, including CFI, PCFI, and PNFI, were 0.82, 0.66, and 0.44, respectively, indicating a moderate fit that falls below the recommended thresholds for excellent parsimony. However, these indices are considered acceptable for our sample, which encompasses diverse education levels and a moderate number of items. The tool demonstrated high internal consistency (Cronbach's alpha = 0.866) and excellent test-retest reliability (ICC = 0.979).

The P-SLUMS exam is a valid, reliable, and user-friendly tool for early detection of Mild Cognitive Impairment (MCI) and dementia.

Fibromyalgia is a multifactorial syndrome characterized by chronic widespread pain, fatigue, and cognitive dysfunction that primarily affects women of working age. Because it lacks biological markers and its diagnosis is largely based on clinical criteria, fibromyalgia has been subject to gender biases that tend to minimize its symptoms and question the legitimacy of the condition. This delegitimization affects the employment trajectories of women with fibromyalgia, who experience higher rates of unemployment, withdrawal from employment, and discrimination. Studies indicate that only a minority are able to remain in the workforce and that many women feel compelled to conceal or minimize symptoms, which increases emotional exhaustion and worsens their health. In Chile, despite advances such as the enactment of Law 21,531 on fibromyalgia and non-cancer chronic pain, comprehensive programs integrating health and employment from a biopsychosocial perspective remain lacking. The aim of this article is to contribute to academic and social reflection on the occupational and psychosocial implications of fibromyalgia in women, highlighting the urgent need for inclusive strategies that support their ability to remain employed or return to work. Evidence indicates that employment plays a protective role by improving physical and mental well-being, providing economic independence, and fostering a sense of purpose. Therefore, the implementation of ergonomic interventions, reasonable accommodations, and psychoeducational strategies involving patients, families, health care teams, and employers should be prioritized. Only through inclusive policies with a gender perspective will it be possible to reduce occupational exclusion and improve the quality of life of individuals with fibromyalgia.

The aim of this study was to examine how a set of selected interacting maternal and perinatal clinical characteristics are associated with symptoms of post-traumatic stress after birth.

We conducted a cross-sectional online survey among women between 3 and 18 months after birth. Participants completed self-report measures of post-traumatic stress symptoms and questions regarding clinical variables related to pregnancy, birth and the postnatal period. Statistical models were used to estimate the association between clinical factors and symptom severity.

The strongest predictors of elevated post-traumatic stress symptoms were short-term complications like postpartum curettage and the need for hospitalisation due to neonatal health complications. Emergency caesarean section during the first stage of labour was also associated with higher symptom severity, whereas planned caesarean section, postpartum haemorrhage and prolonged postnatal stay were not significantly related to symptoms.

These findings highlight the importance of recognizing acute obstetric and neonatal events as relevant factors contributing to post-traumatic stress after birth. They specify that trauma-informed perinatal care must be actively implemented by establishing targeted psychological screening protocols for women experiencing emergency surgical interventions or neonatal separations, and by prioritizing transparent communication and continuous consent during acute obstetric procedures.