Neuroimaging studies have revealed altered functional connectome dynamics in autism spectrum disorder (ASD) and linked these alterations to clinical symptoms. However, most studies have emphasized population-level contrasts, leaving interindividual variability in connectome dynamics and its structural underpinnings poorly understood. To address this gap, we analyzed resting-state functional and structural MRI data from 939 male participants (440 with ASD, 499 typically developing controls) across 18 sites in the Autism Brain Imaging Data Exchange (ABIDE). Whole-brain functional state dynamics was characterized using five leading activity modes and their expressions via eigen-microstate analysis. Age-related trajectories of mode expressions were constructed for typically developing controls using normative modeling, enabling quantification of individual-level deviations in functional dynamics. Compared with controls, ASD individuals showed greater interindividual variability in functional deviation profiles. Unsupervised clustering of these profiles identified two robust ASD subtypes with distinct mode-specific dysfunctions. One subtype primarily involved the visual, default-mode, frontoparietal, and dorsal attention networks, whereas the other subtype primarily involved the somatomotor, visual, frontoparietal, and ventral attention networks. These subtypes were clinically dissociable, differing in restricted and repetitive behaviors and social impairments, and exhibited mode-specific brain-symptom associations. Furthermore, the subtypes exhibited distinct cortical thickness alterations, and individual subtype membership was predicted with high accuracy (83%) using a random forest classifier based on cortical thickness. The main findings were replicated in an independent cohort outside ABIDE. This study delineates two reproducible and clinically dissociable ASD subtypes and links functional connectome dynamics to structural substrates, offering novel insights into the neurobiological basis behind ASD heterogeneity.

Post-traumatic stress disorder (PTSD) is a common psychiatric condition, with a global prevalence of 3.9% and a lifetime prevalence of 7.4% in the Netherlands. Although numerous evidence-based treatments are available, their use varies considerably. Understanding patient perspectives and experiences in the decision-making process when choosing a specific treatment is crucial for improving the quality of care.

This study aimed to explore the decision-making process from the perspective of patients with PTSD, focusing on their considerations and experiences when choosing a specific psychotherapeutic treatment.

In this qualitative study, twelve semi-structured interviews were conducted with patients with PTSD (aged 21-55 years) receiving care at a mental health organisation in the east of the Netherlands. Data were analysed using reflexive thematic analysis, informed by grounded theory-inspired analytic techniques. Analysis was iterative and inductive, focusing on the identification and interpretation of patterns of meaning across patients' accounts.

Five themes were identified, connected through an overarching interpretive concept of patient-attunement: (1) the role of treatment characteristics (2), the role of therapeutic factors (3), the role of treatment duration and intensity (4), the role of significant others, and (5) the role of information about trauma-focused treatment. Patients emphasised the importance of personalised information and support from clinicians and significant others. Ongoing responsiveness within the therapeutic relationship, including trust and collaboration, was central to experiencing the decision-making process as supportive and meaningful.

For patients with post-traumatic stress disorder, multiple factors play a role in choosing a psychotherapeutic trauma-focused treatment. This study shows that continued attunement to patients' diverse needs is central to the decision-making process. Such attunement may take various forms, including attention to the therapeutic relationship, discussion of treatment characteristics and frequency, and responsiveness to patients' preferences regarding information provision. Involving patients' support systems may further support decision-making. Together, these findings suggest that clinicians should remain attentive to patients' needs at multiple points during the pre-treatment phase. Approaches such as shared decision-making may help facilitate this attunement.

Not applicable.

To investigate the current status and dyadic mechanism of maternal and spousal role adaptation for postpartum anxiety and depression.

Convenience sampling was employed to select 276 pairs of mothers and their spouses from October 2023 to October 2024 as study participants. Binary analyses were conducted using the actor-partner interdependence model (APIM) and the mediation model.

The prevalence rates of anxiety and depression during the first postpartum year were 38.5% and 14.5% among mothers, and 36.9% and 12.9% among their spouses, respectively. The APIM revealed that maternal and spousal role adaptation significantly and negatively predicted their own postpartum anxiety (maternal actor effect: β = -0.120; spousal actor effect: β = -0.081) and depression (maternal actor effect: β = -0.165; spousal actor effect: β = -0.113), and that role adaptation similarly predicted each other's anxiety (maternal partner effect: β = -0.115; spousal partner effect: β = -0.059) and depression (maternal partner effect: β = -0.129, spousal partner effect: β = -0.064). Mediation analyses suggest that future time insight and parenting competence mediate this process.

Postpartum anxiety and depression serve as a dyadic phenomenon, where maternal and spousal role adaptation significantly affects mental health outcomes. Future time insights and feelings of parenting competence serve as mediating variables in the relationship.

Not applicable.

Virtual reality (VR) has generated growing enthusiasm as a tool to deliver evidence-based mental health treatments. By immersing individuals in interactive, simulated environments, VR allows for repeated exposure to feared stimuli, real-time practice, and clinician involvement. While the strongest evidence supports using VR exposure therapy for anxiety-related disorders, promising applications are emerging across a range of conditions. Despite promising findings, most studies have small samples with limited follow-up. Broader integration in clinical practice will require continued innovation, testing, and adaptation to meet patient needs, enhance therapist training, and address health care system constraints.

The Disrupted-in-Schizophrenia 1 (DISC1) gene and negative symptoms in schizophrenia are both implicated in neurodevelopmental abnormalities. However, their relationship remains unclear. Thus, this study aimed to compare plasma DISC1 levels and negative symptoms severity between first-episode schizophrenia (FDS) patients and healthy controls (HCs), and examine their association. Sixty-six FDS patients meeting the DSM-IV diagnostic criteria, and 66 age- and sex-matched HCs were enrolled in this case-control study. Plasma DISC1 protein levels were measured by enzyme-linked immunosorbent assay (ELISA). Negative symptoms were assessed using the Clinical Assessment Interview for Negative Symptoms (CAINS). Compared to HCs, patients showed significantly higher CAINS scores for Motivation and Pleasure (MAP, F (1,130) = 5.24, p = 0.02), Expression (EXP, F (1, 130) = 33.89, p < 0.001), and total symptoms (F (1, 130) = 15.14, p < 0.001), alongside lower plasma DISC1 levels (F (1, 130) = 4.622, p = 0.034) after adjusting for convariates. Plasma DISC1 levels were negatively correlated with EXP score in patients (r = -0.30, p = 0.02), but not shown in HCs (r = -0.14, p = 0.26). Multiple linear regression identified lower plasma DISC1 levels as an independent predictor of higher EXP score in patients (β = -3.46, t = 2.23, p = 0.03), but not in HCs (β = 0.15, t = 0.29, p = 0.77). These findings suggest that reduced plasma DISC1 levels in FDS patients are significantly associated with greater expressive deficits, further supporting a potential role for DISC1 in the neurobiology of negative symptoms of schizophrenia.

Body positioning is a standard nursing practice in the intensive care unit (ICU) and it is linked with physiological variations in oxygenation and hemodynamic stability. However, there is a lack of comparative data as to why different positions relate to different parameters that are critical.

The aim to assess the changes in key physiological hemodynamic parameters, across different body positions and during transitions between positions in critically ill patients admitted to the ICU.

A single group before and after quasi experimental design was used. A total 100 critically ill patients randomly selected from the ICU at King Abdullah University Hospital in Jordan. Each position session lasted two hours, with a 30-minute interval between transitions. Physiological data were collected before and after each session using validated tools.

Among 100 ICU patients (56% female) a significant change in hemodynamic parameters were observed across positions. Temperature significantly decreased in the supine (p < 0.001) and prone (p = 0.008) positions. Pulse rate decreased significantly in the upright position (p < 0.001). Systolic BP significantly increased in supine and decreased in upright (p < 0.001). Diastolic BP also showed significant changes (p < 0.001). SpO₂ significantly increased in the supine and prone (p < 0.001) positions, while the upright position showed a significant decrease (p < 0.001). Repeated Measures ANOVA confirmed these differences (p < 0.001).

Body positioning is associated with the changes in hemodynamic and oxygenation parameters in critically ill patients. In particular, prone positioning was associated with an increase in oxygenation, and upright positioning was associated with temporary decreases.

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.