Depression is a common mental disorder and a leading cause of global disease burden. Emerging evidence supports diet as an adjunct treatment for depression. Previous studies are limited, meaning it is unclear whether improvements are directly due to dietary change. The OPTIMISM trial aims to address this gap through a sham-controlled randomised feeding trial design.The OPTIMISM trial is a 4-week double-blind, sham-controlled, randomised feeding trial. A total of 44 participants with MDD in a current major depressive episode of moderate to severe severity will be recruited and randomised to a Mediterranean or a sham control diet, designed to reflect typical dietary intake of the general population. All food will be provided for four weeks. Participants will complete assessments and have blood and stool collected at baseline and four weeks. The primary outcome is the differential change in clinician-rated depressive severity at four weeks. Exploratory outcomes include patient-rated depressive and anxiety symptoms, and quality of life. Potential mechanisms will be evaluated through analysis of biological samples. An additional group of 22 healthy individuals without depression will also be recruited and will receive a Mediterranean diet for four weeks; their data will determine whether clinical and biological responses to the intervention are unique to depression and whether the diet treatment modulates depression-related pathology.If the intervention diet leads to a greater reduction in depressive symptoms compared with a sham control diet, this trial will provide preliminary evidence supporting the use of a Mediterranean diet in the treatment of depression.

The extent and burden of post-acute cognitive dysfunctions following SARS-CoV-2 infection is uncertain.

25,485 SARS-CoV-2 test-positive and 25,032 test-negative individuals were repeatedly asked to score symptoms of subjective cognitive deficits 2 to 18 months after test using the "Cognitive complaints in bipolar disorder rating assessment" (COBRA) tool. Poisson mixed-effects models were used to estimate Score Ratios (SRs) by comparing scores between test-positive and test-negative individuals.

At each follow-up point, test-positive individuals have low but slightly higher mean COBRA scores compared with test-negatives. For the combined 2-18 months period, COBRA scores among test-positive individuals are 11% higher than corresponding scores among test-negatives (SR_2-18mth = 1.11 (95% CI; 1.09-1.13)). Of effect modifiers explored, being hospitalized with a positive SARS-CoV-2 test particularly elevates COBRA scores (SR_2-18mth = 1.38 (95% CI; 1.24-1.54)).

In the general population of SARS-CoV-2 infected individuals, self-reported post-acute scores of cognitive dysfunctions are low and only slightly higher than corresponding scores among test-negatives. Higher COBRA scores among hospitalized SARS-CoV-2 test positives corroborate with long-term cognitive impairment being most pronounced among those with severe SARS-CoV-2 infection.

Comorbid insomnia and sleep apnea (COMISA) is associated with poorer clinical outcomes than chronic insomnia disorder (CID) or obstructive sleep apnea (OSA) alone. However, the psychobehavioral characteristics that differentiate COMISA remain unclear. We aimed to examine the combined roles of dysfunctional beliefs and attitudes about sleep (DBAS) and excessive daytime sleepiness (EDS) in COMISA. We analyzed data from 283 patients (42 with CID alone, 166 with OSA alone, 75 with COMISA) from the National Center of Neurology and Psychiatry database, a component of a polysomnography databank for sleep disorders in Japan. DBAS was assessed using the 16-item DBAS scale (0-160 points), and EDS was measured using the Epworth Sleepiness Scale (ESS; 0-24 points). Participants were categorized into four groups based on median ESS and DBAS scale scores (medians: 90 and 9, respectively): low ESS/low DBAS, low ESS/high DBAS, high ESS/low DBAS, and high ESS/high DBAS. Logistic regression analyses, adjusting for multiple covariates, such as age, sex, and body mass index, were conducted. The high ESS/high DBAS phenotype was significantly associated with COMISA relative to the low ESS/low DBAS reference group in comparisons with both CID and OSA. The low ESS/high DBAS phenotype was also significantly associated with COMISA compared with OSA. Coexisting elevated DBAS and EDS appear to represent a distinct psychobehavioral phenotype distinguishing COMISA from CID or OSA alone. Assessing DBAS in patients with OSA and evaluating daytime sleepiness in those with CID may support earlier identification of COMISA and inform targeted management.

Medication use during adolescence provides important insight into current health and treatment patterns. However, these data are often difficult to analyze due to the complexity of medication labeling and classification. We present a reproducible framework that standardizes medication categorization in the Adolescent Brain Cognitive Development Study (ABCD Study), improving analytic consistency and enabling more reliable findings across the research community. Parent-reported data on youth prescription and over-the-counter medication use from baseline through Year 6 of the ABCD Study were reviewed and harmonized. Medications were categorized using a combination of the Anatomical Therapeutic Chemical (ATC) Classification System, artificial intelligence-assisted methods, and expert clinical input. A case study illustrated the utility of this tool by examining longitudinal associations between antidepressant use and youth-reported internalizing symptoms on the Brief Problem Monitor (BPM-Y). More than 6,300 unique medication entries were consolidated into 95 clinically meaningful categories, each coded across three recall periods (past 24 h, past 2 weeks, past year). The most common unique medication labels were for cold/flu/allergy (553) and acne treatments (355). In the case study, adolescents taking antidepressants showed a significantly greater reduction in BPM-Y internalizing scores over time compared to nonusers. This study introduces a standardized and reproducible classification of prescription and over-the-counter medication use in the ABCD Study. The resulting framework-accompanied by an interactive dashboard and publicly available code-facilitates new opportunities for researchers to examine how medication exposure relates to adolescent brain, neurocognitive behavior, and developmental outcomes.

Psychotic-like experiences (PLEs) are subthreshold psychotic phenomena that occur along the psychosis continuum and are frequently accompanied by distress. However, the factors underlying distress in individuals reporting PLEs-particularly within non-clinical populations-remain insufficiently understood. This systematic review aims to synthesise the evidence on factors directly or indirectly associated with distress in PLEs among non-clinical samples.

A systematic search of Medline, Web of Science, Embase, and Cochrane (January 2000-March 2025) using the terms psychotic-like experiences AND (distress OR resilience OR burden OR coping OR adaptive behaviour) identified 762 studies, of which 111 met inclusion criteria and were included in a narrative synthesis.

Distress related to PLEs can be differentiated into direct PLE-related distress and indirect psychological distress. Factors associated with distress clustered into three domains: (i) Symptomatology-greater frequency, intensity, persistence and specific subtypes predict higher distress, as do comorbid depression, anxiety and suicidality. (ii) Psychological factors-maladaptive metacognitive biases, poor emotion regulation and avoidant or emotion-focused coping contribute to distress, whereas self-compassion and problem-focused coping may be protective. (iii) Environmental and contextual factors-traumatic life events, discrimination, daily stressors and substance use amplify distress, often by interacting with internal vulnerabilities and emotion regulation capacities.

Distress in PLEs arises from the interaction between symptom features, internal psychological vulnerabilities and external environmental factors. Consistent with emotion regulation models, distress reflects disruptions in adaptive appraisal and coping processes that heighten emotional reactivity. Conceptualizing distress as a transdiagnostic vulnerability underscores its relevance for early identification and preventive interventions. Future research should harmonise definitions of distress, examine longitudinal pathways and evaluate resilience-building approaches to mitigate risk and improve mental health outcomes.

In line with sport psychology's growing focus on wellbeing and mental health, meaning (i.e., experiencing life as coherent, significant, oriented, and belonging) has been gaining attention in elite sport. Its study is theoretically and practically relevant, since athletes often refer to meaning, especially when it is lacking. However, while wider research highlights its role for physical and mental health, empirical inquiry in sport psychology has produced diverse conceptualizations and lacking alignment with psychological theory. This makes it difficult for practitioners to address meaning when its nature, threats, and supports remain unclear. To address this gap, our study sought to (a) provide an empirical account of athletes' lived experience of meaning, (b) advance theoretical integration with psychological frameworks by proposing a contextualized model of meaning in elite sport that draws on pertinent meaning in life theory, and (c) facilitate applied work. To this end, we interviewed 13 international Olympic athletes multiple times from February 2022 to August 2024. Through framework analysis, we developed an empirical model, incorporating the dimensions of coherence, significance, purpose, belonging, alongside the psychological needs for autonomy, competence, relatedness, and contribution. The model identifies two routes to experiencing meaning in elite sport: Self-actualization arises when athletes connect to themselves through feeling self-determined, competent, mattering to themselves, and having a personal purpose. Self-transcendence emerges when athletes connect with others by pursuing a wider purpose, mattering to others, contributing through giving back, and nurturing relationships. We conclude with critical reflections and recommendations for supporting both routes in practice.

Crisis response planning (CRP) reduces suicide attempts and suicidal ideation among high-risk patients, yet little is known about how it alters the processes through which suicidal ideation emerges and resolves. This study examined dynamic interactions among positive affect (PA), negative affect (NA), and suicidal ideation (SI) in treatment-seeking U.S. military personnel and veterans with posttraumatic stress disorder (PTSD) who received CRP or safety planning prior to PTSD treatment.

This secondary analysis used ecological momentary assessment (EMA) data from a randomized clinical trial comparing CRP and safety planning (SP) delivered alongside massed cognitive processing therapy for PTSD (N = 116). Participants completed four EMA surveys per day for 14 days assessing PA, NA, and SI. Differential equation modeling was used to estimate temporal stability and cross-variable coupling, followed by eigenvalue and eigenvector decomposition to characterize system organization and patterns of change.

Across interventions, PA, NA, and SI exhibited negative autocorrelation effects indicating temporal stability; however, SI showed weak self-regulation, suggesting greater persistence once elevated. Coupling patterns differed by intervention. In SP, NA was directly coupled with SI, indicating distress readily translated into suicidal thinking. In contrast, CRP showed coupling between NA and PA rather than SI, suggesting distress was regulated before activating suicidal ideation. Follow-up analyses further indicated that CRP strengthened affective regulation and integrated SI with affective processes.

Although both interventions produced stable cognitive-affective systems, CRP uniquely altered the relationships among affect and suicidal ideation, promoting regulatory feedback loops that may reduce vulnerability to acute suicidal risk.

Continuous positive airway pressure (CPAP) treatment brings more benefits to most patients with obstructive sleep apnea (OSA), especially OSA patients with coronary heart disease(CAD). These patients often have emotional disorders such as anxiety and depression, which have a negative impact on their clinical prognosis.

To investigate whether CPAP can improve anxiety, depression, and inflammatory cytokine levels in patients with OSA with and without comorbid CAD.

72 patients were randomly assigned to a CPAP group or a control group. The CPAP group received conventional OSA management plus CPAP therapy, while the control group received only routine OSA treatment. All CAD patients in both groups received standardized CAD treatment. Peripheral blood test reports were collected from each patient at the beginning of treatment and at 6 and 12 months, and the Hospital Anxiety and Depression Scale (HADS) was used for evaluation.

After 12 months of treatment, the HADS anxiety and depression scores of patients in the CPAP group were significantly improved compared to those in the control group, and the levels of inflammatory factors such as white blood cells (WBC), neutrophils (N), C-reactive protein (CRP), interleukin-6 (IL-6), and procalcitonin (PCT) were also decreased markedly.

12 months of CPAP treatment significantly alleviates anxiety and depression in OSA patients, especially those with CAD, and lowers systemic inflammation . More attention should be paid to the relationship between OSA and emotional disorders, particularly in CAD patients. This not only benefits patients' physical well-being, but also supports their mental health.

Somatic Symptom Disorder (SSD) and Functional Neurological Disorder (FND) are among the most prevalent conditions within the DSM-5 category of somatic symptom and related disorders (SSRD) and are associated with substantial psychological distress and functional impairment. Although the aetiology of SSRD is multifactorial and remains uncertain, emerging evidence suggests that impairments in mentalizing - the capacity to understand one's own and others' mental states - may contribute to the development and persistence of functional somatic symptoms. Despite growing research interest, no systematic review has synthesised the evidence comparing mentalizing abilities in individuals with SSD or FND to those without these diagnoses. The present systematic review addressed this gap by examining whether individuals with SSD and FND differ in mentalizing relative to healthy and clinical control groups, focusing on studies explicitly assessing mentalizing-related constructs. A comprehensive search of three electronic databases identified 18 eligible studies, comprising 1801 participants. Methodological quality was appraised using the Joanna Briggs Institute (JBI) Critical Appraisal Tool for case-control studies, and the psychometric robustness of mentalizing measures was critically evaluated. Overall, adults with SSD and FND - particularly those with psychogenic non-epileptic seizures (PNES) - demonstrated impairments in other-focused cognitive mentalizing compared to control groups. In contrast, self-focused mentalizing was rarely assessed, precluding firm conclusions. Findings suggest that mentalizing may be clinically relevant in SSD and FND and support further investigation of mentalization-informed assessment and intervention. However, substantial diagnostic and measurement heterogeneity underscores the need for high-quality, adequately powered studies employing validated, multidimensional assessments of mentalizing.

Subjective Cognitive Decline (SCD) is considered a risk stage for future cognitive impairment and dementia.

This study examined whether different neuropsychological criteria for defining cognitive normality influence SCD's ability to predict conversion to dementia.

Participants from the Cognitive Complaints Cohort were diagnosed according to the Subjective Cognitive Decline Initiative criteria. Normal cognition was defined by the absence of Mild Cognitive Impairment according to five Jak and Bondi criteria. Sociodemographic, clinical, and neuropsychological data were analyzed using descriptive statistics. Bootstrap methods characterized group profiles given overlap between SCD definitions. Kaplan-Meier curves illustrated time to dementia, and a clustered Cox proportional hazards model accounted for overlapping group membership and adjusted for baseline variables.

Among 838 subjects, the five SCD groups showed similar age and sex distributions but differed in education, cognition, and functional status, while subjective complaints and depressive symptoms did not differ meaningfully. Kaplan-Meier curves showed variability in conversion probabilities. At five years, conversion ranged from 3.9% (Liberal) to 25.5% (Conservative); at ten years, from 16.2% to 40.9%. Clustered Cox analysis showed that Conservative and Historical SCD remained associated with higher hazard of conversion after adjustment, whereas Typical and Comprehensive SCD were associated with lower hazard estimates.

Neuropsychological criteria for cognitive normality define SCD groups with distinct clinical profiles and risks of dementia. Broader definitions identify individuals at higher risk, whereas more stringent definitions capture populations with lower likelihood of decline, highlighting the importance of criterion selection according to clinical and research objectives.