Persistent fear memories, central to trauma-related psychopathology, rely on long-term consolidation. While initial encoding involves subcortical circuits, the precise timing and necessity of neocortical engagement for remote fear memory expression remain elusive. In the present translational study from rats to humans, we identified a late consolidation phase in the medial prefrontal cortex (mPFC) that occurs around 18 h after fear conditioning, a phase essential for remote memory. Neuronal ensembles in the mPFC activated during this phase mediate the expression of remote fear memory in rats. Critically, dopaminergic signaling in the mPFC modulated by ventral tegmental area (VTA) projections specifically during this delayed phase is required for remote fear memory maintenance. Consistent with these findings in humans, non-invasive stimulation of homologous mPFC regions during this temporal window selectively reduced remote fear memory retrieval without affecting recent memory. These findings reveal an evolutionarily conserved temporal window for remote fear memory and identify novel time-specific targets for clinical intervention in fear- and trauma-related disorders.

Magnetic seizure therapy (MST) is a potential alternative to electroconvulsive therapy (ECT) with a favorable cognitive adverse effect profile.

We present the first report of MST administration in India on six patients with severe depressive episodes referred for convulsive therapy. MST was administered thrice weekly under general anesthesia. Four of six patients achieved remission following MST (mean 8.5 sessions per patient, range 7-13). No clinically meaningful cognitive decline occurred; reorientation was consistently rapid with mild self-limiting adverse effects.

MST was feasible and safe within the existing ECT infrastructure, with meaningful clinical effectiveness, and preserved cognitive function.

In India, adolescent psychiatric hospitalization is influenced by clinical, familial, and systemic factors. Caregivers' perspectives on admission decisions remain underexplored, particularly in low-resource settings.

To explore the perceived need for inpatient admission or re-admission of adolescents with mental illness, as expressed by their primary caregivers.

A qualitative descriptive study was conducted at a tertiary Child and Adolescent Psychiatric Centre in India. Twenty-six primary caregivers of adolescents (13-18 years) were interviewed using a validated semi-structured guide, and the data were analyzed thematically.

Thematic analysis identified several themes: factors influencing admission/re-admission, caregiver burden, family and home dynamics, social withdrawal and inadequate school support, adolescent coping strategies, and treatment-related challenges such as medication side effects and inadequate aftercare.

Caregiver-perceived admission drivers are multifactorial. Strengthening community services, caregiver psychoeducation, and adolescent-friendly aftercare is essential to reduce preventable hospitalisations.

Postpartum depression (PPD) is a significant global public health concern, with a high prevalence in India. While the EPDS is widely used, there is a lack of rigorous validation studies specifically for Hindi-speaking postpartum mothers.

This study aimed to translate, culturally adapt, and evaluate the psychometric properties of the Hindi EPDS in postpartum mothers against a clinical diagnosis.

An observational study was conducted at a tertiary care hospital involving 181 mothers, 48 hours to 7 days after childbirth. The original English EPDS underwent a five-stage translation and adaptation process, including independent forward and back-translations and expert committee reviews. Validity was assessed against a clinical diagnosis made by a psychiatrist. Statistical analysis included Cronbach's alpha for internal consistency, Principal Axis Factoring with Promax rotation for construct validity, and receiver operating characteristic (ROC) curve analysis to determine the optimal cut-off score.

The prevalence of depression in the cohort was 26.0% (47/181). Hindi EPDS showed good internal consistency (Cronbach's α =0.859) and demonstrated good diagnostic accuracy with an Area Under the Curve (AUC) of 0.912. At an optimal cut-off score of 9, the scale showed a sensitivity of 70.2% and a specificity of 91.8%. Factor analysis revealed a three-factor structure: Anxiety, Depressed Affect, and Anhedonia, which accounted for 62% of the total variance.

The Hindi version of the EPDS is a valid, reliable, and culturally sensitive tool for screening postpartum depression in Indian tertiary care settings. A threshold score of nine is recommended for identifying at-risk mothers, enabling clinicians to apply cultural formulations for mothers facing significant neonatal stressors or breastfeeding difficulties.

Treatment-resistant depression (TRD) is a major clinical challenge, with many patients failing to respond to conventional antidepressants. Psychedelic compounds such as psilocybin and ayahuasca have recently gained attention as potential rapid-acting therapies. Beyond their neurobiological effects, methodological, ethical, and real-world applicability concerns are critical for understanding their clinical utility.

We conducted a narrative review of literature on psilocybin and ayahuasca in adult patients with TRD, focusing on safety, efficacy, and study design characteristics. PubMed and PsycINFO databases were searched from inception to August 2025. Studies were assessed for clinical outcomes, side effect profiles, and methodological and ethical limitations, including participant selection, blinding, and informed consent procedures.

Both psilocybin and ayahuasca demonstrate rapid reductions in depressive symptoms, with psilocybin showing more robust evidence for sustained effects. However, clinical trials are predominantly conducted in highly controlled environments with stringent inclusion and exclusion criteria, systematically excluding patients with comorbidities, high suicide risk, or polypharmacy. Challenges in maintaining blinding, high participant expectations, small sample sizes, and reliance on adjunct psychotherapy further limit the interpretation and generalizability of findings. Ethical considerations, including informed consent for intense psychedelic experiences and the potential for enduring personality or cognitive changes, remain under-addressed. Consequently, current evidence primarily reflects outcomes in clinically stable and selected subpopulations, rather than real-world TRD patients.

Psychedelic-assisted therapies hold significant potential for TRD, but their current evidence base is constrained by methodological and ethical limitations. Future research should prioritize large, representative trials, standardized protocols, and robust safeguards to ensure both scientific validity and patient safety. Unlike previous reviews that primarily synthesized efficacy outcomes across different psychedelic compounds, the present narrative review specifically compares psilocybin and ayahuasca within the framework of treatment-resistant depression while integrating methodological, ethical and real-world implementation issues. This perspective aims at complementing the existing evidence by highlighting factors that may influence future clinical translation.

Breastmilk, with its unique biological components, is the optimal source of neonatal nutrition, and WHO global feeding guidance recommends that all infants are exclusively breastfed for the first 6 months. The composition of human milk depends on multiple factors such as maternal diet, exposure to pathogens, metabolic or autoimmune disorders, smoking, mental health, and genetics. Breastfeeding not only transfers nutrients to the child, but it also influences the infant immune function, through the transfer of immune cells, antibodies, microbiota from the mother, cytokines, or growth factors. Among these, human milk-derived extracellular vesicles (hMEVs) are emerging as key yet understudied elements in neonatal growth, development, and immunity. This review explores their structure, formation, uptake, and roles in supporting development, modulating immune responses during early life, and influencing allergic outcomes, highlighting their potential significance in infant health.

Self-harm is a major public health concern among adolescents, particularly those hospitalized with psychiatric disorders. Despite its clinical salience, risk stratification tools incorporating both individual-level and family-level factors remain limited. This study aimed to develop and preliminarily evaluate a prediction model for self-harm among adolescent inpatients with mental disorders.

This cross-sectional study included 123 adolescent inpatients (aged 12-17 years). Self-harm was defined as intentional self-injury or poisoning regardless of suicidal intent. Demographic, clinical, and familial variables were extracted from electronic medical records. Psychological assessments included the Children's Depression Inventory (CDI), Parent-child Relationship Scale, Parents' Perception of Uncertainty Scale (PPUS), parental Generalized Anxiety Disorder-7 (GAD-7), and parental Patient Health Questionnaire-9 (PHQ-9). The dataset was split into a training set (80%, n = 98) and a test set (20%, n = 25). Logistic regression with backward stepwise selection was used to construct a nomogram, with model performance assessed by the area under the curve and decision curve analysis.

Four independent predictors of self-harm were identified: female sex (OR = 9.484, 95% CI: 2.736-32.868), higher CDI score (OR = 1.175 per 1-point increase, 95% CI: 1.058-1.305), higher parental PHQ-9 score (OR = 1.235 per 1-point increase, 95% CI: 1.064-1.433), and parental marital status (overall P = 0.001). The model showed good discrimination in the training set (AUC = 0.873) and acceptable performance in the testing set (AUC = 0.720). Decision curve analysis confirmed clinical utility across relevant threshold probabilities.

Female sex, higher depressive symptom severity, higher parental depressive symptoms, and parental marital status were associated with self-harm among hospitalized adolescents with mental disorders. The developed nomogram may serve as a preliminary screening aid for individualized risk stratification and may help clinicians identify patients requiring further assessment. External validation in larger, multicenter cohorts is needed before routine clinical use.

Direct verbal disclosure may be evaluatively demanding for university students with social anxiety. Group art therapy (GAT) offers an externally focused, materially mediated mode of engagement, but its active processes remain uncertain.

In an assessor-blinded, two-arm randomized trial, 120 students with elevated social anxiety were assigned to eight weekly sessions of GAT or a structurally matched supportive discussion group (SDG). Clinical outcomes were assessed at baseline, post-intervention, and 3-month follow-up; an adapted AEQ-derived session score and two study-specific cognitive process measures were assessed after each session and analyzed exploratorily.

GAT produced larger LSAS-SR reductions at post-intervention (adjusted difference = -9.5, 95% CI [-15.3, -3.7], d = 0.63) and follow-up (-10.9, 95% CI [-16.7, -5.1], d = 0.71). Relative reductions calculated from group means were 35.6% and 41.4% in GAT, compared with 19.6% and 23.6% in SDG. The Condition × Session coefficient for the adapted AEQ-derived score was 0.27 (p < 0.001), and exploratory indirect associations were observed through self-focused attention (-0.088) and negative self-evaluation (-0.061).

GAT was associated with greater and sustained improvement in social anxiety, while the repeated process findings support aesthetic engagement as a candidate process for further testing rather than an established causal mechanism.

Irritable bowel syndrome (IBS) is a common functional gastrointestinal disorder, substantially affecting quality of life among young adults. Although regular physical activity (RPA) benefits both mental and gastrointestinal health, its potential psychological mechanisms in IBS-related symptom severity remain unclear. This study was designed to examine the association between RPA and IBS-related symptom severity among Chinese college students and to clarify the mediating roles of depressive symptoms.

A cross-sectional survey was conducted among 872 students from three universities in Shandong Province, China. Data on demographics, RPA, anxiety and depression assessed by the Self-Rating Anxiety Scale (SAS) and Self-Rating Depression Scale (SDS), and IBS-related symptom severity evaluated using the Irritable Bowel Syndrome Severity Scoring System (IBS-SSS) and the Gastrointestinal Symptom Rating Scale (GSRS) were collected. Group comparisons, multiple regression, and mediation analyses were performed.

Comparisons between students engaging in RPA and their sedentary peers revealed significantly lower IBS-SSS and GSRS scores in the RPA group. Consistent with these observations, multiple linear regression indicated that RPA was inversely associated with IBS-SSS [β = -28.665, 95% CI: (-40.129, -17.201), p < 0.01] and GSRS [β = -3.538, 95% CI: (-5.740, -1.335), p < 0.01] scores. In addition, higher SAS and SDS scores were positively associated with IBS-SSS and GSRS scores (all p < 0.001). Mediation analysis showed an estimated indirect association between RPA and IBS-SSS scores through depressive symptoms (p < 0.001), with a mediation proportion of 19.43%.

These findings indicate that RPA is associated with reduced IBS-related symptom severity, and that depressive symptoms statistically account for part of this association, highlighting the importance of lifestyle strategies integrating physical and psychological interventions for managing IBS-related symptom in young adults.

Psychological distress among public health nurses (PHNs) during major public health emergencies may vary across response phases, from acute crisis to prolonged chronic strain. Although the mental health consequences of sustained emergency response are well documented, evidence on how symptom connectivity patterns differ across acute and chronic phases remains limited.

This study aims to compare symptom centrality and connectivity patterns of job stress, anxiety and insomnia among PHNs during acute crisis and chronic strain and to identify phase-specific associations that may inform tailored intervention strategies.

We conducted a city-wide, two-wave census survey of PHNs across all 249 community health centres in Shanghai, China. Data were collected during the acute crisis phase (October-November 2022; n = 1565) and the chronic strain phase (November 2023-January 2024; n = 1718), with response rates exceeding 96% at both waves. Validated instruments were used to assess job stress, anxiety and insomnia. Undirected symptom networks were estimated using graphical least absolute shrinkage and selection operator models to characterise symptom connectivity patterns, whereas Bayesian network modelling was used to explore conditional probabilistic dependencies among symptoms. Exploratory subgroup analyses examined network heterogeneity by age and working hours.

Overall psychological distress was lower during the chronic strain phase than during the acute crisis phase; however, symptom-level connectivity patterns differed between the two phases, with notable differences in centrality. Conflicting responsibilities and limited opportunity to draw on prior experience and training showed stable metric-specific centrality across both phases. During the acute phase, network centrality was anchored by operational instability-including unclear roles and high effort demands-alongside anxiety-related hyperarousal. During chronic strain, the most central nodes were characterised by sustained workload burden and impaired recovery, such as difficulty relaxing. Bayesian models consistently positioned work-related stressors at upstream positions within the distress architecture. Subgroup analyses revealed that symptoms were more tightly interconnected among younger PHNs (< 36 years) during acute crisis.

The psychological architecture of workforce distress is phase-specific; therefore, 'one-size-fits-all' interventions are inadequate. Interventions should prioritise operational clarity during acute crises and workload management and recovery support during prolonged strain. Integrating these phase-adapted strategies into public health systems may help sustain a resilient frontline workforce.