Enhanced Cognitive Behavior Therapy (CBT-E) is the leading outpatient treatment for eating disorders but is typically delivered by a single clinician and does not routinely incorporate interprofessional expertise. In broader healthcare settings, Interprofessional collaborative practice (IPCP), characterized by role clarity, shared values, structured communication, and teamwork, is associated with improved patient, clinician, and organizational outcomes. Interprofessional Enhanced Cognitive Behavior Therapy (CBT-IE) adapts CBT-E by embedding IPCP through co-delivery by a mental health professional and dietitian. This pilot evaluated the feasibility, acceptability, and preliminary effectiveness of CBT-IE for adults with anorexia nervosa (AN) and atypical AN in outpatient settings.

In this single-group mixed-methods pilot (ACTRN12622000305729), adults with AN or atypical AN were recruited from two Australian private practices and received up to 40 sessions over 12 months. Feasibility was assessed via recruitment, retention, and treatment dose, and explored alongside acceptability through post-treatment interviews. Preliminary effectiveness outcomes included body mass index (BMI), eating disorder psychopathology, psychosocial functioning, intuitive eating, and dietary intake.

Sixteen participants enrolled; 12 completed treatment (75% retention; mean 27.2 sessions). BMI increased significantly with a large effect (d = 0.98), and eating disorder psychopathology decreased significantly (d = 1.01). Psychosocial impairment and intuitive eating showed non-significant improvements with moderate effects. Dietary intake data were limited by missingness. Qualitative findings highlighted the central role of dietitians, the importance of interprofessional relationships, and areas for refinement.

CBT-IE was feasible, highly acceptable, and showed promising clinical outcomes. A fully powered trial is warranted to evaluate efficacy, cost-effectiveness, and implementation across diverse outpatient settings.

Mental health recovery, a core concept in contemporary mental health care, emphasizes that service users can pursue meaningful life goals by rebuilding hope, identity, and purpose even as related symptoms persist. As care has shifted from a biomedical focus on symptom control toward person-centered and community-oriented approaches, the mental health recovery process has presented challenges to traditional nursing roles and practices. Moreover, misperceptions of these approaches as psychiatric rehabilitation or illness management interventions have led to gaps between principles and practice. In this article, the relevant literature is reviewed to describe the meaning of recovery and its influencing factors, and measurement tools widely used to support nurses' understanding of recovery processes are summarized. In addition, the authors integrate their practical experiences in community psychiatric rehabilitation to reflect on challenges related to role positioning, intervention flexibility, and organizational support when implementing recovery-oriented care in practice.

To systematically review educational interventions for staff working on acute paediatric wards aimed at improving the care of children and young people (CYP) admitted for mental health support.

We conducted a systematic search of PubMed, The Education Resources Information Centre, PsychInfo and Web of Science from 2000 to March 2026 using terms related to healthcare professionals, training/education, mental health and children/young people. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. Interventions were classified using the Kirkpatrick model and the Behavioural Change Technique Taxonomy (BCT V.1) to identify mechanisms underpinning effective change.

We found nine studies meeting inclusion criteria, across a range of teaching methodologies and settings. Most interventions were designed and applied for nurses. Overall quality of evidence was poor. Although no single intervention could be recommended, analysis identified potentially useful components tailored to different learner needs, mapped through the Kirkpatrick and BCT frameworks. A notable gap was a lack of codesign with CYP and carers with lived experience and the absence of strategies to engage ambivalent or reluctant learners who might not attend educational interventions voluntarily.

Existing educational interventions contain elements that may support behavioural and practice change among staff caring for CYP with mental health needs. However, future research should prioritise high-quality, framework-based evaluations developed through codesign with CYP and carers. Interventions should also address how to engage learners who may be reluctant to participate in training for this area of clinical practice.

Arabic-speaking refugees and displaced populations in the Middle East and North Africa (MENA) face ongoing adversity that negatively impacts their mental health. Despite increasing mental health needs, there is no published systematic review evaluating non-clinical mental health and psychosocial support (MHPSS) interventions in the MENA region for this population, particularly through a culturally grounded framework.

We conducted a systematic review of MHPSS interventions published from 2011 to 2022 targeting non-clinical Arabic-speaking adult refugees and/or displaced persons in MENA countries. Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines and PROSPERO registration (CRD42023421057), we searched ten databases and grey literature sources. Objectives were to identify, appraise and synthesise eligible MHPSS interventions and assess their alignment with the Integrative Complexity (IC)-Adaptation and Development After Persecution and Trauma (ADAPT) framework. Studies were appraised using four validated quality assessment tools and a novel tool assessing links to the IC-ADAPT framework, which integrates an eco-psycho-social model (ADAPT) and a cognitive-interactionist model (IC). A subset of ten top-rated interventions was synthesised for IC-ADAPT alignment.

Thirty-eight studies met the inclusion criteria. Most interventions were conducted in Lebanon or Jordan, group-based and delivered by non-specialist facilitators in community settings. Parenting, resilience-building and trauma-focused therapies were the most common modalities. Most studies prioritised feasibility and effectiveness over efficacy. While none explicitly applied IC-ADAPT, several implicitly aligned with its eco-psychosocial systems (eg, bonds/networks, safety/security and roles/identities) and IC (eg, increased 'differentiation'), reporting reduced harsh parenting and improved reflective capacity. Culturally adapted interventions that promoted complex thinking, relational healing and community participation were linked with more favourable outcomes.

This review highlights the value of culturally sensitive, non-clinical MHPSS interventions in enhancing mental health outcomes for Arabic-speaking refugee populations in MENA. Programmes grounded in eco-psychosocial and cognitive complexity frameworks-such as IC-ADAPT-offer effective, scalable strategies for addressing refugee mental health. Future work should embed these models explicitly to optimise intervention design, relevance and impact.

CRD42023421057.

Pharmacological augmentation is commonly used for patients with major depressive disorder (MDD) who respond inadequately to antidepressant treatment. However, the robustness of evidence supporting lithium, second-generation antipsychotics (SGAs), and triiodothyronine (T3) augmentation for MDD remains uncertain.

To reappraise the efficacy and robustness of evidence for pharmacological augmentation strategies for MDD, focusing on lithium, SGAs, and T3.

We systematically searched five electronic databases and included placebo-controlled RCTs in adults with MDD who received augmentation with lithium, SGAs, or T3. The primary outcome was response rate (defined as ≥50% depressive symptom reduction). Random-effects meta-analysis and trial sequential analysis (TSA) were conducted. We also performed publication-bias-adjustment analyses, including PET-PEESE and selection models. Subgroup analyses were conducted for individual SGAs.: To reappraise the efficacy and robustness of evidence for pharmacological augmentation strategies for MDD, focusing on lithium, SGAs, and T3.

Fifty-six RCTs were included (n=13616). SGA augmentation was associated with a higher response than placebo (k=45; reported as OR with 95% CI: 1.53; 1.42-1.65; I²=0%), and the evidence was supported by TSA. Conversely, while lithium showed benefit in conventional meta-analysis (k=17; OR 2.06; 1.30-3.27; I²=11.5%), this effect was not supported by TSA (accrued information size reached 8% of the required information size; 1.99, TSA-adjusted 95% CI 0.02-189.11) and became statistically non-significant in the PET-PEESE-adjusted and selection models. Additionally, T3 augmentation was not associated with significantly higher response than controls (k = 6; 1.19; 0.53-2.70). Among individual SGAs, only aripiprazole, quetiapine, brexpiprazole, and cariprazine demonstrated TSA-supported efficacy, whereas evidence for other SGAs was limited or inconclusive.

The certainty and robustness of evidence for lithium and T3 augmentation remained limited. Evidence for T3 was sparse and did not show a significant advantage over control, while interpretation of the lithium findings is further constrained by the fact that most trials were conducted before treatment-resistant depression was more operationally defined in contemporary research. SGAs with TSA-supported benefits (aripiprazole, quetiapine, brexpiprazole and cariprazine) may be prioritised, pending individual patient considerations.

https://osf.io/27gp9.

Placenta accreta spectrum (PAS) is a complex obstetric condition with a rising incidence in parallel with the rising rate of cesarean delivery. Given the significant and rapid hemorrhage associated with cesarean hysterectomy it is critically important to prepare for resuscitation and transfusion. Both neuraxial and general anesthesia can be used, each having their own advantages and disadvantages. The diagnosis of PAS can have significant mental health effects on the mother that need to be considered both during pregnancy and postpartum.

Infectious oral diseases represent the most prevalent categories of oral conditions, including dental caries, periodontitis, periapical lesions, and pericoronitis. Their bidirectional relationship with mental health has emerged as a critical interdisciplinary research frontier. This paper integrates epidemiological findings and molecular mechanism evidence to analyze the significant comorbidity and correlation characteristics between infectious oral diseases such as caries and periodontitis, and psychological disorders including depression and anxiety. Oral diseases not only directly impair mental well-being through pain, functional impairment, and social anxiety, but also induce systemic inflammatory responses that disrupt the blood-brain barrier, activate microglia, and alter neurotransmitter metabolism, thereby contributing to functional dysregulation within emotional regulatory centers. The dysbiosis of the oral microbiota caused by infectious oral diseases plays a central role in the vicious cycle of "oral infection-mental health disorders" through the"oral-gut-brain axis", inflammation-mediated neuroimmune cascades, and hypothalamic-pituitary-adrenal axis dysregulation. Meanwhile, mental disorders exacerbate oral microbial imbalance and tissue destruction through poor oral hygiene behaviors, xerostomia induced by psychotropic medications, and stress-related neuroendocrine alterations. This paper advocates for synergistically integrate oral clinical interventions with mental health improvement strategies, and for the development of microbiome-targeted precision modulation approaches. It further proposes an integrated health management paradigm that bridges dentistry and psychiatry, providing both theoretical foundations and practical pathways to transcend traditional disciplinary boundaries and achieve holistic oral-mental co-management.

This study aimed to (a) identify NexGen athletes' levels of mental health, anxiety, and depressive symptoms; (b) determine associations between sport type, psychological violence, mental performance, and athletes' mental illness and mental health; and (c) assess whether mental performance moderates these associations. A total of 318 NextGen athletes completed an online survey. Results showed that 19.8% and 21.4% reported clinical anxiety and depressive symptoms, respectively, and 45.3% were flourishing. Participating in an aesthetic sport was significantly associated with lower mental health. Only peer psychological violence was associated with higher mental illness scores and lower mental health. Higher mental performance was associated with less anxiety and depressive symptoms and higher mental health. Mental performance moderated the association between psychological violence from authority figures and anxiety symptoms when levels of authority-figure violence were low. Findings emphasize the importance of strengthening athletes' mental performance and addressing psychological violence through education and systemic safeguards.

Late-life depression (LLD) is commonly accompanied by cognitive impairment and poor response to first-line antidepressants. Repetitive transcranial magnetic stimulation (rTMS) is an effective treatment for treatment-resistant LLD, yet neurobiological predictors of cognitive and clinical outcomes remain unclear. Brain aging, quantified via magnetic resonance imaging (MRI)-derived centile scores from normative brain charts, may capture individual variability in neurostructural aging relevant to rTMS treatment response.

We examined relationships between centile scores, cognition, and antidepressant outcomes in older adults with LLD (n=112) and healthy controls (HC; n=41) who participated in a noninferiority clinical trial of bilateral dorsolateral prefrontal cortex (DLPFC) rTMS versus theta burst stimulation. Structural MRI was obtained before and after treatment. Centile scores leveraging cortical and subcortical tissue volumes were generated using BrainChart.io. Cognitive outcomes were assessed using standardized neuropsychological measures, including verbal learning and executive function.

Baseline centile scores did not differ between the LLD cohort and HCs and were unrelated to depression severity or antidepressant response. However, participants in a cognitively-diminished LLD subtype exhibited significantly lower centile scores driven by reduced white-matter volume. Across LLD participants, higher baseline centile scores predicted greater improvement in verbal learning following rTMS, but not global cognition or executive function, independent of antidepressant response. Centile scores remained stable post-treatment.

Brain age measures reflect cognitive, but not antidepressant, outcomes following rTMS in LLD. Structural-MRI based centile scores may serve as biomarkers of cognitive function and predictors of rTMS-related cognitive improvement in individuals with LLD.