The loss of close social relationships triggers profound mental and physical health consequences across social species. We utilized the socially selective prairie vole (Microtus ochrogaster) to investigate how 5-day separation from a bonded mate or peer partner shapes social motivation and dopamine release kinetics in males and females. Prior to partner loss, baseline social motivation to access a partner or a novel object differed by sex and relationship type (mate or peer partnership). Across all groups, however, separation induced heightened partner-seeking. Partner loss enhanced dopamine signaling in the nucleus accumbens, increasing evoked dopamine release, the number of putative dopamine release sites, and tyrosine hydroxylase abundance, regardless of sex or relationship type. These findings suggest that mesolimbic reward circuitry rapidly adapts to the loss of a bonded partner, signaling a critical social deficit across relationship frameworks. Furthermore, by leveraging synthetic sensors, this study provides novel subcellular insights into presynaptic dopaminergic plasticity following 5-day relationship disruption, directly linking relationship loss to heightened social motivation and shifts in reward signaling.

From friendships to mate partnerships, reciprocal social connections are vital for humans and other species that form social bonds. This study explores the behavioral and neural consequences of disrupting these relationships using the prairie vole, a species capable of forming selective bonds with both peers and mates. We demonstrate that, despite baseline sex and relationship-type differences in social reward, separation from a bonded partner triggers a uniform enhancement in social drive accompanied by elevated accumbal dopamine release and synthesis. This reveals a conserved, homeostatic reward mechanism that treats the loss of relationships as a critical deficit, advancing our understanding of the neurobiology of social bonding as well as grief and loneliness.

Early COVID-19 pandemic-era studies documented rapid adoption of telemental health, but current utilization patterns and disparities, particularly among children and young adults, remain poorly characterized since the COVID-19 Public Health Emergency ended in May 2023. The objective of this work was to characterize current utilization of virtual versus in-person outpatient mental health care in a large national cohort of commercially insured children and adults and to assess variation by patient, provider, clinical, and geographic characteristics.

In this retrospective cohort study, we analyzed 28,844,298 outpatient mental health visits delivered to 1,843,439 commercially insured patients aged 6-64 years between January 2023 and December 2025. The primary outcome was the percentage of visits delivered virtually, compared across age, gender, provider type, diagnosis, state, urbanicity, and social vulnerability index.

Overall, 77.6% of visits were delivered virtually, declining from 79.7% (2023) to 76.2% (2025). Children aged 6-12 years had substantially lower telehealth utilization than young adults aged 18-24 years (37.1% vs. 77.0%, p < 0.001), a disparity more pronounced for psychotherapy than psychiatry. Virtual care was highest for attention-deficit/hyperactivity disorder, anxiety, and depressive disorders, and higher among prescribers than psychotherapists (90.4% vs. 75.7%). Rural patients used virtual care less than urban patients (70.3% vs. 77.5%), whereas utilization was higher among patients in areas of greater social vulnerability.

In this large national cohort, virtual mental health care remained widely used but unevenly distributed. Persistent disparities by age, geography, clinical need, and social vulnerability highlight the need for hybrid care models and policies addressing digital access barriers.

Sleep-related breathing disorders, particularly the obstructive sleep apnea syndrome, lead to an urgent demand for continuous, comfortable, and accurate monitoring technologies. However, conventional polysomnography is limited by complex procedures, poor wearing comfort, and restricted suitability for long-term monitoring. Owing to their skin-like mechanical performance, high biocompatibility, high ionic conductivity, and excellent tissue compatibility, hydrogels have emerged as promising materials for flexible bioelectronic devices. Recent multimodal hydrogel-based sensors enable simultaneous acquisition of mechanical, thermohygrometric, and electrophysiological signals, providing new opportunities for comprehensive sleep respiratory monitoring. This review systematically discusses the mechanisms for acquiring and analyzing multimodal physiological signals, including respiratory motion, respiratory airflow, auxiliary physiological signals, and AI-assisted sleep respiratory state recognition. Furthermore, structural design strategies, including single-layer, multilayer, biomimetic, and integrated architectures, are reviewed to clarify how structural configurations facilitate multimodal signal acquisition, signal interference suppression, and sensing performance optimization. This review provides valuable references for the future development of high-performance wearable multimodal hydrogel-based sensors toward sleep respiratory monitoring.

Unhoused individuals are at high risk for chronic illness and early mortality. For those who have serious or life-limiting illness, being unhoused can negatively impact symptom management, access to disease-modifying therapies, and ability to receive goal-concordant care at the end of life (EOL). Palliative care (PC) clinicians should be prepared to take a thorough housing history, identify barriers to care, and work with patients and teams to devise care plans that are realistic and in line with the patient's preference and values. In this article, an interdisciplinary group of PC, internal medicine, psychiatry, and addiction medicine clinicians and researchers with expertise in caring for unhoused patients present an overview of the assessment and management of patients with serious illness who are unhoused. We outline key considerations for addressing symptoms associated with serious illness, engaging in Advance Care Planning, evaluating for comorbidities and mental health concerns, and coordinating medical therapies for the patient's underlying serious illness.

BackgroundRetirement well-being is a multidimensional concept shaped by individual, interpersonal, community/service, and policy-related factors.AimThis study examined physical, mental, social, spiritual, and financial well-being among retired older adults in New Brunswick and identified factors associated with each dimension.MethodsA cross-sectional survey was conducted with 1,903 retired older adults aged 65 years and older in New Brunswick, Canada. Guided by the Socio-Ecological Model, descriptive statistics, bivariate analyses, and five hierarchical multiple linear regression models were conducted.ResultsParticipants reported moderate well-being across all domains, with financial well-being appearing most vulnerable. Bivariate analyses showed associations between well-being dimensions and several sociodemographic, retirement-related, household, service access, and policy/satisfaction factors. In the final regression models, not being married/common-law was associated with higher physical, mental, social, and spiritual well-being, while living with a spouse/partner was associated only with higher financial well-being. Other significant predictors varied by domain and included education, service use, perceived policy support, satisfaction with services, employment sector, and retirement duration. Final models explained small proportions of variance.ConclusionRetirement well-being is shaped by factors across socio-ecological levels. Findings support integrated age-friendly strategies addressing health, social connection, housing, services, financial security, and policy support.

Access to nature has been associated with improved physical and mental health through multiple pathways, including stress reduction, physical activity promotion and reduced chronic disease risks. In contrast, urban areas lacking nature often expose residents to pollution, noise and heat. This study examines whether natural area availability is associated with morbidity.

We conducted a cross-sectional study using 2023 outpatient billing data, with the Charlson Comorbidity Index (CCI) as a measure of morbidity. (Mixed) linear regression models were applied in ecological-regional (full sample) and individual (2.5% stratified random sample) designs to examine associations between CCI and three natural area indicators (semi-natural, forest and water) while controlling for sociodemographic, socioeconomic and infrastructural variables.

Nationwide ambulatory claims data (secondary data analysis).

Data from 72.7 million individuals with statutory health insurance in Germany were used.

In the ecological-regional analysis, higher proportions of semi-natural, forest and water areas per inhabitant were negatively associated with the average regional CCI, with coefficients of -0.433 (95% CI -0.723 to -0.143, p=0.004), -0.080 (95% CI -0.139 to -0.021, p=0.008) and -0.612 (95% CI -1.137 to -0.087, p=0.022). Multilevel analyses confirmed these associations at the individual level: an increase of one SD of semi-natural (-0.013, 95% CI -0.023 to -0.003, p=0.009), forest (-0.012, 95% CI -0.022 to -0.002, p=0.024) or water area (-0.011, 95% CI -0.021 to -0.001, p=0.032) was each associated with a lower CCI.

Regions with more natural areas were associated with lower morbidity. Green spaces may support better health. Equitable access to natural environments could promote population health.

This systematic review and meta-analysis examine the globally available evidence for an association between maternal mental health, such as depression, anxiety and common mental disorders and child undernutrition; both of which are global public health problems.

Databases including MEDLINE, PsycINFO, CINAHL, Cochrane Library, Global Health Library and relevant reports from the World Health Organisation, United Nations of Children Education Fund and other organisations working in maternal and child health from 1995-2025 were searched. The risk of bias was assessed by recognised tool for assessing cohort studies. Random effects meta-analyses were conducted for all outcomes.

Meta-analysis of the primary outcome revealed that a synthesised estimate of the adjusted odds ratio for the proportion of stunted children of mothers with depression or mental health disorder compared to the proportion of stunted children of mothers with no depression or mental health disorder was 1.41 (95% CI 1.17, 1.69). Secondary meta-analyses revealed significant detrimental effects of maternal depression or mental health issues on underweight. Subgroup analyses suggest that the association is strongest in children up to 2 years of age in middle-income countries, and that there is insufficient evidence for an association in a meta-analysis conducted on low risk-of-bias studies only.

The review provides evidence of a significant association between maternal mental health and child growth disorder.

Real-world prognostic evidence for cerebrospinal fluid (CSF) biomarkers during lecanemab therapy remains limited. We examined whether baseline CSF phosphorylated tau 181 (pTau181), total tau, and amyloid beta (Aβ) 42/Aβ40 were associated with 6-month clinical change.

This prospective single-center cohort included 50 patients with early Alzheimer's disease spectrum treated with lecanemab. CSF biomarkers were measured using the Lumipulse G system. The primary outcome was 6-month change in Clinical Dementia Rating Sum of Boxes (CDR-SB). Models were adjusted for age, sex, and baseline Mini-Mental State Examination; sensitivity analyses included APOE ε4 status.

CDR-SB worsening occurred in 19 participants (38.0%). Higher pTau181 (β per SD = 0.408; 95% CI: 0.106 to 0.709; p = 0.0091) and total tau (β = 0.341; 95% CI: 0.032 to 0.651; p = 0.0314) were associated with worsening. Aβ42/Aβ40 was not.

Baseline CSF pTau181 and total tau were associated with 6-month clinical trajectories, supporting cautious cohort-level risk stratification.

Frontiers in Psychiatry - Hypothesis and Theory | Research Topic: School Avoidance and Anxiety Disorders in Childhood.

Anxious school avoidance (ASA) affects 1 to 5% of school-aged children and adolescents and carries well-documented consequences including school dropout, social isolation, and comorbid anxiety and depressive disorders. While functional, cognitive- behavioral, and psychodynamic models have significantly advanced the understanding of ASA, one dimension remains strikingly underexplored: its transcultural dimension. With over 281 million international migrants worldwide - including 35.5 million children under 18 - families from migration backgrounds represent a growing proportion of those consulting child and adolescent mental health services. Existing frameworks only partially account for the specific psychic configurations that emerge when migratory trajectories, intergenerational transmission, and identity construction intersect. Hypothesis: This article proposes that, in certain transcultural configurations, school engagement may be experienced - at an unconscious level - as a symbolic threat of rupture with familial, cultural, historical, and migratory roots. We conceptualize this process as a roots breach. Rather than proposing a new diagnostic category, this heuristic clinical construct - grounded in complementarist epistemology - operates across four registers: loyalty, identity, filiation, and debt, designating the unconscious pathways through which school investment becomes entangled with dynamics of belonging and intergenerational transmission.

The hypothesis is developed through eight theoretical sections articulating the complementarist epistemology of transcultural clinical practice (Devereux, Moro), the psychopathology of migration and cultural bereavement, the school institution as a site of identity tension in migratory trajectories, and the psychoanalytic dimensions of learning as subjective transformation (Bion, Meltzer & Harris). The concept of métissage and Bhabha's third space are mobilized to articulate the creative and conflictual dimensions of plural belonging.

Three anonymized clinical vignettes illustrate the diversity of presentations in which the roots breach manifests and demonstrate the role of transcultural psychotherapy in creating a space where this configuration can be named and worked through.

The roots breach hypothesis opens new research directions for ASA in transcultural contexts and carries significant implications for clinical training, school-care collaboration, and culturally responsive mental health services for adolescents.

Zopiclone is widely prescribed for insomnia, but the pharmacovigilance reporting signals for hallucinations remain poorly characterized. This study combines a case report and pharmacovigilance data to evaluate the association between zopiclone and hallucinations, compare hallucination subtype signals, and examine factors associated with higher reporting odds.

We reported a clinical case assessed by the Naranjo scale and analyzed the Canadian Vigilance Adverse Reaction Database (1994-2025) for zopiclone-associated hallucinations. Three disproportionality methods (ROR, PRR, and BCPNN-IC) were used for signal detection. Univariate and multivariate logistic regression were applied to identify factors associated with higher reporting odds.

In the presented case, auditory hallucinations worsened following zopiclone initiation and improved after discontinuation, with a Naranjo score of 4, suggesting a possible temporal association. A total of 58 valid cases of zopiclone-associated hallucinations were included in the database, accounting for 2.41% of all zopiclone-associated adverse events. All three algorithms detected positive disproportionality signals for zopiclone-associated hallucinations, with auditory hallucinations showing a numerically higher point estimate (ROR = 4.71, 95% CI: 2.87-7.72), visual hallucinations (ROR = 3.49, 95% CI: 2.13-5.72), and hallucination (ROR = 2.39, 95% CI: 1.70-3.37). Multivariate logistic regression analysis showed that age ≥ 65 years was independently associated with higher reporting odds of zopiclone-associated hallucinations (adjusted OR = 2.48, 95% CI: 1.42-4.30, P < 0.01). Sex was not independently associated with reporting odds of hallucinations, while BMI was not included in the multivariable model because of substantial missing data.

Zopiclone is associated with a reporting signal for hallucinations, with auditory hallucinations showing a numerically higher point estimate in this dataset. Age ≥ 65 years was independently associated with approximately 2.5-fold higher reporting odds of zopiclone-associated hallucinations. Caution is warranted when prescribing zopiclone to elderly patients. These findings represent pharmacovigilance signals derived from spontaneous adverse-event reports and do not imply causality. The database contained only one schizophrenia case (n = 1); therefore, no subgroup-specific conclusion can be drawn.