As individuals with neurodevelopmental disabilities transition to adulthood, the experiences of their caregivers change, and caregivers' roles may be different from when their children were young. During this transitional period, there are few integrated supports for caregivers, which can affect their mental health.

Using a sample of caregivers (N = 106), this study aimed to identify protective and risk factors of caregiver mental health outcomes including the behavioural characteristics of their adults with neurodevelopmental disabilities (at age 18), sociodemographic, and psychosocial factors in a well-characterised longitudinal sample.

Sociodemographic factors and psychosocial characteristics, and not characteristics of their adult children, are robust predictors of caregiver mental health during middle age (mean age = 56.81, SD = 5.39).

We discuss important formal and natural supports that can work together to promote caregivers' mental health as their children transition to adulthood.

Mental disorders are a leading cause of sickness absence and disability in Europe. They often follow chronic or recurrent patterns, hindering a sustainable return to work (RTW). In Germany, RTW aftercare interventions focusing on maintaining recovery and minimizing relapse among employees transitioning from psychiatric treatment to the workplace are scarce. We therefore developed an intensified RTW clinical aftercare program (RTW-PIA). This study aimed to (i) evaluate the effectiveness of RTW-PIA in addition to Care as Usual (CAU) on achieving sustainable RTW (SRTW) compared to CAU only, (ii) assess its impact on secondary outcomes, and (iii) explore potential moderators.

This multicentre randomized controlled trial, conducted in psychiatric outpatient clinics, included sick-listed employees diagnosed with a mental disorder. Participants (N = 484) were randomized to RTW-PIA + CAU (n = 240) or CAU only (n = 244). RTW-PIA is an 18-month multimodal aftercare combining medical-psychotherapeutic and work-oriented components. Primary outcome was self-reported SRTW, defined as ≤ 6 weeks of sickness absence within 12 months after full RTW. Primary and secondary outcomes (e.g., RTW self-efficacy, work ability) were collected at baseline and at 6, 12, 18, and 24 months. Intention-to-treat analyses used logistic regression and growth curve models, complemented by prespecified sensitivity and exploratory moderator analyses.

Overall, RTW-PIA had no significant effect on achieving SRTW (OR = 1.38 [95% CI 0.89 to 2.12]). Secondary outcomes revealed no significant effects, despite a consistent pattern of slight improvements favoring RTW-PIA. Per-protocol and complete-case sensitivity analyses led to the same conclusion. In diagnostic subgroup sensitivity analyses, employees with recurrent depressive disorders showed significant improvements in several secondary outcomes. Prespecified exploratory moderator analyses suggested potential benefits for employees without a recognized disability degree and for those with low social support at work. After multiplicity adjustment, only recurrent depressive disorder still moderated the treatment effect on work ability.

On average, RTW-PIA did not significantly improve SRTW or secondary outcomes. Employees without a recognized disability degree, with low social support at work, or with diagnosed recurrent depressive disorders might benefit from RTW-PIA. These hypotheses need to be tested in independent samples. Further research should also focus on the implementation of RTW-PIA.

DRKS00026232 (prospectively registered on 01/09/2021).

Descendants of mentally ill parents (DMIP) make up about 22% of the population and are 2-13 times more likely to experience mental problems themselves. Preventive health interventions are needed, which should foster protective factors. Unfortunately, little is known about which variables can serve as protective factors for this at-risk group.

In this quasi-experimental cross-sectional study, we compared DMIP (n = 332) with a control group (n = 90) with mentally healthy parents. We predicted that (1) DMIP report a lower well-being than the control group and that DMIP who experienced more sample-specific stressors report lower well-being, (2) that family identification relates to better well-being but that this relationship is moderated by ambivalent identification and disidentification and (3) that the relationship between sample-specific stressors and well-being is moderated by resilience and stress mindset.

Analyses show that compared to a control group, DMIP rather have a negative stress-mindset, identify less with their family, show higher disidentification and ambivalent identification with their families and report poorer well-being for most measures. DMIP who experience more sample-specific stressors report lower well-being. Identification with the family positively relates to DMIP's well-being. This relationship was especially strong when ambivalent identification was low (for DMIP but not for the control group). The relationship between the sample-specific stressors and well-being is not moderated by resilience or the stress mindset.

For preventive health programs, we propose to assess specific stressors and tailor interventions accordingly; to integrate modules which foster identification with the family and reduce ambivalent identification and to test if a stress mindset training benefits DMIP.

Not applicable.

Infant and early childhood mental health (IECMH) is increasingly recognized as relevant to psychiatric practice; however, its integration into psychiatry training in Canada remains unclear. This study examined how IECMH education is currently delivered within Canadian general psychiatry and child and adolescent psychiatry (CAP) residency programs.

Program directors (PDs) and associate PDs from all Royal College of Physicians and Surgeons of Canada-accredited General Psychiatry residency programs and CAP subspecialty programs were invited to complete an anonymous survey between August and December 2023. Survey items explored IECMH teaching practices, curricular structure, clinical exposure, perceived resident competence, and barriers and facilitators to implementing formal IECMH curricula.

Nine PDs participated (four general psychiatry; five CAP). No general psychiatry programs reported mandatory IECMH rotations, and most reported no dedicated IECMH teaching. CAP programs reported greater clinical exposure, with most requiring an IECMH-focused rotation; however, formal didactic teaching remained limited across programs. No programs reported the use of e-learning modules. General psychiatry PDs commonly rated their programs as educating residents in IECMH "not very well," whereas CAP PDs generally selected "moderately well," citing limited faculty expertise as a primary barrier. Conversely, all respondents endorsed IECMH training as "important" or "very important" and expressed strong interest in scalable, self-directed educational approaches.

IECMH education within Canadian psychiatry residency training is variable and inconsistently structured, despite widespread recognition of its relevance. These findings highlight opportunities to develop feasible, competency-aligned IECMH curricula to strengthen psychiatry training and support developmentally informed clinical practice.

Alcohol-related morbidity and mortality have risen in recent years while the U.S. confronts a housing affordability crisis. This quasi-experimental event study assessed the association between the end of the federal eviction moratorium and receipt of treatment for alcohol use disorder (AUD) among U.S. residents.

Using national claims data for June-December 2021, this study calculated state-week measures of AUD treatment. Event study models using Poisson regression estimated how the number of individuals receiving outpatient AUD treatment, prescription medication for AUD, and outpatient treatment for a behavioral health disorder with co-occurring AUD changed in the weeks before and after the federal eviction moratorium expiration in states where evictions resumed (treatment states) compared to states maintaining eviction moratoria (comparison states).

The state-weekly average number of individuals receiving outpatient AUD treatment was 9.95% greater (Confidence Interval (CI): 2.41%, 18.05%), with about 2440 more individuals receiving an outpatient AUD visit per week, than expected in the 5-16 weeks following the expiration of the federal moratorium in states where evictions resumed.

Resumption of evictions was associated with greater than expected rates of outpatient AUD treatment . Findings underscore the importance of considering the connection between housing policy and AUD treatment patterns.

Profound autism is a proposed subcategory of autism including individuals unable to meet basic daily adaptive needs and requiring 24-hour care. This report describes documented assessment practices and profound autism prevalence derived using different definitions.

Among 7,084 8-year-old children with autism from a population-based surveillance program in 13 US sites in 2022, we calculated the availability of IQ, verbal status, and adaptive data. We imputed missing data to calculate profound autism prevalence using the "updated" (2025) definition, which includes having 1) either an intellectual quotient (IQ) score <50 OR being nonverbal/minimally verbal AND 2) adaptive functioning significantly below age level (≤70). We compared prevalence using the updated definition to using the "prior" (2021) profound autism definition that did not incorporate adaptive scores, the updated definition with higher IQ score cutoff (≤70), and using only nonverbal/minimally verbal status and adaptive ≤70.

Among children with autism, 61.1% had IQ data, 74.0% had verbal status data, and 55.9% had adaptive data available. Cognitive data (IQ or verbal status) and adaptive data were available to determine profound autism status for 54.4%. After imputation, updated definition profound autism prevalence was 5.4 (95% CI: 5.1-5.8) and nonprofound autism prevalence was 27.5 (95% CI: 26.8-28.1) per 1,000 8-year-olds in 2022. Of children with autism, 16.5% met the updated profound autism definition and 32.1% met one element of the definition but did not meet full criteria. Prevalence was 33.5% higher using the prior definition, 70.9% higher using the updated definition with higher IQ score cutoff, and 33.3% lower using only nonverbal/minimally verbal status and adaptive ≤70.

Prevalence of nonprofound autism was higher than profound autism. Adaptive or other assessments underlying the profound autism definition were missing almost half the time. Community evaluation practices and the profound autism definition can evolve to better understand and meet needs of individuals with autism.

Latina adolescents and emerging adults navigate conflicting appearance ideals, balancing the "Latina curvy ideal" with Eurocentric thinness standards that contribute to body dissatisfaction, disordered eating, and emotional distress. Few culturally tailored interventions have been developed or evaluated specifically for Latina youth, particularly in ways that directly center their lived experiences and adaptation priorities. The mind.body.voice (m.b.v.) curriculum is a near-peer-led program integrating cognitive dissonance, contemplative practices, and community action to counter harmful appearance ideals and foster body acceptance. To examine the acceptability and cultural resonance of this approach, we engaged 17 Latina adolescents and young adults (ages 13-22) in virtual focus groups and administered self-report measures of body image, discrimination, acculturation, and ethnic identity. Thematic analysis identified five key domains: 1) body image and identity are shaped by intersecting cultural and societal expectations; 2) appearance biases arise from family influences, cultural norms, media exposure, and internalized pressures; 3) practices such as self-acare, physical activity, mindfulness, and a sense of strength drawn from cultural and familial roots promote body appreciation; 4) empowerment develops through peer support, safe spaces, and shared voice; and 5) culturally congruent, linguistically flexible facilitators enhance engagement. Participants viewed m.b.v. as acceptable and culturally resonant and identified both surface- and deep-structure adaptation priorities to inform future refinement and evaluation.

Rates of firearm-related deaths from suicide and homicide have continued to rise during the last several years. This has prompted large-scale debate over the role of mental illness in gun violence and the need to investigate strategies for reducing harm. Many countries require either some form of mental health evaluation or a simple doctor's note on mental fitness before purchasing a firearm. This study focuses on practitioner attitudes toward this practice in South Carolina and looks to examine the primary factors that may interfere with implementing mandatory fitness evaluations before firearm purchase. Our specific aim was to assess the level of concern that practitioners had with 12 barriers that were identified by the research team as potentially problematic for conducting fitness screenings for gun ownership. Comfort with performing these evaluations also was assessed, including differences in attitudes and comfort level based on the specialty of the practitioner.

A survey was created and dispersed to regional providers in the fields of Family Medicine, Internal Medicine, and Psychiatry. The survey contained questions assessing provider beliefs on the capability and feasibility of fitness evaluations for firearm purchase, comfort in performing such evaluations, and the level of concern with 12 potential barriers to performing evaluations using a Likert scale.

A total of 794 individuals received the survey, with a response rate of 18.9% (150) and a completion rate of 17.4% (138). The majority of respondents (84.7%) believed that implementing mandatory fitness evaluations before firearm purchase is a good idea; however, fewer than half (48%) believed that it is feasible. The most concerning barriers were related to the unreliability of an applicant's self-reporting, concerns over liability, and a large abundance of firearm sales.

Findings from this study indicate that although most respondents viewed mandatory fitness evaluations as a good idea, the act of implementing them was viewed to be less feasible for a variety of factors. Most of the barriers presented were met with at least a moderate level of concern. Although a common practice in many other countries, the United States presents unique challenges when it comes to the potential for implementing mandatory fitness evaluations. This is the first known study to gather practitioners' perspectives on this process. More research is needed on investigating solutions for reducing gun violence and whether the use of fitness evaluations is a viable tool.

Emerging data support the benefits of creative arts interventions for addressing depression in adolescents, but the neural mechanisms are poorly understood. This study examined changes in connectivity among large-scale brain networks implicated in both depression and creativity, before and after an arts intervention for adolescents with depression. Thirty-nine adolescents with depression completed resting-state functional magnetic resonance imaging scans before and after completing a two-week arts intervention called Creativity Camp. To approximate a "waitlist" control, half the sample also completed scanning 2 weeks before camp. Using a graph theory approach, we calculated the strength of connectivity between four networks at the "nexus" of mood and creativity: Default, Control, Salience, and Limbic. For these between-network connection strength indices, we (1) measured pre- to post-camp changes across the whole sample; (2) compared changes during waitlist versus during camp for the rest of the sample; and (3) explored correlations between changes in connectivity and changes in depression. In the whole sample, the strength of connectivity between three network pairs increased significantly from pre- to post-camp: Default-Control, Limbic-Control, and Salience-Default (all p < 0.05, corrected). The waitlist control comparison revealed that pre-to-post camp changes were greater than those observed during the waitlist for two of these network pairs (uncorrected). Connectivity changes did not significantly correlate with changes in depressive symptoms. Intensive engagement in creative arts may contribute to increases in connections between large-scale neural networks that are implicated in both mood and creative thinking. Future research is needed with larger samples using randomized control trials to further understand how creative arts engagement confers its mental health benefits for adolescents.