In multiple sclerosis (MS), symbol digit modalities test (SDMT) scores are often influenced by practice effects. We evaluated the SDMT practice effect as a proxy of cognitive performance by relating it to disease severity and future performance.

People with MS (pwMS) and healthy controls (HCs) were evaluated at baseline and five-year follow-up. Practice effects were modeled using two-part piecewise linear regression on daily smartphone SDMT (sSDMT) scores. Cognitive impairment (CI) and preservation (CP) were defined relative to HC baseline sSDMT z-scores (CI: z < -1.67, CP: z ≥ -1.67). Practice outcomes across HC/CP/CI were compared using ANCOVA and correlated to baseline variables. They were also assessed in relation to clinical outcomes and brain volumes in cross-sectional and baseline-follow-up models.

85 pwMS (CP/CI: 66/19) and 20 HCs were analyzed. 73 pwMS completed follow-up (5.39 ± 0.38y). A practice plateau occurred in 80%/82%/100% of HC/CI/CP. Higher baseline sSDMT was related to higher plateau sSDMT (ρ = 0.930, p < 0.001) and lower %-increase (ρ = -0.266, p = 0.013). %-increase was higher in CI than CP (CI/CP = 22.0%/15.5 adj.p = 0.004), but the absolute ∆-increase and breakpoint were similar across groups. Associations of disability, cognition, and brain volumes with the plateau sSDMT were stronger when compared to the baseline sSDMT. No other associations were found cross-sectionally and in the baseline-follow-up models.

Early-phase sSDMT practice effects were related to cognitive performance but were unique to disease status or associated with disease severity in pwMS. Plateau sSDMT showed stronger associations with disability and brain volumes than baseline performance. Interpretation of SDMT performance should therefore consider practice effects.

Partner support is both an important protective and risk factor for women's mental health perinatally. Although there is likely a bidirectional relationship between support and mental health, a research gap exists in understanding changes in women's experience of partner support over pregnancy and early childhood, and whether this differs for women with Major Depressive Disorder (MDD). This study examines whether women diagnosed with MDD antenatally are at increased risk of deteriorating partner support over the perinatal period, after accounting for demographic effects, ongoing depressive symptoms, stressful life events, and attachment orientation.

731 women recruited into a longitudinal pregnancy cohort study, the Mercy Pregnancy Emotional Wellbeing Study, were included, of whom 124 were diagnosed with MDD first trimester using the Structured Clinical Interview for the DSM (SCID). Perceived partner support was measured with the Social Support Effectiveness Questionnaire (SSEQ) in third trimester, 6 and 12 months, and 4 years postpartum. Partner support changes over time were analysed with mixed effects modelling.

There was an overall small but significant decline in partner support over time for all women. However, this decline was larger for women with MDD between 12 months and 4 years postpartum. Ongoing depressive symptoms, stressful life events, and insecure attachment orientation contributed to perceptions of lower partner support.

The perinatal and early childhood period poses an increased risk for the partner relationship for all women, but this risk is increased for women with MDD. This knowledge could be translated into identifying vulnerable women and offering appropriate interventions.

This scoping review synthesizes empirical research on how autistic family members shape family dynamics across relational subsystems, cultural contexts, and developmental stages. A comprehensive search conducted in January 2025 across five databases using the SPIDER framework yielded 102 studies analysed through convergent integrated three-stage thematic analysis informed by family systems theory. Five interconnected themes emerged: family identity reconstruction and role adaptation; emotional climate and communication patterns; cultural, societal, and structural contexts; pathways to resilience and positive adaptation; and developmental trajectories across the lifespan. These themes were integrated into an interpretive conceptual model in which communication emerged as a cross-cutting relational process, family adaptation unfolded across developmental time, and contextual conditions shaped which adaptive pathways were more or less available. Across studies, adaptive flexibility was a recurring feature of more positively adapting families, and caregiver mental health, especially maternal mental health in a mother-dominated evidence base, appeared closely linked to family emotional climate. A dedicated analysis reinterprets findings through a neurodiversity-informed lens, proposing foundational shifts toward investigating family adaptation with rather than to autism. Critically, autistic perspectives remain largely absent: of the 102 included studies, only five included autistic self-report as a primary data source. Future research must centre autistic voices, employ integrated longitudinal designs, and address structural barriers supporting equitable family systems.

This study examined behavioral, clinical, and hematologic factors associated with HIV-associated neurocognitive disorder (HAND) among people with HIV (PWH) using the International HIV Dementia Scale (IHDS) within a randomized clinical trial. This secondary analysis used data from the Hospital Visit as Opportunity for Prevention and Engagement for HIV-Infected Drug Users (HOPE) study, which enrolled 801 PWH who use substances from 11 U.S. hospitals. CD4 cell count, HIV-1 viral load, Global Severity Index (GSI), Global Assessment of Functioning (GAF), and Physical and Mental Component Scores (PCS, MCS) were assessed at baseline, 6 months, and 12 months. HAND was defined as an IHDS score ≤ 10. Multivariable linear and logistic regression models were used to identify baseline correlates of IHDS score and HAND, respectively. Linear mixed models were applied to evaluate the longitudinal changes in clinical outcomes. HAND prevalence was 76.3% (84.2% for females and 72.5% for males). Multivariable linear models revealed that obesity, CD4 cell counts < 200 cells/ µL, higher hemoglobin level and hematocrit, and higher GAF scores were significantly associated with IHDS score (p < 0.05). Furthermore, logistic models showed that recent alcohol use, obesity, viral suppression (≤ 200 copies/mL), hemoglobin and hematocrit levels, and GAF scores were associated with lower odds of HAND, whereas platelet count was linked to higher odds. Longitudinal analyses demonstrated significant increases in hemoglobin, hematocrit, PCS, and MCS over time, alongside decreases in platelet count and GSI. Compared with participants without HAND, those with HAND consistently exhibited lower hemoglobin, hematocrit, GAF, and GSI scores, and higher platelet counts and MCS scores across follow-up. These findings underscore the complex interplay between hematologic and mental health, substance use, and functional status in shaping neurocognitive outcomes among PWH. Targeting modifiable hematologic, behavioral, and psychosocial factors may help reduce HAND risk and improve long-term cognitive and functional outcomes. ClinicalTrials.gov ID: NCT01612169.

Incisional hernia is a common long-term complication of abdominal surgery and is traditionally seen as a structural defect. However, recent patient-centered research suggests that abdominal wall pathology may also impose substantial psychological burden. Whether incisional hernia is associated with an increased risk of clinically diagnosed depression at the population level remains unclear.

This retrospective cohort study used data from the German Disease Analyzer database (IQVIA). Adults with a first documented diagnosis of incisional hernia (ICD-10: K43.0-K43.2) between 2005 and 2024 were identified. Individuals with recent psychiatric disorders were excluded to assess incident depression. Patients were matched 1:1 to controls without hernia using propensity scores based on age, sex, index year, consultation frequency, somatic comorbidities, and remote history of depression. The primary outcome was incident depression (ICD-10: F32, F33) within five years. Associations were analyzed using conditional Cox regression.

A total of 10,075 patients with incisional hernia were matched to 10,075 patients without hernia. During five years of follow-up, 18.4% of patients with and 16.5% without incisional hernia were diagnosed with depression. Incisional hernia was associated with a slightly increased risk of incident depression (hazard ratio 1.12; 95% confidence interval 1.04-1.20). The association was more pronounced among women and among individuals without prior depression.

Incisional hernia is associated with a slightly increased risk of clinically diagnosed depression. These findings indicate a modest statistical association between incisional hernia and subsequent depression diagnoses in routine care. While the magnitude of the association was small, awareness of potential psychosocial comorbidity may be relevant in selected clinical contexts.

Exercise addiction (EA) represents an emerging mental health issue among athletic communities, manifested by compulsive exercise with negative psychological and physiological consequences. Although EA phenotypically coincides with overtraining syndrome and burnout, no study has explored this athlete mental health continuum in recreational athletes, especially regarding comorbid psychological distress and maladaptive food choice motivations.

To explore EA risk as an athlete mental health concern among Jordanian recreational athletes, examining the EAI screening-positive rate, associations with psychological distress and maladaptive food choice motivations, and multifactorial risk predictors including demographic, behavioral, and motivational variables.

A cross-sectional study recruited 1,036 recreational athletes (18-45 years) across Jordanian fitness facilities. Subjects completed validated Arabic versions of the EA Inventory, Depression Anxiety Stress Scale-21, and Athlete Food Choice Questionnaire. Binary logistic regression determined independent predictors.

Overall, 47.8% screened at risk for EA (22% low activity, 30% moderate, 66% high; p ≤ 0.001). At-risk individuals showed considerably high stress, depression, and anxiety (p ≤ 0.001), and valued performance, weight control, and nutritional optimization over sensory appeal and cultural food. Multivariable modeling (R² = 0.336; accuracy = 72.9%) identified independent predictors: male gender (OR = 1.66), high physical activity (dose-response: low OR = 0.13, moderate OR = 0.20 vs. high reference), lower stress levels compared to extremely severe stress (ORs 0.29-0.47; Normal through Moderate levels reaching conventional significance), and performance-oriented eating (OR = 1.12). Living alone (OR = 0.60) and hedonic food motivations showed protective associations.

This first integrated assessment of EA risk in an Arabic-speaking recreational-athlete sample identified a high EAI screening-positive rate within a fitness-oriented Jordanian sample, together with multifactorial associations involving male gender, higher recent activity, psychological stress, and maladaptive eating patterns; however, this screening-positive rate should be interpreted cautiously because the EAI is a screening instrument rather than a diagnostic tool.

Birthdays are typically a joyous occasion, but they can paradoxically conjure negative feelings, including reflections on failures and underachievement. In this study, we investigated a relationship between admission dates and patients' birthdays.

Electronic health records from the Dunn Center hospitals were obtained from April 2021 to June 2024. Patients who were 12 to 80 years of age, except for those in competency restoration units, were included in the analysis. Any admissions occurring 2 weeks before and after the patient's birthday were defined as birthday-associated admissions. A case-crossover analysis was employed to examine the plausible temporal relationship between the birthday period and the acute psychiatric hospitalization. A conditional logistic regression model was used to test the odds of birthday-associated admission versus non-birthday-associated admission. Relevant covariates consisted of age, sex, primary diagnosis, and social determinants of health.

A total of 17,847 admissions were included. The case-crossover analysis found that patients were approximately twice as likely (OR=2.08, 95% CI=1.89-2.30, P<0.0001) to be admitted 14 days before or after their birthday relative to a 28-day control window randomly selected within each calendar year. Potentially confounding variables, such as age, admission diagnosis, and social determinants of health, showed no difference in the likelihood of admission.

This analysis supports the hypothesis that, for persons with psychiatric disorders, birthdays may represent periods of increased risk/stress that can manifest in increased inpatient psychiatric admissions. With these results, we can supplement education efforts to inform patients, families, and providers to recognize birthdays as a possible risk factor for worsening psychiatric symptoms.

Childhood anxiety disorders are prevalent and impair children's socioemotional functioning. Abnormalities in sensory processing may play a role in the presentation of anxiety disorders. One important domain of sensory processing is sensory sensitivity, referring to heightened or diminished responses to sensory stimuli. While anxiety and sensory sensitivity frequently co-occur, research thus far has primarily focused on associations among autistic children, with limited investigation in anxious children. This study examined the associations between sensory sensitivity and anxiety symptom severity, externalizing problems, emotion dysregulation, and quality of peer and family relationships in children with elevated anxiety symptoms without neurodevelopmental disorders.

Ninety-four children aged 8 to 17 years (mean age=12.41, SD=2.55 y) with elevated anxiety symptoms but without neurodevelopmental disorders completed self-report assessments of sensory sensitivity, anxiety symptom severity, externalizing behaviors, emotion dysregulation, and quality of peer and family relationships. Participants' parents completed a parent-report assessment of children's externalizing behaviors.

Sensory sensitivity and anxiety symptom severity were not statistically significantly associated. Controlling for anxiety symptom severity and relevant sociodemographic covariates, sensory sensitivity explained a statistically significant amount of variance in youth-reported (but not parent-reported) externalizing symptoms, emotion dysregulation, and quality of family but not peer relationships.

Anxious youth with sensory sensitivity may experience externalizing symptoms, emotion dysregulation, and difficulties with family relationships. Study limitations included a racially/ethnically homogeneous sample and a cross-sectional design. Further research is necessary to better understand the causal impact of sensory sensitivity on behavioral difficulties and quality of life, identify potential protective factors, and test intervention strategies for this population.

Importance: Tardive dyskinesia (TD) is a persistent, potentially disabling, medication-induced movement disorder that has been underrecognized. Involuntary movements in TD have a substantial impact beyond movement on individuals with TD. To quantify TD impact and burden, the Tardive Dyskinesia Impact Scale (TDIS), a new, TD-specific, fit-for-purpose patient-reported outcome (PRO) measure, was developed. Objectives were to examine how TDIS contributes to understanding of TD burden and use of clinician-reported outcomes (ClinROs) and other PROs in clinical trials assessing effects of vesicular monoamine transporter 2 inhibitors on TD. TDIS analyses included assessment of correlations between TDIS and other clinical outcome assessments (PROs and ClinROs), estimation of the minimal clinically importance difference (MCID), and description of the change in TDIS individual items longitudinally and via item response theory. Observations: In KINECT trials, TDIS followed a similar trajectory to Abnormal Involuntary Movement Scale. An MCID of 4 points in TDIS was considered clinically meaningful. Item-level analyses showed that TDIS is reliable and precise for individual items. Most improved items in longitudinal analyses were self-consciousness (mean change: -1.24), embarrassment (-1.19), unwanted attention (-1.00), and mouth noises (-1.05), which exceeded the empirically derived item-level threshold for meaningful change (≥0.8). TDIS showed moderate correlation with treatment response as measured by Patient's Global Impression of Change (r=0.30) and Clinician's Global Impression of Change (r=0.34) scores. Conclusions and Relevance: TDIS is the only disease-specific PRO that has been validated in individuals with TD and complements ClinROs and other PROs by providing a comprehensive picture of TD impact beyond movement symptoms and can measure potential benefit of TD treatments.

The article focusses on the use coercion in acute psychiatric wards for children and adolescents in Norway.

The purpose of this article is to provide insight into how coercion within a continuum of formal and informal coercion is embedded in psychiatric treatment of children and adolescents. This integrated focus on multiple forms of coercion is critical for raising professional awareness regarding the effects of coercion on children's wellbeing, trust in professionals and future access to mental health services.

The study is based on ethnographic fieldwork in three acute wards in Norway conducted in 2023-2024. The research is part of a larger mixed-methods study focusing on the complexities of coercion in Norwegian child and adolescent psychiatry, which in addition to fieldwork includes interviews and surveys with clinical staff and patients in 18 acute wards.

The study shows how formal and informal coercion is embedded in routine therapeutic practices in child and adolescent acute wards. Three forms of informal coercion are highlighted: misinformation or withholding information, the use of leverage to obtain treatment compliance, and the threat of formal coercion to secure treatment compliance. In clinical practice, the use of formal and informal coercion is interrelated. Children experience distress, frustration and exhibit forms of withdrawal when exposed to coercion. The study concludes that providing transparency in treatment activities and plans, listening to children's perspectives on treatment needs, and showing respect for their autonomy, also when they are admitted on parental consent, is vital for their wellbeing, recovery and future access to mental health care and other support systems.