Scalable approaches such as digital cognitive-behavioural therapy guided self-help (D-CBTgsh) may help close the treatment gap for college students with mental disorders. In a randomized clinical trial (ClinicalTrials.gov: NCT04162847) across 26 US colleges, populations were offered a mental health screen (39,194 assessed). Students with clinical levels or high risk for anxiety, depression and/or eating disorders (N = 6,205) were randomized to screening+D-CBTgsh or screening+referral-to-college-provided-care groups. Screening+D-CBTgsh reduced prevalence of any mental disorder (primary outcome) at 6 weeks (odds ratio (OR) = 0.80, 95% CI = 0.70-0.91), 6 months (OR = 0.77, 95% CI = 0.68-0.88) and 2 years (OR = 0.82, 95% CI = 0.72-0.93). Services uptake was greater in screening+D-CBTgsh (74.4%) versus screening+referral (30.2%) at 6 months (OR = 6.72, 95% CI = 6.01-7.52) and 2 years (OR = 1.83, 95% CI = 1.64-2.04), including for minoritized groups. Screening+D-CBTgsh (versus screening+referral to college-provided care) also improved dimensional outcomes of generalized anxiety, social anxiety, depression, eating disorder symptoms and mental health functioning. Findings supported transdiagnostic prevention and intervention benefits of screening+D-CBTgsh and its viability as a scalable, population-based approach.

The heterogeneity of depression complicates treatment. Identifying stable biological subtypes could advance precision-targeted interventions. This study aims to identify stable depression subtypes using functional connectome normative deviation models and to assess their response to repetitive transcranial magnetic stimulation (rTMS). We analyzed 1204 patients spanning different states of depression, together with 1636 healthy controls. Functional connectome normative models were derived from healthy controls to generate individual deviation maps for patients with depression, which were clustered using k-means to identify biologically informed subtypes. Subtype-specific responses to dorsolateral prefrontal cortex rTMS were evaluated, and putative neurobiological mechanisms underlying differential rTMS responsiveness were investigated. Two reproducible subtypes emerged across various clinical and methodological conditions: subtype-1 exhibited hyperconnectivity in somatomotor and ventral attention networks and hypoconnectivity in frontoparietal and default mode networks, whereas subtype-2 showed the opposite pattern. Only subtype-2 showed significant improvement in anhedonia following rTMS treatment (SHAPS: z =- 2.92, P = 0.001, FDR), which was significantly greater than that of subtype-1 (SHAPS, subtype-1 vs. subtype-2 efficacy: z = -2.43, P = 0.046, FDR). Patients whose connectome deviation patterns more closely resembled subtype-2 had better anhedonia improvement (r = 0.48, P = 0.012), while those closer to subtype-1 had less improvement (r = -0.46, P = 0.016). Only the pattern of deviation changes in subtype-2 was positively correlated with the anhedonia-related functional connectivity network mapping (r = 0.43, P < 0.001). These preliminary findings highlight potential avenues for subtype-targeted interventions in depression and warrant validation in larger randomized controlled trials.

To investigate the relationships between serum adipocytokines, body mass index (BMI), disease activity, and symptoms of depression and anxiety in patients with axial spondyloarthritis (axSpA). Ninety-three patients with axSpA and 100 age- and sex-matched healthy controls were assessed. Serum adipocytokines (resistin, leptin, fetuin-A, visfatin) and ghrelin, BMI, and disease activity (BASDAI, ASDAS-CRP) were measured. Depression and anxiety were evaluated using the Beck Depression Inventory-II (BDI-II) and Beck Anxiety Inventory (BAI). Patients with axSpA exhibited higher BDI-II (6.76 ± 6.81 vs 2.81 ± 3.31, p < 0.001) and BAI scores (6.67 ± 7.71 vs 3.89 ± 3.88, p < 0.05) than controls, with the somatic domain most pronounced. Depressive and anxiety symptoms correlated strongly with disease activity (ASDAS-CRP and BASDAI) but not with BMI or spinal involvement. Leptin and ghrelin reflected BMI, whereas fetuin-A and resistin were independently associated with affective symptoms: doubling of fetuin-A increased BDI-II and BAI scores by ~ 4 and 3 points, respectively, whereas doubling of resistin decreased them by ~ 2.5 points. Resistin was inversely correlated with BASDAI (r = -0.33, p < 0.05) and anxiety (r = -0.42, p < 0.001). Other adipocytokines showed limited associations with clinical or psychological measures. Depressive and anxiety symptoms in axSpA are primarily driven by inflammatory burden rather than BMI or structural disease severity. Fetuin-A and resistin exert opposing effects on affective symptoms, highlighting disease-specific immunometabolic pathways. Early identification of psychological distress and integrated management with anti-inflammatory therapy are warranted.

The negative impact of infertility and its treatments on sexual health is well-documented. Self-concept plays a crucial role in sexual behavior and overall sexual health. This study aims to investigate how couple-oriented counseling, using the Ex-Plissit model, can influence the sexual self-concept of infertile couples. This parallel-group randomized controlled clinical trial was conducted in Hamadan, Iran, at the infertility clinic of Fatemieh Hospital, from 2022 to 2023. One hundred twenty individuals (60 infertile couples) who referred to the clinic were randomly assigned to either the intervention group (n = 30 couples) or the control group (n = 30 couples). Based on entry criteria, the allocation sequence was determined using six blocks of 4 before the study began. Demographic characteristics and a self-reported sexual self-concept questionnaire were used to identify infertile couples with negative sexual self-concepts. The intervention group received four sessions of couple-centered sexual counseling based on the Ex_PLISSIT model, while the control group received routine treatments. Registration date in IRCT: 2022-09-13 .After the sessions, both groups completed the sexual self-concept questionnaire again. Data analysis was performed using SPSS version 26 software, including descriptive and inferential statistics (paired T-test, independent T-test, Wilcoxon, covariance) with a significance level of P < 0.05. The research findings indicated that the average score of women's sexual self-concept in the intervention group before the intervention was 21.50 (4.86), slightly higher than the control group's average of 19.87 (8.41). However, this difference was not found to be statistically significant (p = 0.361). Furthermore, there was no significant difference in the average sexual self-concept scores between the intervention and control groups of women after the intervention (p = 0.053). Interestingly, there was a statistically significant difference in the average sexual self-concept scores between the intervention and control groups of men after the intervention (p = 0.003). The paired t-test results revealed a statistically significant difference in the average score of men's self-concept before and after the intervention group intervention (p = 0.001). Furthermore, when comparing the mean (standard deviation) of men's self-concept scores in the post-intervention phase while controlling for pre-intervention scores, smoking, and male occupation, the average score in the intervention group was found to be 17.45 (3.23) lower than the control group's average score of 21 (3.23). This difference was also statistically significant (p = 0.001). The results of the current study indicate that couple-based counseling using the Ex-PLISSIT model has a significant impact on improving negative sexual self-perception in infertile couples. Therefore, infertile couples visiting fertility centers should be evaluated for their sexual function and self-perception. If needed, they should be offered educational, therapeutic, and counseling programs to provide them with the necessary information.Trial registration: Iranian Registry of Clinical Trial IRCT20120215009014N443.

Functional seizures (FS) and functional motor symptoms (FMS), subtypes of functional neurological disorder, may involve shared and distinct predisposing, precipitating, perpetuating and triggering (PPPT) factors. This study investigated potential self-reported PPPT factors in FS and FMS separately.

200 participants (FS=50, FMS=50, individuals with anxiety and/or depression (clinical controls [CC]=50, healthy controls [HC]=50) completed an in-depth medical history interview and online questionnaires to assess potential aetiological factors including traumatic/adverse life events, alexithymia, autistic traits, psychological and physical symptoms, illness perceptions, cognitive-behavioural responses and outcome measures of general functioning and health-related quality of life (HRQoL).

Participants with FS more frequently reported traumatic/adverse events and psychopathology (eg, dissociation, posttraumatic stress disorder) as possible illness causes/precipitating factors and sensory symptom triggers, relative to FMS and/or CCs. In contrast, participants with FMS endorsed physical illness causes/precipitating factors and physical activity and emotion-related symptom triggers more frequently than FS and/or CCs. Physical and dissociative symptoms were elevated, alongside reductions in HRQoL and general functioning in FS/FMS compared with CCs/HCs. Greater current, threatening illness-related beliefs/cognitions were disclosed in FS/FMS compared with CCs. Negative associations between HRQoL, cognitive-behavioural responses and traumatic/adverse events were also seen in FS/FMS.

Traumatic events and psychopathology may be more prominently involved in the development/maintenance of FS and physical illness/injury, physical functioning and alexithymia may be more central to FMS. Unhelpful illness-related beliefs and impacts on HRQoL and general functioning are shared between these subtypes. The results of this study provide insight into potential unique and overlapping characteristics of FS/FMS, with implications for treatment.

Treatment resistance in bipolar depression is one of the most challenging clinical conditions to treat in psychiatry. We present a case of an elderly gentleman with chronic Multi-Therapy Resistant Bipolar Depression (MTRBD), where ketamine, a preferential NMDAR blocker on cortical GABAergic interneurons, is used adjunctively with sequential theta burst stimulation (sTBS) to achieve remission.

Intravenous ketamine thrice a week was administered with sequential bilateral intermittent- and continuous-Theta Burst Stimulation (iTBS and cTBS) in 69-year-old man, with 2 years of bipolar depressive episode with multiple comorbidities, resistant to numerous antidepressants, anticonvulsants and antipsychotic mood stabilizers, individualised psychotherapies, trial of electroconvulsive therapy and sTBS. Roving mismatch negativity (rMMN), a robust passive EEG-ERP paradigm measuring neuroplasticity, was evaluated before and after this treatment protocol RESULT: A significant clinical improvement with Hamilton depression rating scale (HDRS 17) score improving from 15 to 8 with progressive improvement to achieve complete remission that persisted even at the latest 2-year follow-up on stable medications. A pronounced correction of dysregulated repetitive positivity, partial correction of deviant negativity was noted in rMMN after the treatment.

The novel combination of ketamine has resulted in sustained clinical remission in a patient with MTRBD. Earlier failure of sTBS and ECT underlines the importance of this combination. The rMMN findings were consistent with changes in short-term adaptive plasticity and may represent a potential neurophysiological correlate of treatment response. Combining Ketamine.

Traditional surveillance may not capture heterogeneous patterns of cannabis use disorder (CUD) risk during policy transitions. We used latent class analysis (LCA) to identify substance use patterns associated with varying CUD risk during U.S. recreational cannabis legalization expansion (2015-2023).

We analyzed 326,193 U.S. adults aged 18 + from the National Survey on Drug Use and Health (2015-2023, excluding 2021). LCA identified classes based on eight indicators: past-year alcohol and cannabis use disorders, lifetime use of alcohol, cannabis, cocaine, and heroin, and arrest history and suicidal ideation. Model selection evaluated 2-15 class solutions using Bayesian Information Criterion (BIC) and entropy.

Five classes emerged (BIC = 1,598,194, entropy = 0.680): Minimal Substance Use (47.3%), Low-Risk Cannabis Use (36.3%), Alcohol-Dominant Comorbidity (5.6%), Polysubstance/High Legal Involvement (7.3%), and High-Risk CUD (3.4%), with the highest cannabis use disorder (42.1%), alcohol use disorder (82.7%), arrest history (29.4%), and suicidal ideation (25.9%). This class increased from 2.6% (2015-2020) to 5.8% (2022-2023) (slope=+0.46 pp/year, p = 0.010). Daily/near-daily cannabis use showed a severity gradient: 32.2% in High-Risk CUD versus 0.0% in Minimal Substance Use (χ² = 73,297, p < 0.001). Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition period (2015-2019) sensitivity analyses confirmed stability (p = 0.614), indicating observed increases reflect population changes rather than diagnostic criteria evolution.

LCA identified five classes with distinct CUD risk profiles. The High-Risk CUD class increased during legalization expansion, with frequency patterns validating clinical significance. Class-based surveillance may complement prevalence monitoring during policy transitions, though causal attribution requires longitudinal designs with state-level legalization timing.

The challenge of improving academic performance, retention, and graduation rates has prompted researchers to examine the role of psychological factors in higher education success. Among these, grit, self-control, sense of belonging, and motives for attending college have emerged as key psychological variables that shape academic trajectories. The purpose of this study was to identify latent profiles of university students based on grit, self-control, sense of belonging, and motives for attending college, and to explore their associations with academic performance. The sample consisted of 1,651, mostly first-year students, from a private highly selective university in Santiago, Chile. Participants completed validated scales measuring each of the four psychological variables. Latent Profile Analysis was conducted to uncover distinct psychosocial configurations, followed by multinomial logistic regression to identify predictors of profile membership and associations with academic outcomes. Results supported a four-profile solution, with most students classified into a predominant group characterized by moderate grit and self-control but a strong sense of belonging. Profiles were primarily differentiated by self-control and motivational orientations rather than grit or belonging. Neither grit nor sense of belonging predicted academic performance; however, self-control subscales showed differential associations-interpersonal self-control was positively related to academic achievement, whereas work self-control showed a slight negative association. These findings suggest that while psychosocial profiles offer valuable insights into student diversity, their predictive power for academic performance may be limited in homogeneous, high-achieving university contexts. Nevertheless, the differential role of self-control highlights the importance of targeted interventions promoting adaptive self-regulation and emotional competence in higher education settings.

With the widespread use of smartphones, smartphone addiction has become a prominent mental health issue Negative attentional bias, a stable cognitive trait, is closely linked to addictive behaviors. Drawing on cognitive resource theory and emotional regulation theory, self-reported negative attentional bias may be linked to increased impulsivity via cognitive resource depletion and heightened anxiety through amplified negative perceptions, with these associations potentially forming a chain pathway related to smartphone addiction. However, the specific mechanism remains unclear.

A convenience sample of 646 male flight cadet was surveyed using online questionnaires, including the Negative Information Attention Subscale (ANI), Barratt Impulsiveness Scale (BIS), Generalized Anxiety Disorder-7 (GAD-7), and Smartphone Application-Based Addiction Scale (SABAS). SPSS 29.0 was used for correlation analysis, and the PROCESS macro with Bootstrap method was employed to test the mediating effects.

There were significant positive correlations between negative attentional bias, impulsivity, anxiety, and smartphone addiction. Negative attentional bias is directly positively associated with smartphone addiction and shows indirect associations through three paths: impulsivity alone, anxiety alone, and the chain of "impulsivity→anxiety".

This study identifies that self-reported negative attentional bias is associated with smartphone addiction in male flight cadets through both direct and indirect associative pathways involving impulsivity and anxiety. Given pilots' occupational demands for high cognitive stability, emotional regulation, the proposed interventions are relevant, targeting negative attentional bias may improve situational awareness, and managing anxiety may mitigate compensatory smartphone use that may disrupt pre-flight preparation or in-flight focus, and controlling impulsivity supports compliance with aviation safety rules. These findings provide a targeted theoretical basis for reducing smartphone addiction in male flight cadet.