Background: Ocular trauma is a significant cause of monocular visual impairment and potential psychological morbidity. This study aimed to determine the prevalence of anxiety, depression, and post-traumatic stress disorder (PTSD) in patients with mechanical ocular trauma and to investigate the predictive value of baseline clinical characteristics, specifically initial visual acuity. Methods: This retrospective study included 58 adult patients treated for mechanical ocular trauma. Sociodemographic data, injury mechanisms, and clinical variables, including initial visual acuity (LogMAR), ocular trauma score, and number of ocular surgeries, were analyzed. Psychological status was assessed using the Beck Depression Inventory, Beck Anxiety Inventory, and a PTSD checklist. Multivariate logistic regression and correlation analyses were performed to identify predictors of severe PTSD. Results: The cohort was predominantly male (86.2%) with a mean age of 42.5 years. Severe or very severe PTSD symptoms were identified in 35.1% of patients. Analysis revealed a significant positive correlation between initial visual acuity and PTSD scores (r = 0.273, p = 0.038). In the logistic regression model, initial visual acuity (LogMAR) demonstrated the highest odds ratio for severe PTSD in the multivariable model; however, this association did not reach statistical significance (OR = 2.164, 95% CI: 0.720-6.508, p = 0.169) and should therefore be interpreted as an exploratory trend rather than a confirmed predictor. Conclusions: Greater visual loss at the time of injury showed the strongest, although non-significant, association with subsequent PTSD symptom severity. These findings suggest that patients with severe initial visual impairment following ocular trauma may benefit from early psychological screening and timely mental health referral, warranting confirmation in larger prospective studies.

Autism spectrum disorder (ASD) is a heterogeneous neurological condition with an unclear etiology and pathogenesis. In recent years, studies have identified changes in lipid metabolism, inflammation, mitochondrial dysfunction, and mitophagy in patients with ASD. However, the specific interactions between these molecular signatures and their clinical applications in ASD remain largely unexplored. The aim of our study is to search for correlations between changes in gene and miRNA expression and the clinical characteristics of ASD. The investigation included a cohort of children with idiopathic ASD and healthy controls (HC). Diagnosis was established based on ADOS assessment (autism diagnostic observation schedule). Gene expression levels of sphingomyelin phosphodiesterases (SMPD1 and 5), ceramide synthases (CerS1 and 6), cyclooxygenase-2 (COX2), chitinase-3-like protein 1 (YKL40), and lysosome-associated membrane proteins 1 and 2 (LAMP1 and 2) were assessed using qPCR. The TaqMan assay was used for the quantification of miR-143-3p and miR-181a-5p. Our findings provide novel data on altered expression profiles of molecules related to lipid metabolism and LAMP1/2 in patients with ASD. We observed increased mRNA levels of CerS1, SMPD5, COX2, YKL40, LAMP1, and LAMP2 and decreased expression of miRNA-181a-5p in ASD patients compared to HC. Additionally, we identified a correlation between CerS1, CerS6, COX2, and miRNA-143-5p with ADOS scores. Multiple regression analysis revealed that 48.0% of the variance in the total ADOS score was explained by the combined effects of COX2, miRNA-143-3p, CerS1, CerS6 and age. These results provide new insights into the molecular alterations associated with ASD and may reinforce future studies aimed at clarifying their functional relevance.

Children with Developmental Coordination Disorder (DCD) show substantial motor and balance difficulties that affect daily activities. Although action observation (AO) and motor imagery (MI) are effective in other neurological conditions, their impact in DCD remains underinvestigated. This review explores the preliminary evidence of AO- and MI-based interventions for improving motor and functional outcomes in children with DCD.

A systematic search of PubMed, Scopus, and Web of Science identified randomized controlled trials and controlled trials published in the last 15 years evaluating AO and MI interventions in children with DCD. Two independent reviewers conducted the screening of the studies, data extraction, and the risk-of-bias assessment using RoB2 and ROBINS-I. The review followed PRISMA reporting guidelines and was pre-registered on the PROSPERO database (CRD420251084196).

Of 320 records initially identified, seven studies, involving 199 children with DCD (aged 5-12 years), were included. Interventions varied from single-session to multi-session protocols (1-16 sessions) and included AO, MI, or a combination of both (AO + MI), with heterogeneous control conditions. Within these studies, the outcomes were primarily assessed using standardized motor coordination measures (MABC/MABC-2, DCDQ), planning tasks, and performance-based activities of daily living (ADLs) measures. Improvements were reported in motor imagery tasks, planning, and functional task performance. However, RCTs and CTs were identified to have a moderate and high risk of bias, respectively.

The present review suggests that AO and MI, either alone or in combination, may enhance motor planning, coordination, and daily functional skills in children with DCD, supporting internal motor representations and predictive motor control, reflecting functional gain in motor skills and ADL performance. Interestingly, these mental training approaches can be applied in clinical and everyday settings and are suitable for supporting these processes, with VR-based combinations representing a promising, but exploratory, approach. Although critical heterogeneity and a moderate risk of bias remain, the findings need to be interpreted with caution and require further investigation.

Background/Objectives: College student athletes can experience sleep and circadian rhythm disturbances. Methods: A PRISMA-based systematic review about young adult athletes' sleep and circadian rhythms was conducted, with 41 published studies analyzed. Results: Studies suggest that extending sleep duration could enhance athletic performance and support mental health. Risk factors for sleep and circadian rhythm disturbances include early morning practice sessions, late night games, jet lag, and female sex. Consequences of inadequate sleep include reduced reaction times and mental health problems, such as depressive symptoms and anxiety. Across the studies, numerous research design limitations reduced scientific rigor and hindered the ability to test hypotheses about sleep, circadian rhythms, athletic performance, and mental health outcomes. For example, most studies were underpowered due to small sample sizes and missing data. Many studies lacked randomization, control groups, and objective measures of sleep. Researchers commonly failed to control for variables that could confound results (e.g., caffeine, diet, and menstrual cycle hormones). Conclusions: Recommendations for future directions include conducting randomized clinical trials to test interventions related to sleep patterns, nutrition, light exposure, training schedules, and cognitive behavioral therapies to enhance sleep quality. Evidence-based education programs about healthy sleep are essential for coaches and athletes.

Background: Creative Expressive Therapies, including Art Therapy and Dance/Movement Therapy (DMT), are increasingly integrated as adjunctive interventions in the treatment of complex psychiatric conditions. However, comparative evidence regarding their differential effects across diagnostic groups remains limited. Methods: This exploratory quasi-experimental 2 × 2 factorial study compared Art Therapy and DMT, delivered as adjuncts to treatment as usual, in patients with first-episode psychosis (FEP) and eating disorders (EDs) (N = 36). Participants received ten weekly group sessions. Changes in perceived well-being, emotional tension regulation, and physical tension regulation were assessed at baseline and post-intervention using self-report measures. Data were analyzed using repeated-measures ANOVA and linear mixed-effects models. Results: Significant pre-post improvements were observed across all outcome domains, indicating a transdiagnostic effect of Creative Expressive Therapies. Differential response patterns emerged according to clinical profile and therapeutic modality. DMT was associated with relatively greater improvements in physical tension regulation in patients with EDs, whereas Art Therapy showed relatively greater effects on emotional tension regulation in patients with FEP. Conclusions: Within the limitations of an exploratory, non-randomized design and the use of non-validated outcome measures, the findings suggest modality-specific patterns of response to Creative Expressive Therapies. These results should be considered hypothesis-generating and support further investigation through adequately powered randomized controlled trials employing validated clinical and neurobiological outcomes.

Caffeine is the most consumed psychostimulant worldwide. Schizophrenia is an uncommon mental disorder affecting 0.34% of the global population. The aim of the current study was to investigate a possible association between caffeine consumption and symptom profile, dangerous behavior, and cognitive functions in patients with schizophrenia.

This prospective cohort study included consecutive patients diagnosed with schizophrenia who were admitted to the psychiatry ward or visited the psychiatry outpatient clinics at a tertiary University Hospital in Greece for a period of 12 months. All patients underwent an extensive psychiatric and cognitive function assessment using the standardized Greek version of the Positive and Negative Symptom Scale (PANSS), the generalized anxiety disorder scale (GAD-7), and the Addenbrooke cognitive test (ACE-R).

In total, 53 patients were included in the present study. Mean age of the participants was 45 ± 11 years. The mean age at onset was 23 ± 7 years, while mean duration of illness from age of onset was 21.58 years. Caffeine serum levels exhibited a positive correlation with the poor attention component of the general psychopathology PANSS subscale, as well as with the attention and orientation component in the ACE-R. Moreover, another positive correlation was observed between the perilous behavior PANSS subscale and caffeine serum levels. Conversely as caffeine serum levels increased, fewer negative symptoms were reported, specifically, the poor rapport and passive/apathetic social withdrawal of the negative PANSS subscale.

In summary, this study highlights the significant associations between caffeine serum levels, symptom severity, and cognition among patients with schizophrenia. While the findings provide valuable insights, they should be interpreted with caution due to the study's several limitations. More larger scale cohort studies are needed in order to elucidate the impact of caffeine consumption in patients with schizophrenia.

Background/Objectives: Esketamine-related dissociation is a transient, pharmacologically induced altered state that differs from the trait-like pathological dissociation typically observed in trauma-related conditions. While most studies have quantified these effects using the Clinician-Administered Dissociative States Scale (CADSS), patients' subjective phenomenology and meaning-making remain underexplored. This qualitative exploratory study investigated how patients narrate, interpret, and integrate dissociative experiences occurring during intranasal esketamine treatment for treatment-resistant depression (TRD). Methods: We conducted semi-structured interviews with 36 adults with TRD who were receiving intranasal esketamine in outpatient settings in Northern Italy (2022-2024). Interviews focused on the most salient dissociative experiences during treatment. Transcripts were anonymized and analyzed using inductive thematic analysis. Two researchers coded the data independently; discrepancies were resolved by consensus, and recruitment continued until thematic saturation was reached. Results: Four experiential domains emerged: sensory alteration and perceptual flow (10/36, 27.8%), time suspension and chronological drift (21/36, 58.3%), body and space alteration (20/36, 55.6%), and psychic distance from suffering (30/36, 83.3%). While a minority described transient distress or loss of control, most narratives framed dissociation as neutral or subjectively meaningful, often associated with a temporary reduction in ruminative self-focus and depressive distress. Conclusions: A narrative, phenomenological lens complements quantitative research by clarifying what esketamine-induced dissociation feels like to patients and how it is appraised in context. The findings do not imply a causal or mediating role in antidepressant efficacy. Rather, they suggest that dissociation functions as a transitional subjective state, the clinical relevance of which depends on anticipation, framing, monitoring, and integration. These results support the use of structured psychoeducation, in-session support, and post-session integration within real-world esketamine programs.

Background: Transcranial Direct Current Stimulation (tDCS) has shown potential in improving negative symptoms (NS) and Cognitive Impairment Associated with Schizophrenia (CIAS). However, heterogeneity in stimulation protocols and sample characteristics limit definitive conclusions regarding tDCS effectiveness in schizophrenia. Given the detrimental effects of cigarette smoking, particularly on cognition, this study explored the role of cigarette smoking as a modifiable individual factor potentially contributing to methodological heterogeneity by evaluating tDCS effects on NS and CIAS in Smoker (SM) and Non-Smoker (NoSM) patients. Methods: Post hoc analyses of a double-blind RCT were performed on 50 patients, randomized to 2 mA active or sham-tDCS (15 weekday sessions) with bilateral bipolar-nonbalanced prefrontal placement. The sample was divided according to the smoking status, consisting of 28 SM and 22 NoSM. Separate one-way analyses of covariance (ANCOVA) were performed within each subgroup to assess changes over time between treatment conditions. Clinical outcomes included Positive and Negative Symptoms Scale (PANSS), Brief Assessment of Cognition in Schizophrenia (BACS), Clinical Global Impression (CGI) and Calgary Depression Scale for Schizophrenia (CDSS) total scores. Results: SM exhibited baseline lower cognitive scores in verbal memory, motor speed and working memory domains. NS improved in both SM and NoSM with large effect size. Significant improvement in CIAS, specifically in working memory and verbal fluency, were found exclusively in NoSM. Conclusions: Cigarette smoking appeared to limit tDCS effectiveness in improving CIAS but not NS in schizophrenia. We suggested that the neurotoxic milieu linked to chronic exposure to neurotoxins of cigarette smoking could be responsible for these effects, counterbalancing the neuroprotective effects of tDCS. Further studies are warranted to replicate these findings.

Objectives: The present study aimed to explore psychiatrists' perceptions of duloxetine in routine clinical practice, focusing on its efficacy, tolerability, and treatment adherence in major depressive disorder (MDD) and generalized anxiety disorder (GAD). Methods: A structured questionnaire was administered to 97 psychiatrists from different regions of Spain. The survey covered demographic and professional data, prescription frequency, perceived clinical efficacy, tolerability, dosing patterns, and factors influencing adherence. Results: Overall, duloxetine was perceived as an effective treatment for both MDD and GAD, particularly in patients with somatic symptoms or comorbid anxiety. Tolerability was also positively rated, with nausea and fatigue identified as the adverse effects most commonly associated with reduced adherence. In addition, patient education and close follow-up were identified as the most effective strategies to improve adherence, whereas digital tools were considered promising but underused. Compared with other antidepressants, duloxetine was viewed as having a favorable balance between efficacy and tolerability, with similar or slightly higher adherence rates. Conclusions: These findings reflect a positive clinical appraisal of duloxetine among psychiatrists, highlighting its role as a versatile therapeutic option for affective and anxiety disorders, within the context of routine clinical practice in Spain, provided that appropriate adherence-support strategies are implemented.

Background/Objectives: Sensory deprivation, defined as a reduction or absence of external sensory input across one or more modalities, has long been investigated in extreme and experimental settings. More recently, its relevance has expanded to clinical contexts and environmental conditions. The present narrative review aims to synthesize current evidence on the neurobiological mechanisms, psychological effects, and clinical implications of sensory deprivation, with particular attention to its dual role as both a risk factor and, under controlled conditions, a potential therapeutic tool. Methods: A narrative literature search was conducted using PubMed, Scopus, and PsycINFO, covering studies published up to August 2025. Search terms included sensory deprivation, neuroplasticity, neurotransmitters, HPA axis, neuro-inflammation, circadian rhythms, psychopathology, extreme environments, and spaceflight. Preclinical and clinical studies examining biological, cognitive, and psychological consequences of reduced sensory stimulation were included. Data were synthesized thematically without quantitative meta-analysis. Results: Evidence indicates that sensory deprivation induces widespread neurobiological adaptations involving neurotransmitter systems (particularly dopaminergic pathways), dysregulation of the hypothalamic-pituitary-adrenal axis, neuroimmune activation, circadian rhythm disruption, and structural and functional brain changes, notably affecting the hippocampus. These alterations are associated with increased vulnerability to depression, anxiety, hallucinations, dissociative symptoms, and cognitive impairment. Duration, voluntariness, and individual differences (e.g., baseline vulnerability/resilience, trait anxiety, and prior psychiatric history) critically modulate outcomes. However, short-term and voluntary sensory restriction, such as Floatation-REST, may promote relaxation and emotional regulation under specific conditions. Conclusions: Sensory deprivation exerts complex, context-dependent effects on brain function and mental health. Duration, individual vulnerability, and voluntariness critically modulate outcomes. Understanding these mechanisms is increasingly relevant for clinical practice and for developing preventive strategies in extreme environments, including future long-duration space missions.