Healthcare professionals in intensive care units face substantial psychological stress, yet structured educational approaches to promote mental health during early training remain underdeveloped. While current recommendations advocate early integration of psychosocial support into onboarding, they have not been translated into competency-based educational frameworks aligned with modern health professions education.

To develop a competency-based educational framework for ICU onboarding that integrates mental health promotion into structured learning objectives across knowledge, reflection, and action domains.

A mixed-methods design was applied, combining a structured consensus process with competency-based curricular mapping. Guiding questions were iteratively refined using a two-stage rapid consensus process involving a multidisciplinary panel of clinicians, educators, and external experts in psychology and occupational health. Consensus was defined as the absence of substantial disagreement. The resulting content was mapped to competency dimensions informed by competency-based medical education principles and aligned with Miller's Pyramid, a hierarchical model of clinical competence ranging from knowledge to action.

The process resulted in a competency-based framework comprising eight educational domains: relevance of mental health, ICU-specific stressors, conceptual understanding of stress, resilience and coping, the second victim phenomenon (the psychological impact on healthcare professionals following adverse events), structural support systems, professional self-reflection, and shared responsibility. Each domain was operationalized into competency levels (knowledge to evaluation), enabling constructive alignment between learning objectives, teaching formats, and potential assessment strategies. The framework integrates individual, team, and organizational perspectives and provides a structured basis for embedding psychosocial competencies into onboarding curricula.

This study may contribute to advancing health professions education and supports constructive alignment among learning objectives, teaching formats, and assessment strategies. It operationalizes existing recommendations into actionable educational components and supports constructive alignment in curriculum design. Implementation and evaluation studies are warranted to assess its impact on learning outcomes, behavioral change, and clinical practice.

Healthcare maintenance plays a vital role in the long-term management of patients with inflammatory bowel disease (IBD), particularly those receiving immunosuppressive therapies. This review emphasizes the importance of maintaining up-to-date vaccinations, regular bone and mental health assessments, and appropriate cancer screening in this population. It also highlights the added complexity of preventive care in immunosuppressed patients, outlining specific modifications to vaccination and screening strategies required to ensure safe and effective disease management. Gastroenterologists and other clinicians involved in IBD care should remain familiar with current guidelines and consistently integrate preventive health measures into routine clinical practice.

Abstract.

Depression is a pervasive mental health disorder that has been extensively studied, but effective treatment remains elusive. This is due to the lack of understanding regarding the underlying molecular mechanisms. Antidepressants usually target the monoaminergic system, but studies show that other neurotransmitters, such as acetylcholine (ACh), may be involved. Many clinical and preclinical studies show that increased ACh levels are associated with depression. Particularly, acetylcholinesterase (AChE) activity is shown to decrease in depression and antidepressants are known to increase it. However, it is not known whether this effect is direct or downstream.

To check whether antidepressants can directly modulate AChE activity, we evaluated the effect of various classes of antidepressants on ex vivo AChE activity in the frontal cortex, hippocampus and striatum of male and female rats.

Briefly, sertraline (SER), escitalopram (ESC), amitriptyline (AT), duloxetine (DUL), bupropion (BUP) and ketamine (KET) were incubated with the brain tissue homogenates in a 96-well plate for 30 min, following which AChE activity was evaluated by modified Ellman's method.

SER and ESC increased AChE activity in the frontal cortex, while AT, DUL, BUP and KET did not affect it.

This points to a novel mechanism of action of selective serotonin reuptake inhibitors (SSRIs) and a potential target for developing new therapeutics with better efficacy and lower side effect profiles.

The adversities and inheritance patterns of left-handedness have been associated with gender-related distress. Such driving factors predispose individuals to multiple mental health outcomes, shifting attention to the role of ruminative thinking.

The study seeks to examine the effects of handedness patterns on gender dysphoria and rumination among young adults, observing the intricate relationships among these variables and postulating a substantial influence of handedness on both gender-related distress and rumination in this population.

A cross-sectional design with purposive sampling was used to recruit 180 young adults aged 18-25 years. Study parameters were quantified using three self-report measures: the Edinburgh Handedness Inventory-Short Form, the Utrecht Gender Dysphoria Scale-Gender Spectrum, and the Rumination-Reflection Questionnaire. Data were analysed through moderation tests, correlation tests, and descriptive statistics.

The results reveal that the links between rumination and gender dysphoria appear to be stronger in left-handed than in right-handed participants. Furthermore, variations in rumination and handedness patterns in the sample contributed to a significant interaction effect (19.1%) in gender dysphoria, moderated by rumination.

The study presents a comprehensive perspective for considering and structuring interventions for individuals with gender-related distress, covering major concepts of hormonal and genetic mechanisms, also underscoring the relevance of handedness and rumination in clinical and research settings.

Mental health outcomes, such as depression and stress, are shaped by various factors, including childhood abuse, emotional and physical awareness deficits like alexisomia and sociodemographic influences. This study aimed to investigate the mediating role of alexisomia in the relationship between childhood abuse and mental health outcomes, specifically depression and stress, among Lebanese adults. A cross-sectional study was conducted in July 2024, enrolling 1,205 participants via a snowball sampling technique from various Lebanese regions. Higher childhood abuse was significantly associated with greater alexisomia, depression and stress. Mediation analyses with adjustment for covariates (gender, smoking, socioeconomic status, etc.) revealed that alexisomia mediated the association between childhood abuse and both depression (Beta = 0.018; Boot CI: 0.002-0.034) and stress (Beta = 0.005; Boot CI: 0.001-0.009). Higher childhood abuse was significantly associated with higher alexisomia and directly associated with higher depression/stress. Higher alexisomia was significantly associated with higher depression/stress. The findings suggest the need for greater clinical focus and targeted interventions to enhance emotional and physical awareness and improve mental health outcomes, particularly for individuals with a history of trauma.

Tobacco use is significantly more prevalent among individuals with schizophrenia spectrum disorders (SSD) compared to the general population, contributing to elevated rates of premature mortality from smoking-related diseases. Despite a decline in smoking prevalence in the general population, individuals with SSD continue to smoke at persistently high rates, driven by biological, psychological, and social factors. Standard smoking cessation approaches yield markedly poorer outcomes in this group compared to non-psychiatric populations. This scoping review aimed to map the emerging evidence on the use of e-cigarettes among individuals with SSD or serious mental illness (SMI).

This scoping review was conducted in accordance with the Population-Concept-Context (PCC) framework and reported following the PRISMA extension for Scoping Reviews (PRISMA-ScR) guidelines. The review focused on studies published between January 2020 and February 2026, searched on PubMed and EMBASE, providing an up-to-date synthesis of emerging evidence on e-cigarette use in this vulnerable population.

Three studies reported across four publications were included (total N = 323); one research group (Pratt et al.) contributed two separate publications reporting distinct outcomes from the same study cohort. Findings suggest that e-cigarette-based interventions are feasible and acceptable in individuals with SSD and SMI, with preliminary evidence of smoking reduction and decreased exposure to tobacco-related carcinogens. However, sustained harm reduction appeared dependent on a combined approach considering that device provision was empowered in its efficacy to sustain harm reduction over time when integrated with behavioral support.

The available evidence, while preliminary and limited by the small number of included studies, should be interpreted with caution regarding generalizability to patients with Schizophrenia Spectrum Disorders exclusively, as three of the four included publications recruited participants with broader SMI diagnoses of which SSD represents only a subset. Further research, including larger adequately powered trials with standardized outcome measures and longer follow-up, is needed to establish the generalizability and long-term impact of these interventions.

Faith-sensitive depression therapies address a core aspect of cultural values but are not specifically promoted within global mental health policy. This study evaluated a culturally adapted Behavioural Activation intervention for Muslim patients (BA-M) compared with standard treatments across diverse settings. A patient-level meta-analysis combined data from two randomised controlled trials and one feasibility trial, comparing BA-M with cognitive behavioural therapy (CBT) and, in the UK, social interventions. The primary outcome was post-treatment depression severity (PHQ-9) and retention was analysed using Poisson regression alongside qualitative evaluation. A total of 266 participants were recruited (Turkey: 22; Pakistan: 103; UK: 141), with no baseline differences in depression severity between groups. BA-M produced significantly greater reductions in PHQ-9 scores, with an adjusted mean difference of -2.72 (95% CI: -3.93 to -1.51). Engagement was also higher in BA-M (IRR: 1.30; 95% CI: 1.18-1.44). Qualitative findings (n = 66) indicated strong support among patients, therapists and service managers, highlighting increased patient motivation and engagement in both Muslim majority and minority contexts. Participants emphasised the importance of religious identity in recovery from depression. The faith-adapted therapy BA-M demonstrates superior effectiveness to CBT and social interventions, supporting the integration of faith-sensitive approaches into global mental health practice.

Despite growing recognition of the intergenerational effects of maternal mental health, evidence from tea garden communities remains limited. This study assessed the mental health status of working mothers in tea gardens of Moulvibazar, Bangladesh, examined its association with children's well-being, and explored contextual factors shaping maternal mental health. A convergent cross-sectional mixed-methods study was conducted. Using a purposive and stratified random sampling technique, the quantitative data were collected from 451 working mothers with at least one child aged 2-7 years. Mothers' psychological well-being was assessed using the Depression, Anxiety, Stress Scale-21 and World Health Organisation-Five scales, while children's behavioural and emotional well-being was measured using the Strengths and Difficulties Questionnaire (SDQ). The qualitative component included 11 key informant interviews and two focus group discussions (FGDs) from Moulvibazar, Bangladesh. Quantitative data were analysed using descriptive and inferential statistics, and qualitative data were thematically analysed. A substantial proportion of mothers reported high levels of psychological distress, with 32.4%, 29.9% and 31.7% experiencing moderate to extremely severe depression, anxiety and stress, respectively, while 33.9% had poor well-being. Age was significantly associated with stress (p = 0.014) and overall well-being (p = 0.002), whereas no significant association was observed between childcare arrangements and anxiety (p = 0.171). Among children, 87.8% were classified as having abnormal SDQ scores based on maternal report. Addressing maternal mental health through improved working conditions, accessible childcare and targeted mental health interventions is critical for breaking cycles of intergenerational vulnerability.