Suicidal ideation and non-suicidal self-injury (NSSI) among elementary school students represent critical public health concerns that require develop-mentally appropriate, evidence-informed school-based interventions. This study con-ducted a retrospective comparative analysis of two school-based approaches-Sandplay Therapy with Suicidal Ideation and Self-Injury-Focused Engagement (SPT-SAFE) and a School-based Dialectical Behavior Therapy-informed Brief Intervention (DBT-BI)-for elementary school students presenting with suicidal ideation and NSSI. The objective was to describe pre-post-changes in key outcomes within each intervention and to explore whether outcome trajectories differed between the two approaches in a non-randomized, real-world school-based setting.

This retrospective study analyzed archival clinical records from 109 elementary school students (SPT-SAFE: N = 59; DBT-BI: N = 50) who received services at a school-based suicide prevention center in South Korea between 2022 and 2024. Seven validated outcome measures assessed suicidal ideation, NSSI frequency, depression, anxiety, aggression, impulsiveness, and self-concept at pre- and post-intervention. Pre-post-changes and exploratory between-group differences were examined using 2 × 2 mixed-design ANOVAs (Group × Time interaction), with baseline-adjusted ANCOVAs conducted as complementary analyses. Suicidal ideation was operationalized using the SIQ-JR total score, and NSSI was operationalized using the FASM summed frequency index.

Both interventions were associated with significant reductions in suicidal ideation (F = 29.98, p < 0.001, partial η² = 0.219) and NSSI frequency (F = 15.95, p < 0.001, partial η² = 0.130), with large within-group effect sizes and no significant Group × Time interactions. Accordingly, between-group differences were limited and should be interpreted as exploratory rather than comparative-effectiveness evidence. Modest between-group differences favoring DBT-BI were observed for self-concept outcomes (F = 4.14, p = 0.044, partial η² = 0.037; d = -0.39).

These findings suggest that both interventions were associated with pre-post-improvements in suicidal ideation and NSSI frequency within a school-based clinical context.

Meaning in life (MIL) is recognized as a protective factor for adolescent mental health, being associated with reduced risks of depression, suicidal ideation, and non-suicidal self-injury. This study examined associations between attachment styles and MIL, with hopelessness and emotion dysregulation as potential mediators. Participants were 2067 Spanish adolescents (51.9% male, 48.1% female; M age = 14.62, SD = 1.80) who completed validated measures of attachment, emotion dysregulation, hopelessness, and MIL. Structural equation modeling indicated that secure attachment was associated with higher MIL both directly and indirectly through lower levels of hopelessness and emotion dysregulation. Disorganized attachment was not directly associated with MIL but was indirectly associated with MIL through these vulnerabilities. Hopelessness emerged as the strongest mediator, while emotion dysregulation was associated with satisfaction and meaning only. Findings highlight psychological vulnerabilities as pathways linking attachment to MIL, with implications for clinical and preventive strategies.

Elder abuse is an increasingly common problem in modern society, in the context of rapid population aging. Despite increasing awareness, this phenomenon remains heavily underreported, and effective interventions are yet to be made, thus leading to significant medical, social, and legal implications. The purpose of this review is to present an updated situation of the depths of elder abuse, presenting its prevalence both at the global and European level, the two main environments in which it is the most common (community and institutional settings), different forms of abuse, risk factors, and consequences for each one of them, as well as medico-legal aspects on the matter. A narrative review was conducted based on PubMed/MEDLINE, Scopus, and Web of Science databases, in association with data presented in reports from international organizations. The review included only articles published in English, in peer-reviewed journals, addressing elder abuse in adults aged 60 years and older, and those that didn't respect the criteria were excluded. Elder abuse comes in different forms, most of the time overlapping, with psychological abuse being the most prevalent. Each one of them has its own risk factors and specific consequences, but all of them will eventually lead to increased morbidity, accelerated cognitive impairment, and functional decline. In community settings, the elders usually experience abuse related to dependency on the family and social isolation, while in institutional settings, abuse is frequently associated with understaffing and inadequate care. From a forensic perspective, functional and cognitive decline complicate the proper documentation of the abuse. Thus, the role of the physician in providing legal support to the victim is essential. Elder abuse continues to be heavily overlooked, losing sight of the fact that its consequences extend beyond immediate physical harm, affecting the general physical and mental health of the victims. A possible solution to this problem is envisioned, with the purpose of raising awareness of this situation and contributing to a change in the perspective from which society looks at the elderly.

Emotion processing is critical in the neuropathology of major depressive disorder (MDD), while its relationship with clinical treatment remains unclear. This study aims to indicate the associations between emotion processing and treatment effects following a sequential dual-site accelerated repetitive transcranial magnetic stimulation (rTMS) protocol.

MDD patients were recruited to receive rTMS treatment with four sessions per day for four consecutive days, with stimulation sequentially delivered to the left dorsolateral prefrontal cortex (dlPFC) and the dorsomedial prefrontal cortex (dmPFC). Symptoms were assessed at baseline, end of treatment, and week 4 using the Montgomery-Åsberg Depression Rating Scale (MADRS), Snaith-Hamilton Pleasure Scale (SHAPS), and Fatigue Severity Scale (FSS). Emotional valence and arousal were evaluated with the Affect Rating Task (ART).

A total of 51 participants completed the clinical assessments and ART, with two excluded due to missing baseline data in the SHAPS and FSS. The linear mixed-effects models revealed significant improvement in depressive (p < 0.001, d = -0.343) and fatigue symptoms (p = 0.010, d = -0.572) following rTMS treatment. Neutral valence was correlated with MADRS scores at baseline (R² = 0.096, p = 0.027). In addition, changes in arousal for positive images (p = 0.047, adjusted R² = 0.097) and neutral images (p = 0.019, adjusted R² = 0.160) at treatment end were significantly correlated with MADRS improvement at week 4.

Our study highlights the association between changes in emotional arousal and improvement in MDD following accelerated dlPFC-dmPFC dual-site rTMS treatment.

Surgery is the most effective treatment for early-stage lung cancer but imposes a greater physical burden than other therapies. We previously identified socioclinical factors associated with reduced perioperative health-related quality of life (HR-QOL) in patients undergoing anatomical pulmonary resection. This study aimed to evaluate the relationship between predictors of HR-QOL and long-term survival.

In this prospective study, 87 patients undergoing anatomical pulmonary resection for non-small cell lung cancer at Shonan Kamakura General Hospital, Japan, were evaluated using the Short Form Health Survey 36. Multivariable analyses identified socioclinical factors associated with physical and mental QOL preoperatively and at 6 months postoperatively. Survival analyses were performed for factors showing differences in multivariable analysis and related trends in univariable analysis of HR-QOL.

Preoperatively, lower performance status (PS) and living alone were independently associated with poorer physical QOL (regression coefficient [95% CI]: -10.94 [-14.34--7.54] and -9.86 [-13.89--5.82], respectively; both p < 0.001) and mental QOL (-9.34 [-13.30--5.37] and -10.33 [-15.30--5.35]; both p < 0.001). At 6 months postoperatively, smoking cessation within 1 year, lower PS, and living alone predicted worse physical QOL, while smoking cessation and lower PS predicted worse mental QOL. Lower PS and higher comorbidity burden were also adverse prognostic factors for long-term survival (p < 0.001 and p = 0.015, respectively).

Reduced physical activity and greater comorbidity are associated with poorer HR-QOL and survival after lung cancer surgery. These findings highlight the need for careful consideration of surgical indications in patients with these risk factors.

This study evaluated the impact of standard inpatient rehabilitation on physical and mental health outcomes in patients with multiple myeloma (MM). Since prior data showed that physical activity (PA) is beneficial for patients with MM, this study assessed (1) the onset and (2) durability of these benefits with and without rehabilitation.

Sixty patients with MM, undergoing a three-week rehabilitation program in the rehabilitation clinic of the University of Freiburg between April 2022 and September 2023, were assessed at three time points: baseline (T0), post-rehabilitation (T1), and 3-months post-rehabilitation (T2). Six patients, declining rehabilitation, were also examined. Tests included the timed-up-and-go-test (TUGT), handgrip strength, laboratory parameters, subjective fitness-rating, validated questionnaires for PA, fatigue, depression, and health-related quality of life (HRQoL: SF-12, R-MCI).

Patients showed meaningful improvements in physical function, TUGT, and grip strength from T0 to T1. Fatigue, depression, and HRQoL improved considerably. After their return home (T2), 80% of patients remained physically active. Patients reported substantially higher subjective physical fitness at T2 compared to T0, improving to 5.0 from 3.1 on a 10-point scale, respectively. Non-rehabilitation-undergoing patients were fitter at baseline but did not improve in any tests/questionnaires at T1.

Structured three-week rehabilitation led to a substantial improvement in both the physical and psychological well-being of patients with MM, despite their compromised bone health. These effects persisted 3-months after patients' dismission home. The non-rehabilitation group showed no comparable improvement, underscoring the potential benefit of structured rehabilitation in enhancing HRQoL, fatigue, and depression. Continued post-rehabilitation support is pertinent to sustain these benefits.

Smart devices and multimodal biosignal systems, including electroencephalography (EEG/MEG), ECG-derived heart rate variability (HRV), and electromyography (EMG), increasingly supported by artificial intelligence (AI), are being explored to improve the assessment and longitudinal monitoring of mental health conditions. Despite rapid growth, the available evidence remains heterogeneous, and clinical translation is limited by variability in acquisition protocols, analytical pipelines, and validation quality. This systematic review synthesizes current applications, signal-processing approaches, and methodological limitations of biosignal-based smart systems for mental health monitoring. Methods: A PRISMA 2020-guided systematic review was conducted across PubMed/MEDLINE, Scopus, the Web of Science Core Collection, IEEE Xplore, and the ACM Digital Library for studies published between 2013 and 2026. Eligible records reported human applications of wearable/smart devices or multimodal biosignals (e.g., EEG/MEG, ECG/HRV, EMG, EDA/GSR, and sleep/activity) for the detection, monitoring, or management of mental health outcomes. The reviewed literature after predefined inclusion/exclusion criteria clustered into six themes: depression detection and monitoring (37%), stress/anxiety management (18%), post-traumatic stress disorder (PTSD)/trauma (5%), technological innovations for monitoring (25%), brain-state-dependent stimulation/interventions (3%), and socioeconomic context (7%). Across modalities, common analytical pipelines included artifact suppression, feature extraction (time/frequency/nonlinear indices such as entropy and complexity), and machine learning/deep learning models (e.g., SVM, random forests, CNNs, and transformers) for classification or prediction. However, 67% of studies involved sample sizes below 100 participants, limited ecological validity, and lacked external validation; heterogeneity in protocols and outcomes constrained comparability. Conclusions: Overall, multimodal systems demonstrate strong potential to augment conventional mental health assessment, particularly via wearable cardiac metrics and passive sensing approaches, but current evidence is dominated by proof-of-concept studies. Future work should prioritize standardized reporting, rigorous validation in diverse real-world cohorts, transparent model evaluations, and ethics-by-design principles (privacy, fairness, and clinical governance) to support translation into practice.

Progression of pectus excavatum and carinatum coincides with adolescence, a critical period for identity and self-esteem development. While clinical decision-making and insurance coverage have historically emphasized anatomic severity and cardiopulmonary functioning, increasing evidence suggests that psychosocial burden and quality of life (QoL) impairment represent central components of disease impact. A narrative review was conducted using the PubMed database to synthesize the current literature on the psychological impact of these deformities in adolescents and young adults, including body image distress, social functioning, and mental health effects before and after surgical and non-surgical correction, focusing on validated tools and qualitative studies. Across multiple cohorts, adolescents and young adults with chest wall deformities consistently report impaired body image, reduced self-esteem, social avoidance, and diminished QoL, even in the absence of diagnosable psychiatric disorders. Surgical and non-surgical corrections have positive effects in these domains. Psychological burden, therefore, represents a clinically meaningful component of chest wall deformities and should be considered alongside anatomic and physiologic criteria. Current evidence advocates for the integration of standardized psychosocial screening and support into evaluation and follow-up, which is essential for providing comprehensive, patient-centered care. Greater recognition of psychosocial outcomes may inform advocacy for broader treatment criteria, increasing accessibility among affected individuals.

Sleep plays a central role in shaping emotional development during childhood and adolescence, yet increasing evidence indicates that these processes unfold differently in boys and girls. This narrative review synthesizes current findings on sex-specific associations between sleep patterns, neurodevelopmental trajectories, and emotional regulation across pediatric populations. It examines how biological factors, including pubertal timing, sex hormones, circadian physiology, and maturation of fronto-limbic circuits, interact with environmental influences to generate distinct vulnerabilities to anxiety, depression, and behavioral dysregulation. Growing data suggest that girls exhibit greater sensitivity to sleep disturbances, particularly during the pubertal transition, with stronger links to internalizing symptoms such as anxiety and mood disorders. In contrast, boys appear more prone to externalizing behaviors and show differential responses to circadian misalignment and short sleep duration. Emerging evidence on sex-specific sleep architecture, REM-related emotional processing, and the bidirectional pathways through which sleep quality affects affective functioning are explored. Finally, clinical implications for early detection, personalized prevention, and targeted interventions tailored by sex and developmental stage are discussed. Understanding sex-based differences in sleep-emotion interactions offers a critical opportunity to refine pediatric mental health strategies and improve outcomes across developmental trajectories.