Adolescent pregnancy is common across Africa. Although programs emphasize contraception, support for those who do become pregnant is limited. We conducted a mixed-methods study in Zimbabwe to understand the service gaps and the needs of pregnant adolescents.

Pregnant adolescents (<18 years) identified by community child workers underwent clinical and mental health assessment, and birth outcomes were recorded. Longitudinal in-depth interviews were conducted with 18 pregnant and postpartum adolescents in three waves; in addition, nonrepeat interviews were conducted with 10 next-of-kin and 16 health and community workers. These interviews were thematically analyzed.

The median age of 119 participants was 16 years (range 12-17). Nearly all were neither in education nor employed, and >90% (108/119) were not in a relationship with the father of their pregnancy. HIV prevalence was 10.1% (12/119) and 38.7% (46/119) had at least one curable sexually transmitted infection. Over one-third (42/119) had moderate-to-severe depression. Pregnancy loss, stillbirth, or neonatal death occurred in 7% (8/115), and 25.9% (28/108) of live births were preterm. Participants highlighted that intergenerational poverty increased pregnancy risk and antenatal and postnatal adversity. Households struggled financially, forcing girls into inappropriate economic and social responsibilities, causing substantial anxiety. Mental health support was limited and poorly tailored, while sociocultural and policy-related barriers restricted access to education, health, and psychosocial services.

There is an urgent need for approaches and policies that promote the socioeconomic empowerment, physical, and mental well-being of pregnant adolescents. Health-care providers must be equipped to offer comprehensive, nonjudgmental care, with age-appropriate and longer-term psychosocial support.

AIM: To assess the association between Modic changes (MCs) and clinical outcomes in patients undergoing one-level lumbar fusion surgery. MATERIAL and METHODS: A retrospective cohort study included patients (>18 years) with single-level DDD treated with one-level lumbar fusion from 2016 to 2020 at a single center. Preoperative and 2-year postoperative outcomes were collected, including the Visual Analog Scales (VAS-back and VAS-leg), Oswestry-Disability-Index (ODI), Core-Outcome-Measures-Index (COMI-back) and Short-Form-Health-Survey-36 (SF-36). The association of patient reported outcomes measurements (PROMs) with preoperative MCs on MRI were assessed. Subjects with MC2 and MC3 were pooled in the No-MC1 group and compared to MC1 group. Continuous variables were compared using independent or paired t-tests, and non-parametric data with Mann-Whitney U or Wilcoxon signed-rank tests. Categorical variables were analyzed with Chi-square or Fisher's exact test. RESULTS: Preoperatively, the MC1 group exhibited higher ODI scores (47.05±14.60 vs. 36.84±13.12; p=0.026) and lower SF-36-PCs (30.80±7.22 vs. 35.61±5.17; p=0.021) compared to the No-MC1 group. Postoperatively, no significant intergroup differences were observed. However, the MC1 group demonstrated greater improvements in ΔODI, ΔVAS-back, and ΔSF-36-PCs. Intragroup analysis revealed significant postoperative improvements in ODI, VAS-back, and VAS-leg in the MC1 group (e.g., ΔODI= 29.14±13.27; p= 0.007), while the No-MC1 group improved in ODI and SF-36-Mental Components (ΔODI= 21.10±12.26; p= 0.023; ΔSF-36-MCs= 5.98±12.44; p= 0.003). Notably, 7 patients did not reach the ΔODI minimum clinically important difference, with higher prevalence in the No-MC1 group (71.4%). CONCLUSION: One-level spinal fusion improves clinical outcomes in symptomatic degenerative disc disease. Patients with MC1 demonstrate greater functional and pain-related improvements compared to those with MC2 or MC3.

Psilocybin use has increased in the US alongside promising therapeutic potential for depression, raising concerns that individuals may forgo conventional mental health treatment for unsupervised psilocybin use. However, no nationally representative studies have examined whether psilocybin use is associated with differential treatment utilization or perceived unmet need for mental health care among individuals with depression.

We analyzed data from 6,793 individuals aged ≥ 12 years with a past-year major depressive episode (MDE) from the 2024 National Survey on Drug Use and Health, a nationally representative survey of the noninstitutionalized US population. Sociodemographic and substance use characteristics were first compared by past-year psilocybin use. We then examined associations between past-year psilocybin use and eight past-year mental health treatment outcomes using Poisson regression, adjusting for sociodemographic characteristics, other past-year substance use, psychotherapeutic prescription misuse, and alcohol use disorder.

Among individuals with past-year MDE, an estimated 7.3% (95% CI: 6.4-8.3) used psilocybin in the past year. In multivariable models, psilocybin use was not associated with any mental health treatment utilization, including outpatient, inpatient, or telehealth treatment; prescription medication use for mental health; seeing a doctor for depressive feelings; or prescription medication use for depressive feelings. However, psilocybin use was associated with greater perceived unmet treatment need (52.0% vs. 33.9%; aPR = 1.44; 95% CI: 1.04-2.01).

Findings suggest that psilocybin use among individuals with depression co-occurs with perceived unmet need for conventional mental health care but is not associated with lower utilization of any conventional mental health treatments.

Inhibitory control deficits represent a core cognitive feature in patients with obsessive-compulsive disorder (OCD), yet their neurophysiological mechanisms remain unclear. Electroencephalogram (EEG) microstates offer a novel framework for investigating large-scale brain network dynamics in psychiatric disorders. This cross-sectional study aimed to investigate EEG microstate dynamics in OCD patients and their relationships with cognitive and response inhibition.

A total of 91 OCD patients and 76 healthy controls were recruited. Participants completed an Emotional Stroop Task (EST) and a stop-signal task (SST). Resting-state EEG was recorded, and microstate parameters and transition probabilities were analyzed. Correlations between microstate parameters and inhibitory control performance were assessed.

OCD patients exhibited significant deficits in both response inhibition and cognitive inhibition, with both types of deficits positively correlated with obsessive symptom severity. Microstate analysis revealed increased mean duration and time coverage of microstate A, but decreased mean duration, occurrence, and coverage of microstate C in OCD patients. Additionally, transition probabilities from microstates B and D to C were significantly elevated. Notably, the mean duration of microstate C was positively correlated with stop-signal reaction time (SSRT), while the occurrence of microstates C and D and the time coverage of microstate D were negatively correlated with the Stroop effect.

These findings reveal dissociable microstate mechanisms associated with distinct inhibitory dysfunction domains in OCD patients. Resting-state microstate dynamics may represent candidate neurobiological markers for cognitive subtype classification in OCD and may help inform the development of targeted therapeutic interventions.

This study aimed to develop and test reliability and validity of a short version of the Norwegian Awareness of Social Inference Test to ease assessment of social cognition after traumatic brain injury.

The least suitable items were identified statistically and from quality ratings made by clinical experts and persons with lived experience. Psychometric properties of the resulting short version were then estimated.

Adults with (n = 101) and without (n = 50) traumatic brain injury.

Predetermined fit criteria from Rasch and confirmatory factor analysis identified least-fitting items. Further item reduction was based on expert ratings. The reliability of the short version was estimated with Cronbach's alpha for internal consistency and intraclass correlations for test-retest reliability. Construct validity was estimated based on differences in performance between individuals with and without traumatic brain injury (known groups validity), correlations with measures of social cognition (convergent validity) and with measures of cognitive ability (discriminant validity).

The number of items was reduced from 59 to 28. Statistical analyses supported the short version's structure, and reliability and validity were similar to the full version.

The short version has acceptable psychometric properties and is more feasible than the full version; its implementation is recommended.

Adverse childhood experiences (ACEs) are a significant determinant of health across the life course and exhibit a dose-dependent relationship with the risk of mental and physical disorders in adulthood. One common yet under-recognized ACE is growing up in a family with an alcohol problem. The objective of this study was to review current data on the neurobiological mechanisms and clinical consequences of early exposure to parental alcohol use disorder, considered an ACE, along with implications for medical practice. A review was conducted of the literature on ACEs, with a particular focus on exposure to parental alcohol use disorder, the co-occurrence of other developmental adversities, and health outcomes in adulthood. Data on ACE screening and the trauma-informed care approach were also included. Parental alcohol use disorder often co-occurs with violence, neglect, and mental health disorders among caregivers, increasing overall stress exposure. Chronic developmental stress is associated with hypothalamic-pituitary-adrenal axis dysregulation and persistent inflammation, as well as an increased risk of depression, anxiety disorders, posttraumatic stress disorder, and substance use disorders. Somatic consequences are also described, including a higher risk of type 2 diabetes and cardiovascular disease, as well as a poorer response to treatment in individuals with ACE exposure. The term adult children of alcoholics is descriptive in nature and does not constitute a diagnostic entity. Early exposure to a parent's alcohol use disorder as an ACE is associated with multidimensional health consequences in adulthood. Further research is needed on the efficacy and safety of ACE screening and the implementation of trauma-informed care.

Despite the importance of early intervention, a substantial proportion of students experiencing psychological distress do not access professional care. This study compared the coping responses that Japanese university students without a history of psychological distress anticipate with those that students with such a history report and examined factors associated with the use of formal professional care rather than inaction among the latter group.

A cross-sectional survey was completed by 2025 undergraduates (Grades 1-4) at a large Japanese public university, representing 16.9% of the eligible undergraduate population. Students who reported no history of psychological distress described hypothetical help-seeking intentions; those with such a history reported the coping responses they had used, classified as Formal Help, Informal Help, Self-Care, or Inaction by a hierarchical priority rule. A binomial logistic regression (N = 402) examined adjusted associations with Formal Help versus Inaction.

The distribution of hypothetical intentions differed from the distribution of reported behaviour across groups (χ²(3) = 109.0, p < 0.001). Informal help accounted for 50.5% of hypothetical intentions and 30.8% of reported behaviour, whereas formal care accounted for 20.7% and 36.6%, respectively, and inaction for 7.0% and 13.0%. Higher generalized-anxiety scores were associated with formal care rather than inaction (OR = 2.51, p < 0.001); depression was not associated with the binary outcome (OR = 0.81, p = 0.434). Positive attitudes toward professional help (OR = 1.23, p < 0.001), female sex (OR = 2.06, p = 0.011), and independent living (OR = 1.82, p = 0.035) were also associated with formal care, whereas perceived stigma was not significant (p = 0.385). The model showed adequate discrimination (area under the ROC curve = 0.82).

In this cross-sectional sample, generalized anxiety, positive attitudes toward professional help, female sex, and independent living were associated with formal care relative to inaction; depression was not independently associated with the outcome. The findings support prospective evaluation of low-threshold outreach and multidimensional literacy and access interventions but do not establish causality or intervention effectiveness.

To investigate the protective effects of ligustrazine (Lig) against nitroglycerin (NTG)-induced migraine and explore its underlying mechanisms, with a particular focus on mitochondrial energy metabolism and the coordinated regulation of protease-activated receptor 2 (PAR2), cyclophilin D (CypD), and adenine nucleotide translocator (ANT). An NTG-induced rat migraine model and NTG-challenged PC12 cells were utilized. Migraine-like behaviors, cell viability, oxidative stress, and mitochondrial function parameters (reactive oxygen species [ROS], nitric oxide [NO], mitochondrial membrane potential [MMP], ATP, and lactic acid) were evaluated. The expression of PAR2, CypD, and ANT was analyzed via Western blotting. Erastin was applied to verify the specific mechanisms. Furthermore, immunoprecipitation-mass spectrometry (IP-MS) was performed to identify CypD-interacting proteins. Validating IP-MS results through protein docking. Lig significantly alleviated NTG-induced migraine-like behaviors in rats and improved the viability of NTG-challenged PC12 cells. Biochemically, Lig mitigated oxidative stress and mitochondrial dysfunction by reducing ROS, NO, and lactic acid levels while restoring MMP and ATP production. Mechanistically, Lig effectively suppressed the NTG-induced upregulation of PAR2, CypD, and ANT. The application of Erastin abolished Lig's protective efficacy, confirming its dependence on mitochondrial energy metabolism pathways. Additionally, IP-MS successfully identified 46 CypD-interacting proteins, expanding the mechanistic understanding of migraine pathogenesis. The protein docking results also support the reliability of the IP-MS results. Lig effectively alleviates NTG-induced migraine by restoring mitochondrial energy metabolism, in close association with the coordinated modulation of PAR2, CypD, and ANT expression. These findings highlight Lig as a promising therapeutic candidate and offer potential molecular targets for clinical migraine management.

Suicidal ideation and behavior (SIB) represent a major clinical challenge in major depressive disorder (MDD), yet the multimodal brain structural signatures associated with SIB and their relationships with cognitive dysfunction remain poorly understood. We acquired multimodal neuroimaging measures, including gray matter volume, cortical thickness, pial area (PA), white matter fractional anisotropy, together with neurocognitive measures from 61 MDD patients with SIB (MDD-SIB), 38 without SIB (MDD-nSIB), and 142 healthy controls (HC). Linked independent component analysis (LICA) was used to identify covarying multimodal structural brain patterns, followed by group comparisons and exploratory association analyses. LICA identified distinct multimodal structural patterns related to SIB status, with IC1, IC9, and IC14 differing between MDD-SIB and HC, and IC12 between MDD-SIB and MDD-nSIB. Spatial working memory (SWM), visual memory, sustained attention, and cognitive flexibility also differed significantly across groups, with the MDD-SIB group showing poorer performance across these cognitive domains. Within the MDD-SIB group, IC1, a fronto-temporal-cingulate structural covariance pattern characterized predominantly by PA alterations, was associated with both SWM strategy performance and depressive symptom severity. These findings identify distributed multimodal structural signatures associated with SIB in MDD and highlight a fronto-temporal-cingulate neural correlate linking cognitive dysfunction with depressive symptom severity.

Research addressing the challenges faced by families affected by addiction remains limited, and family-related treatment needs are often insufficiently emphasized in clinical practice. Even when families are included in treatment processes, the primary focus typically remains on individuals with substance use disorders. This study aimed to evaluate the effectiveness of psychoeducation and counseling services provided to families in an addiction rehabilitation center on perceived family burden and family functioning. First-degree relatives of patients receiving follow-up care at an addiction rehabilitation center were included. The psychoeducation program consisted of an average of 12 sessions and was based on a structured family-oriented psychoeducation module widely used in Türkiye. Participants completed a Sociodemographic Data Form, the Burden Assessment Scale, and the Family Assessment Device before and after the intervention. Pre- and post-test scores were statistically compared. A total of 63 family members participated in the study, 81% of whom were women. Significant reductions were observed in perceived burden domains, including daily life restriction, concern for the patient, caregiver losses, impairment in activities, and occupational functioning (all p<0.001). Significant improvements were also found across all Family Assessment Device subscales, including problem solving, communication, roles, affective responsiveness, affective involvement, behavior control, and overall functioning (all p<0.001). Psychoeducation and counseling interventions provided to family members were associated with significant improvements in perceived burden and family functioning. These findings support the conceptualization of addiction as a family-related condition and highlight the importance of strengthening structured, family-oriented interventions within addiction treatment services.