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.

ObjectivesTo examine the clinical governance implications of Health of the Nation Outcome Scales (HoNOS) rating quality in Australian mental health services. The paper argues that HoNOS occupies a distinctive position among clinician-rated measures because it requires clinicians to translate the overall clinical assessment into structured ratings across domains of behaviour, symptoms, impairment, and social functioning. It considers why poor-quality HoNOS ratings should not be treated as a narrow technical or training problem, but as a signal of potential risk in assessment practice, documentation quality, organisational reporting, and service credibility.ConclusionsHoNOS rating quality should be understood as a clinical governance responsibility. Because HoNOS data are embedded in routine outcomes and casemix infrastructure, unreliable or invalid ratings can compromise clinical interpretation, service monitoring, benchmarking, system reporting, and funding-related classification processes. Maintaining rating quality therefore requires more than individual clinician training. Health service organisations need structured implementation protocols, supervision, periodic calibration, documentation standards, and routine monitoring of rating patterns. HoNOS should be treated not simply as a clinical instrument, but as a governed clinical data asset whose integrity is necessary for accountable mental health service delivery.

To investigate the association between apolipoprotein E (APOE) gene polymorphisms and coronary heart disease (CHD) risk within a localized Mongolian clinical cohort.

This hospital-based case-control study recruited 63 patients with angiographically confirmed CHD and 61 sex-matched healthy controls. Anthropometric measurements and lipid profiles and pathways for APOE genotypes were strictly assessed. This exploratory hospital-based case-control study was not designed as a nationally representative population-based survey, and participant recruitment was limited to a single tertiary referral center in Mongolia.

High-density lipoprotein cholesterol levels were significantly higher in the case group than in the control group (1.56 ± 0.14 vs. 1.33 ± 0.18 mmol/L, P < .001), while total cholesterol was significantly lower in cases than in controls (3.91 ± 0.60 vs. 5.34 ± 0.80 mmol/L, P < .001). The distribution of APOE genotypes (ε2/ε3, ε3/ε3, ε3/ε4, and ε4/ε4) differed significantly between the case and control groups (P = .009). Both systolic and diastolic blood pressure significantly correlated with waist circumference (P = .026). Multivariable logistic regression revealed that the ε2/ε3 genotype was associated with significantly lower odds of disease (odds ratio [OR] = 0.29, P = .007, 95% CI: 0.12-0.71), whereas ε4-related findings were highly imprecise due to sparse genotype counts and lacked statistical significance (OR = 1.07, P = .930, 95% CI: 0.23-5.02).

This study showed a significant association between the APOE genotype and CHD in a Mongolian population. These findings highlight the importance of considering qualitative aspects of lipid metabolism, rather than total cholesterol alone, and suggest that genetic factors, including APOE polymorphisms, may contribute to CHD risk independently of absolute cholesterol levels, underscoring the need for population-specific cardiovascular risk assessment.

Post-migration stressors can exacerbate post-traumatic stress disorder (PTSD) and reduce treatment effectiveness among refugees. Evidence for integrated care models in high-income settings remains limited.

To compare treatment as usual (TAU) with an add-on integrated care intervention for unemployed refugees with PTSD.

We conducted a two-arm, parallel-group superiority trial with 1:1 randomisation to TAU or TAU with an add-on integrated care intervention, delivered at a specialised out-patient clinic in Denmark (ClinicalTrials.gov NCT04244864). TAU included sessions with a psychologist and physician over 8-12 months. The integrated care intervention also included structured collaboration with employment services. The primary outcome was functioning, using the 12-item World Health Organization Disability Assessment Schedule 2.0 (WHODAS) interview. Secondary outcomes included symptoms, quality of life and post-migration stressors. Analyses followed the intention-to-treat principle, using analysis of covariance and linear regression with multiple imputations.

The study included 195 patients in treatment from 2020 to 2025. No difference was observed in WHODAS score between groups pre- to post-treatment (mean difference 0.30, 95% CI -2.40 to 3.00; P = 0.825). Similarly, no differences were found for secondary or exploratory outcomes, and overall change was limited. However, the integrated care group had a lower rate of early dropout (P = 0.042) and higher level of treatment satisfaction (P = 0.035).

Integrated care was feasible but not superior to TAU in improving outcomes for refugees with longstanding symptoms and unemployment. Future research should examine how the timing and intensity of integrated care interventions influence outcomes, including earlier implementation and adequate support for refugees with longstanding and complex needs.

Emerging adulthood represents a period of life characterized by a high prevalence of mental health problems, including depressive symptoms. This is especially evident among sexual minority individuals who continue to face discrimination despite increasing societal acceptance. Attachment insecurity, which has been widely recognized as a vulnerability factor for mental health problems, may play a key role in how sexual minority individuals experience and cope with stress, particularly in relation to the internalization of negative beliefs regarding one's sexual orientation. Nevertheless, we are not aware of previous studies that have considered internalized homonegativity when investigating the connection between attachment insecurity and depressive symptoms in this group. We used structural equation modeling to explore the cross-sectional direct and indirect associations between attachment insecurity (anxiety and avoidance) and depressive symptoms through internalized homonegativity in a sample of 536 Chilean emerging adults self-identified as gay, lesbian and bisexual. Our analyses revealed that higher attachment insecurity was associated with higher depressive symptoms directly and indirectly. Specifically, higher attachment anxiety and attachment avoidance were linked to greater internalized homonegativity, and thus to higher depressive symptoms. The theoretical and clinical implications of our findings are discussed.