Suicide is one of the major health problems that imposes a heavy burden on the health system. Currently, there is a notable absence of review and meta-analysis studies capable of exploring a broader spectrum of occupational factors associated with dimensions of suicide. This study was conducted to investigate occupational risk factors related to suicide dimensions by systematic review and meta-analysis.

Preferred Reporting Items for Systematic Reviews and Meta-analyses have been used. The databases searched in this study included: PubMed, Web of Science, and Scopus. The defined period included the beginning of the formation of these databases until August 2023, and this search was limited to studies published and available in English. The random effects method was used in a pool of different studies. In this research, the odds ratio with a 95% confidence interval (CI) was used in the report of findings.

The relationship between job demands and suicide dimensions was equal to the odds ratio of 1.29 with a CI between 1.11 and 1.50. This relationship was equal to the odds ratio1.15 with a CI between 1.08 and 1.23. Also, other risk factors for suicide were: conflict at work, job strain, job insecurity, workplace bullying, job stress, burnout, and work-family conflict.

This study showed how much the work environment and related risk factors can play a role in different aspects of suicide. Therefore, in the policies related to health at work, it is necessary to pay attention to the field of monitoring and screening of mental health in the work environment.

Clothing styles influence both outward appearance and internal emotional responses. Adolescents and young adults are particularly susceptible to emotional responses and irrational beliefs related to clothing styles. However, there is limited evidence on the efficacy of cognitive-behavioral therapy (CBT)-based journaling interventions in addressing these issues among non-clinical populations. This study examined the effects of CBT-based journaling on emotional responses and irrational beliefs related to clothing styles.

A randomized controlled trial involving 128 adolescents and young adults aged 15 to 22 years was conducted in Nsukka, Nigeria. Participants were randomly assigned to either a CBT-based journaling intervention group (n = 63) or a control group (n = 65). The 6-week intervention consisted of structured journaling targeting cognitive restructuring, emotional responses, and irrational beliefs related to clothing styles. Baseline and post-intervention assessments utilized the Difficulties in Emotion Regulation Scale for Clothing Styles and the Clothing Style Automatic Thoughts Questionnaire. Data were analyzed using ANCOVA, controlling for baseline scores.

The intervention group demonstrated significant improvement in emotional regulation compared with the control group, F(1, 125) = 253.10, P < .001, partial η² = 0.669. Similarly, the intervention group exhibited significantly reduced irrational beliefs, F(1, 125) = 127.82, P < .001, partial η² = 0.506. In both cases, CBT-based journaling accounted for a large proportion of the variance in post-intervention outcomes.

CBT-based journaling is an effective and scalable intervention for improving emotional responses and reducing irrational beliefs related to clothing styles. Its efficacy highlights the potential for broad application in mental health promotion, particularly in appearance-sensitive contexts among adolescents and young adults.

Early detection and prevention of psychiatric disorders, particularly depression, remain as major global health challenges, yet reliable tools for identifying individuals before symptom onset are lacking. Here, we combine functional neuroimaging with computational modeling to identify a mechanistic biomarker of depression risk. In a population-based adolescent cohort (IMAGEN, N = 1332), we found that weakened neural representations of emotional signals were linked to depressive symptoms. Perturbation experiments in a brain-aligned deep learning model showed that this deficit reflects overregularized emotion perception, producing a negative perceptual bias. A neurocomputational signature of this mechanism predicted depression symptom onset up to 4 years later at the IMAGEN follow-up (N = 725), was associated with both a genetic-risk variant and polygenic risk for depression, and improved depression classification in a patient cohort (STRATIFY, N = 411). These findings suggest a possible mechanism linking genetic vulnerability to altered emotion perception and future depression, and propose a predictive computational marker with potential for early detection and prevention.

Population aging has increased interest in Intrinsic Capacity (IC), defined as the composite of physical and mental abilities that support healthy aging. Because declines in IC precede disability, IC is a useful framework for characterizing individuals with greater vulnerability in later life.

We conducted a cross-sectional analysis of the 2021 Mexican Health and Aging Study, a nationally representative survey of adults aged 50 years and older. IC was assessed across five domains using domain-specific impairment, number of impaired domains, and a continuous latent IC score derived from factor analysis. Ordinal logistic regression models were used to examine associations with sociodemographic characteristics, health conditions, and a Social Vulnerability Index (SVI) constructed using a cumulative deficit approach.

The sample included 13,403 adults (mean age 65.9 years [SD 9.8]; 57.3% women). IC impairment was highly prevalent: 67.1% had impairment in two or more domains, whereas only 12.5% had no impaired domains. Lower IC was associated with increasing age (≥80 years: OR 3.31; 95% CI 1.10-10.02) and poorer health, including multimorbidity (OR 2.29; 95% CI 1.44-3.64) and poor self-rated health (OR 1.69; 95% CI 1.24-2.28). Lower IC was further associated with social disadvantage, including lower educational attainment (OR 2.33; 95% CI 1.69-3.22) and food insecurity (OR 1.51; 95% CI 1.06-2.16), with higher social vulnerability associated with lower IC (β -0.46; 95% CI -0.51 to -0.41).

IC impairment is highly prevalent among Mexican adults aged 50 years and older and is strongly associated with social vulnerability and modifiable health factors, supporting IC as an integrative framework to identify vulnerable individuals and inform intervention strategies.

Metabolic dysfunction-associated steatotic liver disease (MASLD) and metabolic dysfunction-associated alcohol-related liver disease (MetALD) are becoming more recognised as common chronic liver conditions. Despite this, their relationship with suicide mortality has not been thoroughly investigated.

We conducted a nationwide population-based cohort study involving 4,348,487 Korean adults who underwent health screening in 2012. Participants were categorised into four groups based on fatty liver index, metabolic risk factors, and alcohol consumption: no steatotic liver disease (no SLD, n = 3,794,988), MASLD (n = 450,600), MetALD (n = 81,079), and alcohol-associated liver disease (ALD, n = 21,820). We utilised Cox proportional hazards models to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for suicide mortality. Participants were followed until death or the conclusion of the study period.

During a median follow-up of 9.2 years, 9,830 participants died by suicide. Compared to individuals without SLD, the adjusted HRs for suicide mortality were significantly elevated across all SLD subtypes: 1.20 (95% CI: 1.12-1.29) for MASLD, 1.39 (95% CI: 1.23-1.57) for MetALD, and 1.39 (95% CI: 1.11-1.74) for ALD. A dose-dependent increase in suicide mortality was observed with higher levels of alcohol consumption. Even among individuals with low alcohol intake, SLD remained associated with a higher risk of suicide compared to non-SLD (HR: 1.24; 95% CI: 1.15-1.33).

Both MASLD and MetALD were associated with a higher risk of suicide mortality. These findings highlight the combined effects of metabolic dysfunction and alcohol use on suicide risk within these populations.

The use of antidepressants is increasing globally. Despite their obvious benefits, ongoing use of these medications is often not properly monitored or deprescribed when a person returns to better mental health. In addition, providing prescriptions to those who do not have clinical depression leads to personal and societal cost burdens.

This trial aims to assess the clinical effectiveness and cost-effectiveness of an online support tool designed to help patients with mild to no symptoms of depression and their general practitioners manage the careful and appropriate tapering and cessation of antidepressants at 6 months, and compare the effectiveness to that of usual care.

This stratified, single-blind, parallel, 2-arm, superiority randomized controlled trial includes Australian primary care patients (aged 18-75 years) with mild to no symptoms of depression who have been on antidepressant medication for longer than 12 months. After obtaining informed consent, 340 eligible patients will be randomized in a 1:1 ratio to an active intervention arm and an attention control arm, with stratification by general practice or state of residence, if recruited via social media. Those in the active intervention arm will be asked to reduce their antidepressant use with the aid of a clinically guided online support tool (WiserAD), while those in the attention control arm will continue to receive usual care. Participants in both arms will be provided with information about antidepressants through the Beyond Blue website and followed up at 3, 6, 12, and 18 months to record antidepressant use, depression and anxiety symptom severity, quality of life, and health economic data. An intention-to-treat analysis will determine the clinical effectiveness of the online tool compared with usual care. The primary outcome is the between-arm difference in the proportion of participants who successfully cease medication use at 6 months and have mild or absent depressive symptoms. Cost-consequence and cost-utility analyses will be used to determine the cost-effectiveness of the intervention and its impact on quality of life, and comparisons will be made with usual care.

The study was funded by the National Health and Medical Research Council in 2019. At submission of this manuscript in July 2025, 310 participants have been randomized, and recruitment ongoing. The target number of 340 randomized participants was achieved in January 2026. Trial outcomes will be reported in peer-reviewed journals in Febraury 2027.

The WiserAD online support tool assists patients and their general practitioners with deprescribing and may lead to successful cessation of antidepressant medication, resulting in enhanced quality of life and cost savings over the longer term.

Gambling consumers show low uptake and engagement with tools designed to support safer gambling practices and reduce the risk of experiencing gambling-related harms. We used co-design principles to design and develop a digital tool for safer gambling (BetWell) to overcome known barriers to tool uptake, including a focus on gambling problems. BetWell aims to increase awareness of personal gambling expenditure and knowledge of how gambling products function to support informed decision-making about gambling. It was designed based on behavioral change theories and presents a personalized amalgamation of gambling expenditure relative to alternative spend options, and psychoeducational information via a quiz.

This exploratory study assessed the perceived acceptability and usefulness of the newly designed digital tool and gathered end-user feedback to improve future prototypes. The study explored whether usability, gambling severity, financial well-being, gambling frequency, spend tracking, activity statement use, and the number of accounts held impacted acceptability and perceived usefulness, and the extent to which these factors independently predicted acceptability and perceived usefulness when controlling for life satisfaction, gambling satisfaction, and demographic variables.

This cross-sectional study recruited 140 gambling consumers (mean 41.3, SD 10.9 years) via the market research panel CRNRSTONE. Participants accessed and engaged with BetWell and completed an online survey to share their perceptions towards the tool.

The overall acceptability (mean 32/40, SD 5.2) and perceived usefulness (mean 20/25, SD 3.9) of the tool were considered "good" and "useful," respectively by participants. Individuals with higher gambling severity scores were more likely to perceive the tool as useful than those of the lower risk categories. Individuals with higher financial well-being were more likely to perceive the tool as useful and acceptable compared to those in lower financial well-being categories. Higher usability scores corresponded with higher tool acceptability. Previous efforts to monitor and track gambling spend was associated with acceptability and perceived usefulness. Gambling frequency and the number of gambling accounts held were not related to acceptability and perceived usefulness. Qualitative feedback included participant identified suggestions for improvements such as a need for interactive elements, a more detailed view of gambling expenditure, automation of activity statement upload functionality, more challenging and positively framed quiz content, and an emphasis on data security.

The study provides preliminary support for the acceptability and perceived usefulness of a newly developed tool to increase awareness of gambling expenditure and knowledge on how gambling products function, providing directions for future improvements to the tool.

Bullying poses a major risk for poor mental health. While findings from the general population highlight harmful effects of bullying, data from clinical samples with diverse diagnoses and evidence-based diagnostic methods is rare. This study aimed at exploring the association between psychopathology and active bullying involvement in child and adolescent psychotherapy outpatients.

The preregistered study ( https://aspredicted.org/VYW_9TT ) included data from N = 719 outpatients aged 6-20 years from a German child and adolescent psychotherapy centre. Current experiences as a victim, bully-victim, or bully and distressing bullying-specific intrusions were assessed with a screening instrument. Gold-standard diagnostic assessment of psychopathology provided categorial ICD-10 diagnoses. The Strength and Difficulties Questionnaire depicted a dimensional proxy measure of psychopathology. Analyses included examining the frequencies of the bullying roles (victim, bully-victim, bully) and the occurrence of distressing bullying-specific intrusions, Pearson's chi-square tests for gender-specific differences, binary logistic regression analyses testing the bullying roles as predictors of ICD-10 diagnoses, and multiple one-way ANOVAs examining group differences on the Strength and Difficulties Questionnaire scores between the bullying roles.

29% of all outpatients reported to be actively involved in bullying (22% victims, 5% bully-victims, 2% bullies), with 32% frequently experiencing distressing bullying-specific intrusions. While victims were more likely to have mood disorders (ICD-10 F3 disorders), bully-victims were less likely to have internalising and more likely to have externalising disorders and behavioural and emotional disorders with onset usually occurring in childhood and adolescence (ICD-10 F9 disorders). Bullies were more likely to have multiple disorders but less likely to have internalising disorders. Independent from specific diagnoses, victims, bully-victims, and bullies overall reported greater emotional and behavioural difficulties than outpatients without bullying experiences.

Among outpatients in child and adolescent psychotherapy, bullying is linked to specific related psychological burden and role-specific psychopathology. Bullying and related psychological burden should be addressed and routinely assessed in mental health care settings. The link between bullying and psychopathology as well as specific intervention methods may be explored further in future research.

General and exertional fatigue are associated with worse outcomes in clinical heart failure (HF). Little is known about their prognostic importance in stage B HF.

We included 2972 individuals at visit 5 (2011-2013) of the ARIC (Atherosclerosis Risk in Communities) study without clinical HF but with echocardiographic or biomarker evidence for stage B HF. Using general and exertional fatigue scale scores, individuals were categorized as low/no fatigue, high general fatigue only, high exertional fatigue only, or high general and high exertional fatigue. We determined their associations with quality of life and incident HF events using adjusted linear and Cox regression, respectively.

Participants were 60% female, 18% Black, with a mean age of 76 years. Compared with low/no fatigue, all fatigue categories were associated with lower quality of life, with high general and high exertional fatigue having the lowest scores (physical: β=-11.48 [95% CI, -12.80 to -10.17]; mental: β=-5.97 [95% CI, -7.03 to -4.92]). There were 338 incident HF events over a median of 8.4 years. Compared with low/no fatigue, increased incident HF overall was found for high exertional fatigue only (hazard ratio [HR], 1.86 [95% CI, 1.39-2.49]) and high general and high exertional fatigue (HR, 2.16 [95% CI, 1.46-3.20]) but not general fatigue only (HR, 1.42 [95% CI, 0.99-2.04]). All 3 categories were independently associated with increased risk of incident HF with preserved ejection fraction but not with HF with reduced ejection fraction.

General and exertional fatigue demonstrate prognostic importance in pre-HF and appear to be linked to underrecognized poor quality of life before the onset of clinical HF.

Non-fatal strangulation (NFS) is a severe form of Intimate partner violence (IPV) that can result in acquired brain injuries (ABI), yet this link is frequently overlooked. Misdiagnosis and limited awareness contribute to long-term physical and mental health complications. Evidence-based protocols for identifying and managing non-fatal strangulation-acquired brain injury (NFS-ABI) are lacking, which prevents the delivery of standardised care. Long-term outcomes remain understudied. To synthesise current evidence on the neurological and psychological sequelae of (NFS- ABI), and to identify implications for clinical practice and policy. An integrative review. A comprehensive search of eight databases was conducted. Twenty-six peer-reviewed articles met the inclusion criteria, exploring IPV-NFS and its potential link to ABI, associated neurological and psychological deficits, and implications for healthcare professionals. Findings were synthesised to inform policy and improve clinical management of NFS-ABI. Evidence indicates that NFS-ABI can lead to significant cognitive, emotional, and physical impairments. However, screening and management strategies remain inconsistent. The review highlights the urgent need for validated screening tools and clinical guidelines to ensure timely identification and intervention for survivors. Healthcare professionals require training and standardised assessment tools and protocols to recognise and manage NFS-ABI effectively. Improved detection and treatment can reduce chronic morbidity and enhance outcomes for NFS-ABI survivors. This review informs policy development and clinical practice, emphasising the importance of integrating NFS-ABI screening into health care pathways. This review contains no patient or public contribution since it was examining the neurological and psychological sequelae of (NFS- ABI), and to identify implications for clinical practice.