Auditory hallucinations (AHs) are debilitating symptoms of schizophrenia spectrum disorders (SSDs) associated with several negative outcomes. AHs are often resistant to existing pharmacological and psychological interventions. Virtual reality (VR) has emerged as a promising intervention for AHs. This systematic review and meta-analysis aimed to assess the effectiveness of VR interventions in treating AHs in SSDs.

A comprehensive literature search was conducted on Embase, APA PsycINFO, and MEDLINE via the Ovid Database. Studies with a randomized controlled trial (RCT) or randomized cross-over trial design that had treatment and active or treatment-as-usual control conditions were included. Random-effects meta-analyses compared the change in the primary outcome of AH severity from baseline to post-treatment and at follow-up between the groups.

Eight studies (n = 1004) met the criteria for the meta-analyses. Eight studies used avatar therapy (AT), and 1 study used a VR-based mindfulness intervention. Random-effects meta-analyses found that VR interventions were more effective than the control conditions in reducing AH severity immediately post-intervention (Hedges' g = -0.41, 95% CI [-0.62, -0.20], P < .01) and at follow-up (Hedges' g = -0.28, 95% CI [-0.40, -0.17], P < .001).

This review was limited by a small sample size, study heterogeneity, and intervention homogeneity. Future research should prioritize larger RCTs of VR-based interventions for psychosis before VR can be reliably used in clinical settings. Overall, the results of this meta-analysis suggest that VR-based AT may be a promising avenue to improve AHs in SSDs.

A sex difference in the clinical presentation of schizophrenia is well known. Males have on average an earlier symptom onset, worse functional capacity, and more negative symptoms. Studies on the neurobiological correlates of psychosis show that brain endocannabinoid system (ECS) is dysregulated in male patients with first-episode psychosis (FEP). We now evaluated whether the brain ECS is also altered in female patients with FEP.

In this cross-sectional case-control study, brain CB1R availability was measured in 39 participants, including groups of male and female patients with FEP, and healthy control participants (HC) of similar age and sex (n = 8-11/group). Brain CB1R availability was measured with the selective CB1R radiotracer [18F]FMPEP-d2 and positron emission tomography. Arterial input derived distribution volumes (VT) were extracted from regions of interest (ROI) representing the anterior cingulate cortex, hippocampus, thalamus, and putamen.

Within-subjects analyses showed a regionally differential effect of ROI*sex*group (ε = 0.77; F(2.31,80.85) = 4.31, P = .013). Simple effect analyses indicates that male FEP had significantly lower overall CB1R VT when compared to male HC (F(1,17) = 15.64, pFWER = 0.018), while female FEP VT did not differ from female HC (F(1,18) = 0.12, pFWER = 1). A regionally specific difference of VT between males and females with FEP (F(3,48) = 3.43, P = .024) did not survive the correction for multiple comparisons (pFWER = 0.14).

The availability of brain CB1R is differentially altered in males and females with early psychosis. Sex-related neurobiological patterns including the ECS may offer new treatment strategies for alleviating the core symptoms of psychotic disorders in male and female patients.

Excess mortality in psychotic disorders is largely due to preventable cardiometabolic morbidity. Efforts to evaluate the link between the psychosis spectrum and cardiometabolic health have been confounded by early-life adversity (ELA) and biased sampling. This population-based study examined prospective associations between psychosis-spectrum status and cardiometabolic biomarkers at age 44-45, adjusting for ELA.

We analyzed data from the 2002/03 biomedical sweep of the British National Child Development Study (n = 9377; age 44-45). Psychosis-spectrum status (exposure; n = 171) was defined using repeated screening across adulthood (ages 23 to 44-45), including self-reported diagnoses, antipsychotic medication use, or professional help-seeking for hallucinations. Cardiometabolic biomarkers at age 44-45 (outcomes) were compared between individuals on the psychosis spectrum and psychosis-free controls (comparator; n = 2448). Analyses were conducted using unimputed and multiply imputed datasets (n = 7391-9298), adjusting for 24 indicators of ELA.

In both unimputed/imputed analyses, individuals on the psychosis spectrum had significantly worse cardiometabolic profiles. Adjusted results showed elevated abdominal obesity (exp(b), 1.404; 95% CI, 1.177-1.676; P < .001), higher glycated hemoglobin (B = 0.321; 95% CI, 0.089-0.553; P = .008), lower high-density lipoprotein cholesterol (B = -4.472; 95% CI, -7.782 to -1.162; P = .009), and increased fibrinogen (B = 4.542; 95% CI, 0.939-8.144; P = .015) compared to controls.

Overcoming early-life confounders and biases that limited prior research, our study demonstrates a robust, independent association between psychosis-spectrum status and cardiometabolic dysfunction at age 44-45. These findings underscore the urgent need for comprehensive screening, treatment, and monitoring of cardiometabolic morbidity in psychosis, guided by a life-course perspective.

 Mental health is a fundamental component of overall well-being and a critical determinant of academic success and professional functioning. However, stress is an often-overlooked burden for nursing students, adversely impacting their learning, clinical performance and overall quality of life.

 To determine the levels of stress among nursing students and to examine the associations among demographic characteristics. The study was conducted at a selected Nursing Education Institution in Limpopo province, South Africa.

 A descriptive, cross-sectional quantitative design was employed to determine stress levels among 262 nursing students. Data were collected through an anonymous, self-administered online questionnaire using the Student Stress Inventory, which demonstrated strong internal consistency (Cronbach's α = 0.910). Data were analysed using descriptive statistics in the Statistical Package for the Social Sciences, Version 30.

 Respondents had a mean age of 20.20 years (s.d. = 1.48) and reported moderate stress levels. Female nursing students were significantly more likely to report higher stress than males (p  0.001). Stress levels also differed significantly across study levels (p = 0.005), with second-year students reporting the highest stress.

 Nursing students face significant stress, which may impact their learning and professional development. This highlights the importance of implementing supportive strategies to foster resilience and coping skills.Contribution: The study provides evidence to guide targeted interventions promoting students' mental well-being and academic success.

 Best practice guidelines suggest that patients should be well acquainted with their healthcare provider, and that doctors should introduce themselves or be introduced by another member of the patient's healthcare team. This aligns with the National Patients' Rights Charter by the National Department of Health, which states that every patient has the right to be treated by a named healthcare provider. Nevertheless, many patients have trouble recalling the name of their doctor. This study aimed to determine whether patients admitted to the adult ward of the National District Hospital in the Free State province, South Africa, could recall their doctor's name.

 Structured interviews were conducted with consenting patients to evaluate whether they knew their doctors' names.

 Only 10% of patients recalled their doctor's name. Less than half reported that doctors introduced themselves, 41% noticed a name badge, 63% saw their doctor more than once daily and 86% understood the reason for admission. The education levels of the patients showed no discernible influence on the results.

 A minority of patients could recall their doctors' names, indicating a potential gap in communication and connection. Many patients expressed uncertainty regarding their doctor's name. This study underscores the importance of improving the visibility, accessibility and consistency of doctor identification methods in healthcare settings to strengthen the doctor-patient relationship and optimise patient care experiences.Contribution: This study underscores the necessity for institutions to prioritise and implement strategies to enhance patient-doctor recognition, thereby improving therapeutic relationships and potentially improving patient outcomes.

The duration of untreated psychosis (DUP) is still considerably long in patients with psychotic disorders worldwide. Social determinants, such as the socioeconomic status, can influence DUP, exacerbating health inequalities in access to timely care. We investigated whether subpopulations with shared characteristics are associated with longer DUP.

We performed latent class analyses to investigate whether classes with shared configurations of social and substance use-related risks can be identified in two large cohorts with psychotic disorders: N = 780 patients from the GROUP project and N = 847 patients from the EU-GEI project. Subsequently, we conducted survival analyses to analyze whether identified classes are associated with DUP.

We identified three classes in both samples. Membership of the class with predominantly younger men, higher proportion of cannabis use, and supported living was associated with longer DUP compared with a class with predominantly White ethnicity, higher education, and current employment in GROUP (HR = 1.28, 95% CI: 1.06-1.56, p = .011) and in EU-GEI (HR = 1.27, 95% CI: 1.07-1.51, p = .007). In GROUP, membership of a third class with predominantly White women, without cannabis use, was associated with the shortest DUP (HR = 0.78, 95% CI: 0.63-0.95, p = .016).

Results suggest that specific populations differ in their risk distributions for prolonged DUP and highlight the importance of considering configurations of social determinants in context. Public mental health programs need to establish their differential impact for diverse populations and facilitate more targeted pathways to care.

'Ego dissolution' refers to a temporary state characterized by diminished self-referential processing, which leads to a breakdown of personal boundaries and an enhanced sense of unity with the environment. Both psychedelics, such as ayahuasca, and contemplative practices, like meditation, have been proposed as mechanisms for modulating the ego. While ayahuasca induces transient self-perception alterations, meditation promotes more sustained changes through cognitive and emotional regulation. This study examines whether ayahuasca consumption modulates the ego and compares its effects with those of meditation.

A total of 37 ayahuasca users and 137 meditators participated. We used the "Delusion of Me" (DoM) index, a unidimensional self-report measure comprising three domains: acceptance, decentering, and non-attachment. It could be considered closely related to the concept of self 'as a content' and may potentially serve as a measure of ego.

Meditators exhibited significantly higher DoM scores than ayahuasca users. The quadratic regression did not show a cumulative effect, with no significant relationship found between the number of ayahuasca sessions and DoM scores.

Meditation practice correlated with higher DoM scores and cumulative practice showed a significant non-linear association with DoM. Conversely, repeated ayahuasca exposure demonstrated no evidence of a cumulative association in this sample.

This study presents the development of a supplementary questionnaire assessing lifestyle behaviors, psychological well-being, and contextual factors, designed to complement the World Mental Health International College Student (WMH-ICS) survey, within the Italian Health Mode On project.

A preliminary questionnaire, based on a literature review and composed of brief standardized measures across 15 sections, was drafted. Its validation was conducted through a two-round electronic Delphi process involving 17 experts from Italian universities and research institutes. In the first round, the experts rated the relevance of each section and domain and suggested item revisions or additions. Feedback was synthesized and presented in the second round, during which the experts re-rated their agreement with all proposed modifications.

All sections proposed in the preliminary version were retained. Experts provided 115 item-modification proposals and 10 suggestions for new sections or domains; 35 modifications (30.4%) and 3 additions (30%) were accepted. The final instrument comprises 18 sections and 64 items covering anthropometry, socio-economic status, housing, commuting, physical activity, diet, sleep, nicotine product use, social media, gaming, gambling, loneliness, hopelessness, life satisfaction, academic stress, student services, discrimination, and general well-being.

A rapid e-Delphi process produced a concise, expert-validated supplement expanding the WMH-ICS survey's capacity to inform health promotion and prevention interventions.

Participation in daily activities is essential for health and well-being. It helps in physical, mental, and emotional health and plays a significant role in the positive development of children and young people. As it is a crucial goal for health and rehabilitation services, the purpose of this study was to translate and assess the psychometric properties of the Persian version of the Participation and Environment Measure-Children and Youth (PEM-CY) in 5- to 17-year-old children with cerebral palsy.

The study involved 150 parents of children with CP (n = 100) and typically developing peers (n = 50), aged 5-17 years. To evaluate face and content validity, we consulted occupational therapists and parents of children with CP. Moreover, the Mann-Whitney test used to assess divergent validity. Internal consistency was assessed using Cronbach's alpha (α), whereas test-retest reliability was evaluated using intraclass correlation coefficients (ICCs).

The internal consistency (0.77-0.95) and test-retest reliability (0.85-0.95) of various summary scores ranged from moderate to very strong. The divergent validity of the Persian version of PEM-CY was supported by significant differences between children with and without disabilities on the participation and environment scales (p < 0.05).

The Persian version of the PEM-CY is a valid and reliable tool to determine the participation and environmental factors in the home, at school, and in community settings in Persian children and youth aged 5-17 years, with CP.

Sexual assault can lead to long-term health problems, yet many victims do not seek help from sexual assault centers. This cross-sectional observational study examined factors distinguishing help-seekers from non-help-seekers and identified factors related to concerns about help-seeking in non-help-seekers. A sample of 669 recent sexual assault victims (97.5% women; mean age 26) was recruited from sexual assault centers and social media; 251 had attended a sexual assault center and 418 had not. Multiple logistic regression was used to identify factors differentiating help-seekers and non-help-seekers. Logistic regressions identified factors associated with help-seeking, and ordinal logistic regressions examined factors related to 3 types of concerns among non-help-seekers: concerns about the incident, about the health service, and about potential negative consequences. Victims of assaults consistent with the rape stereotype (completed penetration, unknown perpetrator) were more likely to seek help. Among non-help-seekers, concerns about seeking help at a SAC were prevalent (34%-65%), while few felt they had no need (11.5%). Physical violence (OR = 0.33, 95% CI = 0.20-0.52) and higher age (OR = 0.97, 95% CI = 0.95-1.00) were linked to fewer incident-related concerns; penetration (OR = 1.73, 95% CI = 1.10-2.72) and highaer age (OR = 0.97, 95% CI = 0.94-0.99) to fewer service-related concerns; and physical violence (OR = 1.85, 95% CI = 1.18-2.90), penetration (OR = 1.95, 95% CI = 1.26-3.02), and social support (OR = 1.82, 95% CI = 0.68-0.99) to fewer concerns about negative consequences. Public information efforts highlighting the benefits of post-assault healthcare, especially for younger victims and those experiencing less stereotypical assaults, may encourage help-seeking. Support from family and friends may play an important role in victims' decisions about seeking help.