International studies exploring the enduring effects of early non-familial childhood care on mental health outcomes show varying impacts depending on the quality of care, age of entry, and socio-economic factors.

This German longitudinal study, involving 225 families, investigated the impact of early non-familial child care on the development of mental health problems, risk behaviors, and academic as well as vocational achievements in young adulthood (M_age = 22.6 years, SD_age = 1.1 years).

In comparison to parental care, early non-familial childcare was associated with significantly elevated levels of risky behaviors (such as risky sexual behavior, alcohol abuse, and tobacco consumption), low intimate relationship quality, and a higher likelihood of achieving advanced vocational qualifications. Migration background was identified as a relevant moderating factor in an exploratory analysis. An early age of entry into non-familial care was weakly associated with more mental health problems in young adulthood.

Parental decisions on early non-familial childcare should carefully consider the child's age of entry, the quality of care, and the family's socio-economic context.

International evidence suggests that Early Intervention for Psychosis (EIP) services are both effective and cost-effective. Such evidence, however, comes almost exclusively from high-income countries.

Our aim was to estimate the cost-effectiveness of EIP services in a Latin American setting.

We compared EIP services against community mental health teams (CMHT) from the Chilean health system perspective. We developed a six-state Markov model to estimate the costs, benefits (measured as quality-adjusted life-years (QALYs)) and incremental cost-effectiveness ratio (ICER) for a 10-year time horizon. The model was populated with data from a Chilean EIP cohort, published literature and expert opinion. We characterised uncertainty through probabilistic sensitivity analysis and calculated the value of information to reduce such uncertainty.

In the base case analysis, EIP was cost-effective compared with CMHT, with an ICER of 5 550 044 Chilean pesos per QALY (USD 13 742 adjusted for purchasing power parity). Uncertainty analysis revealed an 80% probability of EIP services being the most cost-effective option at a willingness-to-pay threshold of one gross domestic product per capita (USD 15 923). Sensitivity analysis showed that the results were sensitive to parameters such as intervention effectiveness and cost, suggesting that a new trial might be worthwhile to reduce uncertainty.

This model suggests that implementing EIP services in Chile may cost more, but it is likely to be cost-effective. Nonetheless, more evidence about affordability, equity and broader perspectives is needed to improve the economic case of implementing EIP services in less-resourced settings, such as in Latin America.

Gender-affirming surgery (GAS) and gender-affirming hormone therapy (GAHT) and are evidence-based components of care that support the health and well-being of transgender and gender-diverse (TGD) individuals, with extensive evidence linking them to reduced suicidality, improved mental health, and quality of life. Whereas most studies examine isolated outcomes-often within urban populations-this review adopts a system-level, cross-domain perspective to examine how access to gender-affirming care is shaped by structural conditions, including the urban concentration of affirming services, limited clinician training, fragmented insurance coverage, and the underrepresentation of rural TGD populations in research. These intersecting barriers undermine timely initiation, continuity, and quality of GAHT and GAS across diverse care settings. A distinctive contribution of this review is its integration of artificial intelligence (AI) as an emerging dimension of gender-affirming care. By synthesizing evidence on AI-enabled decision support, training simulations, and voice therapy, the review positions AI as a promising, equity-enhancing pathway to expand access, strengthen provider competency, reduce administrative burden, and advance global TGD health equity at scale.

Structural and social inequities greatly impacted the mental and physical health of Latinx and Indigenous Mexican populations Hispanic/Latino immigrants in rural communities in the COVID-19 pandemic. These populations experienced disproportionate infection and mortality rates, exacerbated by existing structural and social inequities, creating unique stressors that negatively impacted community members' mental health. Limited financial resources, lack of healthcare infrastructure, fear of deportation, and stigma shaped decisions to access mental healthcare services. The historical economic instability, social isolation, and limited healthcare access experienced by this group set the stage for the challenges they faced throughout the pandemic.

Between September 2022 and June 2024, qualitative, semi-structured interviews were conducted with 12 participants, focusing on their mental health experiences during the pandemic. The socioecological model was used as a conceptual framework to contextualize findings with multiple spheres of influence.

At the macro level, structural inequities such as precarious labor, exclusionary immigration policies, and underinvestment in rural regions, set the stage for pandemic-related stressors such as isolation, loss, and misinformation. At the individual level, fear of deportation and stigma surrounding mental health discouraged help-seeking behaviors. These intersecting influences underscore the socioecological determinants that shaped mental health care access among rural Latinx and Indigenous Mexican communities.

Structural interventions are needed to reduce inequities, rebuild trust, and improve access to mental healthcare services in underserved, rural populations.

Trans young people report lower levels of physical activity than their cisgender peers, with one in four limiting exercise participation due to their gender. Exercise provision within gender-affirming services represents an underexplored strategy to support health and wellbeing. To inform the development of collaborative and responsive programs, this study engaged stakeholders-including trans young people, parents, and healthcare providers-to explore exercise experiences, beliefs, barriers, and support needs.

Participants were recruited through networks of trans youth, families, and professionals working in trans healthcare across Australia. Twenty individuals participated (six trans and gender diverse young people, two parents, and 12 healthcare providers). Semi-structured interviews were conducted and analysed using reflexive thematic analysis to identify patterns of shared meaning across accounts.

Four themes were developed; navigating intersectionality in adolescence; binary nature of community sport and physical activity spaces; external pressures and societal marginalisation shaping participation; and inclusive exercise as a reimagined social practice.

Findings highlight the need for structural and cultural change within sport and exercise environments to better support trans young people's physical activity participation. Embedding inclusive, gender-affirming exercise models within multidisciplinary services may enhance access, sustained engagement, and wellbeing, while providing a foundation for future research evaluating exercise-based health interventions.

Burnout and compassion fatigue are prevalent among healthcare professionals, prompting interest in well-being interventions. This study aimed to understand how staff perceive the support of Comfort Corner - a chaplain-led program - on resilience, provision of care, team engagement, and turnover, and to describe the self-care behaviors among Comfort Corner attendees. A sample of convenience included 384 completed surveys. Among the respondents, there were high levels of mental (80%), emotional (77%), and physical (82%) fatigue. Most (59%) continue to practice self-care strategies outside of hospital hours to sustain wellbeing. Nearly all agreed Comfort Corner enhanced self-care knowledge, skills, and attitudes (KSA) (90%), resilience (88%), mood (97%), clarity (90%), and energy (92%). A majority (87%) reported safer care provision and 90% cited better teamwork. Of importance, 23% identified Comfort Corner as a factor in their decision to remain in the hospital. Survey respondents value the support from Comfort Corner. Additional longitudinal studies are needed to understand Comfort Corner's action mechanisms and its indirect effects on patient outcomes.

An individual's chronotype reflects their intrinsic circadian rhythm preference and is closely associated with cognitive function and mental health. However, the relationship between chronotype and whole-brain morphological structural network organization remains unclear. This study aims to explore differences in the topological organization characteristics of morphometric similarity networks (MSNs) among healthy young adults of different chronotypes from a graph theory perspective. We employed a novel Morphometric INverse Divergence (MIND) method, which is more sensitive to subtle morphological differences, to construct individual-level brain MSNs. This method aggregates morphological metrics (cortical thickness, mean curvature, sulcal depth, surface area, gray matter volume) from all vertices within each cortical region to form a regional multivariate distribution. Subsequently, a k-nearest neighbor density algorithm constructs a pairwise distance matrix, and symmetric Kullback-Leibler divergence between regional multivariate distributions quantifies similarity among cortical regions. Using high-resolution Glasser atlas, medium-resolution Destrieux atlas, and low-resolution Desikan-Killiany atlas, MIND networks were constructed for 68 healthy young individuals with early chronotype (EC) and 68 with late chronotype (LC) patterns. We calculated the area under the curve (AUC) for multiple graph-theoretic metrics, including small-world properties, across varying sparsity levels in weighted networks, followed by intergroup comparisons and correlation analyses. Analysis based on the Destrieux atlas revealed that EC participants exhibited significantly higher AUC of Small-World Properties (AUC-SWP) compared to LC participants (P = 0.0045), and this metric showed a significant negative correlation with ChQ-ME scores (rs = -0.2114, P = 0.0135). When using the Desikan-Killiany atlas and the Glasser atlas, the aforementioned intergroup differences and correlations were not detected (P > 0.05). These findings suggest that an individual's chronotype correlates with the topological organization of brain MSNs. This association was detected specifically when using the medium-resolution Destrieux atlas, while was not found with either the lower-resolution Desikan-Killiany atlas or the higher-resolution Glasser atlas under the conditions of this study. This pattern indicates that chronotype-related brain differences may operate at an optimal spatial scale, where brain parcellation strikes a balance between signal integration and anatomical specificity. The results support a model of distributed, subtle morphological alterations that together form a detectable "weak signal" network. This study presented a novel spatial-scale perspective on the relationship between brain structure and circadian rhythms.

Large language models (LLMs) are increasingly integrated into digital mental health tools, yet their role in substance use disorder (SUD) interventions remains poorly understood. This review synthesizes emerging evidence on the opportunities and risks of applying LLMs across the digital SUD care continuum.

Studies report promising applications in early detection, personalized support, continuous monitoring, and relapse prevention. LLMs demonstrate capacity to extract substance-use signals from natural language, generate supportive and motivational responses, and interpret narrative data for patient-reported outcomes. However, risks are substantial. LLMs can produce inaccurate or hallucinated content, may reinforce stigma or demographic bias, and can generate misleading or potentially unsafe advice. Privacy concerns are amplified in SUD contexts, where sensitive data are often managed outside regulated healthcare systems. Existing regulatory frameworks such as the EU AI Act or U.S. device regulations, do not yet provide clear governance for anonymous, AI-supported SUD interventions.

LLMs have potential to expand scalable, low-threshold support for SUDs, but their safe deployment requires validation, bias mitigation, transparent data governance, and robust human oversight. Evidence remains preliminary, and clinical integration should proceed cautiously.

The old oncology approach, which considered the clinical and performance status as the most relevant diseases course and well-being indexes, has been recently replaced by a care system also focusing on a person's characteristics and needs. This study analyzed the role of physical symptoms, illness awareness, individual activities and social contexts on anxious/depressive symptoms and mental health in localized (LP) and advanced/metastatic (AMP) cancer patients.

Socio-demographic and medical information was gathered. The Revised Illness Perception Questionnaire, Hospital and Depression Anxiety Scale, and Mental Health Continuum Short-Form were administered.

One hundred and thirteen patients, 75 LP and 38 AMP, aged 27-82, were enrolled. Unique patterns of difficulties and resources emerged at different stages of cancer. AMP reported a worse quality of life in perceived illness persistence and treatments control, anxious/depressive symptoms, and psychological well-being. In LP, higher levels of anxious/depressive symptoms were associated with lack of hobbies, and higher perceived illness control was linked to higher mental health. LP did not report higher well-being than AMP. No significant differences in flourishing persons distributions were detected among groups. A multivariable model showed that the independent presence of pain and partner influenced higher levels of mental health more in AMP than in LP.

Tailored intervention should enhance individuals' mental health and active resources mobilization.