Cognitive analytic therapy (CAT) is a relational, time-limited psychotherapy primarily evidenced to support adults with emotional and relational difficulties. The extent of evidence for CAT in younger populations is not known. This paper aimed to collate all published articles describing CAT with under-18-year-olds and establish feasibility and effectiveness of CAT in this population. An initial systematic search was conducted in MEDLINE, PsycINFO and CINAHL databases, with a second search using key terms and author names in the Association for Cognitive Analytic Therapy website bibliography.

Thirty-seven articles were found to meet the inclusion criteria, 11 of which contained quantitative studies. Articles described CAT as individual therapy for young people or their parents, group therapy and consultation frameworks for staff and parents.

The limited evidence published on CAT in under-18-year-olds suggests that it is feasible and accessible. Further randomised controlled studies and publication of practice-based outcomes are required.

Cyclooxygenase-1 (COX-1), an essential enzyme in the synthesis of pro-inflammatory prostanoids from arachidonic acid, is widely expressed in the brain, primarily in microglia. Previous studies from our laboratory found that the novel positron emission tomography (PET) radioligand [¹¹C]PS13 has excellent in vivo selectivity for constitutively expressed COX-1 in human brain. This study sought to further evaluate the effects of age and sex on levels of constitutive COX-1 expression in the brains of 56 healthy volunteers. COX-1 density in the brain measured by [¹¹C]PS13 PET showed a significant positive correlation with age in the whole brain, as well as in regions with the highest COX-1 expression, such as the hippocampus, lateral occipital cortex, and pericentral cortex. No significant sex differences were observed in any regions. Consistent findings were observed regardless of partial volume correction (PVC), while overall statistical significance was enhanced with PVC. In conclusion, the present study found that constitutive COX-1 binding in the brain, which is associated with microglial density, increased with age with no significant sex differences. The physiological roles of COX-1 in these regions and its potential contributions to the aging process remain largely unknown, and further investigation is warranted. Clinical trial registration information: NCT03324646; NCT04396873 in ClinicalTrials.gov.

The decriminalization of suicide under Section 115 of the Mental Healthcare Act (MHCA), 2017 marked a paradigm shift in India, reframing suicide attempts as manifestations of severe stress requiring care rather than punishment. However, gaps in clinician awareness and ambiguity regarding medico-legal responsibilities may hinder effective implementation of the law in clinical settings. This study aimed to assess non-psychiatric clinicians' awareness and attitudes regarding the decriminalization of suicide under the MHCA, 2017, and to explore potential implementation gaps.

A cross-sectional questionnaire-based study was conducted among 134 clinicians from non-psychiatric departments at a tertiary-care center in central India. A structured, self-administered questionnaire assessed sociodemographic characteristics, awareness of legal provisions related to decriminalization, and attitudes toward its impact on stigma, help-seeking, and clinical practice. Descriptive statistics were computed, and subgroup comparisons based on years of clinical experience (≤1 year vs. >1 year) were performed using the chi-square test.

Most clinicians were aware that suicide has been decriminalized in India (76.1%) and that individuals attempting suicide are presumed to be under severe stress (84.3%). Nearly four-fifths (79.1%) recognized the government's obligation to provide care and rehabilitation. However, 80.6% believed that reporting suicide attempts to legal authorities remains mandatory, and only 51.5% were aware of professional immunity from civil or criminal liability. Attitudes toward decriminalization were largely positive: 55.2% agreed that it reduces stigma, 56.8% felt it encourages help-seeking, and 88.8% reported a greater likelihood of psychiatric referral following decriminalization. Subgroup analysis did not reveal significant differences across experience levels.

Non-psychiatric clinicians demonstrated generally favorable awareness and supportive attitudes toward the decriminalization of suicide. However, persistent misconceptions regarding medico-legal obligations suggest an implementation gap. Targeted training, legal-literacy initiatives, and clear institutional protocols are needed to ensure consistent, rights-based care in alignment with the MHCA 2017.

Quality of life (QoL) is a core outcome in schizophrenia. Guided by the biopsychosocial model, this study examined whether social functional impairment and internalized stigma independently predict QoL and mediate the impact of depressive symptoms on QoL among clinically stable patients in rural China.

In a multicenter cross-sectional survey (Chaohu City, September-October 2022), 796 clinically stable adults with schizophrenia were recruited via stratified random sampling. Participants completed standardized assessments: Patient Health Questionnaire-9 (PHQ-9), Insomnia Severity Index (ISI), Social Disability Screening Schedule (SDSS), Social Impact Scale (SIS), and WHOQOL-BREF. Analyses included hierarchical regression (entering demographics/health, health behaviors, clinical symptoms [PHQ-9, ISI], and psychosocial factors [SDSS, SIS]) and parallel mediation analysis (PROCESS Model 4).

PHQ-9, ISI, SDSS, and SIS scores differed significantly across QoL groups (all *p* <0.001). Hierarchical regression showed that explained variance increased from 2.9% (Model 1) to 21.8% (Model 4). After adjusting for all covariates, depressive severity (β = -0.230), social disability (β = -0.161), and stigma (β = -0.153) were robust negative predictors of QoL (all *p* <0.001). Mediation analyses revealed a significant total effect of depression on QoL (-0.037, 95% CI [-0.046, -0.027]). This effect was partially mediated by social disability (indirect effect: -0.005, 95% CI [-0.008, -0.002]; proportion: 13.5%) and stigma (-0.006, 95% CI [-0.009, -0.003]; 16.2%), with a significant total indirect effect accounting for 29.7% of the total effect.

Social functional impairment and internalized stigma were independent predictors of QoL and statistically mediated the relationship between depressive symptoms and poorer QoL in clinically stable schizophrenia. Moving beyond symptom control to integrated interventions targeting these psychosocial pathways is crucial for enhancing QoL, especially in resource-limited rural settings.

Community-acquired pneumonia (CAP) remains a major cause of morbidity in children. Although severity assessment tools are available, they are not specifically designed to predict the development of a broad spectrum of pulmonary and systemic complications. This study aimed to identify admission factors associated with complicated pneumonia (CP) in hospitalized children with CAP and to develop a practical risk scoring model for early risk stratification.

Patients hospitalized with CAP were classified into two categories: uncomplicated CAP and complicated pneumonia. Independent predictors for the development of complicated pneumonia were identified.

Multivariate logistic regression identified the following as independent risk factors for complicated pneumonia: older age (OR: 1.011; p < 0.001), hypotension (OR: 28.083; p < 0.001), altered mental status (OR: 5.033; p = 0.024), low haemoglobin values (OR: 0.835; p = 0.015), leukopenia (OR: 3.197; p = 0.040), increased neutrophil-to-lymphocyte ratio levels (OR: 1.045; p = 0.049), hyponatremia (OR: 2.840; p < 0.001), hypoalbuminemia (OR: 6.489; p < 0.001) and increased C-reactive protein levels (OR: 1.034; p = 0.039). The scoring system demonstrated a sensitivity of 82% and a specificity of 79%.

We identified admission characteristics associated with the development of pulmonary and systemic complications in hospitalized children with CAP and developed a complication-focused risk scoring model based on routinely available parameters. The model showed good performance within this retrospective cohort and may support early risk stratification. Prospective multicentre validation is required to confirm its generalizability and clinical utility.

Lithium is the only true mood stabiliser as it is able to both treat and prevent mania and depression. In practice, its popularity has declined despite discovering it has anti-suicidal and neuroprotective properties. Here, we argue for recognition of its benefits and advocate for its clinical use more widely.

This study explored the effect of including parents in embodied arts-based therapy sessions with neurodivergent adolescents. The aim was to understand how parental involvement might influence the development of skills essential for mental well-being, including communication, boundary setting, and emotional regulation. Guided by an interpretive paradigm within a qualitative research approach, the study used purposive sampling to select three parent-adolescent pairs from the Gauteng Province of South Africa. Data were generated through group observations, artworks, journals, and semi-structured interviews, and analysed thematically. The findings indicated that participants in each parent-adolescent pair perceived the joint sessions as supportive and meaningful, contributing to improved communication, strengthened relationships, and enhanced self-expression. The embodied nature of the process created a non-intimidating therapeutic space that facilitated clearer expression of needs and emotions. The study concludes that parent-inclusive embodied arts-based therapy can enhance therapeutic outcomes for neurodivergent adolescents, particularly when opportunities for joint engagement are integrated alongside individual therapeutic work. The primary contribution of the study lies in demonstrating the value of collaborative, embodied approaches in supporting the mental health and relational well-being of neurodivergent adolescents and their families.

This study aimed to examine the relationship between psychological well-being and aggression among handball players and to determine whether exercise addiction mediates this relationship.

A descriptive, cross-sectional, and correlational design was used. The population consisted of players competing in the Turkish Handball Leagues during the 2024-2025 season, and 442 athletes participated using a non-probability sampling method. Data were collected via an online survey including a personal information form, the Psychological Well-Being Scale, the Buss - Perry Aggression Questionnaire, and the Exercise Addiction Inventory.

Psychological well-being showed a significant negative correlation with aggression (r = -0.242, p < 0.001). Exercise addiction was positively associated with both psychological well-being (r = 0.212, p < 0.001) and aggression (r = 0.105, p = 0.027). Mediation analysis indicated that exercise addiction significantly and partially mediated the relationship between psychological well-being and aggression (indirect effect 95% CI: 0.0246-0.1654). The direct effect of psychological well-being on aggression remained significant (β = -0.7093, p < 0.001).

Higher psychological well-being was associated with lower aggression among handball players, whereas exercise addiction was associated with both higher psychological well-being and higher aggression and emerged as a partial statistical mediator of this relationship. These findings may help inform future studies and preventive strategies focusing on athlete mental health and behavioral regulation. However, because of the cross-sectional design, causal inferences cannot be drawn.

Neuropathic pain (NP) is a prevalent chronic pain disorder that severely impairs the physical and mental health of patients, affecting 6.9%-10% of the general population. The dorsal root ganglion (DRG) is a crucial locus in the pathogenesis of NP. However, the underlying mechanisms by which DRGs contribute to this condition remain incompletely understood.

High-throughput sequencing data of DRGs was downloaded from the Gene Expression Omnibus (GEO) and integrated for analysis. Differential expression analysis combined with multiple machine learning methods was employed to identify candidate genes associated with NP in DRGs. The spared nerve injury (SNI) model was used to assess gene expression patterns. Small interfering RNA-mediated knockdown of the target gene was performed to evaluate its functional role. Bioinformatics analysis and chromatin immunoprecipitation (ChIP) experiments were conducted to explore the transcriptional regulation of the target gene.

Sez6l was identified as a candidate gene upregulated in DRGs. In the SNI model, Sez6l was significantly upregulated. Knockdown of Sez6l reduced the expression levels of inflammatory cytokines (IL-6, TNF-α, and IL-1β) and alleviated mechanical allodynia and thermal hyperalgesia in SNI mice. Bioinformatics analysis and ChIP experiments suggested that Foxo1 may enhance the transcription and expression of Sez6l. Mechanistically, Sez6l promoted NP by activating the Wnt5a/Ca²⁺ signaling pathway in DRGs.

Our findings suggest that Sez6l, which is transcriptionally regulated by Foxo1, facilitates neuropathic pain through activating the Wnt5a/Ca²⁺ signaling pathway in DRGs.

Despite the increasingly visible anti-Asian racism, primary data collection studies highlighting both discrimination and resilience experiences are limited. Informed by Asian Critical Theory (AsianCrit), this study examined the associations among discrimination, resilience, and mental health of Asian and Asian American (AAA) older adults. Between 2023 and 2024, primary data were collected through surveys offered in English, Hmong, and Korean. A total of 126 community-dwelling AAA adults aged 50 and older were recruited, of whom nearly two-thirds lived in urban areas. Descriptive and multivariate regression analyses examined the associations among discrimination, resilience, and psychological well-being, controlling for known covariates. Higher levels of discrimination were associated with greater severity of depression, increased anxiety, and poorer mental health. Conversely, higher levels of resilience were associated with better psychological well-being. We highlight the impacts and innovative approaches to support AAA older adults and other minoritized communities.