Schizophrenia is increasingly recognized as a disorder with a prominent neuroimmune component. Researchers have observed elevated markers of inflammation (e.g., cytokines, CRP, and NLR) not only during first-episode psychosis but also in chronic stages, suggesting that immune dysregulation may play a key role in the illness's pathophysiology. Yet, current pharmacological treatment mainly targets dopaminergic dysregulation, which is effective in reducing positive symptoms but is ineffective in managing negative symptoms and cognitive decline associated with schizophrenia. Antipsychotics (APs) may exert anti-inflammatory effects, possibly through attenuating glial activation and modulation of the immune pathways, though these effects remain still underexplored. That is why, in this narrative review, we synthesize evidence from in vitro, animal, and human studies to examine whether APs influence inflammatory processes and assess their potential in mitigating the refractory symptoms of schizophrenia through the immune modulation. Despite promising findings, several key uncertainties persist: inflammatory markers exhibit inconsistent patterns across studies, methodological approaches differ considerably, and antipsychotic-induced metabolic alterations further complicate interpretation. To fully understand the anti-inflammatory potential of APs, future research should identify the most effective compounds, determine optimal treatment timing, and rigorously control for confounding factors. Crucially, a paradigm shift is needed: clinical trials must adopt biomarker-guided stratification, and drug development should focus on agents that modulate the innate immunity. These steps are essential for developing more effective treatments for the refractory symptoms of schizophrenia.

Using data from the VA Million Veteran Program (MVP), this study aimed to (1) examine rates of environmental exposures as a function of traumatic brain injury (TBI) history in post-9/11 veterans and (2) examine the independent and interactive effects of TBI and exposures on subjective cognition. Participants included 6707 MVP-enrolled veterans (78 % male; age: M = 44.66, SD = 10.91) who were deployed in support of the Iraq/Afghanistan-era conflicts, completed MVP surveys, and participated in the VA TBI Screening and Evaluation Program (TBI-SEP). Veterans were classified into three groups based on the results of the TBI-SEP: (1) negative TBI screen; (2) positive TBI screen but no TBI diagnosis; or (3) positive TBI screen and confirmed TBI diagnosis. Environmental exposures were extracted from MVP surveys and included solvents/fuels; pesticides; lead; other metals; combustion products; open-air burn pits; and chemical/biological warfare (CBW) agents. The Medical Outcomes Study Cognitive Functioning-Revised (MOS-Cog-R) scale was used to assess subjective cognition. Chi-square tests showed that exposure rates were highest among veterans screening positive for TBI. The most commonly reported exposure types were combustion products, burn pits, and solvents/fuels. Adjusted linear regressions showed that both TBI and environmental exposures independently contributed to worse subjective cognition, but there were no synergistic effects between TBI and exposures on cognition, except for CBW agents. Our findings emphasize the importance of considering environmental exposures as independent risk factors for subjective cognitive difficulties in post-9/11 veterans and support the use of toxic exposure screenings to connect veterans with appropriate resources and clinical care.

Suicide attempts (SA) are common in elderly patients with major depressive disorder (MDD), but few studies have focused on the prevalence and associated factors in elderly Chinese Han patients with MDD.

A total of 266 first episode and drug naïve older patients with MDD (age ≥ 50 years) were recruited. We measured depressive symptoms, anxiety symptoms and psychotic symptoms by the Hamilton Depression Rating Scale (HAMD), the Hamilton Anxiety Rating Scale (HAMA), the positive subscale of the Positive and Negative Syndrome Scale (PANSS) and the Clinical General Impression Inventory (CGIS). Fasting serum samples were collected to measure thyroid hormone levels and metabolic parameters.

The prevalence of SA was 24.4 %. Patients with SA had higher HAMD, HAMA, PANSS positive subscale and CGI-S scores, as well as higher levels of TSH, TgAb, TPOAb, FBG, TC, LDL-C, TG, and systolic and diastolic blood pressure. Logistic regression analysis showed that suicide attempts were correlated with HAMA score, CGI-S score and TC levels in elderly patients with MDD.

The findings show a high prevalence of suicide attempts in elderly patients with MDD. In elderly patients with MDD, severity of anxiety, CGI-S score and TC levels were associated factors for suicide attempts.

Circadian rhythms are major determinants of physical and mental health and sleep at the crossroads of physiology and behavior. Circadian physiology is traditionally described according to three main dimensions: circadian phase, amplitude, and stability. Nycthemeral behaviors are typically characterized by two primary dimensions: nycthemeral timing and regularity. Circadian-related sleep complaints arise from a circadian disruption between circadian physiology and nycthemeral behaviors and represent a potential sixth clinical dimension. Based on scientific knowledge, this article defines each of these dimensions, explores their main determinants (genetics, age and sex, external factors), and presents objective (melatonin, temperature, actimetry) and subjective (sleep diaries, self-report questionnaires) measurement tools. The interactions between these six dimensions are discussed, along with their impact on sleep and health (mental, cardiovascular, metabolic, immune health), and on physical and cognitive performance. Finally, a definition of circadian health is proposed, as well as strategies for its promotion (light exposure, physical activity, melatonin), offering new opportunities for improving public health in both general and clinical populations. Promoting circadian health should take into account all external factors (individual, social, societal, environmental) to be effective and contribute to reducing health inequalities. In the future, developing a unique tool to measure circadian health could enhance its characterization and management in both general and clinical populations.

Cognitive impairment is an increasingly common complication of diabetes, yet its underlying pathophysiological mechanisms remain poorly understood. Neuronal pentraxin 2 (NPTX2), a recently identified synaptic biomarker linked to cognitive disorders, has not previously been examined in relation to cognitive function in geriatric individuals with diabetes. This cross-sectional study enrolled 90 participants-46 geriatric patients with diabetes and 44 age-matched non-diabetic controls. Demographic and clinical data were collected for all participants. After informed consent, cognitive function was assessed with the Montreal Cognitive Assessment (MoCA) and the Mini-Mental State Examination (MMSE). Serum NPTX2 levels were measured by ELISA. No significant differences were found between the diabetic and control groups in age, sex, education level, marital status, smoking history, comorbid conditions, or polypharmacy. However, the groups differed significantly in MoCA scores (p < 0.001), MMSE scores (p = 0.028), and NPTX2 levels (p = 0.048); the diabetic group showed lower cognitive scores and biomarker levels. NPTX2 levels correlated positively with MoCA and MMSE scores and negatively with diabetes duration, patient age, and the presence of microvascular complications. In conclusion, cognitive function was significantly lower in geriatric patients with diabetes than in controls, and serum NPTX2 levels were significantly associated with cognitive performance. These findings suggest a possible role for NPTX2 in diabetes-related cognitive decline and support further investigation of its utility within a broader biomarker panel.

The current trial aimed to assess the effectiveness of Mindfulness-Based Stress Reduction training on salivary cortisol and α-amylase levels, anxiety and depression of students. This research was an experimental trial with a pre-test-post-test design and a control group. The statistical population of the research included all students studying in the universities of Khoy, Iran in 2021. The sample consisted of 30 people who were assigned to two experimental and control groups equally. Stress, anxiety and depression scale (DASS-21), General Health Questionnaire (GHQ-28) and saliva samples were passively taken by ELISA laboratory method with special kits. Data analysis was done using an independent t-test and analysis of covariance using IBM-SPSS version 26 software. The results showed that MBSR training on general health, alpha-amylase level and alpha-amylase/cortisol ratio of experimental group participants was more effective than the control group (P < 0.05). However, it was not effective on students' cortisol levels (P > 0.05). According to the findings, it can be argued that MBSR training has been able to promote the psychological (DASS and general health) and hormonal (alpha amylase level and alpha-amylase/cortisol ratio) mental health indicators of the experimental group participants compared to the control group.

Mental health stigma is a pervasive issue which can adversely affect patient care and outcomes. Stigma may manifest through discrimination and negative stereotypes, and can be damaging when inadvertently perpetuated by practitioners and trainees. This study aims explore the effect of experiential learning in decreasing stigma measured by changes in the perceived attitudes and behaviours of trainees at a specialized mental health hospital. Participants (N = 139) are trainees who were scheduled to undergo clinical or non-clinical placement at a mental health hospital. Participants completed a demographic survey prior to placement and a qualitative student evaluation after placement. Validated scales measuring changes in attitude (MICA-4) and behaviour (RIBS), were used as both pre- and post-placement evaluations. Trainee placement variations were accounted for using correlation analysis of the MICA-4 and RIBS data. Most participants identified as females with a college or university education, in their second to fourth years of study. Analysis of both MICA-4 (P = 0.0001) and RIBS (P = 0.009) revealed significant differences between pre-placement and post-placement scores on stigma-related attitudes and behaviours, respectively. These results were supported by qualitative responses which revealed alignment with recovery-oriented philosophy and reflections of stigma. Overall, this study demonstrates possible benefits of experiential learning in mental health care settings to address stigma in clinical and non-clinical trainees.

Autistic young adults often face significant challenges during the transition to adulthood, yet few tools exist to assess their readiness in a developmentally appropriate and culturally responsive manner. This study presents the development and initial validation of the Transition Readiness Scale for Autistic Adolescents and Adults (TRS-A), a brief caregiver- and self-report measure designed to assess key domains of transition readiness. Guided by qualitative input from Latino families, community stakeholders, and clinicians, the TRS-A was piloted with 114 autistic young adults, 66 Spanish-speaking parents, and 48 English-speaking parents. Psychometric analyses supported the scale's internal consistency and construct validity, mirroring the results from the initial development of the measure, with TRS-A scores correlating with adaptive functioning and mental health outcomes. The TRS-A offers a promising way to identify strengths and needs in autistic youth as they prepare for adult roles and responsibilities. Future research should explore its use across broader populations and its predictive value in transition-related interventions and clinical decision-making.

Artificial intelligence (AI) has been increasingly integrated into medical publishing, hopefully improving efficiency and accuracy, but serious concerns persist regarding ethical implications, authorship attribution, and content reliability. We aimed at understanding the perspectives of editors of medical journals on AI. A structured online questionnaire was developed and distributed to Editors-in-Chief of medical journals worldwide. The survey comprised 27 concise questions exploring demographics, journal practices, and perspectives on AI in editorial workflows. Quantitative data were analyzed using descriptive statistics to summarize usage patterns, perceived benefits, risks, and future expectations. A total of 59 Editors-in-Chief completed the survey (response rate: 19%), with replies suggesting substantial variability in beliefs and attitudes towards AI for publication in medical journals. Artificial intelligence tools were already in use by 49% of journals, mainly for plagiarism detection (76%) and data verification (35%). Only 9% of responders reported that journals used AI for both scientific and linguistic review. Time savings (79%) and cost reduction (43%) were the most commonly cited benefits, and concerns included potential bias (71%) and lack of accountability (60%). Overall, 81% of responders anticipated a major role for AI in publishing within 10 years. Exploratory analyses suggested several potential associations between replies and respondent or journal features, requiring further validation in future surveys. In conclusion, the present survey on attitudes toward AI in publication in medical journals suggests that Editors-in-Chief are cautiously adopting AI in their editorial workflow, supporting its operational use while explicitly calling for clear guidance to address ethical and regulatory concerns.

Examine changes in work impairment and associated cost savings among employees receiving psychotherapy through an employer-sponsored benefit.

A retrospective analysis evaluated changes in work impairment and lost productive time (LPT) among N = 5,450 adults receiving psychotherapy. Per employee per year (PEPY) cost savings due to gains in productive time were estimated using a range of salary benchmarks.

Employees experienced significant reductions in work impairment (b = -2.88, 95% CI [-3.01, -2.75]) and LPT (b = -4.00, 95% CI [-4.25, -3.74]). Based on the median U.S. salary, improvements corresponded to an average cost savings of $4,806 PEPY. Cost savings increased with increasing baseline work impairment severity (very severe: $20,882 PEPY at the median U.S. salary).

Employees receiving evidence-based psychotherapy experience meaningful reductions in work impairment, which are associated with employer cost savings due to productive time gains.