Mental health challenges among university students have intensified globally, with rising anxiety and social isolation reported across diverse educational contexts. These trends demand innovative, accessible, and non-stigmatizing approaches that complement traditional clinical services. This study examined whether participation in Rock "n" Roll Dancesport (Jive and Cha-Cha) was prospectively associated with improvements in self-efficacy, anxiety symptoms, and heart rate variability (HRV) among Chinese university students over 6 months.

A three-wave longitudinal mixed-methods design was employed. Quantitative assessments were conducted at baseline (T1, n = 152), 3 months (T2, n = 136), and 6 months (T3, n = 131). Measures included the General Self-Efficacy Scale (GSES), Social Self-Efficacy Scale (SSES), GAD-7 for anxiety symptoms, and resting HRV. Linear mixed-effects models examined the effects of time, baseline dance frequency group (high: ≥3 sessions/week vs. low: 1-2 sessions/week), and their interaction on each outcome, controlling for age, gender, and academic year. Semi-structured interviews (n = 32) and 50 + hours of observation explored participants' lived experiences.

Mixed-effects models revealed significant main effects of frequency group across all outcomes: high-frequency participants showed higher GSES (β = 3.60, p < 0.001), higher SSES (β = 8.62, p < 0.001), lower GAD-7 (β = -2.80, p < 0.001), and higher HRV (β = 7.64 ms, p < 0.001). Significant Time × Frequency Group interactions indicated that high-frequency participants showed greater improvements over 6 months in SSES (T2: β = 2.40, p = 0.001; T3: β = 2.37, p = 0.001), GSES (T3: β = 0.99, p = 0.007), and HRV (T3: β = 3.10, p = 0.004). Qualitative analysis identified four interconnected experiential themes: rhythmic entrainment as affective catalyst, embodied mastery as a source of self-efficacy, synchronized partnership as a context for trust, and meaning-making as narrative integration.

More frequent Rock "n" Roll Dancesport participation was prospectively associated with improvements in self-efficacy, anxiety symptoms, and HRV over 6 months. The convergence of quantitative trajectories and qualitative narratives supports a directional interpretation consistent with participation temporally preceding psychological gains, while acknowledging that self-selection and reciprocal effects remain plausible. These findings suggest that structured, arts-based physical activities may serve as promising, non-stigmatizing contexts for resource-building among university students.

Mental health disorders constitute a major public health concern globally, especially in low- and middle-income countries. Despite the increase of mental disorders and integration of mental health services into primary healthcare in Rwanda, the evidence on contextual and structural factors of service utilization remains scarce. This research aimed to investigate factors associated with utilization of mental health services among adults and healthcare professionals (HCPs) in Gasabo District, Kigali.

A convergent mixed-methods design was used, with quantitative and qualitative data collected concurrently. Quantitative data were collected from 149 adults using a structured questionnaire, and qualitative data were collected through key informant interviews with 29 mental health professionals. Quantitative data were analyzed using descriptive statistics and logistic regression, while qualitative data were analyzed using inductive thematic analysis. The results from both methods were integrated during interpretation to provide a comprehensive understanding of factors associated with mental health service utilization.

Overall, 62.4% of adults reported using mental health services. Service utilization was lower among those endorsing traditional explanations of mental illness (AOR=0.52, 95% CI: 0.27-0.98; p=0.041), and those reporting high perceived stigma (AOR=0.46, 95% CI: 0.23-0.91; p=0.028). Qualitative interviews with mental health professionals identified four themes: sociocultural barriers, health-system factors, accessibility challenges, and strategies to improve access. Qualitative results converged with quantitative results by identifying stigma and traditional beliefs as key barriers to service utilization, while additionally reporting limited-service availability, workforce constraints, and transportation as structural challenges.

Our study underscores that improving access to mental health services requires culturally responsive community engagement alongside sustained efforts to reinforce service availability, workforce capacity, and accessibility. Further research is needed to better understand long-term and context-specific mental health service needs, especially given the country's history of genocide against the Tutsi and its persistent implications for mental health and access to care.

Obsessive-compulsive disorder (OCD) is a chronic and disabling condition, and although exposure and response prevention (ERP) is the first-line psychological treatment, many patients decline it, drop out, or retain residual symptoms. According to Wells' metacognitive model, OCD is maintained less by intrusive thoughts themselves than by metacognitive beliefs about the significance, danger, and control of thoughts, which metacognitive therapy (MCT) targets directly. However, individual MCT has been evaluated almost exclusively in high-income Western settings, and whether metacognitive belief change temporally precedes symptom improvement remains untested. This multisite, assessor-blinded randomized controlled trial (RCT) addressed both gaps in Pakistani outpatient services. Seventy-six adults with OCD were randomized to 12 weekly sessions of individual MCT (n = 38) or documented treatment as usual (TAU; n = 38) and assessed at baseline, post-treatment, and 6-month follow-up; outcomes were analyzed with intention-to-treat (ITT) mixed-effects models and an exploratory three-wave panel mediation model. MCT produced greater reductions in clinician-rated Yale-Brown Obsessive-Compulsive Scale severity than TAU, F(1.81, 134) = 11.30, p < 0.001, with mean differences of -4.00 at post-treatment and -6.92 at follow-up (both p < 0.001) and more frequent treatment response. MCT also reduced Metacognitions Questionnaire-30 belief domains, with gains maintained at follow-up. However, the prespecified lagged indirect effect through post-treatment beliefs was not supported (β = -0.01). Findings extend the evidence for MCT to a non-Western clinical context and suggest that broad metacognitive belief domains behave as markers of clinical state rather than proximal mechanisms, underscoring the need for temporally fine-grained mechanism research.

Veterans in rural and underserved communities face persistent care barriers from provider shortages, travel burdens, and the digital divide. Within the Department of Veterans Affairs (VA), the Clinical Resource Hub (CRH) National Telehealth Program delivers primary, mental health, specialty, surgical, and rehabilitative care into veterans' homes and rural clinics, while VA Immersive scales extended reality (XR) across the system. Embodied XR telehealth, where provider and patient meet as full-body avatars in a shared immersive environment, intersects these programs and introduces new design requirements. This study extends our embodied XR codesign series from physical rehabilitation to mental health and whole health.

Stakeholders from VA, academia, and industry ( N = 30 ), drawn from Boise and other participating CRHs, joined a 3-day codesign at the Boise VA Medical Center in June 2026, including shadowing telehealth workflows, a full-day workshop with five teams, and a half-day debrief with program leads. Seven usability task ratings, 164 four-axis ideas (Raise, Reduce, Eliminate, Create), 95 debrief proposals, 188 prioritization votes, and 19 discussion transcripts were analyzed through descriptive statistics and reflexive thematic analysis.

Perceived task ease was high among a cohort with mixed VR experience across seven tasks (tutorial, joining a telehealth room, exercise completion, movement recording, environment and interactable customization, and spatial drawing), each above 4.1 of 5 on the Single Ease Question, led by customizing virtual environments ( M = 4.84 ± 0.37 ). Stakeholders most endorsed minimalist defaults, onboarding resources, and out-of-the-box readiness, followed by embodiment with personalized environments, disability representation, and veteran identity markers. The debrief prioritized breathing and grounding, graded exposure, psychoeducation, and whole-health movement, delivered through headsets paired to an in-clinic tablet or monitored home deployment. Infrastructure compatibility, workforce fit, and governance emerged as pervasive constraints. Workshop satisfaction was high ( M = 4.82 ± 0.53 of 5) with 88% requesting follow-up; platform-specific ratings were favorable but lower and more variable (e.g., user-friendliness M = 3.76 ± 0.97 of 5).

We propose candidate design principles for extending an embodied XR telehealth platform, built for physical rehabilitation, to mental health and whole health care for veterans, and discuss implications for platform design, piloting, and deployment.

Depression is a widespread mental disorder imposing significant societal burdens. The COVID-19 pandemic exacerbated its prevalence, emphasizing the need for improved access to affordable and effective treatments. This study aims to examine the trends of antidepressant availability and affordability in China from 2019 to 2022 and the role of the National Volume-Based Procurement (NVBP) policy.

Using nationwide daily procurement data of 19 antidepressants encompassing all medical facilities in China from 2019 to 2022, this study adapted the World Health Organization/Health Action International (WHO/HAI) methodology. Availability was defined as the percentage of health facilities procuring specific antidepressant during the year. Affordability was expressed as the number of days at provincial minimum wage to pay for a one-month course of treatment. Temporal variations were described and explored using fractional logit regression, stratified by originator, NVBP involvement, clinical preference, hospital features, and regions.

Affordability improved steadily between 2019 and 2022 across most antidepressant groups. The largest improvement occurred among first-line NVBP antidepressants, where the monthly expenditure declined by 0.022-day minimum wage annually. In contrast, affordability changed little for first-line non-NVBP medicines (0.015-day decrease per year) and second-line non-NVBP medicines (0.004-day decrease per year). Availability of originator brands declined annually by 0.8 percentage points, while lowest-priced generics increased by 1.1 percentage points. The largest decline occurred in tertiary private facilities, where availability fell by 3.7 percentage points annually. Improvements in availability were mainly observed in secondary and tertiary public facilities, particularly in the East and Northeast regions. Overall, NVBP first-line medicines had 15.5 percentage points higher availability and greater affordability of 0.167-day minimum wage than other antidepressants.

The study highlights the positive influence of the NVBP policy on antidepressant affordability and availability. Regional gaps and facility-specific disparities, though narrowed, still call for policy response.

Insomnia is common and often coexists with depression and anxiety. Digital delivery can expand access, yet few trials have compared insomnia-focused behavioral interventions with strong active controls under standardized conditions.

To examine whether a smartphone-delivered behavior therapy for insomnia (BI) improves insomnia more than a mood-focused behavioral activation (BA) module or a health-information (HI) comparator, and whether combining BI with BA (BA+BI) adds benefit.

We conducted a secondary analysis of the multi-arm RESiLIENT randomized controlled trial among adults from the general population with elevated insomnia (Insomnia Severity Index (ISI) ≥8). Participants were assigned to BI, BA+BI, BA, or HI, each self-guided over six weeks. The primary outcome was ISI change at weeks 6 and 26, analyzed using mixed-effects models. Depressive (PHQ-9) and anxiety (GAD-7) symptoms were secondary outcomes. Analyses followed a modified intention-to-treat approach (≥1 post-baseline assessment).

At week 6, BI reduced insomnia severity more than HI (ES: -0.43, CI: -0.58 to -0.28) and BA (ES: -0.26, CI: -0.42 to -0.11); BA also exceeded HI (ES: -0.16, CI: -0.32 to -0.01). Adding BA to BI gave no benefit over BI alone (vs HI, ES: -0.30, CI: -0.45 to -0.14). BI reduced depressive (ES: -0.44, CI: -0.59 to -0.29) and anxiety symptoms (ES: -0.27, CI: -0.42 to -0.12) more than HI, and matched BA (each ES: 0.05, CI: -0.10 to 0.20). At week 26, ISI differences persisted but PHQ-9 and GAD-7 differences attenuated.

This exploratory, hypothesis-generating analysis associated a focused smartphone-delivered sleep intervention with durable improvements in insomnia severity and mood. Replication in independent samples, and confirmation in trials recruiting participants with elevated insomnia, is required before recommendation at scale.

Colorectal cancer (CRC) is the second most common cause of cancer-related death globally and the third most common type of cancer.

This study aims to evaluate the prevalence of psychiatric morbidities after colorectal surgical procedures, identify associated risk factors for their development, and determine whether improved access to psychological therapies would benefit this patient population.

Between January 2019 and December 2023, 603 patients with a diagnosis of colorectal disease underwent elective colorectal operations in our institution and were considered for this retrospective study. Data were collected from medical and operating theatre records as well as from the hospital-coded database. Patient data were primarily analysed for the incidence of colorectal diseases such as colorectal cancer, diverticulitis, and inflammatory bowel disease. Secondary variables include patient characteristics (age at operation, gender), length of hospital stay, and operative parameters (time and type).

During the 5-year study period, a total of 603 records of patients operated on for colorectal disease in our institution were retrieved from the computer database. A total of 499 (83%) colectomies were performed using the open method, and 104 (17%) were performed using the laparoscopic technique. Among patients undergoing colorectal operation in our institution 126 (20.1%) had a psychiatric disorder in the one-year postoperative follow-up. The most common type of mental disorder was mood disorder, which appeared in 26 patients.

This retrospective study shows that the technique of colectomy does not appear to affect the incidence of psychiatric disorders. However, our study indicates the need for a prospective randomised controlled trial with a larger number of participants.

Mental disorders contribute significantly to the disease burden in Europe. Brain stimulation treatments such as electroconvulsive therapy (ECT) and repetitive transcranial magnetic stimulation (rTMS) are supported by strong evidence and are recommended in clinical guidelines in many countries. However, access to these interventions remains highly inconsistent across Europe. Reimbursement by public health services plays a critical role in enabling equitable access to these therapies. In this study, we examined disparities in national reimbursement policies for ECT and rTMS for the treatment of mental disorders in both inpatient and outpatient settings across 28 European countries, leveraging information from public databases and expertise from a multinational expert group within the ECNP Neuromodulation Network. Our results show that ECT is reimbursed for inpatient care in all 28 studied countries, while outpatient ECT is reimbursed in 15 of 28 countries (53.6%), with a geographic trend toward higher availability in Scandinavian and Western European countries. rTMS reimbursement was reported in 15 of 28 countries (53.6%) for inpatient care and in 8 of 28 countries (28.6%) for outpatient care, with no consistent geographic pattern. Subsequent analyses examining reimbursement policies in relation to the national Human Development Index (HDI), the Gini coefficient, and healthcare infrastructure metrics revealed no statistically significant differences between countries that do and do not reimburse outpatient ECT. Although countries reimbursing outpatient ECT showed numerically fewer hospital beds and slightly higher HDI values, these differences did not reach statistical significance. Similarly, no significant associations were observed between rTMS reimbursement and indicators of socioeconomic development, income inequality, or healthcare infrastructure. These findings highlight a striking disparity in national reimbursement policies across Europe, despite the solid evidence base for ECT and rTMS in treating mental health disorders. The current landscape suggests that many patients in Europe experience limited access to these effective treatments that could alleviate individual suffering and reduce societal disease burden. We call for urgent policy action to align health system reimbursement with clinical evidence for treatment efficacy and to improve access to evidence-based brain stimulation therapies across Europe.

Special care dentistry (SCD) provides oral healthcare for adults who are unable to accept routine dental care due to physical, intellectual, medical, emotional, sensory, mental, or social impairments. In England, demand for SCD services is increasing in the context of population ageing, rising multimorbidity, improved tooth retention into later life, and persistent inequalities in access to National Health Service dental care. Recent national survey data highlight substantial levels of untreated dental disease, increasing oral-health-related impacts on quality of life, and significant barriers to accessing care, with these burdens disproportionately affecting individuals with disabilities. Against this backdrop, this paper examines the growing challenges facing SCD in England and argues that these pressures provide a critical lens through which to evaluate equity, integration and resilience within the wider healthcare system. It highlights opportunities to improve service delivery and enable more equitable access to oral healthcare for medically and socially vulnerable populations.

Supportive text message interventions provide reassurance and psychological support during high-stress situations like wildfires. By assessing user satisfaction with these interventions, we can gauge their effectiveness.

This study explored subscriber satisfaction, experience, and perception related to the Text4Hope-AB and Text4Hope-NS text message interventions designed to provide psychological support during wildfires. It also explored the age and gender differences in overall satisfaction with the programs.

A mixed-methods approach was utilized, involving both quantitative and qualitative data collection. Quantitative data were gathered using categorical responses to an online satisfaction and user experience survey, while qualitative data were collected through written responses to open-ended questions on the online survey. Participants included 312 individuals who received daily text messages over 3 months. An Analysis of Variance and Games-Howell post hoc analysis were used to examine age- and gender-related differences in overall satisfaction scores measured on a scale from 0 to 10.

The mean satisfaction score was 8.66 (SD = 1.63)/10. Most participants reported that the daily messages helped them cope with stress (76.0%), anxiety (73.4%), and depression (67.0%). In addition, 79.5% reported feeling connected to a support system, 77.9% felt hopeful about managing their mental health or addiction issues, 78.2% reported improved overall mental wellbeing, and 72.8% reported an enhanced quality of life. Participants generally perceived the messages positively. The qualitative analysis identified two main themes reflecting participants' experiences and perceptions: expectations and recommendations, and experiences with the service. Satisfaction differed significantly by age and gender, with older participants generally reporting higher satisfaction than younger participants; male and female participants reported higher satisfaction than those identifying as other gender; however, the other-gender subgroup comprised only two participants, and this comparison should therefore be interpreted with considerable caution.

Text4Hope-AB/NS were well received and positively perceived as useful and supportive during the wildfires. The findings demonstrate high user satisfaction, positive participant experiences, and differences in satisfaction across demographic groups. Future interventions may benefit from greater personalization and adaptation to the needs and preferences of different populations. Gender-related findings should be interpreted cautiously due to the small sample size.