Digital mental health programs can expand access to psychological support for children and adolescents, especially where stigma, cost, and workforce shortages limit traditional care. Understanding which features young people and parents value most is essential for improving engagement and real-world uptake.

We conducted a cross-sectional discrete choice experiment to quantify preferences for online youth mental health program features among adolescents and parents. Data were collected through an online survey of BRAVE Program families with prior experience using the BRAVE self-help anxiety program. Participants completed ten choice tasks comparing two program options varying by content format, effectiveness or professional contact, personalization, cost, and session frequency or additional supports. Preferences were analyzed using mixed multinomial logit models.

Among 238 participants (80 parents; 158 adolescents), both groups preferred programs that were engaging, interactive, and personalized, and both were sensitive to program cost. Parents placed strong emphasis on effectiveness, with cost (36%) and effectiveness (27%) the most influential attributes. Adolescents valued direct contact with a professional and additional supports, but cost was the dominant attribute influencing their choices (47%). Scenario analyses showed that predicted uptake remained high for programs with preferred features, although uptake decreased when the program cost was A$300.

Within their respective choice sets, parents placed particular value on demonstrated program effectiveness, while adolescents placed particular value on access to professional support. Programs offering flexible, optional professional input, and low or no cost may maximize appeal and accessibility while informing future policy and design of scalable youth e-mental health solutions.

Nonadherence to pharmacological treatment for attention-deficit/hyperactivity disorder (ADHD) is common among children and adolescents. Despite well-documented clinical and contextual barriers, to the best of our knowledge no dedicated tool exists to quantify parental challenges in supporting adherence. This study aimed to develop and evaluate the My Experience with ADHD Pharmacotherapy - Parent Report (ME WAPH-P) questionnaire. The ME WAPH-P was developed based on existing instruments, clinical experience, expert input, and literature on nonadherence. The initial 30-item questionnaire assessed adherence-related challenges across six subscales. Parents of children aged 4-18 years who had received ADHD medication were recruited via social media and a commercial survey platform. The final sample included 351 parents. Psychometric evaluation included internal consistency, item discrimination, subscale intercorrelations, and exploratory factor analysis (oblique rotation). After removing one item, the 29-item scale demonstrated excellent internal consistency (Cronbach's α = 0.90). Subscale reliability demonstrated moderate-to-high intercorrelations. Parallel analysis supported a three-factor structure explaining 44.7% of variance, with moderately correlated factors and some cross-loadings. Parents' primary concerns focused on adverse effects, doubts about effectiveness and safety, summer treatment breaks, and child resistance. Parents of children treated for less than one year reported significantly higher challenge scores, supporting criterion validity. The current preliminary study supports the potential of the ME WAPH-P in capturing a broad, multidimensional construct of parental challenges in ADHD medication adherence. Findings highlighted child resistance as an underexplored barrier. The dimensionality of the questionnaire construct suggests a cumulative "adherence burden". This novel tool may support clinical identification and monitoring of adherence challenges with implications for targeted clinical intervention.

Our study aimed to evaluate procalcitonin (PCT) as a prognostic marker in advanced odontogenic infections. In addition, we sought to identify further prognostic markers that could be used to predict the length of hospital stay (LOS).

We retrospectively analysed 61 patients who were hospitalised between January and August 2020 for surgical abscess drainage in the Department of Oral and Maxillofacial Surgery at the University Hospital of Bonn. Univariable logistic discrete hazard models were used to assess the association between baseline levels as well as temporal changes in laboratory parameters (PCT, C-reactive protein (CRP), and leukocytes) and LOS. In addition, a tree-based approach for modelling discrete time-to-event data was used to identify risk groups of patients with a prolonged LOS.

Median LOS were 5, 7, and 9 days for different PCT concentrations < 0.1 µg/l, 0.1-0.5 µg/l, and > 0.5 µg/l, respectively (p < 0.001). The data-driven tree identified three subgroups with median LOS of 4, 6, and 10 days based on preoperative CRP and PCT levels. Patients with CRP > 153 mg/l had a median LOS of 10 days, while those with CRP ≤ 153 mg/l had median LOS of 6 or 4 days depending on whether PCT was > 0.03 µg/l or ≤ 0.03 µg/l.

PCT may serve as a useful prognostic marker for estimating LOS, even in severe odontogenic infections. Exploratory decision tree analysis demonstrated that the combined assessment of PCT and CRP levels could help stratify patients into distinct LOS subgroups, which may facilitate clinical decision-making and more accurate estimation of treatment outcomes.

Patient-reported outcomes following gender affirming vaginoplasty remain understudied. The aim of this study was to evaluate patient-reported outcomes during the first postoperative year following penile inversion vaginoplasty.

This retrospective cohort study included n = 76 consecutive patients undergoing penile inversion vaginoplasty (March 2021-January 2024) who completed questionnaires pre-op, and at 1, 3-, 6-, 9-, and 12-months post-op (n = 59, 78%). Patient-reported satisfaction with functional and anatomic outcomes including improvements in gender dysphoria were compared with logistic regression, cumulative link mixed models, and Mann-Whitney U tests.

Vaginoplasty reliably improved patient reports of matching gender identity (P < .0001), comfort in clothes (P < .0001), and reduced feelings of embarrassment (P < .0001) and distress when looking at or touching the genitals (each P < .0001). Fifty percent of respondents reached the #4 dilator by 6 months. At 1 year, the reported average vaginal depth was 12.7 cm (min 8.9 cm, max 14.0 cm), and 60% of patients had no issues with dilation. Slight or moderate difficulty was reported by 54% of respondents during the first 3 months, while 20% progressed to severe difficulty or complete cessation, beginning at 6 months and peaking at 9 months post-op. Three patients reported inability to dilate (6-12 months), all with preceding difficulties. Respondents were more likely to endorse ability to engage in their preferred sexual activity after vaginoplasty (P < .0001). Return of genital sensation was gradual, with 100% of patients having at least partial sensation at 6 months and 61% describing full sensation by 1 year (P < .001). Of those who had attempted to achieve orgasm, all were able at 9 months (P < .001). Respondents reported greater satisfaction with urinary function post-operatively (P < .001), despite 25% having diverted stream. All but 1 participant, who had a complicated post-op course, agreed with the statement "I am now happier after my surgery than before my surgery" at 1-year. Mental health concern prevalence remained stable over the course of 1 year (time effect P = .64).

During the first year after penile inversion vaginoplasty, we found high patient satisfaction for functional outcomes and alleviation of gender dysphoria. Results may assist in pre-operative counseling surrounding goals and expectations, increasing patient involvement, preparedness, and thereby outcomes and satisfaction.

Approximately 4500 Canadians die by suicide annually, with men at three times the risk of women. Some ethnic and racialized groups face heightened vulnerability due to discrimination, historical trauma, and limited access to mental healthcare. In response to an alarming number of suicide deaths among Sri Lankan Tamil men in the Greater Toronto Area in 2019, this community-engaged study investigated micro-, meso-, and macro-level factors that contribute to suicide deaths in this population. In collaboration with Vasantham Tamil Wellness Centre, we conducted a community-based qualitative interpretive study, which was informed by an ecosystemic framework. Following research ethics board approval, individual semi-structured interviews were conducted with 10 family members and friends, and 12 service providers. The interviews were audio-recorded, (as needed) translated, transcribed, and analysed. We identified contributing factors at micro- (financial burden and upholding social status), meso- (community expectations and pressures, trauma related to the civil war in Sri Lanka, stigma of mental illness, and rigid gender role expectations), and macro-levels (lack of culturally-safe and linguistically-appropriate mental health services and experiences of systemic racism). These factors appeared to intersect and affect numerous domains of life (e.g., education and employment), leading to a cycle of marginalization, social isolation, mental health problems, and loss of hope and life. Multilevel interventions are urgently needed to prevent suicide deaths among Sri Lankan Tamil men in the Greater Toronto Area. Mental health initiatives and suicide prevention programs in Canada should be culturally-safe, linguistically-appropriate, and address historical and intergenerational trauma.

There is a pressing need to address the unique challenges of managing Schizophrenia Spectrum Disorders (SSD) in Low- and Middle-Income Countries (LMICs), where mental health resources are scarce and unevenly distributed. To develop this evidence-based guideline, we conducted a systematic review of the literature, followed by three rounds of Delphi surveys with experts from LMICs. The first two Delphi rounds identified and refined priority topics, while the third assessed their practical applicability in resource-limited contexts. The guideline emphasizes early intervention, continuity of care, and the integration of psychosocial interventions with pharmacological treatment, while explicitly tailoring recommendations to the realities of LMICs. Antipsychotic medications remain central, with second-generation agents recommended as first-line treatment for acute psychosis where available, but with recognition that first-generation agents are often the only accessible option. The guideline also discourages mega-dosing and unnecessary polypharmacy-common practices in some LMICs-in favor of rational monotherapy at the lowest effective dose. Psychosocial interventions are positioned as critical but are reframed for scalability: psychoeducation for patients and families, task-sharing to community health workers and trained lay providers, and reliance on peer support and faith-based networks where specialist services are lacking. The guideline stresses comprehensive care addressing physical, mental, and social needs, including vocational rehabilitation and housing support, while acknowledging barriers such as stigma, insecurity, and climate-related disruptions. Cultural adaptation is emphasized throughout, aligning interventions with local beliefs, social norms, and community structures to promote engagement, adherence, and sustainable outcomes.

Adolescence is a critical period with a high incidence of psychological problems. Anxiety, depression, and non-suicidal self-injury (NSSI) are relatively common among adolescents and can affect their physical and mental health. This study aims to investigate the dynamic temporal interactions among anxiety, depression, NSSI, and distress tolerance in adolescents using three waves of longitudinal follow-up data and cross-lagged network analysis. This study also aims to quantify the relative importance of each variable in the network and its cross-time predictive effects, thereby providing empirical evidence for early prevention and precision intervention in adolescent mental health.

Cluster sampling was used to recruit first-year students from 3 public junior high schools and first-year students from 3 public senior high schools in Yiyang, Hunan Province. Three follow-up surveys were conducted at T1, T2, and T3, with 6-month intervals between assessments. A total of 1 621 adolescents who completed all 3 surveys with valid responses were included. The assessment tools included the simplified Chinese version of the Depression Anxiety Stress Scale-21, the Tolerance for Mental Pain Scale (TMPS)-10, and the Ottawa Self-Injury Inventory.

Repeated-measures analysis of variance showed that from T1 to T2, the total score of distress tolerance and scores for tolerating distress and managing distress significantly decreased, whereas the scores for anxiety, depression, and NSSI thoughts and behaviors in the past month significantly increased. From T2 to T3, the total score of distress tolerance and the score for tolerating distress significantly decreased, while the scores for anxiety and NSSI thoughts in the past month significantly decreased (all P<0.05). Cross-lagged network analysis revealed that in the T1→T2 network, managing distress had the highest out-expected influence (out-EI=-2.01) and showed strong negative predictive effects on both anxiety and depression. In the T2→T3 network, managing distress still had the highest out-expected influence (out-EI=-1.67) and continued to negatively predict anxiety and depression, while NSSI behavior in the past month positively predicted anxiety and depression.

The relationships among anxiety, depression, NSSI, and distress tolerance in adolescents are dynamic and stage-specific. The ability to manage distress is a protective factor against anxiety and depression in adolescents, although its predictive effect weakens over time. In contrast, NSSI behavior gradually becomes a risk factor for depression at later stages. Therefore, improving adolescents' ability to manage distress, especially at an early stage, and intervening in NSSI behavior may effectively reduce anxiety and depression levels.

To identify correlations between the levels of platelet enzyme activity and clinical responses to antipsychotic pharmacotherapy in patients diagnosed with late-onset manifesting schizophrenia-like psychosis (late-onset schizophrenia, LOS) and very late-onset manifesting schizophrenia-like psychosis (VLOSLP).

The mental health status of 76 hospitalized patients with LOS and VLOSLP was evaluated using standardized psychometric scales at two time points: prior to the initiation of treatment and after a 28-day course of psychotropic therapy. Prior to treatment commencement, the activity levels of platelet enzymes involved in glutamate metabolism, energy metabolism, and glutathione antioxidant metabolism were measured for all subjects. A statistical analysis of the database with clinical and biochemical examination results, was conducted.

A comprehensive psychopathological assessment enabled the identification of patients exhibiting specific small-range delusions within their psychosis, notably «dwelling paranoid» delusions. It was observed that this type of delirium was predominantly present in patients with VLOSLP (X²=9.8, p=0.0018 with Yates correction). When participants were categorized into subgroups based on the presence or absence of «dwelling paranoid» delusions, a significant difference in platelet glutamate dehydrogenase activity was noted: patients exhibiting this type of delirium demonstrated significantly higher activity levels (p=0.009). Furthermore, several notable clinical and biological correlations were established between platelet enzyme activity levels and the clinical response to psychotropic therapy.

The significant correlations identified between platelet enzyme activity levels prior to therapy and individual clinical responses to psychotropic interventions hold potential for prognostic applications in clinical psychiatry, particularly for patients with disorders along the schizophrenia spectrum in later life.

To evaluate the prevalence and clinical structure of comorbid mental disorders among patients with chronic dermatoses, to identify associations with specific nosological forms of skin diseases, and to perform a differential analysis of subsyndromal mental distress.

A single-center, cross-sectional epidemiological study was conducted, including 500 patients diagnosed with chronic dermatoses at the Clinic for Skin and Venereal Diseases named after V.A. Rakhmanov of the Sechenov First Moscow State Medical University from March 2025 to March 2026. Dermatological and psychiatric diagnoses were validated according to ICD-10 criteria. To assess participants' mental status, a battery of validated assessment scales was used, along with a consultation with a psychiatrist. Participants were stratified into three groups: patients with psychiatric comorbidity, patients with subsyndromal mental distress, and a comparison group.

Psychiatric diagnoses conforming to ICD-10 criteria were confirmed in 46.4% of the overall population (n=232). The structure of comorbidity was primarily characterized by a prevalence of adaptation disorders (F43), which accounted for 61.2% of the group diagnosed with mental disorders. The highest risk of comorbid conditions was associated with psoriasis (odds ratio [OR]=2.34; p<0.001), atopic dermatitis (OR=2.18; p=0.002), and vitiligo (OR=2.13; p=0.044). Subsyndromal mental distress was identified in 39.6% of patients (n=198). Quality of life, as measured by the Dermatology Life Quality Index, was significantly reduced in the group with subsyndromal mental distress (median score of 14.0), which was comparable to that of the group with verified psychiatric diagnoses (18.4±6.3). Notably, psychogenic exacerbations of dermatosis were reported in 37.6% of patients, with those receiving psychotropic therapy experiencing significantly fewer exacerbations (median 2.0 vs. 4.0; p=0.018).

The prevalence of psychiatric comorbidity among patients with chronic dermatoses is substantial, encompassing 86.0% of the population when considering subsyndromal conditions. The data obtained underscore the necessity for the introduction of systematic screening for psychosomatic status within dermatological protocols and advocate for a transition towards a multidisciplinary care model that integrates both dermatological and psychiatric management.

This study examines disparities in rates and number of telehealth used among Indigenous Medicare mental health services users in Southeast Queensland.

We analysed the 2021 Census and Medicare Benefits Schedule data for 298,283 individuals who used MBS-subsidised community mental health services, including 78,048 who used telehealth. Descriptive and regression analyses were conducted.

Indigenous Australians were significantly less likely to use telehealth than non-Indigenous Australians (24.66% vs 26.23%, p < 0.001), although difference was small. Video-based telehealth was associated with a significantly greater increase in service use for non-Indigenous Australians than Indigenous Australians (coefficient = -0.76, p < 0.001). Indigenous adults who were female, aged 25-69, or not in the labour force were more likely to use telehealth, while number of telehealth services used was higher among those aged 40+, those who did not speak an Aboriginal language at home, and those receiving psychotherapies or video-based services. Indigenous children aged 12-17 years and those living in the Gold Coast Hospital and Health Service region were more likely to use telehealth, while greater telehealth utilisation was associated with psychotherapies and video services.

Compared with non-Indigenous Australians, Indigenous Australians were less likely to use telehealth services, particularly for video services and psychotherapies, more likely to rely on general practitioner-delivered services and phone consultations. These patterns suggest systemic and cultural barriers, including cost, service availability, and preferences. Tailored telehealth interventions are needed to address these disparities and promote equitable utilisation.