Older adults are disproportionately affected by suicide, yet suicidal ideation in this population remains underexplored. This study examines gender-specific risk factors and regional differences in late-life suicidal ideation across Nordic and Visegrad countries, with loneliness as a key social determinant. This study analysed data from 11,712 participants aged 50 years and older from seven European countries (Nordic and Visegrad regions), drawing on Wave 8 of the Survey of Health, Ageing and Retirement in Europe (SHARE). Logistic regression was used to examine gender- and region-specific associations with late-life suicidal ideation. Increased loneliness was strongly associated with higher odds of suicidal thoughts in both men and women. Higher education acts as a protective factor, with middle and high education reducing risk in men, and high education reducing risk in women. Living with a partner lowers suicidal thoughts for women but not for men. Age showed no consistent association, and Nordic men show a lower risk compared to their Visegrad counterparts, whereas no regional differences observed for women. Social and contextual factors, especially loneliness, education, and partnership, shape late-life suicidal ideation in gender- and region-specific ways, highlighting the need for targeted preventive interventions.

Migraine is a primary headache disorder wherein vascular changes are well known. We aimed to evaluate the retinal and choroidal parameters in migraine patients longitudinally, with a particular focus on treatment-related changes.

We conducted a prospective longitudinal study of 45 patients with migraine (ICHD-3 criteria) who were indicated for prophylactic treatment. The patients were evaluated clinically using the visual analogue scale (VAS), monthly migraine days (MMD), migraine disability assessment score (MIDAS), and Optical Coherence Tomography (OCT) at baseline and after 3 months of follow-up. The peripapillary retinal nerve fibre layer (PPRNFL), peripapillary choroid thickness (PPCHT), subfoveal choroid thickness (SFC), ganglion cell layer (GCL), and central macular thickness (CMT) were the parameters assessed using OCT. 45 age- and gender-matched healthy controls were recruited for comparison of baseline parameters.

The majority of patients (38/45) were females, and the mean age was 37.3 ± 10.0 years. The PPRNFL, PPCHT, SFC LE, GCL, and CMT were thinner in patients than in controls. All parameters, except the GCL and CMT, increased significantly during follow-up after 3 months of prophylactic treatment.

This longitudinal study demonstrated partial structural recovery, suggesting that some retinal and choroidal changes in migraine may be reversible. Our findings support the role of these OCT parameters as surrogate markers of disease burden and treatment response in migraine. Large-scale, multicentre prospective studies with longer follow-up are warranted to evaluate the prognostic utility of OCT parameters in migraine.

The Internet holds potential for alleviating cognitive decline through cognitive stimulation and social engagement. However, existing studies often overlook the crucial role of Internet access as the foundational layer of the digital divide. This study investigated the association between Internet access and cognitive function among middle-aged and older adults and examined age-specific differences in this relationship. Data were drawn from the 2015 and 2018 waves of the China Health and Retirement Longitudinal Study (CHARLS). Participants aged ≥ 50 years with complete follow-up cognitive assessments were included (n = 7721; mean age = 60.48, SD = 9.37; male, 56.1%). Lagged dependent variable models were used to evaluate associations between Internet access and cognitive function. Chain mediation analyses were used to test whether family connection mediated this association. Internet access was significantly associated with better cognitive outcomes over time. Participants with Internet access demonstrated greater significant improvements in episodic memory (β = 0.29,95%CI = 0.14-0.44) and mental status (β = 0.28,95%CI = 0.12-0.44) compared to those without access. Age-stratified models indicated stronger effects in adults aged 50-59 for episodic memory (β = 0.36,95%CI = 0.17-0.55) and aged 60-69 for mental status (β = 0.42,95%CI = 0.15-0.69). Chain mediation analyses revealed that Internet access enhanced family connection, thereby contributing to better cognitive function. Internet access is positively associated with cognitive function in mid- to later life, partly through strengthened family ties. These findings underscore the importance of digital inclusion policies to support cognitive health and promote healthy aging.

Sleep-related eating disorder (SRED) is a parasomnia characterized by involuntary nocturnal eating with amnesia, which can result in serious injuries, weight gain, and metabolic complications. Reports implicate the use of ultra-short-acting benzodiazepine receptor agonists (USBZRAs)-especially zolpidem-in SRED, but the magnitude of this risk in psychiatric patients remains unclear.

We performed a cross-sectional observational survey at two Japanese hospitals of 157 psychiatric outpatients receiving one of four USBZRAs (triazolam, zopiclone, zolpidem, or eszopiclone) for ≥7 days. High-dose USBZRA therapy was defined as the maximum recommended dose per package insert. SRED was assessed using an International Classification of Sleep Disorders-based checklist. A Firth bias-reduced logistic regression model with four prespecified clinically relevant variables was employed due to the limited number of events.

Fourteen patients met SRED criteria (8.9%; 95% CI, 4.9-14.4). Zolpidem use (adjusted odds ratio [aOR] 5.98; 95% CI, 1.57-33.58) and high-dose USBZRA therapy (aOR 4.87; 95% CI, 1.56-17.51) were independently associated with SRED. Age (aOR 0.98; 95% CI, 0.94-1.02) and female sex (aOR 0.75; 95% CI, 0.22-2.87) were not significant.

The observed prevalence aligns with earlier reports, confirming that nearly one in eleven psychiatric outpatients receiving USBZRAs experiences SRED. Our study extends prior work by showing that SRED risk is highest at the maximum recommended dose, and especially with zolpidem. The wide confidence intervals reflect the small number of events and should be interpreted as hypothesis generating rather than definitive. These findings support limiting USBZRA dosage, favoring lower-risk hypnotics, and actively screening for nocturnal eating. This pilot study warrants validation in larger cohorts.

Cognitive impairments are common in depression and often persist beyond mood resolution. However, the relationship between cognitive performance, its neurological underpinnings, and future depression risk is unclear, limiting strategies for primary and secondary prevention.

Our objective was to determine whether cognition associates with subsequent depression, both relapse and first-episode occurrences.

1862 UK Biobank participants with a history of International Classification of Diseases (ICD)-10-defined depression in remission (RD) (mean (SD) age: 52.7 (7.13) years) were age-matched and sex-matched to 1862 participants without depression history or current antidepressant use. Cognitive scores were compared between groups at the composite (z-score), domain and task levels. MRI-derived phenotypes assessed brain network structure and functional connectivity. Longitudinal associations with future depression were assessed using logistic regression models and a Cox proportional hazards model controlling for key confounders.

Participants with RD had a higher risk of future depression (33%) than controls (13%), including when we accounted for temporal differences in longitudinal assessment (HR=3.16 (95% CI 2.71 to 3.67), global proportional hazard assumption p=0.07). Composite cognitive performance in controls was inversely associated with future depression risk (risk estimated marginal means: 0.25% at -1SD, 0.20% at mean, 0.15% at +1 SD). In RD, this relationship was reversed (0.74% at -1SD, 0.90% at mean, 1.10% at +1 SD). Executive functioning, processing speed and reasoning task scores all contributed. Higher grey matter in default mode network regions was associated with better concurrent cognitive performance across all participants, but not with future depression risk. Other MRI findings were limited.

RD carried a threefold higher risk of future depression than controls. Cognitive performance was a risk marker for future depression in both groups but in opposing directions. Neuroimaging metrics provided little predictive value.

Personalised risk factor assessment for depression is likely to be dependent on depression history. Those without previous history of diagnosed depression are at higher risk of future depression when cognitive performance is lower at baseline. RD is a high-risk group for future depression, and those with relatively higher cognitive performance may be more likely to report future depressive symptoms.

This study aimed to evaluate the effects of Pilates-based tele-exercise (PBTE) on physical and mental health in women diagnosed with primary dysmenorrhea.

The study included 22 volunteers diagnosed with primary dysmenorrhea, who were randomly assigned to two groups. The intervention group (PBTE, n = 11) participated in Pilates-based tele-exercises for 6 weeks, twice a week, with 50-min sessions. The control group (CG, n = 11) received no intervention. Menstrual-related symptoms were evaluated using the Menstrual Symptom Questionnaire (MSQ), the Menstrual Attitude Questionnaire (MAQ), and the Functional and Emotional Dysmenorrhea Scale (FEDS).

The total MSQ score and all subdimensions in the PBTE group decreased significantly following the intervention (p < 0.05). The MAQ subdimensions, including "menstruation as a bothersome phenomenon" and "menstruation as a natural phenomenon," along with the total MAQ score, showed significant intra-group improvements in the PBTE group (p < 0.05). The FEDS total score also significantly decreased in the PBTE group (p < 0.05).

The findings demonstrate that Pilates-based tele-exercises significantly enhance the overall health and well-being of women with primary dysmenorrhea. This is achieved through improved menstrual symptoms and positive changes in attitudes toward menstruation. These results suggest that PBTE could be an effective non-pharmacological approach to managing primary dysmenorrhea.

Potentially inappropriate prescriptions (PIPs) in older adults, such as long-term use of benzodiazepines, proton pump inhibitors without indication or antipsychotics in dementia, are associated with adverse events and increased healthcare utilisation. Despite clinical guidelines discouraging their use, PIPs remain frequent in primary care. An audit and feedback (A&F) intervention of PIPs to general practitioners (GPs), led by pharmacists, may reduce the prescription of PIPs in primary care.

A two-arm, pragmatic, controlled trial will be conducted to evaluate the effectiveness of an A&F-based intervention and a pharmacist-led intervention to reduce the proportion of patients aged ≥65 years receiving inappropriate prescriptions. A total of 170 participating GPs, 85 per group, are required. GPs will be randomised into intervention or control groups (1:1). The intervention includes feedback reports, pharmacist-led academic detailing and access to online training modules. The primary outcome is the proportion of older adults receiving at least one PIP at 12 months as well as the total number of PIPs. A random effects Tobit regression model, censored at 0 and 100, will be used to estimate between-group differences adjusted for baseline prescribing. Subgroup analyses will explore heterogeneity of effect by baseline prescribing level and healthcare region. Implementation outcomes, including reach, fidelity, engagement and maintenance, will be evaluated using the Reach, Effectiveness, Adoption, Implementation and Maintenance framework, combining quantitative and qualitative data.

Ethical approval was obtained by the Balearic Island Committee Ethics (IB5219/23PI). Study findings, including primary and secondary outcomes and qualitative implementation results, will be disseminated through peer-reviewed publications and stakeholder reports.

ISRCTN14449434.

Rates of mental health difficulties among girls and young women in the UK have risen sharply, and disproportionately so for those from marginalised groups. My Story and Me is a new digital public mental health intervention that uses storytelling to reduce stigma, increase awareness and support early help-seeking among girls and young women aged 14-18. The feasibility study aims to determine the acceptability of the intervention and future full trial, including assessing optimal settings and meaningful changes in the primary outcome measure (anxiety and depression).

This is an 18-month mixed-methods, uncontrolled feasibility study conducted in secondary schools, further education colleges and community organisations across the UK. We will recruit 120-180 participants. Quantitative data will be collected at baseline and 7-month follow-up. The primary outcomes are anxiety and depression, and secondary outcomes are social support, mentalising, stigma, quality of life, loneliness, empowerment, intervention acceptability, resource use and randomisation acceptability. Platform-level engagement data will assess adherence and fidelity. Qualitative interviews with young women and staff will explore acceptability, feasibility, mechanisms of change and views on trial procedures, including randomisation in a future full trial. Analysis will be descriptive and exploratory, including comparisons across settings and priority groups (LGBTQIA+, neurodivergent and those experiencing digital poverty). A framework and reflexive thematic analysis approach will be used for qualitative data. Prespecified progression criteria will inform decisions about advancing to a full cluster randomised trial.

The University College London Research Ethics Committee (0692) has approved the My Story and Me protocol. Interested participants will be required to complete an expression of interest and consent form to take part in the study, and young people under 16 years old will be required to obtain parent/carer informed consent. Results will be disseminated through peer-reviewed publications, lived experience summaries, a policy briefing and academic conference presentations.

ISRCTN12191423.

More than one billion people are affected by a mental disorder according to the World Health Organization (WHO). In this context, information coverage of mental health is one of the great challenges for the media in a scenario marked by misinformation and digital noise. This work, from a transversal descriptive methodological approach, has analysed the news related to mental health in the main digital media of 20 Latin American countries. The study identifies that depression, anxiety, stress, suicide, substances and addictions, and neurocognitive disorders are the disorders with the greatest presence in news coverage. Furthermore, the work detects a moderate relationship between the variable's 'disorder' and 'relationship with violence'. On the other hand, only 25% of the information analysed raised recovery processes as a significant topic in the writing. The work also highlights that messages with interviews with experts or citations to medical studies contribute to more positive approaches in mental health coverage.

This article analyzes the management of Federal expenditure on mental health between 2001 and 2022, reflecting on how this management denies and reaffirms the principles of Brazilian Psychiatric Reform. It involves research, based on publicly accessible data available on Ministry of Health databases, i.e. the I.T. Department of the SUS, the Integrated Public Health Budget System, and the Electronic System of the Citizen Information Service between 2001 (when Law No. 10,216 was enacted) and 2022 (the last year of the Bolsonaro government). Federal spending on mental health, in relation to total spending on health services, fell in the five years, from an average of 2% to 1.7%. Out-of-hospital expenditure on mental health reached 80%, and funding for Brazil's community-based psychosocial care centers (CAPS) increased but saw a reduction in spending on other areas. The management of federal spending reveals the progress, limitations, and setbacks in Brazilian Psychiatric Reform, especially in redirecting resources to institutionalizing healthcare actions, and making mental health expenditure "invisible" within the health budget, which makes the social control of policy application difficult.