Understanding the relationship between health beliefs and other variables, such as physical and mental fatigue, is extremely important for the implementation of a patient-centered therapeutic approach. The main purpose of this study was to investigate the physical and mental fatigue and health beliefs of patients with cardiorespiratory problems.

The sample consisted of 100 patients with cardiorespiratory problems, and the research was conducted at the General Hospital of Argolis, using a questionnaire. The distribution of the questionnaires took place during the period October 2024 - November 2024, and the statistical analysis was performed with the SPSSv24 program.

On average, patients with cardiorespiratory problems who participated in this study presented moderate levels of physical fatigue, very low levels of mental fatigue, fairly high levels of internal health control, low levels of attribution of health control to chance, extremely high levels of attribution of health control to physicians, and moderate levels of attribution of health control to significant others. Various demographic characteristics, such as age, educational level, type of employment, and length of time of treatment of various cardiorespiratory problems, but not the type and number of cardiorespiratory problems, seemed to have a significant effect.

Physical, mental, and overall fatigue were significantly and negatively correlated with internal control, attributing health control to chance, and attributing health control to physicians.

Sociodemographic and clinical factors are associated with fatigue and health locus of control in Greek patients suffering from cardiorespiratory problems.

To evaluate the validity of the six-factor model of the Positive and Negative Syndrome Scale (PANSS) using network analysis and to examine the relationships between depression, anxiety, and symptoms associated with schizophrenia.

The study included a cohort of 150 inpatients diagnosed with schizophrenia. The severity of psychopathological symptoms was assessed using the PANSS based on a six-factor model. The study also utilized the Hamilton Depression Rating Scale (HDRS) and the Hamilton Anxiety Rating Scale (HARS). Network analysis was performed using the R statnet package.

The findings revealed that the highest centrality rates were attributed to the disorganized, negative, and excitation factors within the PANSS scale. Anxiety scores derived from HARS were found to be significantly associated with G16 (active social avoidance), G6 (depression), N2 (emotional withdrawal), and G3 (guilt feelings), which correspond to elements within the negative, depressive, and disorganized factors. In addition, HDRS depression scores demonstrated associations with G6 and N2, representing the depressive and negative factors. A correlation was also observed between the scores from both assessment scales.

The network analysis indicated that depressive symptoms evaluated through the HDRS, alongside anxiety symptoms assessed via HARS, hold substantial significance among the psychopathological presentations observed in patients with schizophrenia. These symptoms exhibit a close interrelationship with components of the negative, depressive, and disorganized factors as identified within the PANSS model. In addition, the analysis substantiated the validity of the PANSS six-factor model.

The reduction in sex hormone levels during the menopausal period substantially impacts patients' quality of life and serves as a significant risk factor for psycho-emotional disorders. Current clinical guidelines from both Russian and international sources recognize menopausal hormone therapy (MHT) as the primary method for addressing menopausal disorders. However, selecting dosage forms tailored to the patient's comorbidities and overall health status is essential. In 2026, the Russian Association of Obstetricians and Gynecologists, the Interdisciplinary Association of Specialists in Healthy Aging and Anti-Aging Medicine, and the Russian Society for the Study of Headache established an interdisciplinary council to implement an integrated approach to the management of peri- and postmenopausal women with psycho-emotional and neurological disorders. The objectives of the expert council included discussing contemporary management strategies for peri- and postmenopausal women and optimizing the application of MHT in complex clinical cases. Additionally, the council aimed to enhance scientific methodologies and devise algorithms for managing patients presenting with menopausal symptoms due to estrogen deficiency, alongside neurological and psycho-emotional disorders. The collaborative efforts of the experts culminated in a consensus document that outlines key principles for the administration of MHT to women with psycho-emotional disorders and somatic comorbidities during the peri- and postmenopausal stages.

Recent Australian and New Zealand clinical practice guidelines for schizophrenia demonstrate important methodological advances, including use of the Grading of Recommendations, Assessment, Development, and Evaluations framework and early involvement of people with lived experience. However, these guidelines remain largely silent on the role of coercion in psychiatric care, despite its prevalence and potential for harm. People diagnosed with schizophrenia experience disproportionately high rates of compulsory interventions-including community treatment orders, involuntary admission, seclusion, and restraint-many of which lack robust evidence of effectiveness. Community treatment orders, the most common form of coercion, show wide and unexplained variation in use across jurisdictions and are disproportionately applied to First Nations people, culturally and linguistically diverse populations, and individuals from socioeconomically disadvantaged areas. Evidence of effectiveness is limited, particularly in more robust controlled designs that have used matching, randomisation, or multivariate analyses to adjust for confounding, while adverse outcomes such as coercion, disempowerment, and disengagement remain under-researched. Similar concerns apply to involuntary admission and other restrictive practices, where evidence of therapeutic benefit is mixed and harms-including trauma and fear-are well documented. Despite this, the latest clinical practice guidelines devote minimal attention to these issues, with potential harms mentioned only briefly and without substantive guidance on minimising coercion. Future iterations of schizophrenia clinical practice guidelines would be strengthened by explicit appraisal of the evidence on coercive practices, systematic consideration of their harms, and incorporation of lived-experience perspectives on the use of coercion, thereby better supporting clinicians and policymakers in delivering care that balances effectiveness, safety, equity, and respect for autonomy.

Mental health problems in adolescents are increasing. Universal school-based interventions may play an important preventative role.

The aim of the Approaches for Well-being and Mental Health Literacy: Research in Education (AWARE) trial was to evaluate two universal, school-based interventions that previously yielded evidence of impact in other countries: Youth Aware of Mental Health (YAM) and The Mental Health and High School Curriculum Guide (The Guide).

AWARE was a multi-school, parallel group, cluster randomised controlled trial in English secondary schools. Schools were allocated on a 1:1:1 ratio to one of two interventions or a usual practice control group, balanced on current levels of mental health provision within schools, school location, deprivation and urbanicity. Eligible participants were pupils in schools across England in Year 9 (aged 13-14 years) at baseline. The statistician, quantitative data analyst and economist were masked. Primary outcomes were depressive symptoms measured with the Short Mood and Feelings Questionnaire for YAM and intended help-seeking, measured with the General Help Seeking Questionnaire for The Guide (both at 3-6 months).

153 schools were randomised, including 12 166 pupils (N_YAM = 4028 pupils, N_guide = 3997 pupils, N_control = 4141 pupils). We found that for YAM vs control (N = 5516) there was no improvement in depressive symptoms s.m.d. = 0.02; 95% CI -0.05 to 0.10), and for The Guide vs control (N = 5409) we found increased intended help-seeking compared with the control group (s.m.d. = 0.10; 95% CI 0.02 to 0.19). A notable minority of schools were unable to deliver YAM because of challenges in implementing it. Increased depressive symptoms scores were observed in both intervention conditions, compared with control at the longer-term follow-up.

The findings indicate that participating in The Guide is effective at improving intended help-seeking. However, due to the increases in depressive symptoms associated with each intervention at the long-term follow-up, further investigation of the potential negative impacts of these programmes is advised before further rollout in English schools.Trial registration number: ISRCTN17631228.

Tiredness is a common presentation composed of sleepiness (propensity towards sleeping) and fatigue (feelings of physiological exhaustion). Differentiating between these presentations is important for diagnosis and management. The current study reports on the development and validation of an integrated measure of tiredness (Tiredness Identification Index-TIDI) incorporating assessment of sleepiness and fatigue, and the relationship of the measure with sleep and mental health outcomes.

A sample of 6706 adult participants responded to a pool of sleepiness and fatigue items. Regularized structural equation modelling and confirmatory factor analysis were used to refine the items and factor structure based on convergence against validation measures of fatigue and sleepiness. Regression analyses were then applied to test relationships of the sleepiness and fatigue factors with sleep, mental health, and wellbeing variables.

An 8-item scale was developed, composed of a sleepiness (TIDI-sleepiness) and fatigue (TIDI-fatigue) factor with divergent and convergent validity, alongside a general tiredness factor. Higher TIDI-sleepiness was associated with increased apnoea risk and shorter sleep duration, whereas TIDI-fatigue was associated with increased insomnia and reduced sleep efficiency. Controlling for TIDI-sleepiness, TIDI-fatigue was associated with increased depression, anxiety, reduced well-being, and lower physical activity. Increased TIDI-sleepiness and TIDI-fatigue were both associated with paranoia and hallucinations.

The results indicate that the TIDI can be used as a brief scale to measure and differentiate fatigue and sleepiness, particularly in non-clinical populations and for research purposes. Assessment of its validity in discriminating fatigue and sleepiness in relevant clinical sleep, mental, and physical health populations should be a focus of future research.

Intrasacral meningoceles (IM) are a type of spinal meningeal cyst that can develop within the sacral spinal canal and cause sacral radiculopathy symptoms. The research on IM is sparse, comprised largely of case reviews lacking standardization with validated measures. However, a disease-specific health-related quality-of-life scale has been published for Tarlov cysts to measure symptoms before and after surgical treatment. The purpose of this study was to validate the Tarlov Cyst Quality-of-Life (TCQoL) survey as a disease-specific health-related quality-of-life measure for patients surgically treated for symptomatic IM.

Patients surgically treated for IM between 2016 and 2024 were included. Patients completed preoperative surveys within 2 weeks of surgery and postoperative surveys 6 months after surgery. Surveys included the Short-Form 36, the Oswestry Disability Index, a visual analog scale for pain, and the TCQoL scale. Psychometric analyses including construct validity, internal consistency, sensitivity to clinical change, and discriminative validity were performed to validate the TCQoL.

Our cohort included 81 patients. Discriminative validity was demonstrated by significant improvement in each of the 11 items and the overall scale score from preoperative to postoperative (P < .001 for all comparisons). Cronbach alpha was 0.84 for the scale, suggesting good internal consistency. Concurrent validity was established by correlating scale scores of the TCQoL with the Oswestry Disability Index r(79) = 0.68 (0.54, 0.79), P < .001 and all 8 of the Short-Form 36 subscale scores with correlations ranging from -0.19 (-0.45, -0.03) for mental health to -0.59 (-0.70, -0.40) for physical function. The minimum clinically important difference was 0.6.

We validated the TCQoL for patients surgically treated for IM. This scale can be used as a disease-specific health-related quality-of-life measure that is sensitive to measure clinical change in this population.

Depression and occupational burnout are prevalent mental health challenges in working-age populations and are linked to adverse health behaviors, with these concerns particularly relevant among individuals with obesity. Although prior research suggests associations with eating behaviors and physical activity, most studies rely on cross-sectional designs, leaving the temporal and potentially bidirectional relationships between mental health and health behaviors unclear.

This longitudinal study examined bidirectional associations between depressive and burnout symptoms, eating behavior, and physical activity among occupational health clients with obesity (N = 110; BMI 30-40 kg/m²) participating in a 12-month behavioral intervention. At baseline, the mean age was 50.8 years and mean BMI 34.2 kg/m²; 17% were male and most were white-collar workers. Assessments at baseline, 6, and 12 months included depression (BDI-21), burnout (BBI-15), eating competence (ecSI 2.0), dietary behaviors (TFEQ-R18), and physical activity (BHPAQ). A random-intercept cross-lagged panel model (RI-CLPM) was used to examine within-person longitudinal associations.

Higher depressive symptoms predicted subsequent decreases in eating competence and increases in emotional eating, although the depression-emotional eating association was derived from a traditional CLPM rather than an RI-CLPM model due to convergence issues. Elevated burnout symptoms predicted subsequent increases in emotional eating and decreases in physical activity. In addition, emotional eating predicted later burnout symptoms. No longitudinal associations were observed between depression and physical activity, or between depression or burnout and uncontrolled eating.

Elevated depressive and burnout symptoms may predispose individuals to less healthy behaviors, potentially limiting the effectiveness of health interventions. These findings highlight the interplay between mental health, eating, and physical activity, suggesting that addressing psychological distress in behavior change programs may improve outcomes for individuals with elevated depression and burnout.

gov NCT04785586; RR2-10.1016/j.conctc.2020.100638.

To analyze the multidimensional factors associated with postpartum post-traumatic stress disorder (PP-PTSD) in primiparas based on the Integrated Framework for Population Health Risk Management (IFPHRM), multiple machine learning-based predictive models were constructed and externally validated to identify high-risk individuals and to provide a robust evidence base for targeted preventive interventions.

This cross-sectional study consecutively enrolled 1, 135 primiparous women from the Department of Obstetrics at Hefei Maternal and Child Health Hospital between June 2024 and May 2025. Participants were divided chronologically into a training cohort and an independent temporal validation cohort. Women recruited from June 2024 to January 2025 were included in the training cohort (n = 794), whereas those recruited from February 2025 to May 2025 were included in the temporal validation cohort (n = 341). At six weeks postpartum, PP-PTSD symptoms were assessed using the Post-traumatic Stress Disorder Checklist-Civilian Version (PCL-C), with a score ≥38 indicating probable PP-PTSD. Multidimensional variables, including physiological and psychological factors, environmental and family-related factors, and social-behavioral factors, were collected. Candidate predictors were first screened using univariate analysis and then selected using least absolute shrinkage and selection operator (LASSO) regression. Multivariable logistic regression was used to identify independent associated factors. Seven machine learning models, including Logistic Regression, Naive Bayes, Support Vector Machine, Decision Tree, Gradient Boosting, AdaBoost, and Linear Discriminant Analysis, were constructed. Model performance was evaluated in the independent temporal validation cohort using receiver operating characteristic curves, calibration curves, decision curve analysis, and the DeLong test. SHAP analysis was used to interpret the optimal model.

Among the 794 participants in the training cohort, the incidence of PP-PTSD was 25.18%. Five key predictors were selected by LASSO regression: social support, depression, neonatal caregiving style, husband's participation, and sleep quality. Multivariable logistic regression showed that depression and poor sleep quality were associated with an increased risk of PP-PTSD, whereas higher social support, greater husband's participation, and parental assistance in neonatal care were associated with a reduced risk. Among the seven models, the Gradient Boosting model achieved the best overall performance in the temporal validation cohort, with an AUC of 0.939, F1 score of 0.700, specificity of 0.943, sensitivity of 0.651, and Youden index of 0.595. The DeLong test showed that Gradient Boosting performed significantly better than Logistic Regression. SHAP analysis further indicated that social support, husband's participation, sleep quality, and depression were the major contributors to model prediction.

Postpartum PTSD (PP-PTSD) exhibits a higher incidence among primiparous women and exerts substantial adverse effects on maternal mental health, the mother-infant relationship, and overall family functioning. Guided by the Integrated Framework of Perinatal Health Risk Management (IFPHRM), this study elucidated the multidimensional mechanisms underlying PP-PTSD, encompassing physiological and psychological factors (e.g., sleep quality and depression), environmental and occupational factors (e.g., social support, paternal involvement, and infant caregiving practices), and social behavioral factors. The Gradient Boosting prediction model demonstrated robust performance and high predictive accuracy upon independent external validation, highlighting its potential utility for risk stratification and future clinical translation. Nevertheless, multicentre validation and the development of clinically implementable tools are warranted. Collectively, this study offers a theoretical foundation and methodological framework for the early identification, targeted intervention, and long-term health management of PP-PTSD in primiparous women.

Northwest Nigeria is highly vulnerable to climate variability and heavily dependent on rain-fed agriculture, which exacerbates existing socioeconomic vulnerabilities.

This study aimed to explore the link among climate-induced stress, poverty, and mental health outcomes, particularly substance use as a maladaptive coping mechanism, in this region.

The study was conducted in Kano, Kaduna, and Katsina in Northwest Nigeria.

A cross-sectional study was conducted among 20 000 adults aged ≥ 18 years from 40 randomly selected communities. Data were collected using validated instruments: The Alcohol, Smoking and Substance Involvement Screening Test (ASSIST), the Kessler Psychological Distress Scale (K10), the Coping Strategies Inventory-Short Form (CSI-SF), and a Multidimensional Poverty Index Questionnaire. Robust statistical analyses, including multivariable logistic regression with cluster-robust standard errors, were employed.

The prevalence of high-risk substance use (ASSIST ≥ 27) was 18.5% (n = 3700). Cannabis was the most commonly misused substance (12.4%, n = 2480), followed by prescription opioids (9.1%, n = 1820) and alcohol (7.8%, n = 1560). High psychological distress (K10 ≥ 20) was identified in 45.2% (n = 9040). Over 85% (n = 17 000) were multidimensionally poor. Maladaptive coping strategies were strongly correlated with both poverty (odds ratio [OR]: 3.12, 95% confidence interval [CI]: 2.85-3.42) and high psychological distress (OR: 4.85, 95% CI: 4.48-5.25).

This study reveals a concerning syndemic of climate-related stress, profound poverty, poor mental health, and substance use in Northwest Nigeria. Associations suggest substance use may function as a maladaptive coping mechanism in the context of climate-induced economic hardship, though causal inference is limited by the cross-sectional design.

Findings underscore the critical need for integrated public health interventions that address mental health and substance use disorders within the context of climate adaptation and poverty reduction strategies.