Perfectionism has a well-established relation with mental health concerns, notably depression and suicidal ideation (SI) severity. Previous research has also shown perfectionism is associated with diminished treatment gains; however, nearly all analyses on this topic are derived from a single dataset at the outpatient level. Our aim was to examine whether perfectionism and its dimensions, as assessed by the Big Three Perfectionism Scale-Short Form (BTPS-SF), are associated with improvements in depression and SI symptom severity during a transdiagnostic partial hospital program (PHP). We analyzed perfectionism scores at baseline and depression and SI scores at baseline and discharge from N = 738 adult patients attending a PHP. The total perfectionism score, and the self-critical and rigid perfectionism dimensions, were significantly associated with baseline depression and SI scores. The total perfectionism score, and the self-critical perfectionism dimension, were significantly associated with diminished treatment gains in depression and SI symptom severity from baseline to discharge. Our results suggest that perfectionism is associated with the baseline severity of psychopathology, specifically depression and SI severity, and may inhibit therapeutic gains. This study expands the existing literature on perfectionism's deleterious relation with psychopathology and treatment effectiveness to more acute levels of care. Clinicians may wish to consider screening for perfectionism and potentially addressing it as a target of treatment.

Social anxiety and related mental health problems in secondary school students require urgent attention. Workshop interventions are particularly suited for school settings, as they can be delivered in a single day and accommodate large groups of participants. This study examined the effects of a 1-day workshop, grounded in cognitive behavioral therapy (CBT), on outcomes such as social anxiety among secondary school students. A total of 89 secondary school students participated in the study, with 44 assigned to the intervention group and 45 to a wait-list control group. The effects of group (intervention vs. wait-list control) and time (pre-intervention T1, post-intervention T2, and 1-month follow-up T3) on social anxiety symptoms, negative emotional symptoms, social anxiety knowledge, attitudes toward professional help-seeking, social anxiety stigma, and fear of negative evaluation were analyzed using linear mixed models. Compared to the control group, the intervention group demonstrated significant improvements in social anxiety symptoms, negative emotional symptoms, social anxiety knowledge, and professional help-seeking attitudes. At the 1-month follow-up, social anxiety knowledge had the largest effect size (d = 1.00), and social anxiety symptoms, negative emotional symptoms, and professional help-seeking attitudes had medium effect sizes (d = 0.45-0.64). The CBT-based workshop enhanced social anxiety knowledge and attitudes toward seeking professional help among secondary students, and these effects persisted at the 1-month follow-up. Furthermore, the workshop reduced secondary students' social anxiety and negative emotions-a change that, although not as rapid as immediately after the intervention, was significant at the 1-month mark.

Group metacognitive therapy (MCT) for anxiety and depression has been shown to be effective, but access could be increased if delivered via telehealth. This pilot study compared outcomes for individuals with anxiety disorders and depression who received group MCT via telehealth (N = 23) to historical controls that received face-to-face (F2F) MCT (N = 52). Patients received six weekly, 2-hour group sessions plus a 1-month follow-up of MCT in a community mental health clinic and completed measures of repetitive negative thinking (RNT), metacognitive beliefs (positive and negative), and symptoms (anxiety, depression) at pretreatment, posttreatment, and follow-up. Group MCT via telehealth achieved medium to very large effects on all outcomes to posttreatment and follow-up. The telehealth and F2F MCT groups did not significantly differ on any demographic or clinical variable at pretreatment. Between-group effect sizes, rates of reliable and clinically significant change, and participant evaluations of treatment acceptability and satisfaction were similar for the two modes of delivery at posttreatment and/or follow-up. Overall, these preliminary findings indicate that telehealth-delivered group MCT is a promising transdiagnostic intervention for anxiety disorders and depression.

This review considers the available research testing the efficacy of self-guided psychotherapeutic interventions in the management of affective premenstrual disorder (PMD) symptoms.

Recent research confirms that clinician-guided internet-delivered cognitive behavior therapy is effective for the management of PMD symptoms. There is also mounting research suggesting that self-guided psychotherapy interventions are effective for a range of mental health conditions when featuring specific design elements aimed at enhancing engagement and learning. Self-guided psychotherapeutic interventions hold promise for the treatment of PMD symptoms. Integrating such interventions within existing menstrual cycle tracking mobile applications may increase access to affordable and effective mental healthcare. Further research in this area is warranted.

Research indicates high prevalence rates of adverse experiences in people experiencing first-episode psychosis. Despite recommendations that mental health staff should routinely ask about adverse experiences, documentation indicates these are not being recorded in service-users' clinical records across different mental health settings. This study audited 48 service-user records in a UK early intervention in psychosis (EIP) community mental health service to examine how often, where, and by whom adverse experiences were recorded. Searching for 22 adverse experience terms, 64.6% of clinical records documented at least one adverse experience, with 80.6% reporting more than one. The profession that most often recorded adverse experiences in service-users' clinical records was psychiatrists. While EIP services may document adverse experiences more frequently than other community mental health settings, recorded rates remain lower than expected based on previous research prevalence rates. Further studies should consider adverse experiences recording across UK EIP services to ensure service-users with adverse experiences receive appropriate support.

Clozapine, a highly effective antipsychotic medication, is associated with rare but potentially life-threatening neutropenia. In February 2025, the US Food and Drug Administration (FDA) eliminated its clozapine Risk Evaluation and Mitigation Strategies (REMS) program, which required documented absolute neutrophil count (ANC) lab results prior to clozapine dispensation. Considering the FDA decision, the purpose of this study was to examine the prevalence and patient-level factors associated with clozapine-associated neutropenia in a large, diverse, US-based integrated health system.

This was a retrospective cohort study of adult Kaiser Permanente Northern California members who initiated clozapine therapy between January 2021 and December 2022. Data were extracted from KPNC's electronic health record, including sociodemographic and clinical characteristics, medication fills, and ANC values. The main outcome was any neutropenic event within two years of clozapine initiation, classified as mild (ANC = 1000-1499/μL) or severe (ANC < 1000/μL).

Among 402 patients, 10 (2.5%) experienced neutropenia within 24 months of starting clozapine. Eight cases were mild, and two were severe, with one resulting in death. Race differed significantly between those who experienced neutropenia and those who did not (p = 0.038). The mean clozapine dose at the time of neutropenia was 192.5 mg, with significant differences between mild and severe cases (p = 0.015). Logistic regression analyses showed no significant associations between neutropenia and patient-level sociodemographic or clinical characteristics.

Clozapine-related neutropenia was rare and typically transient, but it can be life-threatening. Continued adherence to the manufacturer's recommendations for ANC monitoring is warranted to ensure patient safety.

Intensive care unit (ICU) admissions are highly stressful for both patients and their relatives. Many patients develop post-intensive care syndrome (PICS), which includes physical, mental, cognitive and social impairments complicating recovery. Relatives involved in the critical illness trajectory may develop PICS-family (PICS-F). Despite healthcare support, relatives continue to experience stress. Understanding their experiences is essential to improve family-centred care during and after ICU.

The aim of this study was to explore relatives' experiences of being a relative throughout the pathway from the ICU to home.

This qualitative study employed a phenomenological-hermeneutic approach inspired by Ricoeur. We conducted semi-structured interviews with 15 relatives during the ICU stay and at three- and six-month follow-ups. The Consolidated Criteria for Reporting Qualitative Research checklist was applied.

Three themes emerged: (1) Relatives during the ICU-living in two worlds with fear of missing out: Relatives felt torn between hospital and home, overwhelmed by stress and fear of missing crucial moments; (2) Relatives in transitions-a new stage marked by uncertainty: The relatives assumed major responsibilities with limited information; and (3) Returning home-a prolonged, seemingly never-ending journey: Caregiving continued as the relatives adapted to a changed everyday life. Across all phases, relatives described a heavy burden, vulnerability and emotional strain.

Relatives navigate two demanding worlds-the high-stress ICU environment and home-resulting in exhaustion, stress and isolation. Transitioning home brings uncertainty, as caregiving roles expand with little support. Structured, long-term support and family-centred care are essential to reduce anxiety and improve outcomes for patients and relatives.

Relatives require structured, continuous support and clear communication throughout ICU recovery. Future research should develop strategies to reduce the burden of PICS-F and enhance family post-ICU support.

It was registered with the legal office of the Central Denmark Region (file no. 1-16-02-286-21).

BACKGROUND This meta-analysis aimed to identify risk factors for suicide attempts (SA) in patients with depression to inform clinical practice. MATERIAL AND METHODS We searched multiple databases up to January 1, 2025, including MEDLINE and Embase. Case-control and cohort studies reporting risk factors for SA in patients with depression were included. Study quality was assessed using the Newcastle-Ottawa Scale (NOS), and meta-analyses were performed using Rev Man 5.4 software. Results are expressed as odds ratios (OR) and 95% confidence intervals (CI). Heterogeneity was assessed using I² and P values, and publication bias was evaluated using funnel plots and Egger's test. The registration information was deposited in the International Register of Systematic Reviews and Meta-Analyses (PROSPERO) trial registry (CRD420251061401; Retrospective registration). RESULTS  Out of a total of 3792 records, 22 case-control studies were included. The overall heterogeneity (I2) ranged from 0% to 91.9%. Significant risk factors for SA included suicidal ideation (OR=4.98, 95% CI 3.21-7.22), previous hospitalizations (OR=1.38, 95% CI 1.18-1.61), family history of suicide (OR=2.59, 95% CI 1.89-3.57), psychotic symptoms (OR=2.77, 95% CI 1.98-3.88), frequent depressive episodes (OR=2.58, 95% CI 1.58-4.22), self-blame (OR=2.43, 95% CI 1.78-3.31), negative life events (OR=3.77, 95% CI 2.85-5.51), and delusion (OR=3.14, 95% CI 1.99-4.96). Publication bias was detected for family history of suicide and suicidal ideation, but OR values remained significant after correction. CONCLUSIONS Our findings highlight the need for comprehensive risk assessments and targeted interventions in clinical practice to prevent suicide attempts in patients with depression. Future research should explore the mechanisms and interactions of these risk factors to refine prevention strategies.

Healthcare-seeking behavior plays a crucial role in early diagnosis and effective treatment. In conflict-affected low-income communities like Sudan, factors affecting healthcare-seeking behavior and the rationale for engaging in self-medication practices can vary tremendously in comparison to stable communities. Responsibilities placed upon medical students who faced displacement are substantial within their host communities. This study aims to explore the role of armed conflict and the displacement crisis in reshaping the factors affecting the healthcare-seeking behavior and self-medication practices of medical students in Sudan. A Quantitative cross-sectional study was conducted targeting displaced medical students enrolled in different public and private universities across Sudan. Data were collected using structured questionnaires that assessed participant's social data, health awareness and help-seeking behavior, preference for health facilities and self-diagnosing and self-medication practices. Among the 2410 participants, most were females (64%) and over 21 year old (72.4%), 66.7% understood health as multidimensional, yet only 12.1% prioritize social well-being. Self-medication practices was reported by 36.6% of participants, particularly with antibiotics, vitamins and NSAIDS. Older students ≥21, males and those in advanced academic years were more likely to practice self-diagnosing and self-medication. Higher academic years (odds ratio [OR] for fourth year = 1.94) and Urban residency (OR = 1.28) were more associated with positive health attitudes. Private university students were less likely to seek care from their own college hospitals (OR = 0.78). Repeated displacement was linked to poorer attitudes toward health realization (OR = 0.62) and reduced trust in their own health facilities (OR = 0.58). The study showed low awareness of mental and social health and a high prevalence of self-medication among Sudanese medical students, especially analgesics and vitamins. Health education campaigns and empowerment of health infrastructure can help to improve access to healthcare services.