Temporomandibular disorders (TMD), psychological distress, and sleep disturbances are common and frequently co-occur in children and adolescents. However, the patterns and nature of their interrelationships-including potential underlying mechanisms-remain systematically underexplored in this age group.

To synthesize the evidence on the associations among TMD, psychological distress, and sleep disturbances in children and adolescents, and to explore potential interacting mechanisms described in the literature.

We systematically searched PubMed, CNKI, Wanfang, Medline, CINAHL, Cochrane, Web of Science, and Scopus for observational studies between January 2010 and December 15, 2025, that investigated associations among TMD, sleep quality, and mental health in children and adolescents. We included studies reporting on at least two of the three conditions and assessed methodological quality using established critical appraisal tools.

We included 17 studies (16 cross-sectional, 1 case-control), which reported intricate associations among TMD, psychological distress, and sleep disturbances. Anxiety and depression were the most prevalent psychological comorbidities, while poor sleep quality and sleep bruxism were the most frequently reported sleep disturbances. These associations were particularly pronounced in painful TMD subtypes, and their strength was influenced by sex (stronger effects in females), age, and developmental context.

This systematic review summarizes consistent associations among TMD, psychological distress, and sleep disturbances in children and adolescents. The available evidence supports the hypothesis that psychological factors may be involved in the observed association between TMD and sleep disturbances, but this requires confirmation through longitudinal mediation analyses. Given the predominantly cross‑sectional design of the available studies, causal conclusions cannot be drawn. From a clinical perspective, an integrated, multidisciplinary approach addressing all three domains may be beneficial, and future longitudinal research is needed.

The study was registered in the International Database of Prospectively Registered Systematic Reviews (PROSPERO): CRD420251218752.

Not applicable.

To assess the mental nerve's functional integrity after parasymphyseal mandibular fracture fixation using three different miniplates configurations.

A total of 36 patients with unilateral parasymphyseal fractures were included in the study. Patients were randomly allocated into three groups based on the fixation modality configuration. Clinical evaluations were carried out in conjunction with radiographic assessments of mean bone density at the fracture line. Electrophysiological objective nerve testing was conducted 1 month postoperatively to assess the amplitude, onset latency, and conduction velocity of the mental nerve.

Physiological nerve testing intergroup analysis demonstrated no statistically significant differences in latency or amplitude, while conduction velocity showed a trend toward intergroup variation without reaching statistical significance (P = 0.072). Comparing the degree of agreement of nerve conduction parameters between the affected ipsilateral and healthy contralateral sides reported high levels of ICCs for all 3 miniplates configurations. Radiographic analysis revealed significantly greater bone density at the fracture site in the 3D-Interlocking group compared with twin fork and conventional miniplates (P < 0.001).

Fixation of parasymphyseal mandibular fractures using 3D-Interlocking or Twin-Fork miniplates yielded a slightly enhanced mental nerve conduction profile and integrity preservation when compared to the conventional miniplate configuration. Furthermore, the 3D-Interlocking plate demonstrated improved stability and healing of the fracture line. These findings support the use of 3D-Interlocking or Twin-Fork miniplates as preferable alternatives to conventional miniplates in the mental foramen region.

Trial was retrospectively registered at clinicaltrials.gov [NCT07058597/ 2025-07-01].

Mental health disorders cause substantial patient suffering, which could be alleviated through early diagnostic biomarkers. While biomarker discovery is costly, genetic methods utilizing data from large-scale studies, such as Mendelian randomization, may provide a cost-effective approach.

A two-sample Mendelian randomization analysis was conducted to identify potential urinary biomarkers of seven psychiatric disorders using summary statistics from GWAS data.

The analysis revealed 67 analyte-disorder associations, of which 21 were exclusive to a single disorder. Notable associations were observed between tyrosine and schizophrenia (β = -0.041, SE = 0.013, Q = 0.027), creatine and bipolar disorder (β = -0.077, SE = 0.019, Q = 0.002), pyridoxal (β = 0.10, SE = 0.03, Q = 0.042) and ferulic acid 4-sulfate (β =  0.077, SE = 0.025, Q = 0.037) to anorexia nervosa, and N, N-dimethylglycine to ADHD (β = -0.39, SE = 0.11, Q = 0.008).

The results identify candidate urinary biomarkers and demonstrate the utility of genetic instruments for biomarker discovery, warranting experimental validation in independent cohorts.

Not applicable.

To explore the characteristics and influencing factors of mental health needs in patients with osteoarthritis (OA) from a preference-based perspective, and to inform the development of tailored service strategies based on their needs and preferences.

From March to June 2024, 385 patients with OA were recruited from three tertiary hospitals in Changzhou using convenience sampling. Quantitative data were collected using the Hospital Anxiety and Depression Scale (HADS) and a self-developed Mental Health Needs and Preferences Questionnaire, and analyzed using multiple linear regression. Between July and August 2024, a subset of 28 participants was purposively selected from the same sample for semi-structured interviews, and the qualitative data were analyzed thematically.

Quantitative results showed that 56.1% of patients screened positive for anxiety or depressive symptoms. The highest reported need was for disease knowledge (4.21 ± 0.63), followed by symptom control (4.05 ± 0.71), emotion/behavior management (3.85 ± 0.89), and social/occupational functioning (3.42 ± 0.95). Regarding service preferences, patients preferred an orthopedic surgeon-led mode (68.3%), personalized face-to-face consultation (76.4%), pain management content (85.7%), and outpatient support (71.9%). Multiple regression analysis identified six significant influencing factors, including age and education level (P < 0.05). Qualitative findings elaborated on these patterns, revealing four themes: Psychological burden in illness experience, The Foundation of Self-Management: Needs for Health Literacy and Symptom Control, Psychological and Social Functioning Needs, Facilitators Shaping Service Engagement and Preferences. The consistency between quantitative scores and qualitative descriptions reinforced the validity of the identified need domains.

This mixed-methods study found a high prevalence of anxiety/depressive symptoms in OA patients and identified mental health needs across four dimensions: disease knowledge, symptom control, emotion/behavior management, and social/occupational functioning. Service preferences favored surgeon-involved, personalized, and pain-focused interventions. A multidisciplinary model integrating orthopedic and mental health professionals should be developed to provide personalized services aligned with patient preferences.

This study was approved by the Ethics Committee of Changzhou Second People's Hospital (approval No. [2024]KY003-01). The trial was prospectively registered with the Chinese Clinical Trial Registry (registration number MR-32-25-004771, registered on 28 March 2023).

Depression is one of the most prevalent mental disorders globally, severely affecting individuals' emotional, cognitive, and physical functions while imposing profound socioeconomic impacts. Traditional diagnostic approaches primarily rely on clinical judgment and self-assessment scales; however, these methods carry inherent risks of misdiagnosis and missed diagnosis, necessitating more precise and efficient diagnostic tools.

This study employs a two-channel frontal EEG system for depression detection, aiming to simplify data acquisition processes and reduce costs while ensuring high classification accuracy.

Electroencephalography (EEG), as a non-invasive biosignal monitoring technique, enables real-time recording of brain electrical activity. By extracting multiple features including relative power, fuzzy entropy, and mutual information, combined with multi-scale analysis techniques, the detection accuracy for depression was further enhanced.

The study compared three traditional machine learning models with three deep learning models, among which the Gated Recurrent Unit (GRU) model demonstrated superior performance, achieving a classification accuracy of 91.02% and exhibiting strong robustness.

The aforementioned approach provides preliminary technical support for the application of EEG signals in depression detection, and represents a proof-of-concept for multi-scale feature-enhanced automated depression screening. Further validation in larger, clinically representative, and externally verified cohorts is necessary before practical deployment can be considered.

Postpartum depression is one of the most common psychological disorders among women after childbirth, with a global prevalence of approximately 10-20% and an even higher rate of 21.4% reported in China. Women undergoing cesarean section are at increased risk for postpartum depression due to perioperative pain, delayed recovery, maternal-infant separation, and psychological stress. Antenatal depression is also a major risk factor for postpartum depression, highlighting the need for effective preventive interventions in this population. Transcutaneous auricular vagus nerve stimulation (taVNS), a noninvasive neuromodulation technique, has demonstrated antidepressant and anxiolytic effects in multiple neuropsychiatric conditions. However, its preventive value in perinatal depression remains unclear.

This study is a prospective, randomized, double-blind, sham-controlled trial protocol. A total of 254 pregnant women (aged 18-45 years) with an Edinburgh Postnatal Depression Scale (EPDS) score ≥ 9 before elective cesarean section will be enrolled and randomized 1:1 into the active taVNS group or the sham taVNS group. Participants in the active taVNS group will receive electrical stimulation to the left auricular concha (20 Hz, 200 μs, 30 min per session) before anesthesia, on postoperative day 1, and on postoperative day 2. The sham taVNS group will receive identical electrode placement without electrical output. The primary outcome is the incidence of postpartum depression (EPDS ≥ 9) at 6 weeks postpartum. Secondary outcomes include changes in EPDS and anxiety scores, sleep quality, postoperative pain, and recovery parameters.

This trial aims to determine whether taVNS is an effective and safe preventive intervention for postpartum depression in cesarean women with antenatal depressive tendency. The findings will provide new evidence supporting the integration of nonpharmacological neuromodulation strategies into perinatal mental health care.

This study was registered with the Chinese Clinical Trial Registry (ChiCTR; Registration number: ChiCTR2600119584) on 28 February 2026.

Obstructive sleep apnea (OSA) is associated with decreased daytime functional outcomes and increased psychological stress. However, the specific profile of this burden, particularly in the Vietnamese population, remains understudied. This study aimed to analyze sleep-related functional outcomes and psychological stress in a population of untreated Vietnamese patients with OSA.

We conducted a cross-sectional study of 61 untreated patients with OSA (78.7% male, mean age 47.8 ± 12.9 years). Participants completed the 10-item Functional Outcomes of Sleep Questionnaire (FOSQ-10) and the 21-item Depression, Anxiety, and Stress Scale (DASS-21). Descriptive statistics, Spearman correlation coefficients, and a generalized linear model were used to assess the prevalence of symptoms and the relationship between functional and psychological domains.

The majority of the study population presented with severe OSA (mean apnea-hypopnea index [AHI], 47.5 ± 25.5 events/h). The median total score for FOSQ-10 was 16.3 (interquartile range [IQR]: 14.0-18.3). A notable finding was the high prevalence of clinically significant (moderate or higher) psychological distress, including depression, anxiety, and stress (22.9%, 54.1%, and 18.0%, respectively). Multivariate regression demonstrated that age was positively associated with FOSQ-10 general productivity but negatively associated with intimacy, whereas AHI was negatively associated with intimacy. FOSQ-10 and DASS-21 scores showed consistent negative correlations across all domains, indicating that diminished sleep-related functional quality of life correlates with elevated psychological distress.

In untreated Vietnamese patients with OSA, the prevalence of psychological discomfort, especially anxiety, is considerable and is associated with significant functional impairment. The substantial association between low functional quality of life and high levels of psychological distress shows how important it is to do thorough baseline examinations. Routine assessment for functional impairment and psychological distress should be integral components of the clinical evaluation for patients with OSA.

Hypermobile Ehlers-Danlos Syndrome (hEDS) is a connective tissue disorder that is often diagnosed after diagnostic delays due to reliance on heightened clinical suspicion. Hypermobility spectrum disorders (HSD) bridge the gap between asymptomatic joint hypermobility and hEDS. Due to overlapping features and evolving diagnostic criteria, these entities are often discussed collectively as hEDS/HSD. Patients commonly present with gastrointestinal (GI) symptoms, prompting referral for specialized care.

This review summarizes the diagnostic criteria, epidemiology, and GI manifestations of hEDS/HSD to aid gastroenterologists in recognizing common presentations and facilitating earlier diagnosis and appropriate management.

We conducted a narrative review of the GI manifestations of hEDS/HSD, including associations with disorders of gut-brain interaction (DGBIs), organic GI disease, structural abnormalities, motility disorders, postural orthostatic tachycardia syndrome (POTS), and mast cell activation syndrome (MCAS).

The strongest GI association in hEDS/HSD is with DGBIs. Evidence suggests possible associations with organic conditions, such as celiac disease and eosinophilic esophagitis, as well as structural GI abnormalities and dysmotility. In addition, hEDS/HSD is closely linked with POTS and MCAS, which may share pathophysiologic mechanisms and have synergistic effects on symptoms.

Gastroenterologists should maintain a high index of suspicion for hEDS/HSD, which can be readily screened for using the Beighton score. Earlier diagnosis may be therapeutic by reducing uncertainty related to multisystem symptoms. A multidisciplinary approach incorporating mental health, nutrition, and pain management may be required to optimize patient outcomes.

Treating insomnia with Cognitive-Behavioral Therapy for Insomnia (CBT-I) improves depression symptoms, but the underlying mechanisms remain unknown. This single-arm mechanistic trial (ClinicalTrials.gov, NCT04424407) examined fronto-limbic and sleep mechanisms of CBT-I's antidepressant response in 48 participants (64% female; age 25-60) with insomnia and depression symptoms. Participants completed functional magnetic resonance imaging (fMRI), polysomnography (PSG), and symptom assessments before and after 6 CBT-I sessions. CBT-I resulted in reduced amygdala reactivity to fearful faces (d = 0.55, p = 0.008). Depression and sleep (objective and self-reported insomnia symptoms also improved. However, fMRI-assessed fronto-limbic changes were not associated with a reduction of depressive symptom severity. Instead, reduced depressive symptoms correlated with reduced self-reported insomnia symptoms (p = 0.001, η²p = 0.19) and increased objective sleep efficiency (p = 0.04, η²p = 0.10). Notably, pre-treatment PSG-assessed sleep efficiency, but not fronto-limbic function nor insomnia symptoms, predicted reduced depressive symptoms (p = 0.007, η²p = 0.16), suggesting that lower objective sleep efficiency prior to treatment may be associated with greater antidepressant benefit from CBT-I.