Premature ovarian insufficiency (POI) is a harmful disease that leads to decreased fertility and osteoporosis and an increased risk of cardiovascular disease. POI seriously affects women's physical and mental health. Currently, the incidence of POI is rising; however, the etiology of most cases remains unclear, and these cases are referred to as idiopathic POI. Understanding the risk factors for idiopathic POI is beneficial for preventing and recognizing POI early on, as well as for improving treatment outcomes. This paper describes the etiology and pathogenesis of idiopathic POI from five perspectives: genetic and familial factors; environmental factors (including endocrine-disrupting chemicals, persistent organic pollutants, and heavy metals); gut microbial disorders; lifestyle factors (including smoking, diet, physical activity, and pathological sleep); and psychological and social factors. Furthermore, this review discusses the interactions among these risk factors and provides clinical prevention recommendations. This study aims to improve clinical diagnosis and treatment of idiopathic POI and women's health.

Cannabis Use Disorder (CUD) affects ~ 50 million individuals worldwide and is associated with alterations in brain reward pathways. Mindfulness-based interventions (MBIs) show promise in reducing substance use and aberrant brain function in substance use disorders (SUD), but the effects on CUD or brain reward function have not been investigated. To examine whether a 2-week MBI vs. active control (i.e., closely matched relaxation) and passive control (i.e., no intervention) affected brain reward function in CUD using the Monetary Incentive Delay fMRI task, 49 individuals with moderate-to-severe CUD were randomised to: a 2-week MBI (n = 18), active control condition (n = 15), or passive control condition (n = 16), and assessed before and after the intervention. The effect of intervention-by-time was analysed using an exploratory whole-brain approach and a priori regions-of-interest approach (ROIs; ventral striatum, dorsal caudate, putamen, insula, cingulate, and orbitofrontal cortices). Whole-brain results revealed significant intervention-by-time effects. Post-MBI, there was: decreased cerebellum activity while anticipating monetary cues, increased parietal activity while receiving monetary wins, and decreased fusiform/superior frontal gyri (SFG) activity while receiving monetary wins. Post-relaxation, activity increased in several regions (i.e., hippocampus, insula, parietal cortex, fusiform, and SFG) during the receipt of monetary wins. Post-no intervention, activity increased in the cerebellum while anticipating monetary cues, and decreased in other areas (i.e., parietal cortex, hippocampus, and insula) while receiving monetary wins. There were no significant intervention-by-time effects using the ROI approach. Overall, MBI, matched relaxation, and no intervention may share changes in partially overlapping brain regions in distinct directions.

Suicide is a serious public health crisis, and lesbian, gay, bisexual, and transgender (LGBT) adults are at particularly high risk. The present study examined risk factors for mortality by suicide and other causes in LGBT versus non-LGBT middle-aged and older adult veterans who used Veterans Affairs health care services between 2009 and 2019 (n = 834,774). We hypothesized that LGBT veterans (n = 167,676) would be at increased risk of premature mortality from suicide, overdose, and other causes of death compared with non-LGBT veterans (n = 667,774), due to minority stress as measured by proxy risk factors of health and social determinants of health. In bivariate models, LGBT veterans had significantly higher rates of death by suicide and overdose compared with non-LGBT veterans. After controlling for proxy risk factors of minority stress in multivariate analyses, the risk associated with LGBT status was nonsignificant. Sociodemographic variables (e.g., race/ethnicity, age), mental health diagnoses, substance use, and other risk factors contributed significantly to differences in risk. Findings highlight the critical importance of interventions (e.g., U.S. Department of Veterans Affairs Whole Health) for LGBT veterans to manage multiple health risk factors that contribute to mortality risk. Suicide prevention is crucial, especially for middle-aged, older adult, and LGBT veterans. Initiating targeted suicide prevention earlier in life may prevent suicide deaths. Findings also implicate subgroups of veterans who may particularly benefit from systematic improvements to health care delivery. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

This column presents a first draft of the Psychotherapy Selection Algorithm (PSA 1.0), developed by a workgroup of the American Psychoanalytic Association. The goal of PSA 1.0 is to address bias in psychotherapy selection and to reexamine treatment selection so that it is based on evidence that includes the effectiveness and efficacy of psychodynamic therapy and psychoanalysis.

Synthetic cannabinoids (SCs) are the fastest-growing class of novel psychoactive substances in Brazil, yet epidemiological data on their prevalence and correlates remain limited. This study examined differences in sociodemographic, treatment, and clinical characteristics between individuals in substance use treatment who reported SCs use and those who did not, and identified factors associated with SCs use frequency.

The study extracted data from electronic health records of all individuals who sought treatment for their alcohol and/or drug use in "HUB de Cuidados em Crack e Outras Drogas", Sao Paulo, Brazil, between June 2024 and July 2025 (N = 6,660).

A total of 1943 service users (29.17%) self-reported using SCs in the past 12 months. Of these, 28.9% initiated use before age 21, 51.7% reported polysubstance use (cocaine, crack-cocaine, and cannabis) before initiating SCs use, and 63.4% reported daily use. Compared with non-users, SC users were more likely to be younger, to have attended another treatment service in the past 12 months, and to have frequented open drug scenes (ODS). They also reported greater use of cocaine, crack-cocaine, cannabis, solvents, and methamphetamines, higher rates of polydrug use, more severe cocaine/crack addiction scores, and more frequent high or severe psychotic symptoms. Similar factors were associated with the frequency of SCs use.

The findings reveal a mixed profile of SCs users comprising individuals from ODS and younger users from other areas. It highlights the need for adaptive public health policies, enhanced surveillance, and tailored treatment approaches to address the evolving complexity of Brazil's drug landscape.

Real-world evidence on the long-term use of dupilumab in very young children with moderate-to-severe atopic dermatitis (AD) remains limited. Observational data are needed to complement clinical trial findings by describing treatment outcomes in routine clinical practice.

This multicenter retrospective study included children aged 6 months to 5 years with moderate-to-severe AD treated with dupilumab through the Italian Named Patient Program. Clinical assessments were performed at baseline and at weeks (W) 16, 24, 36, and 52. Disease severity, quality of life, and symptom burden were evaluated using the Eczema Area and Severity Index (EASI), Children's Dermatology Life Quality Index (c-DLQI), pruritus-numeric rating scale (P-NRS), and sleep-numeric rating scale (S-NRS). EASI-50/75/90 responder rates were calculated at each time point. Safety data were collected throughout treatment. Growth parameters were monitored between baseline and W52.

Forty-seven children were included. Dupilumab led to rapid and progressive improvement of AD severity, with mean EASI decreasing from 26.1 at baseline to 2.7 at W52 (-89.7%). Marked improvements were also observed in quality of life (-91.3% in c-DLQI), itch intensity (-82.5% in P-NRS), and sleep disturbance (-82.7% in S-NRS). At W52, EASI-75 and EASI-90 responses were achieved by 79.5% and 59.0% of evaluable patients, respectively. Dupilumab was well tolerated, with treatment-emergent adverse events occurring in 10.6% of patients, all mild or moderate and none leading to discontinuation. Weight- and height-for-age z-scores significantly increased over 52 weeks; no child newly developed values below -2 standard deviations, although 1 child remained below this threshold at W52. Percentile-based analyses yielded consistent results, confirming the absence of negative effects on growth.

Dupilumab was effective and well tolerated over 52 weeks in children aged 6 months to 5 years with moderate-to-severe AD, providing sustained skin clearance, symptom relief, and quality-of-life improvement. These findings support dupilumab as a valuable long-term therapeutic option in very young children with uncontrolled AD in clinical practice.

In addition to biological factors, human social behavior, societal structures, and environmental contexts significantly influence the human microbiome. This review examines how socially relevant factors relate to the microbiome to clarify underlying mechanisms and health impacts, aiming to inform effective preventive and therapeutic strategies.

We synthesized relevant literature from PubMed using a biopsychosocial framework, integrating structural socio-political and contextual factors to elucidate interactions between social behavior and the microbiota.

Social behavior shapes the microbiome through complex biological, psychological, and socio‑cultural pathways, with health consequences involving immune, mental, and metabolic functions. Future research should clarify the fundamental drivers of this relationship, identify individual differences, and employ longitudinal designs to measure sustained effects.

Depression in older adults has been associated with negative health outcomes, such as dementia. Previous research has demonstrated that green and blue spaces, defined as areas of vegetation or bodies of water respectively, are beneficial to mental health, although the biological mechanisms are poorly understood. One of the mechanisms proposed is DNA methylation (DNAm). DNAm is an epigenetic process that alters gene expression. Changes in methylation have been observed in those with depression, and associated with green space exposure, while blue spaces have been shown to reduce the risk of depression. Using a mechanistic review approach, we investigated the relationships of green space and depression with DNAm with the aim of identifying potential overlapping mechanisms. In the environmental search, keywords such as 'green space' and 'DNAm' were combined. In the mental health search, keywords such as 'DNAm' and 'depression' were combined. From a total of 45 695 papers returned, four studies on green space, and five studies on depression met the eligibility criteria for this review. All included studies reported significant or suggestively significant methylation sites. No overlapping CpG sites were identified when comparing methylation changes found in response to green space and depression. Changes in the RGS12 gene were associated with both depression and green space exposure. DNAm is a biological mechanism that may contribute to the impact of exposure to green space; further research is warranted to better understand DNAm as a mechanistic pathway between green space and depression.

The surgical options for medically refractory trigeminal neuralgia (TN) are diverse, with limited comparative evidence. This study evaluates and compares pain-free period and time to recurrence for patients who underwent microvascular decompression (MVD), gamma knife radiosurgery (GKRS), and radiofrequency ablation (RFA).

A retrospective review of patients with medically refractory TN over a 10-year period from 2009 to 2018 at a tertiary neurosurgical center was performed. Patients with at least 1 year of follow-up after the treatment procedure were included. Clinical details, radiological records, intraoperative findings, and treatment details of radiosurgery and ablative procedures were recorded.

A total of 189 patients were included, the mean age being 52.54 (± 13.3) years, with a male:female ratio of 1.52:1. The mean duration of symptoms was 70.19 (± 57.6) months, with 86.3% of patients presenting with type 1 neuralgia. The median follow-up duration was 84, 100, and 67 months for MVD, GKRS, and RFA, respectively. The percentages of patients with favorable outcomes (Barrow Neurological Institute Pain Intensity Score [BNI I-IIIa]) were 87.8, 67.3, and 66.5%, respectively, for MVD, GKRS, and RFA. The median pain-free intervals were 65, 59, and 36 months, with recurrence rates of 24.2, 25, and 40.5% for MVD, GKRS, and RFA, respectively.

This study reaffirms MVD as the best first-line treatment for medically refractory TN, with GKRS being a useful alternative in patients who are surgically unfit or unwilling, and an optimum second-line treatment for those with recurrences. RFA is useful as an adjunct in patients unfit for surgery, with a high initial efficacy albeit with high recurrence rates.

Glomus tumors are rare, slow-growing, hypervascular skull base tumors and frequently involve critical neurovascular structures. Surgical resection is technically challenging and is associated with high morbidity rates due to lower cranial nerve injury and CSF leak. Gamma knife radiosurgery (GKRS) has revolutionised the management of these lesions with high clinical and tumor control rates and a low side effect profile. In this study, we have attempted to study the tumor and clinical control rate along with the prediction factors.

This is a retrospective data review of all patients with glomus jugulare tumors from 2010 to 2023 who underwent GKRS in our center. Clinical, neuroimaging, and radiosurgical treatment were re-reviewed, and all patients' prognostic factors for clinical and tumor control were analyzed.

The study included 95 patients. The median age was 45 years, with three-fourths of our patients being female, 69 (72.6%). Hearing loss was the most common symptom. The median marginal dose at the 50% isodose line was 16 Gy. The mean tumor volume was 8.7 cc, and the mean treatment volume was 8.3 cc. The tumor control rate in our study period was 96.9%. Younger age and Glasscock-Jackson type 1 were found to be worse and a good prognostic factor, respectively. The clinical control rate in our study was 93.9%, with no related significant prognostic variable in our study.

Gamma knife is a safe and effective treatment option for these formidable tumors with a very low complication rate.