Premenstrual disorders (PMDs) affect approximately one in three women of reproductive age and have a substantial impact on daily functioning and mental health. Given the challenges observed in diagnosis and clinical management, understanding whether genetic predisposition and readily assessable factors jointly mark greater symptom burden may help inform future risk-stratified monitoring and assessment.

After excluding 424 participants with missing data, we conducted a cross-sectional study of 1528 female college students from the Care of Premenstrual Emotion (COPE) cohort in China. Premenstrual symptoms and probable PMD cases were assessed with the Calendar of Premenstrual Experiences. Four psychosocial and behavioural factors, including alcohol consumption, psychological resilience, adverse childhood experiences (ACEs), and body mass index (BMI), were recorded through electronic questionnaires. The polygenic risk score (PRS) of depression was derived from trans-ancestry genome-wide association study (GWAS) summary statistics. The associations and interactions of the PRS for depression and psychosocial and behavioural factors with premenstrual symptoms and probable PMD cases were examined.

The average age of the participants was 20.1 ± 1.59 years. Positive associations were observed between the depression PRS, alcohol consumption, low psychological resilience, ACEs, and premenstrual symptoms; additionally, positive associations between low psychological resilience, ACEs, and probable PMDs were observed. The psychosocial and behavioural factor score was associated with more severe premenstrual symptoms (β = 0.49, 95% CI: 0.35-0.62, P < 0.001) and higher odds of probable PMDs (OR = 1.97, 95% CI: 1.42-2.73, P < 0.001). Specifically, compared with participants with low depression PRS and no adverse psychosocial-behavioural factors, participants with high depression PRS and alcohol consumption (β = 0.32, 95% CI: 0.14-0.51, P = 0.001), low psychological resilience (β = 0.54, 95% CI: 0.33-0.75, P < 0.001) or ACEs (β = 0.26, 95% CI: 0.08-0.43, P = 0.003) exhibited more severe premenstrual symptoms; moreover, participants with high depression PRS and ≥ 2 psychosocial-behavioural factor scores demonstrated the greatest burden of premenstrual symptoms (β = 0.59, 95% CI: 0.37-0.81, P < 0.001) and higher odds of probable PMDs (OR = 1.79, 95% CI: 1.05-3.11, P = 0.035).

If confirmed in prospective studies, a combined profile of genetic predisposition and psychosocial and behavioural factors may help identify young women who warrant closer evaluation for PMDs, and may inform future prevention-oriented studies focused on actionable exposures.

Over the past decades, the role of socioenvironmental determinants (SEDs) on shaping mental health outcomes has gained increasing attention. However, their relationship with antipsychotic and psychotropic polypharmacy (PP) remains unknown.

This systematic review aimed to synthesise evidence on the association between SEDs and PP, as well as summarising PP prevalence in patients with mental health disorders (MHDs).

A systematic search was conducted in PubMed, Web of Science, CINHAL, PsycINFO and Scopus databases. Literature was also sourced from Google, Google Scholar and the reference lists of included studies. The review included all studies reporting on sociodemographic and SEDs on psychotropic and antipsychotic PP in patients with MHDs. The prevalence rates were computed using medians and interquartile ranges (IQR), while factors associated with PP were summarised in a table.

A total of 65 findings from 57 studies were analysed, 45 examining antipsychotic PP and 20 studied psychotropic PP. The median prevalences of psychotropic and antipsychotic PP were 30.5% (IQR: 18.0-39.5) and 28.1% (IQR: 18.7-42.9), respectively. Additionally, studies targeting inpatients, patients with schizophrenia and those utilising medical records had higher median prevalence rates. Moreover, our review found that family income to poverty ratios, family adverse consequences, Childhood Opportunity Index, social deprivation and area of residence (e.g. rural, metropolitan) were reported to be significant factors of PP in patients with MHDs.

Though the reported PP prevalence estimates varied, our systematic review showed that psychotropic and antipsychotic PPs are widespread in clinical practices. Additionally, a few SEDs were reported to be significantly associated with PP in patients with MHDs. This highlights the importance of investigating these modifiable factors. Hence, further in-depth exploration of the relationships between SEDs and polypharmacy is required. Evidence generated through such studies informs population-level strategies to reduce PP, improve equity in mental healthcare, and ultimately enhance patient outcomes.

Parents of autistic children report more depression, anxiety, and caregiver strain, and poorer well-being than parents of non-autistic children. Though more research has begun to investigate how parent-specific factors may influence these outcomes, few consider cognitive factors like emotion regulation or self-inhibition. These skills may be particularly relevant given their documented benefits and associations with mental health and well-being in the general population. An important consideration when investigating the needs of parents is the interconnectedness of the family unit. Thus, methodologies that consider this shared context are essential to appropriately support resilience of parents of autistic children.

Our sample consisted of 263 different-sex parent dyads with at least one child formally diagnosed with autism spectrum disorder. Using the Actor-Partner Interdependence Model, we assessed the links between parents' emotion regulation and self-inhibition and their own and their partner's depression and anxiety symptoms, caregiver strain, and well-being. Interdependence was established using correlations given the distinguishable nature of our dyads.

Both mothers' and fathers' emotion regulation were associated with their own depression and anxiety symptoms, caregiver strain, and well-being. Stronger emotion regulation was associated with fewer mental health symptoms, less caregiver strain, and better well-being. There was only one significant association for self-inhibition: stronger self-inhibition scores in fathers were linked to better well-being. We did not observe any associations between parents' emotion regulation or self-inhibition and partner outcomes after false discovery rate correction.

Emotion regulation, and not self-inhibition, emerged as an important source of resilience for mental health and well-being of parents of autistic children. Previous work has looked to reduce caregiver strain in this population through interventions that directly and indirectly target emotion regulation. Our findings highlight the need for further research on interventions that both directly target parents' emotion regulation skills and modify environmental contexts (e.g., social support, respite care) to enhance regulatory capacity and support parental resilience. As our work was cross-sectional, future work should investigate the causal relationship between emotion regulation, mental health, and well-being in parents of autistic children.

Autism spectrum disorder (ASD) and schizophrenia spectrum disorder (SSD) both involve social-cognitive difficulties but may rely on opposite predictive mechanisms. Predictive-coding and diametrical accounts propose weak priors in ASD versus strong priors in SSD. We tested whether autistic and positive schizotypal traits differentially shape the use of social priors when interpreting ambiguous social cues. Two studies with non-clinical adults employed an adapted Animated Triangles Task (ATT) with three cueing conditions: Random-Uncued, Random-Cued, and ToM-Cued. Study 1 (n = 71) assessed behavior; Study 2 (n = 45) combined behavioral data with task-based functional magnetic resonance imaging (fMRI), including region-of-interest (ROI) and psychophysiological interaction (PPI) analyses of the temporoparietal junction (TPJ), medial prefrontal cortex (mPFC), and cerebellar Crus II. Social-attribution ratings increased across conditions, confirming the cueing manipulation. At the uncorrected level, higher positive schizotypal traits were associated with greater social attribution without cues, whereas higher autistic traits were associated with lower intention ratings despite strong cues. ToM-Cued trials activated the mentalizing network. Both trait dimensions showed exploratory associations with reduced mentalizing-network connectivity. These preliminary findings suggest potentially shared neural patterns coupled with divergent behavioral responses across the autism-psychosis trait continuum, pending further validation with larger sample sizes and adjusted statistical analyses.

Total hip replacement (THR) is common in older adults with fragility fractures. Early mobilization is a key goal, but optimizing recovery remains challenging. Identifying factors associated with postoperative standing and walking abilities can support targeted interventions.

To analyze recovery of standing and walking within 3 days after THR in older adults with femoral neck fractures, and to assess associations with age, cognitive status, body mass index (BMI), sarcopenia, and functional capacity.

This was a prospective study of 71 older adults with femoral neck fractures undergoing THR between 2021 and 2024 at a reference hospital in Brazil. Preoperative assessments included age, BMI, cognitive status (Mini-Mental State Examination), functional capacity (Modified Barthel Index), and sarcopenia (handgrip dynamometry and calf circumference). Immediate postoperative evaluations (up to the third day) included standing ability (1 minute) and ambulation capacity (≥10 steps), with patients classified as able or unable for each task. Associations between predictors and outcomes were analyzed using multivariate analysis of covariance, Kaplan-Meier curves, and receiver operating characteristic analyses.

Mean age and BMI were 75.9 years and 23.1 kg/m2; 66.2% were female. By day 3, 50.7% stood and 39.4% walked ≥10 steps. Standing ability was associated with younger age, better cognition status, and higher functional capacity, while ambulation was additionally linked to the absence of sarcopenia. Kaplan-Meier analyses showed faster recovery in participants aged <80 years, with preserved cognition, functional independence, and no sarcopenia. Receiver operating characteristic curve analysis confirmed good predictive accuracy.

Advanced age, cognitive impairment, and low prefracture functional capacity were associated with delayed recovery of standing and walking in the first 3 postoperative days. Sarcopenia showed a weaker but relevant association; BMI was not predictive. These findings highlight the value of preoperative clinical and functional factors and the need for targeted strategies to optimize early recovery.

The comorbidity of overactive bladder (OAB) and irritable bowel syndrome (IBS) presents a major clinical challenge, with the underlying neural and microbial mechanisms of the gut-bladder axis poorly understood. Here we aimed to delineate the complete causal pathway from a specific gut microorganism to bladder dysfunction and validate it as a therapeutic target. We combined analysis of human OAB-IBS cohorts with a postinflammatory mouse model, integrating retrograde neuronal tracing, multiomics (16S rDNA and metabolomics), fecal microbiota transplantation, urodynamics, dorsal root ganglion (DRG) electrophysiology and pharmacological and/or surgical interventions. We first confirmed a direct anatomical link, identifying dichotomized DRG neurons co-innervating the colon and bladder. Patients with OAB-IBS and mice exhibited a shared gut dysbiosis characterized by Akkermansia muciniphila enrichment. This comorbidity occurred in the absence of local bladder inflammation or urinary colonization with A. muciniphila, confirming a functional, noninfectious mechanism. Fecal microbiota transplantation of A. muciniphila or patient microbiota causally exacerbated visceral hypersensitivity, the OAB phenotype and DRG hyperexcitability. Mechanistically, A. muciniphila enrichment shunted host tryptophan metabolism toward the serotonin (5-HT) pathway. The resulting excess 5-HT acted on specifically upregulated colonic 5-HT_3a receptors to drive neuronal sensitization. Crucially, pharmacological blockade of the colonic 5-HT_3a receptor or surgical severing of the mesenteric nerves reversed the bladder dysfunction and visceral hypersensitivity. Our findings delineate a novel pathway wherein A. muciniphila drives functional gut-bladder comorbidity by promoting a gut-derived serotonergic signal that sensitizes shared afferent neurons, establishing the gut-specific 5-HT_3a receptor as a key, druggable therapeutic target.

Psychological stress is a key driver of short-term blood pressure (BP) elevations and cardiovascular risk, yet its moment-to-moment impact in daily life remains difficult to predict. In this longitudinal observational study, we collected multimodal data from 20 adults with self-reported hypertension, including continuous wearable-derived heart rate and activity, ecological momentary assessment (EMA) stress ratings, and ambulatory BP measurements in free-living conditions. The dataset comprised 3694 EMA responses and 3812 BP measurements collected over approximately four weeks per participant (mean 24.1 ± 8.5 days). We evaluated whether participant-specific ("personalized") models outperform a single pooled population model. Two prediction tasks were examined: (i) prediction of near-term BP elevations from wearable signals and stress EMA responses and (ii) prediction of self-reported stress from wearable signals and BP. Across both tasks, personalized models consistently improved predictive performance. For BP prediction, personalized models achieved a mean AUROC of 0.803, exceeding the population model by 0.235, while for stress prediction they achieved a mean AUROC of 0.849, exceeding the population model by 0.208. These findings suggest that personalized wearable-based models can capture individual patterns of stress and BP dynamics, with direct implications for precision mental health assessment and just-in-time adaptive intervention design in future work.

With stress being causally linked to the most frequently occurring mental and physical health problems, effective coping with acute stress is essential for promoting overall well-being and building long-term stress resilience. However, most interventions aimed at improving stress regulation require extended periods of training and practice. In a previous study, we demonstrated that the Jena Safety Anchor-a brief, hypnosis-based intervention-effectively reduced subjective stress responses in a controlled laboratory setting using the Trier Social Stress Test (TSST). The present study examined whether this effect extends to everyday life. A total of 80 participants (n = 40 female) were randomly assigned to either a hypnosis group or a control group (n = 40 per group). Over the course of two weeks, all participants collected saliva samples at home to assess their cortisol awakening response (CAR), an indicator of anticipatory stress, reflecting the body's preparation for expected demands upon waking. Additionally, all participants continuously recorded their heart rate via smartwatches during the two data collection weeks. The hypnosis group received a single guided session of the Jena Safety Anchor at the end of the first week, while the control group came to the laboratory but received no intervention. CAR was measured via three saliva samples taken within one hour after waking on specified days. Morning heart rate was measured between 6 and 9 a.m. Results revealed a significant reduction in CAR and morning heart rate in the hypnosis group during the second week, following the intervention. In contrast, no change in CAR and morning heart rate was observed in the control group. These findings show that a single session of the Jena Safety Anchor can effectively reduce physiological stress anticipation in the morning. This points to its potential as a rapid, low-effort intervention for enhancing stress coping and fostering resilience. It offers a promising approach to mental health promotion that is both time-efficient and easily integrated into everyday routines.

Only recently have human postmortem brain studies of differential gene expression (DGE) associated with opioid overdose death (OOD) been published; sample sizes from these studies have been modest (N = 40-153). To increase statistical power to identify OOD-associated genes, we leveraged human prefrontal cortex RNA-seq data from four independent OOD studies and conducted a transcriptome-wide DGE meta-analysis (N = 272). Using a unified gene expression data processing and analysis framework across studies, we meta-analyzed 20, 098 genes and found 335 significant differentially expressed genes (DEGs) by OOD status (false discovery rate < 0.05). Of these, 66 DEGs were among the list of 303 genes reported as OOD-associated in prior prefrontal cortex molecular studies (e.g., genes/gene families OPRK1, NPAS4, DUSP, EGR). The remaining 269 DEGs were not previously reported (e.g., NR4A2, SYT1, HCRTR2, BDNF). There was little evidence of genetic drivers for the observed differences in gene expression between opioid addiction cases and controls. Enrichment analyses for the DEGs across molecular pathway and biological process databases highlight an interconnected set of genes and pathways linked to orexin and tyrosine kinase receptors through MEK/ERK/MAPK signaling to affect neuronal plasticity.

To evaluate the real-world impact of glucagon-like peptide-1 receptor agonists (GLP-1 RAs) on health-related quality of life (HRQoL) and metabolic outcomes in adults with type 2 diabetes and obesity.

We conducted a multicenter prospective cohort study across 13 primary-care centers in Spain. Adults with type 2 diabetes and body mass index (BMI) > 30 kg/m² initiating a GLP-1 RA were followed for 44 weeks. Baseline and week-44 assessments included anthropometric and biochemical parameters and HRQoL measured using the EQ-5D index and visual analogue scale (VAS), and the SF-12 physical and mental component summaries (PCS/MCS). Changes were analyzed using paired statistical tests overall and by achievement of ≥5% weight loss.

Among 135 patients, significant improvements were observed in glucose, HbA1c, LDL-C, waist circumference, body weight, and BMI. HRQoL improved in EQ-5D domains including mobility, pain/discomfort, and anxiety/depression. The EQ-5D index increased from 0.71 to 0.79 (P < 0.001), and VAS from 58.3 to 65.3 (P = 0.007). SF-12 PCS improved significantly, whereas MCS showed no overall change. Patients achieving ≥5% weight loss experienced greater improvements in EQ-5D index, VAS, and PCS. Subcutaneous and oral semaglutide improved the EQ-5D index; oral semaglutide improved VAS and MCS; and subcutaneous semaglutide improved PCS.

In routine clinical practice, GLP-1 RAs were associated with clinically meaningful improvements in HRQoL and metabolic outcomes, particularly when ≥5% weight loss is achieved, supporting the integration of patient-reported outcomes into diabetes and obesity management. TRIAL REGISTRATION CLINICALTRIALS.

NCT05136287.