It has been hypothesized that rTMS improves cognitive performance in SCZ by altering neuronal activity through magnetic field pulses. However, these findings were controversial. The present study examined whether familial relationships impacted the effect of rTMS targeting the left DLPFC on cognitive function improvement in patients with SCZ.

A total of 84 SCZ patients were randomly allocated to the active rTMS or sham rTMS groups and received a 6-week intervention session. Patients were followed up at the end of the 24th week. Cognitive functions were evaluated at baseline and at the end of the 2nd, 6th, and 24th weeks. Patients' relationships with their family members were also evaluated.

Significant interactions of time × treatment on immediate memory and total scores were observed in patients with SCZ treated with rTMS. Active rTMS stimulation showed a beneficial effect on immediate memory in SCZ. In addition, we found that after controlling for confounding factors, patients with positive familial relationships experienced greater improvements in immediate memory after rTMS than those with negative relationships. More importantly, linear regression analysis revealed that familial relationship was a predictor of immediate memory improvement following rTMS intervention.

Our results reveal that familial relationships significantly influence the outcome of rTMS treatment in patients with SCZ. Relative to patients with negative familial relationships, those with positive relationships showed greater cognitive improvement.

ClinicalTrials.gov, NCT03774927, registered on 20,181,211.

A bidirectional relationship between obesity and depression is reported; racial and sex inequities may contribute to this relationship in low- and middle-income countries.

Cross-sectional study with data from 2019 Pesquisa Nacional de Saude (Brazilian National Health Survey), aiming to investigate the association of obesity and the intersection between depression, sex, and race/skin color in Brazilian adults (n = 87,497). Depression was investigated using the Patient Health Questionnaire-9 and obesity by the Body Mass Index (BMI ≥ 30 kg/m²). Sex and race/skin color were analyzed separately and combined: white men; white women; black men; black women. Odds Ratios (OR) were estimated using Logistic regression models adjusted by sociodemographic data. Obesity was the outcome, while depression and its intersections with sex and race/skin color were explanatory variables. Individuals without depression were the reference group in all models.

Depression prevalence was 10.8%, and obesity prevalence was 21.3%. Depression was associated with a higher chance of presenting obesity in the total population (OR:1.37; p < 0.001). Women with depression had higher chance to present obesity (OR:1.55; p < 0.001) compared to those without depression. Black individuals with depression (OR:1.37; p < 0.001) and white individuals with depression (OR:1.38; p < 0.001) had similar higher chances to present obesity. Considering the intersection between sex and race/skin color, compared to individuals without depression, black women with depression presented 59% higher chance of obesity (OR:1.59; p < 0.001), followed by white women with depression (OR:1.50; p < 0.001).

Depression was associated with an increased chance of obesity with this relationship varying by sex and race/skin color. The strongest association was observed among black women.

Suicide is a serious public health concern globally. Many suicide deaths occur in low- and-middle-income countries such as Pakistan, where the stigma related to mental health and suicidal behaviour is high, help-seeking is low, and availability of trained mental health professionals is limited. Community-based suicide prevention programmes such as suicide prevention first-aid guidelines are recognised as cost-effective approaches to strengthen the motivation of local partners within communities and lay public to act. However, there is no such evidence from Pakistan. Therefore, this study aimed to co-develop suicide prevention guidelines for gatekeepers to assist individuals in Pakistan experiencing suicidal ideation or behaviours. This will not only help to prevent or deter suicidal tendency among those experiencing suicidal thought/behaviours but also the stakeholders, especially mental health professionals.

This Delphi expert consensus study was conducted in two phases: (i) development of a semi-structured questionnaire aimed to develop suicide prevention guidelines. This involved compilation of statements from existing guidelines developed for similar context, followed by a one-day multi-disciplinary stakeholder consultation to review and contextualise each statement. The questionnaire with final statement was translated into Urdu. (ii) Phase 2 involved the Delphi process to co-produce contextually relevant consensus-based set of suicide prevention guidelines endorsed by a diverse panel of experts including expert by profession and expert by experience. Statements describing suicide prevention guideline were rated by the participants in two Delphi rounds, using in-person and online approaches.

A total of 45 experts by profession and 27 lived experience experts from across Pakistan completed both rounds of Delphi. The initial compilation from existing guidelines led to a total of 460 statements, which increased to 564 statements after stakeholder consultation, to be rated in Round-1 of the Delphi. The total number of items describing guidelines accepted at Round-1 and 2 were 478. The statements are organised into eleven thematic sections, including the identification of suicide risk and its severity, initial support for individuals at risk, communication strategies for engaging with suicidal individuals, safety planning, and confidentiality protocols. Stakeholders recommended the inclusion of context-specific guidelines, such as recognising culturally relevant warning signs (e.g., verbal or behavioral expressions of feeling unloved or being forced into an unwanted marriage), advising first responders to adopt a friendly and non-judgmental tone, and assessing the urgency of intervention based on the individual's mental health status.

The guidelines developed as result of this mixed-method research has successfully engaged stakeholder to contextualise guidelines for Pakistan such as by adding culturally appropriate examples of warning signs, methods used for self-harm and suicide, and reasons of self-harm etc. and Delphi survey to reach consensus. These guidelines co-adapted through consultations with experts by profession and experience will inform much needed public health initiatives to increase awareness and education and build capacity in a wide range of stakeholders across sectors for suicide prevention in Pakistan.

Cognitive theories suggest that anxiety symptoms are associated with increased recall of threatening information, but previous evidence has been inconsistent. We examined whether recall of socially rewarding or threatening information was associated with concurrent and subsequent generalised anxiety disorder (GAD) symptoms.

We used data from a cohort study (N = 530, 68% female) and the baseline of a randomised controlled trial (N = 653, 58% female). All participants had a history of depressive symptoms. Both studies included a computerised task assessing incidental word recall and measured GAD symptoms using the Generalised Anxiety Disorder Assessment (GAD-7). We tested concurrent associations in both samples and lagged associations in the cohort, which measured GAD scores at four time-points (two weeks apart) and recall at the first three time-points. We used multilevel linear (cohort) and linear (RCT) regression models, before and after adjusting for confounders.

In the cohort, there was strong evidence that better recall of socially rewarding information was associated with lower GAD scores concurrently (coef=-0.18; 95% CI=-0.31-0.04). There was no evidence for an association with recall of socially threatening words (coef=-0.04, 95% CI=-0.20-0.12). Longitudinally, there was no evidence that recall of socially rewarding or threatening information was associated with subsequent GAD scores. In the RCT, there was evidence that better recall of socially rewarding information was associated with lower concurrent GAD scores (coef=-0.32; 95% CI=-0.56-0.08).

GAD may be characterised by difficulty in recalling socially rewarding information but not memory for socially threatening information. Our findings indicate that recalling less socially rewarding information may be a marker of current GAD symptoms, but not a risk factor longitudinally.

Mental health literacy (MHL) is considered a key concept in dealing with mental illness. It encompasses knowledge about illnesses, risk factors, help-seeking behavior, and attitudes toward mental illness. Shame is also associated with these factors. In this study, a modified German version (MHLS-DE) was developed and tested on an online sample (N=533). The psychometric properties of the MHLS-DE and the role of shame as a mediator of MHL were investigated. The MHLS-DE achieved good reliability (Cronbach's χ=0.846) and structural validity. Gender-modulated mediation effects through shame experiences were found for the relationship between psychological flexibility and MHL. Despite ongoing conceptual ambiguities, mental health literacy can be reliably assessed with the MHLS-DE. The mediation analysis highlighted the role of feelings of shame in MHL, which should be considered in interventions to improve MHL.

To determine if the new care element of psychotherapeutic consultation (ptc), which was introduced in outpatient psychotherapeutic care in 2017, has the potential of coordinating care for people with mental health problems and to identify potential barriers and facilitators.A cross-sectional survey of a stratified random sample of 3,400 psychotherapists (pt) was conducted between 07/2021 and 03/2022. Descriptive analyses were performed.760 questionnaires were included in the analysis. Most pt attributed appropriate advice or diagnostics to ptc. 16% of pt recognised that ptc had a role in coordinating care. 5% of pt recognised better communication with other specialist disciplines or improved cross-sectoral collaboration.The survey suggests that improved cooperation and communication between service providers may benefit the ptc for a potential role of coordinating the care of people with mental health problems.

Cancer treatment has come a long way, but not all cancers can be completely cured. The current therapeutic landscape has significantly reduced mortality rates; however, it remains associated with side effects, limited accessibility, financial burden, drug shortages, and emotional as well as mental health consequences for patients. Hence, despite significant advances, the development of novel therapies remains a focal point of research. In this review, we explore the current state of snake venom-inspired peptides as templates for the design of much-needed innovative anticancer agents. Initially, we examine conventional cancer treatments, their main challenges, and the niche filled by newly approved peptide-based therapies. Then, we present a high-level overview of the potential of snake venoms as broad-spectrum libraries of bioactive components and discuss a roadmap for mining these rich and complex mixtures to pioneer the next generation of cancer drugs, leading to the emergence of "oncovenomics". Harnessing the potential of modern in silico approaches, we delve into the structure, biochemical parameters, and bioactivity of venom-inspired peptides. Our research identified more than 30 snake venom-derived peptides with micromolar lytic action against different cancer cells, including solid and liquid tumours. Transitioning from in vitro monolayer analyses to clinical settings remains an unfulfilled goal, with the majority of studies failing to progress to more advanced stages, including the preclinical phase involving in vivo experiments. Here, we also describe how artificial intelligence, and the integration of other cutting-edge technologies can provide an expandable framework for translating the high in vitro potential of venom-derived peptides into clinically useful therapies. Lastly, we examined the translational challenges and the strategies proposed to overcome them. In summary, snake venom-derived peptides are attractive scaffolds for drug discovery programs, demonstrating historical benefits. However, overcoming the existing barriers in their development requires further multidisciplinary efforts. On the horizon, advances in high-throughput research tools and peptide engineering strategies offer opportunities for introducing next-generation venom peptide-based therapeutics to address cancer in clinical practice.

To systematically review and meta-analyze the association between gait speed and incident depression from published prospective studies in adults.

PRISMA 2020-compliant systematic review (PubMed/Embase/Web of Science/PsycINFO, up to 09/05/2025) for cohort studies investigating the associations between gait speed and incident depression. Data on odds ratios (OR) and hazard ratios (HR) were analyzed in meta-analyses separately. The New-Casttle Ottawa Scale was used to assess within study risk of bias. Meta-regression analyses were planned.

From 13.293 records screened, ten studies were included in the meta-analysis. Six studies (n = 13,313; mean age 71.3 years) reporting ORs showed that slower gait speed was associated with an increased risk of incident depression (OR = 1.30, 95 % CI = 1.03-1.66). Four studies (n = 90,729; mean age 71.6 years) reporting HRs corroborated this finding (HR = 1.17, 95 % CI = 1.08-1.28). Meta-regressions revealed no significant moderation by sex, age, follow-up duration, or person-years. All studies exhibited low risk of bias.

Slower gait speed is significantly associated with an elevated risk of incident depression in adults, independent of sex, age, follow-up duration, or exposure time. These findings position gait speed as a potential non-invasive biomarker for identifying individuals at risk of depression. Further studies are needed to integrate speed gait in depression prediction models.

Bipolar II disorder (BD-II) can progress to bipolar I disorder (BD-I), carrying profound psychosocial consequences. However, limited research has investigated the transition from BD-II to BD-I. Our study uses machine learning to predict the conversion using real-world data.

We conducted a retrospective cohort study using the Taiwan National Health Insurance Research Database (2000-2013) to identify adults diagnosed with BD-II. A predictive model for BD-I conversion was developed using extreme gradient boosting (XGBoost), incorporating demographic factors, healthcare utilization, comorbidities, and psychotropic medication use. The dataset was randomly divided into development (80 %) and test (20 %) sets. Model performance was evaluated by accuracy, sensitivity, specificity, and area under the receiver operating characteristic curve (AUC). Feature importance was interpreted using Shapley Additive Explanations (SHAP).

Among the 1890 individuals diagnosed with BD-II, 14 % subsequently converted to BD-I. The final machine learning model demonstrated strong predictive performance, achieving an accuracy of 86 %, sensitivity of 77 %, specificity of 87 %, and an area under the receiver operating characteristic curve (AUC) of 0.91 in the external validation cohort. Younger age, female sex, fewer outpatient visits before and more after diagnosis were key predictors. Lower incidence of new-onset medical (e.g., respiratory, gastrointestinal) and psychiatric (e.g., anxiety, insomnia) comorbidities also indicated higher risk. Increased use of lithium, anticonvulsants, second-generation antipsychotics, and hypnotics further characterized high-risk profiles.

Our findings highlight the utility of machine learning in stratifying BD-II patients at elevated risk for BD-I conversion, offering a data-driven framework to support early clinical intervention and personalized care.

Psychological interventions based on mindfulness and cognition have shown promise for treating ADHD, yet their application in children remains understudied. This study aimed to investigate the effectiveness and sustainability of mindfulness and cognitive strategy interventions in reducing core symptoms of ADHD in children. A randomized controlled trial (RCT) was conducted involving 70 children with ADHD aged 6-12, who were randomly assigned to one of three groups: a mindfulness-based cognitive intervention group (M + CB, n = 22), a cognitive-based mindfulness intervention group (C + MB, n = 23), both of which consisted of a 12-week intervention involving mindfulness and cognitive-behavioral strategy training, or a control group (n = 25) that followed care-as-usual without psychological intervention. Both M + CB and C + MB groups showed significant reductions in parent-rated ADHD symptoms [M + CB: d = 0.68, p < 0.01; C + MB: d = 0.55, p < 0.01] at post-treatment compared to the control group. These effects were consistently maintained at 1- and 4-months follow-ups. A higher proportion of children showed reliable post-treatment improvements in the intervention groups versus the control group (63.6 % vs. 52.2 % vs. 8.0 %, p < 0.01), with those having more severe baseline symptoms benefiting more from the intervention. Significant improvements were also observed in child-measured inhibitory control, with these changes predicting the degree of improvement in core symptoms. Additionally, the M + CB group exhibited greater reductions in parent-rated hyperactivity-impulsivity symptoms and executive function deficits, as well as enhanced performance in child-measured executive function. This study provides evidence supporting the effectiveness of interventions combining mindfulness and cognitive-behavioral strategies for children with ADHD, which may be valuable treatment options for reducing symptoms and enhancing executive functions.