Endometriosis (EM) is a severe chronic inflammatory disease characterized by the presence of endometrium-like tissue outside the uterine cavity, causing pain and significantly reducing quality of life. Worldwide, around 10% of women of reproductive age are affected and there is no cure as of now. The limited treatment options focus on hormone therapy, surgery and pain management--without satisfactory long-term effects. Nutritional strategies might support the prevention and treatment of EM-associated pain as nutrients and phytochemicals exert anti-inflammatory and antioxidant effects, modulate the immune system and hormonal balance. In addition, diet is a key determinant of the composition, health, and function of the gut microbiome. To identify the multitude of potential nutrition-related factors that influence the clinical picture of EM, we conducted a targeted literature search in PubMed, Web of Science, and Google Scholar in 2025. This narrative review examines the association of thirteen areas-including macro- and micronutrients, dietary patterns, contaminants, allergens, and food intolerances-with the risk of EM and therapeutic options. At present, there is only limited scientific evidence regarding the therapeutic benefits of dietary strategies. There are promising indications for the supportive potential of an anti-inflammatory diet, based on elements of the MedD resulting in a regular intake of long-chain n-3 polyunsaturated fatty acids, secondary plant compounds, dietary fibers, vitamins, minerals and trace elements. Certain foods (or food groups) may contribute to a worsening of symptoms in individual patients with EM (eg, cruciferous vegetables, foods containing histamine, gluten, FODMAPs). Since these foods usually provide important nutrients, avoiding them as a preventive measure can lead to nutrient deficiencies. Therefore, individual assessment is required to determine the extent to which these foods are tolerated by women diagnosed with EM. To clarify the supportive role of personalized nutritional concepts to support therapy of EM, there is an urgent need for further high-quality studies.

Chronic musculoskeletal pain (CMP) is a prevalent and disabling condition associated with impaired physical function and reduced quality of life. Graded exposure therapy (GEP), a cognitive-behavioral intervention targeting pain-related fear and avoidance, has been proposed as a non-pharmacological approach for CMP management.

To evaluate the effects of GEP compared with non-GEP interventions in individuals with CMP.

We searched electronic databases from inception to February 2025 for randomized controlled trials (RCTs) comparing GEP and non-GEP interventions in individuals with CMP. Primary outcomes included pain intensity and pain-related disability. Secondary outcomes included pain-related fear and cognition, health-related quality of life, psychological outcomes, sleep-related outcomes, behavioral adaptation, self-efficacy, and physical functioning. The certainty of evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach.

Eight RCTs involving 554 participants were included. Compared with non-GEP interventions, GEP was associated with improvements in pain-related disability and pain-related fear and cognition, including pain catastrophizing (Pain Catastrophizing Scale [PCS]: mean difference [MD] = -4.45, 95% confidence interval [CI] -7.20 to -1.69) and kinesiophobia (Tampa Scale of Kinesiophobia [TSK]: MD = -4.57, 95% CI -7.11 to -2.03). Disability outcomes have showen beneficial effects across several instruments, although many estimates are based on individual studies. Effects on pain intensity were inconsistent, with significant reductions observed for Neuropathic Pain Scale (NPS) (MD = -2.66, 95% CI -4.09 to -1.23) and Fibromyalgia Impact Questionnaire Pain subscale (FIQ-Pain) (MD = -2.51, 95% CI -3.48 to -1.54). The certainty of evidence ranged from very low to moderate, with most outcomes being downgraded owing to the risk of bias and imprecision.

GEP may improve pain-related disability and pain-related fear and cognition in individuals with CMP. However, the limited certainty of evidence and variability across populations, interventions, and outcome measures warrant cautious interpretation. Further high-quality trials with standardized outcomes and longer-term follow-up are needed.

Food noise is a term that has recently emerged in the media, social media, and public discourse to describe people's experiences around food-related thoughts. Despite recent efforts to define and measure food noise and the abundance of online content on the topic, the proportion of US adults who believe they experience it remains unknown.

To estimate the prevalence and demographic and behavioral correlates of perceived food noise experiences in a nationally representative sample of U.S. adults.

Data were drawn from Verasight's SBM Omnibus Survey (May 2026; N = 1000). Perceived experiences of "food noise" were assessed using a single item and categorized as frequent (often/always) versus infrequent. Weighted analyses examined differences across demographic groups, GLP-1 medication use, and eating- and weight-related behaviors.

50.89% of respondents reported experiencing food noise at least occasionally and 17.98% frequently. Frequent endorsement was higher among female-identifying respondents (22.70% vs. 12.68% in males, p < 0.001), younger adults (26.50%, p = 0.002), and Asian respondents (32.22%, p = 0.007). It was also more common among individuals reporting loss of control over eating (56.77%, p < 0.001), dietary restriction (27.84%, p < 0.001), recent weight loss attempts (24.33%, p < 0.001), and current and former GLP-1 users (25.76% and 26.78% vs. 16.30% among non-users, p = 0.009). Those reporting frequent food noise also reported poorer diet quality and mental health. In multivariable analyses, loss of control over eating (OR = 5.95), current GLP-1 use (OR = 1.60), and female sex (OR = 1.47) were the strongest independent predictors.

Self-reported experiences of "food noise" are common and associated with demographic and disordered eating-related factors, highlighting widespread identification with this emerging construct and the need for further research to define and understand its clinical significance.

Children of mentally ill parents (CHIMPS) experience a variety of negative outcomes and have an increased risk for mental illness. Nevertheless, no routine screenings or therapies for CHIMPS exist in the German healthcare system. The CHIMPS program was developed as a psychodynamic, transdiagnostic family intervention for affected children and adolescents (CA). Its effectiveness on mental health and health-related quality of life was evaluated in a prospective, two-arm, cluster-randomized, controlled, open, multicentric trial.

Data from families with mentally ill parents were collected at seven sites in Germany and Switzerland at four measurement points. Group allocation was randomized. The intervention group (IG) received the CHIMPS intervention, while the control group (CG) received Treatment-As-Usual. The primary outcome was the mental health of CA with an initial psychiatric diagnosis according to the Schedule for Affective Disorders and Schizophrenia for School Aged Children, Lifetime Version (applied by blinded external raters) 18 months after baseline. Secondary outcomes comprised mental health assessed with the parent-rated Child Behavior Checklist and the self-rated Youth Self Report, and health-related quality of life assessed with the KIDSCREEN-27 (parent- and self-rated). Multilevel models were used for analysis.

Two hundred fifteen families (109 in IG, 106 in CG) were included in the trial. Data from 43 CA in both the IG and CG were used in the primary analysis. An odds ratio of 0.52 (95% CI: 0.25; 1.09) indicated a statistically not significant advantage of the IG over the CG. No clinically relevant advantage of the IG in any secondary outcome was found.

The CHIMPS program will be revised to provide families with more needs-based assistance. A diagnostic evaluation, which was delivered to both IG and CG families, may have had a therapeutic effect. Future trials should place particular emphasis on improving accessibility and adherence among CHIMPS and their families, as the target group proved difficult to reach and retain. Above all, interdisciplinary structures that enable CHIMPS and their families to receive low-threshold care must be created.

gov NCT0230846 (December 4, 2014). German Clinical Trials Register DRKS00006806 (October 7, 2014).

Emotion regulation (ER) plays a crucial role in adolescent mental health, yet its complexity is often overlooked. ER involves the use of multiple strategies, and individuals frequently combine several strategies to manage their emotions. To better capture this complexity, person-centred approaches have increasingly been used to identify ER strategy profiles. However, research on ER profiles among adolescents remains limited. The present study therefore adopted a person-centred approach to identify ER strategy profiles in adolescents and examine their associations with mental health outcomes.

Survey data were collected from a community sample of Swedish adolescents (n = 759; M_age = 13.9 years; 48.6% girls). The survey included measures of six ER strategies, including rumination/negative thinking, positive reorientation, social support, aggressive outlet, creative expression, and distraction, as well as measures of life satisfaction, anxiety, depression, and non-suicidal self-injury (NSSI). Latent profile analysis was used to identify distinct ER strategy profiles.

Five ER profiles were identified: Positive Reorientation-Focused, Minimal Strategy, Multiple Strategy, Rumination-Focused, and Creative Rumination-Aggression. The profiles differed significantly across all mental health outcomes, with large effect sizes. The Positive Reorientation-Focused and Minimal Strategy profiles showed the most favourable mental health, whereas the Multiple Strategy profile showed intermediate outcomes. The Rumination-Focused and Creative Rumination-Aggression profiles showed the poorest mental health. Notably, the Minimal Strategy profile, comprising primarily boys, was associated with favourable outcomes despite limited strategy use. The Creative Rumination-Aggression profile, which consisted predominantly of girls, showed the most severe pattern, with nearly half of its members scoring within the clinical range for anxiety and 75.5% reporting repetitive NSSI. Creative expression occurred in profiles characterized by both favourable and poorer mental health, suggesting that its associations with mental health may vary depending on the broader ER configuration in which it occurrs.

The findings suggest that favourable mental health outcomes are associated with multiple ER strategy configurations rather than a single optimal pattern, and that the associations between individual strategies and mental health may depend on the broader regulatory repertoire in which they are embedded. Longitudinal research is needed to clarify whether minimal strategy use reflects an adaptive pattern or a potential vulnerability over time, and to evaluate the relative stability and developmental relevance of the five- and six-profile solutions.

Pesticide self-poisoning accounts for 14%-20% of global suicides. Paraquat, a highly lethal pesticide, is involved in a considerable number of suicides in some countries. This study investigated the burden, trends, geographic variations, and demographic characteristics of pesticide and paraquat suicides in Taiwan.

Suicide data (1987, 1992, 1997, and 2002-2017) were obtained from Taiwan's cause-of-death mortality data files. Trends and geographic variations in pesticide and paraquat suicides were examined using graphs and maps. Logistic regression was used to investigate the differences in the characteristics of pesticide versus non-pesticide suicides and paraquat versus non-paraquat pesticide suicides.

Age-standardised pesticide suicide rates decreased by 74%, from 7.7 to 2.0 per 100,000, in 1987-2017. Paraquat was the leading agent involved in pesticide suicides, accounting for 59.9% (2,268/3,786) of pesticide suicides where the pesticide agents involved were recorded on the death certificate and at least 4.0% (2,268/56,361) of overall suicides in Taiwan. The percentage of paraquat suicides in overall suicides varied markedly across cities/counties (0.4%-15.6%). Pesticide suicides were more likely to be male, older people aged 65 + years, and from rural areas than non-pesticide suicides. By contrast, paraquat suicides tended to be younger than non-paraquat pesticide suicides, with no difference in sex distributions in the two groups.

The ban on paraquat implemented in 2018-2020 would have a significant impact on pesticide suicides and overall suicides, particularly in high-risk areas and demographic groups.

Maternal anxiety is a clinically relevant mental health concern during pregnancy and may contribute to reduced fetal growth, particularly when co-occurring with prenatal tobacco use. To examine the individual and contextual associations of maternal anxiety and prenatal tobacco use with infant birth weight using 2021-2023 Pregnancy Risk Assessment Monitoring System data. The analytic sample included 29,288 mothers nested within 11 states or jurisdictions.

Two-level linear mixed models were estimated to predict continuous infant birth weight, with a random slope for maternal anxiety to assess whether the anxiety-birth weight association varied across states or jurisdictions.

Prenatal tobacco use was associated with an approximately 219-gram reduction in birth weight (p < .001), while maternal anxiety was associated with an approximately 60-gram reduction (p < .001). State-level prevalence of anxiety and tobacco use did not directly predict birth weight; however, the association between maternal anxiety and birth weight varied across states or jurisdictions.

These findings support integrated prenatal care approaches that combine maternal mental health screening, tobacco cessation support, and attention to contextual systems that may shape maternal and infant health.

To assess at population level long-term changes in disabilities and health-related quality of life (HRQoL) in persons with multiple sclerosis (PwMS) in the Netherlands.

A prospective web-based study in a real-world population-based self-enrolled cohort; 6-month assessments by means of the Multiple Sclerosis Impact Profile (MSIP) and Multiple Sclerosis Quality of Life-54 (MSQoL-54) questionnaires; Generalized Linear Mixed Models (GLMM) analysis; predetermined anchor points 5, 8 and 10 years follow-up.

Nation-wide 391 patients started (2011-2012), 272 participants were included in the MSIP and 267 in the MSQoL-54 analyses. Female 74%, mean (standard deviation) age 45 (11) years. Baseline Expanded Disability Status Scale scores: 58.9% 0.0-4.0, 35.5% 4.5-6.5, 5.6% >6.5. Baseline demographic and disease characteristics did not differ between participants with and without follow-up data. GLMM indicated that after 10 years disability related to Activities of Daily Living and Basic Movement Activities had increased. Conversely, at 5, 8 and 10 years an improvement was reported in disability related to Lack of Support from Environmental Factors, more specifically Professional Care and Assistance, and Social Security Services. The other MSIP disabilities and symptoms remained stable over time, as did the physical and mental MSQoL-54 scores.

Our findings indicate that in the Dutch MS population in the period 2011-2021 the limitations in activities of daily living and in basic movement activities worsened over time. The improved support from professional care, professional assistance and social security services may be related to the implementation of nation-wide decentralized legislation to support people with disabilities, and the emergence of MS-specific neurological and nursing care. These findings at population level regarding the long-term course of disabilities and HRQoL in PwMS in the Netherlands in the era of (high) efficacy disease-modifying drugs may be useful for policymakers, healthcare providers, and patient organizations.

Personality disorders (PDs) are severe mental health conditions associated with significant distress and functional impairment. However, the epidemiology of personality disorders in non-Western populations is underrepresented. This meta-analysis aimed to estimate the prevalence of any personality disorder in both clinical and community samples in Turkiye. A systematic search was conducted in Web of Science, PubMed, Scopus, TRDizin, and the Turkish Psychiatry Index. The meta-analysis was performed in RStudio following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A total of 49 articles, comprising 61 independent samples and 28,269 participants, were included. The pooled prevalence of any personality disorder across all samples was 26.06% (95% confidence interval (CI) [0.1870, 0.3507]). The pooled prevalence was 30.60% (95% CI [0.2049, 0.4301]) in clinical samples and 15.94% (95% CI [0.1063, 0.2322]) in community samples. The findings indicate that PDs are highly prevalent in both clinical and community settings. These results suggest that PDs represent a substantial public health concern and should not be considered solely within clinical populations.

Evidence regarding the association between dark chocolate consumption and depressive symptoms remains limited, particularly among older adults.

To examine the association between self-reported dark chocolate consumption and depressive symptoms among community-dwelling older adults in Nagoya, Japan.

This cross-sectional study included 3,910 adults aged ≥ 70 years, of whom 2,957 were analyzed. Depressive symptoms were assessed using the Japanese version of the 15-item Geriatric Depression Scale (GDS-15-J). Dark chocolate consumption and depressive symptoms were assessed at the same study time point. Participants were classified into four groups: rare or no chocolate consumption, chocolate consumption without dark chocolate, dark chocolate consumption once or twice per week or more for ≤2 years, and dark chocolate consumption once or twice per week or more for >2 years. Logistic regression estimated odds ratios (ORs) and 95% confidence intervals (CIs) after adjustment of demographic, socioeconomic, lifestyle, and clinical covariates. Sensitivity analyses assessed robustness.

Among the 2,957 participants, 48.4% were women, and the mean age was 78.0 ± 5.0 years. Dark chocolate consumption for >2 years was reported by 24.6%. In the fully adjusted model, participants reporting dark chocolate consumption for >2 years had lower estimated odds of depressive symptoms than those who reported rare or no chocolate consumption, although the confidence interval included the null (OR, 0.73; 95% CI, 0.53-1.01; p = 0.055). Multiple imputation yielded a similar estimate (OR, 0.69; 95% CI, 0.51-0.94; p = 0.020). Analyses restricted to participants with Mini-Mental State Examination (MMSE) scores ≥ 27 and ≥28 also yielded estimates in the same direction (OR, 0.66; 95% CI, 0.43-1.00; p = 0.051 and OR, 0.68; 95% CI, 0.42-1.12; p = 0.132, respectively). Among chocolate consumers, dark chocolate consumption for >2 years was associated with lower odds of depressive symptoms than chocolate consumption without dark chocolate (OR, 0.62; 95% CI, 0.43-0.88; p = 0.008).

Self-reported dark chocolate consumption for >2 years may be associated with lower odds of depressive symptoms among community-dwelling older adults in Nagoya, Japan. Prospective and interventional studies are needed to clarify the temporal and causal nature of this association.