Background: Healthcare professionals in Singapore's primary care face sustained workload pressures and increasing complexity. Grounded in the Job Demands-Resources model, this study identifies demographic, clinical, and lifestyle factors associated with psychological distress among staff across two independent windows spanning the pre- and post-pandemic periods. Methods: The study was conducted among staff in National University Polyclinics (NUP) Singapore. De-identified health screening data included demographics, occupation, clinical measures, medical history, and lifestyle behaviours. Primary outcome was psychological distress, assessed across 2 distinct observation windows: the Hospital Anxiety and Depression Scale (HADS) from 2018-2022 (abnormal ≥ 8) and the General Health Questionnaire-12 (GHQ-12) from 2023-2025 (abnormal ≥ 2). Multivariate mixed-effects logistic regression identified factors associated with psychological distress while accounting for within-person clustering. Results: We analysed 3307 screening visits from 1260 staff. Within the HADS observation window (2018-2022), abnormal scores were significantly higher in 2022 compared with 2018 (OR 2.28, 95% CI 1.64-3.17). Within the GHQ-12 observation window (2023-2025), a non-significant decline in abnormal scores was observed. Older age (2018-2022: OR 0.967, 95% CI 0.948-0.987; 2023-2025: OR 0.955, 95% CI 0.928-0.983) and regular exercise (2018-2022: OR 0.724, 95% CI 0.529-0.991; 2023-2025: OR 0.357, 95% CI 0.231-0.551) were consistently associated with lower odds of distress. Medical staff had significantly lower odds of distress compared to ancillary staff in 2018-2022 (OR 0.391, 95% CI 0.207-0.739). Regular alcohol use was associated with higher distress in 2018-2022 (OR 1.56, 95% CI 1.05-2.31), while active smoking (OR 5.79, 95% CI 1.75-19.10) and family history of chronic disease (OR 2.22, 95% CI 1.28-3.87) were significant in 2023-2025. Conclusions: Older age and regular exercise were consistently associated with lower odds of psychological distress across both windows, while ancillary staff and alcohol use (HADS window), and smoking and family history of chronic disease (GHQ-12 window) were period-specific determinants. These findings support the implementation of proactive, targeted wellness initiatives alongside the routine mental health surveillance among primary care staff.

Background: Health-related quality of life (HRQoL) and job satisfaction are important indicators of nurses and physicians' wellbeing and system sustainability, particularly under conditions of high clinical demand. Although organizational determinants of nurses and physicians' wellbeing have received increasing attention, evidence regarding protocol-based work as a specific organizational characteristic remains limited. Methods: A multicenter cross-sectional study was conducted in 11 Greek public hospitals between September 2022 and March 2023. The study included 405 nurses and physicians (214 nurses and 191 physicians). HRQoL was assessed with the SF-36 and job satisfaction with the MSQ-Short Form. Protocol-based work was assessed using a single self-reported dichotomous item referring to the use of standardized clinical protocols during the pandemic. Associations between workplace characteristics and outcomes were examined using multivariable linear regression models. Results: Vitality (57.24 ± 17.61 among nurses and 53.92 ± 16.93 among physicians) and general health (56.58 ± 19.81 and 53.42 ± 16.32, respectively) were the lowest-scoring HRQoL dimensions in both professional groups. Compared with physicians, nurses reported higher mental health (62.52 vs. 58.11, p < 0.05), social functioning (67.17 vs. 58.96, p < 0.05), and overall job satisfaction (3.23 vs. 2.98, p < 0.01), whereas physicians scored higher in physical functioning (83.47, p < 0.05) and bodily pain (72.87, p < 0.05). Conclusions: Several organizational characteristics were associated with wellbeing among nurses and physicians. Protocol-based work showed consistent associations with better HRQoL and job satisfaction across multiple outcomes. However, longitudinal studies are needed to determine whether these associations reflect causal relationships.

Background: Psychological flourishing is a key indicator of optimal mental health and professional well-being, particularly among psychologists who are routinely exposed to emotionally demanding clinical environments. Although self-compassion has consistently been associated with positive psychological outcomes, few studies have integrated traditional statistical methods with machine learning approaches to predict psychological flourishing among psychologists. Objective: This study aimed to examine the relationship between self-compassion and psychological flourishing among psychologists in Saudi Arabia, identify the unique contribution of self-compassion dimensions, evaluate the predictive performance of supervised machine learning models, and compare their performance with traditional multiple linear regression. Methods: A cross-sectional correlational design was employed, involving 224 psychologists practicing in Saudi Arabia. Participants completed the Self-Compassion Scale and the Flourishing Scale. Descriptive statistics, Pearson's correlation, and multiple linear regression analyses were performed using IBM SPSS Statistics version 29.0. In addition, Random Forest Regression and Support Vector Regression (SVR) models were implemented in Python using scikit-learn version 1.8.0 to predict psychological flourishing based on self-compassion dimensions together with demographic and professional characteristics. Model performance was evaluated using the coefficient of determination (R²), root mean square error (RMSE), and mean absolute error (MAE). Results: Overall, self-compassion was positively associated with psychological flourishing (r = 0.627, p < 0.001). Multiple linear regression showed that self-kindness had a significant positive independent association with psychological flourishing (β = 0.292, p = 0.001), whereas over-identification had a significant negative independent association (β = -0.206, p = 0.009). The regression model explained 40.5% of the variance in psychological flourishing (R² = 0.405, p < 0.001). In the held-out test-set comparison using the same predictor set, predictive performance was similar across multiple linear regression (R² = 0.273; RMSE = 3.583; MAE = 2.849), Random Forest Regression (R² = 0.282; RMSE = 3.562; MAE = 2.771), and Support Vector Regression (R² = 0.272; RMSE = 3.587; MAE = 2.768), with no substantial predictive advantage of the machine-learning models over the linear benchmark. Conclusions: Self-compassion, particularly self-kindness and over-identification, was significantly correlated with psychological flourishing among psychologists. Machine-learning models demonstrated predictive performance comparable to traditional regression, with no substantial predictive advantage over the linear benchmark, indicating that increased model complexity did not improve out-of-sample prediction in the present sample.

Background/Objectives: Psychiatric inpatient care is characterised by power asymmetries between care providers and care receivers. Despite international guidelines and policies promoting autonomy, involvement, and empowerment, these ideals remain challenging to implement in clinical practice. Psychiatric self-admission has been developed to strengthen autonomy; however, its implementation may challenge established power structures, professional roles, and responsibilities within mental healthcare settings. This study aimed to explore stakeholder perspectives on power transfer during the implementation of psychiatric self-admission in Scandinavia. Methods: A qualitative multi-source study was conducted using semi-structured interviews, focus group interviews, and document collection. Interviews were conducted with 36 participants involved in the development and implementation of self-admission in Denmark, Norway, and Sweden. Additionally, approximately 250 documents were gathered. The documentary material was analysed alongside the interviews and focus groups to provide an understanding of the implementation of self-admission models and how power transfer was represented within these processes. The analyses were inspired by methods in qualitative content analysis and document analysis. Results: Findings on stakeholder perspectives on power transfer during implementation revealed a tension reflected in two subthemes: 'Responsive and Responsible', where self-admission was viewed as a necessary response to needs that the healthcare system was unable to address, and 'Unsafe and Unsound', where self-admission was associated with uncertainties and risks related to losing control. Conclusions: Implementing psychiatric self-admission, which involved challenging traditional power relations in healthcare, was permeated by trust, distrust, and fear. The findings highlight the need to address stakeholders' concerns related to safety and professional responsibility.

Background/Objectives: Telerehabilitation may extend neurorehabilitation beyond conventional settings, but comparative effects across neurological diagnoses and motor domains remain uncertain. This systematic review and meta-analysis synthesized motor outcomes while distinguishing International Classification of Functioning, Disability and Health activity domains, delivery models, and comparator questions. Methods: Five databases were searched from inception to 8 June 2026 using two database-specific Boolean search strategies. Comparative studies of adults with neurological disorders receiving active remote, digital, virtual, wearable, or hybrid rehabilitation were eligible. Random-effects models used restricted maximum likelihood estimation; Hartung-Knapp confidence intervals were primary when at least three studies were available, and DerSimonian-Laird models were sensitivity analyses. Results: Eighty-seven studies included stroke, Parkinson's disease, multiple sclerosis, spinal cord injury, acquired brain injury, or ataxia. For walking and mobility activities versus usual care, no additional therapy, or waitlist, the point estimate favoured telerehabilitation but was imprecise and compatible with no difference (standardized mean difference 1.06, 95% confidence interval -0.23 to 2.35; three studies; 121 participants; I² = 57.6%). Global motor-functional and activities-of-daily-living outcomes showed similar uncertainty (0.83, -0.35 to 2.00; three studies; 304 participants; I² = 73.6%). Both findings had very-low-certainty evidence. No pooled comparison included enough studies to assess publication bias. Two-study datasets for balance-related activity/postural control and upper-limb impairment were highly heterogeneous and interpreted descriptively. Conclusions: Comparative evidence for telerehabilitation across neurological diagnoses and motor domains remains uncertain. Programme characteristics are plausible implementation considerations, not established efficacy modifiers. Small evidence sets, wide intervals, clinical heterogeneity, risk of bias, and inconsistent adverse-event ascertainment preclude conclusions about clinical importance or established safety.

Schizophrenia causes substantial disability and reduced life expectancy, while symptoms frequently persist despite antipsychotic treatment. Long-chain n-3 polyunsaturated fatty acids (n-3 PUFAs) have been proposed as adjunctive therapy because of their anti-inflammatory and neurobiological properties. This systematic review and exploratory meta-analysis evaluated the efficacy and safety of adjunctive n-3 PUFAs in adults with schizophrenia.

The review followed PRISMA 2020 and was prospectively registered in PROSPERO (CRD420251178174). PubMed, Web of Science, Scopus, Ovid, CENTRAL, ClinicalTrials.gov, and ICTRP were searched without language or date restrictions. Randomized controlled trials of n-3 PUFAs added to antipsychotic therapy were included. Risk of bias was assessed using RoB 2. PANSS scores were pooled as mean differences (MDs) using an inverse-variance random-effects model with REML estimation; dichotomous outcomes were pooled as risk ratios (RRs) using an inverse-variance random-effects model with the DerSimonian-Laird estimator or a fixed-effect model with the Mantel-Haenszel method, with a 0.5 continuity correction for zero cells.

Of 301 records, 10 randomized controlled trials met the eligibility criteria. Where sufficient comparable data were available, exploratory meta-analyses were conducted. Only one trial provided strict intention-to-treat final PANSS total data. A two-trial sensitivity meta-analysis (116 participants) showed no significant reduction in final PANSS total scores (MD -5.04, 95% CI -14.16 to 4.08; I² = 55.8%). Results were also nonsignificant for clinical response (RR 1.62, 95% CI 0.27-9.78), all-cause discontinuation (RR 1.32, 95% CI 0.31-5.65), and discontinuation due to adverse events (RR 1.35, 95% CI 0.38-4.81). Extreme sensitivity analyses remained nonsignificant. Subgroup signals involving clozapine or baseline fatty-acid status were not consistently replicated. Evidence was limited by few studies, attrition, and substantial heterogeneity in n-3 PUFA formulation, dose, duration, population, and concomitant antipsychotic therapy.

Current evidence does not support routine adjunctive n-3 PUFAs for symptom reduction in adults with schizophrenia. The available data cannot identify an optimal EPA/DHA formulation, dose, or responsive clinical subgroup; larger biomarker-informed trials are needed.

Background/Objectives: Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are increasingly used for the treatment of overweight and obesity because of their established efficacy in achieving clinically meaningful weight loss. However, concerns have emerged regarding their potential association with neuropsychiatric outcomes, including depressive and anxiety symptoms, manic or hypomanic symptoms, and suicidal ideation or behavior. This systematic review aimed to synthesize the available evidence on neuropsychiatric outcomes associated with GLP-1 RA use in adults with overweight or obesity. Methods: A systematic search of PubMed/MEDLINE, Scopus, and Web of Science was conducted following PRISMA 2020 guidelines. Eligible studies included randomized controlled trials, longitudinal observational studies, and cross-sectional studies evaluating neuropsychiatric outcomes associated with GLP-1 RAs in adults with overweight or obesity. Risk of bias was assessed using RoB 2, ROBINS-I, and the Joanna Briggs Institute Critical Appraisal Checklist according to study design. Given the clinical and methodological heterogeneity of the included studies, findings were synthesized narratively in accordance with SWiM guidance, and certainty of evidence was assessed at the outcome level using GRADE. Results: Fourteen studies were included, comprising four randomized studies, nine longitudinal observational studies, and one analytical cross-sectional study. Randomized evidence showed no consistent worsening of depressive symptoms or imbalance in suicide-related outcomes, whereas observational findings were heterogeneous. For depression, observational HRs ranged from 0.63 to 2.95 across different populations and comparators, while randomized studies showed small or no between-group differences in depressive symptoms. For suicide-related outcomes, observational HRs/aHRs ranged from 0.27 to 2.06, while suicidal ideation or behavior was uncommon in randomized studies and showed no consistent treatment imbalance. Anxiety-related findings were also heterogeneous, and manic or hypomanic symptoms were not systematically assessed. GRADE certainty was low for depressive symptoms and very low for anxiety and suicide-related outcomes. Conclusions: Current evidence does not demonstrate a consistent increase in adverse neuropsychiatric outcomes associated with GLP-1 receptor agonists in adults with overweight or obesity. Although some studies reported neutral or potentially beneficial associations, observational findings were heterogeneous, and the certainty of evidence was low or very low across the assessable outcomes. These findings do not establish a class-wide neuropsychiatric safety effect, particularly given differences among individual agents, study populations, and baseline psychiatric characteristics. Further prospective studies specifically designed to assess neuropsychiatric outcomes, including individuals with pre-existing psychiatric disorders, are warranted.

Background/Objectives: The aim of this systematic review is to assess the efficacy, effectiveness, and safety of LAI antipsychotics in patients with schizophrenia and comorbid SUD, providing useful information for clinical decision making and guiding future research in the management of this complex patient population. Methods: The search was conducted on 1 July 2026 and produced 87 results in total; after the screening process, 78 articles were excluded based on the predefined eligibility criteria. The full texts of the remaining 9 studies were retrieved and thoroughly evaluated for inclusion in the qualitative synthesis. Results: The 9 articles that met the criteria for inclusion included 2062 patients in total with follow-up periods varying between 6 months and 3 years. Several studies reported favorable clinical outcomes associated with LAIs; however, not all studies demonstrated clear superiority of LAIs over oral antipsychotics. Conclusions: The present review suggests that LAIs may represent a valuable therapeutic strategy for patients with schizophrenia and comorbid SUD, although the available evidence remains heterogeneous in terms of study design, patient populations, and outcome measures.

This study aimed to investigate the clinical characteristics associated with psychiatric hospitalizations in children with ASD and to evaluate changes in blood-based Inflammatory Indices following treatment.

A retrospective study of 269 children and adolescents with ASD (≤18 years) admitted to Nanjing Brain Hospital between 2012 and 2023 was conducted. Electronic medical records were reviewed for demographic characteristics, primary reasons for hospitalization, ASD-specific clinical scale scores, and routine laboratory parameters. The systemic immune-inflammation index (SII), neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), platelet-to-lymphocyte ratio (PLR), and non-enzymatic antioxidant indicators (uric acid, total bilirubin, direct bilirubin, prealbumin) were calculated.

The mean age at admission was 12.13 years, and 80.3% of admitted patients were male. The leading reasons for hospitalization were aggression (76.21%), psychosocial stressors (48.32%), and ADHD-related symptoms (46.09%), with distinct patterns observed by intellectual disability status, sex, and developmental stage. Multiple regression analyses revealed that age, sex, and specific admission indications were significantly associated with baseline inflammatory indices (SII, NLR, PLR, WBC, NEU, PLT; all p < 0.05) and antioxidant indices (UA, TBIL, DBIL, PA; all p < 0.05). Among 196 patients with 4-week follow-up data, significant post-treatment reductions were observed in SII, WBC, NEU, UA, TBIL, and DBIL, alongside increased prealbumin (all p < 0.05).

Psychiatric hospitalizations of Chinese children with ASD are driven by distinct behavioral and neurodevelopmental profiles. Concurrently, accessible blood-based inflammatory and antioxidant indices show significant baseline clinical associations and post-treatment alterations, suggesting their potential as adjunctive biological markers in acute psychiatric settings. These findings are limited by the retrospective single-center design, absence of a control group, and lack of post-treatment clinical severity assessments.

Fatty acid-binding proteins (FABPs) are a family of intracellular lipid chaperones that transport fatty acids and other hydrophobic molecules, playing essential roles in cellular lipid metabolism, signaling, and brain function. Within the central nervous system, FABP3, FABP5, and FABP7 facilitate the trafficking of long-chain polyunsaturated fatty acids and endocannabinoids, thereby modulating key regulatory pathways including the endocannabinoid system (ECS), peroxisome proliferator-activated receptor (PPAR) signaling, and dopaminergic neurotransmission. Peripherally, FABP1 and FABP4 contribute to hepatic drug metabolism, kidney excretion, and inflammatory processes in both tissues, with implications for the pharmacokinetics of substances of abuse. This narrative review synthesizes the current literature on FABPs and their involvement in substance use and addiction-related behaviors. Evidence from transgenic knockout models, pharmacological inhibition studies, and adeno-associated virus vector approaches demonstrates that manipulation of FABP subtypes can alter reward-related behaviors across multiple substances, including THC, ethanol, nicotine, and cocaine. Reduction or knockout of FABP7 alters THC metabolite levels in a sex-dependent manner. FABP3 shows involvement with dopamine receptor expression; however, interaction between FABP3 modulation and specific substances has sparsely been investigated. FABP5 has vastly diverging interactions with addictive behavior and appears to be substance dependent, as downregulation reduces cocaine self-administration, but knockout enhances nicotine conditioned place preference (CPP) and increases brain uptake of THC. Combined deletion of FABP5 and 7 additionally reduces cocaine CPP and reinstatement, while showing promising decreases in ethanol consumption paradigms. FABPs may be a potential therapeutic target for treating substance use disorders and underlying reward deficiency mechanisms underlying addiction and further research is required to elucidate specific mechanistic effects and eliminate potential adverse consequences of chronic FABP modulation.