To investigate the psychological status of patients with hepatocellular carcinoma (HCC) undergoing hepatectomy, analyze risk factors for anxiety and depression, and provide a theoretical basis for individualized mental intervention strategies.

A total of 412 HCC patients who underwent hepatectomy at Fuyang People's Hospital from January 2022 to January 2026 were enrolled. The Hospital Anxiety and Depression Scale (HADS) and FRAIL scale were used to assess psychological status and frailty, respectively. Univariate ANOVA and linear regression were performed to analyze relationships between anxiety, depression, and perioperative factors.

Of 456 distributed questionnaires, 412 were valid (response rate: 90.35%). Mean HADS-A (anxiety) score was 8.34 ± 2.79: 130 asymptomatic, 192 doubtful, and 90 definite cases. Mean HADS-D (depression) score was 8.68 ± 2.75: 187 asymptomatic, 96 doubtful, and 129 definite cases. Univariate analysis showed associations between anxiety/depression and family income, open surgery, FRAIL score, and complications. Multivariate analysis identified open surgery, FRAIL score, and complications as independent risk factors (p < 0.05).

Patients with HCC undergoing hepatectomy exhibited significant anxiety and depression symptoms. FRAIL score, open surgery, and complication severity were risk factors, warranting attention to postoperative negative emotions and timely intervention.

The shorter lifespan and increased prevalence of physical and psychiatric comorbidities in autistic people is a challenge for mental health. There is a high risk of suicide-related behaviors in autism, which are related to mental health issues, social isolation, and other factors. Here we aimed to systematically review the evidence on risk and protective factors of suicidal behaviors in autistic people. Electronic datasets (PubMed, Scopus, Web of Science, and PsycInfo) were searched for empirical articles on the risk and protective factors for suicide in autism. The PRISMA guidelines were followed, and a series of inclusion and exclusion criteria were applied to the retrieved data. This review included 19 studies reporting multiple risk factors associated with suicide-related behaviors. Noteworthy contributors among these factors include psychiatric comorbidities, bullying, cyberbullying, teacher harassment, and cognitive functions. The evidence for protective factors is limited; however, social relationships are highlighted. Identifying risk and protective factors is paramount for detecting early warning signs and enabling the prevention and intervention of suicidal behavior. Our review identified key sociodemographic, clinical, and cognitive risk factors to take into account as alarm-signs when identifying suicidal behaviors in autism.

COVID-19 severely disrupted labor markets and living conditions, intensifying job precariousness and material deprivation. We examined whether pre-pandemic mental health conditions predicted socio-economic adversity during the first pandemic year and whether resilience buffered changes in mental health.

We analyzed a nationally representative longitudinal cohort of Spanish adults assessed in two assessments: November 2019 (T0, pre-pandemic) and November-December 2020 (T1). Major depressive episode (MDE), generalized anxiety disorder (GAD), and suicidal thoughts and behaviors (STB) were assessed at T0; job precariousness and material deprivation were measured at T1. Weighted multivariable regression models tested (i) associations between T0 mental health and T1 socio-economic adversity and (ii) associations between T1 adversity and changes in mental health symptoms, including resilience interactions.

Pre-pandemic GAD and STB were associated with higher odds of job precariousness during the pandemic, whereas MDE was not significant after adjustment. Job precariousness was associated with small reductions in depressive, anxiety, and STB symptoms, while material deprivation was associated with increased depressive symptoms; higher resilience attenuated the deprivation-depression association.

Pre-existing anxiety and suicide-related symptoms may identify individuals more likely to report job precariousness during socio-economic shocks. Preventing material deprivation and strengthening resilience may help reduce downstream depressive burden during crises.

Neuroinflammation is increasingly recognized as a key contributor and amplifier associated with the pathogenesis of Alzheimer's disease (AD) and Parkinson's disease (PD). Neuroinflammation occurs throughout various stages of these diseases with expanding complexity. Currently, no effective therapies exist that specifically target neuroinflammatory processes in these disorders. In this review, we synthesize current understanding of central and peripheral inflammatory mechanisms implicated in both diseases. We illustrate how endogenous pathological triggers, such as amyloid-β (Aβ) peptide, hyperphosphorylated tau, and α-synuclein, activate glial cells, contributing to chronic neuroinflammation that exacerbates neurodegeneration. Additionally, peripheral factors, including systemic inflammation, environmental exposures, and gut-brain axis interactions, are discussed for their roles in modulating neuroinflammatory responses. Notably, the underappreciated roles of oligodendrocyte precursor cells and oligodendrocytes in neuroimmune crosstalk are also highlighted. Advanced methodologies, including glial cell imaging, single-cell transcriptomics, and human induced pluripotent stem cell-derived organoid models, are providing unprecedented insights into the molecular and cellular mechanisms underlying neuroinflammation. Finally, we evaluate emerging therapeutic strategies and ongoing clinical trials targeting neuroinflammatory pathways and analyze the potential of immunomodulatory approaches to slow disease progression. This comprehensive review emphasizes that precise targeting of neuroinflammation represents a tractable strategy for developing effective disease‑modifying treatments for AD and PD.

Suicide is a leading cause of death among young people worldwide and remains a significant cause of mortality across all age groups, especially in older adults. The underlying causes of suicide span various disciplines and are deeply influenced by societal attitudes, which fluctuate between glorification and severe condemnation of suicide. This study aims to evaluate the role of court rulings on suicidal behavior, with particular attention to implications for healthcare policy in Israel.

We searched the national court rulings databases for alleged psychiatry malpractice in suicide-related cases and of pre-trial settlements from 1985 to 2023. For court decisions, we collected patients' socio-demographic and clinical characteristics, lawsuit characteristics, and the quality of medical documentation and decision-making processes. For pre-trial settlements, we collected data about lawsuit characteristics. Two researchers reviewed the qualitative data, while the quantitative data was analyzed with descriptive statistics.

Over the 38-year period, there were 20 psychiatry malpractice court lawsuits related to patient suicides, including 17 deaths and 3 life threatening attempts. Of these, 12 (60%) of cases were won by the plaintiff, and eight (40%) by the defendant. In 14 cases, the suicides occurred in inpatient units and in six cases in community settings. The number of lawsuits notably increased over time for suicide events, with 17 pre-court settlements between 1985 and 1997, and 56 cases in each of the subsequent periods (1998-2010 and 2011-2023).

The number of malpractice lawsuits related to suicide in Israel is increasing over time. Our findings, which show a rise in both litigation and pre-trial settlements, may put pressure on psychiatrists to avoid certain kinds of work, especially in the public sector. Such a shift could have broader effects on the quality of suicide prevention efforts and overall mental health care. The study highlights the structural tension between retrospective legal accountability and prospective clinical and public-health approaches to suicide prevention. Addressing this challenge requires balanced policy responses, including strengthening patient-safety and risk-management systems, improving clinical documentation and decision transparency, fostering constructive collaboration between legal and mental health systems, and considering alternative compensation mechanisms that reduce adversarial pressures while supporting affected families.

As an evidence-based complementary modality, physical exercise showed significant potential in mitigating sleep disturbances across various populations.

The objective of this study was to determine how physical exercise interventions influence the sleep quality among clinical populations diagnosed with psychiatric disorders.

A systematic search was conducted across four electronic databases, MEDLINE, Embase, the Cochrane Library, and Web of Science, to identify randomized controlled trials (RCTs) available from inception to March 1, 2026. Studies were included if they focused on exercise interventions in patients with psychiatric disorders, using sleep quality as the outcome. Assessment of risk of bias for the enrolled RCTs was conducted using the revised Cochrane Risk of Bias Tool 2. Data synthesis employed random-effects models to estimate Hedges' g, with subsequent subgroup analyses conducted according to the FITT (Frequency, Intensity, Time, and Type) framework.

A total of 21 RCTs (24 comparisons) with 1628 participants were analyzed and results indicated a moderate overall effect size, indicating that physical exercise contributes to a significant improvement in sleep quality (g = -0.57, 95% confidence intervals [CI]: -0.75, -0.38, P < 0.001). Subgroup analyses revealed larger effect sizes for interventions characterized by a weekly frequency of ≥ 3 sessions (g = -0.60), aerobic modalities (g = -0.69), and low-to-moderate intensity (g = -0.70). Furthermore, Furthermore, larger effects were also observed for single sessions lasting ≥ 30 min (g = -0.58) and a total intervention duration under 12 weeks (g = -0.58) in patients with psychiatric disorders. Univariate meta-regression analyses revealed no significant linear moderating effects of intervention duration, frequency, volume, or total weekly exercise time on sleep quality (all P > 0.05).

Overall, physical exercise serves as a potent complementary treatment option for enhancing sleep quality among individuals with mental health conditions. Following the exploration of candidate FITT dimensions, our findings offer actionable clinical insights for incorporating tailored exercise programs as a synergistic component of holistic psychiatric rehabilitation.

Artificial intelligence (AI) is being rapidly and broadly introduced into personal, public, commercial and health/medical practice settings. AI refers to a broad and evolving set of computational technologies, including machine learning, natural language processing, computer vision and generative AI ((Van Bulck et al. 2023; McGrow 2025). AI enables systems to learn from data to perform tasks that have traditionally required human intelligence, such as pattern recognition, clinical prediction, decision support and content generation (Bajwa et al. 2021; Rony et al. 2024; WHO 2021, 2025). Within healthcare, there is growing consensus that AI-informed tools are intended to augment - but not replace - the clinical judgement, ethical reasoning and relational care that are the hallmarks of nursing practice (ANA 2022; Rony et al. 2024). Findings from a recent survey of Canadian Academy of Nursing Fellows (n = 57) indicate that while many nurse leaders have encountered AI in practice, few feel confident with its use or governance. This gap suggests a leadership readiness challenge as well as a technology adoption challenge. Unlike earlier digital health tools, AI changes how information and knowledge are created and subsequently interpreted by clinicians, generating new risks as they become accountable for decisions shaped by systems they cannot fully evaluate (AAN 2026; McGrow 2025). The Canadian nursing informatics entry-to-practice competencies now include expectations that nurses assess AI outputs and safeguard equitable care, yet governance structures to support these responsibilities remain underdeveloped. Fellows also highlighted other concerns related to the use of AI, including the potential for algorithmic bias, ethical use and threats to equity and privacy. In this commentary, we posit that beyond supporting technological adoption, AI in nursing is fundamentally a leadership competency and governance issue. In this context, it is paramount that nurse leaders actively participate in establishing AI policies and evaluation standards, advance AI competency development and set boundaries for nursing judgement that ensure safe, ethical and accountable use of AI in healthcare.

Borderline personality disorder (BPD) is a mental disorder characterized by extreme instability in mood, interpersonal relationships, self-image, and behavioral patterns. Its core symptoms include intense mood swings, strained interpersonal relationships, disturbed self-identity, impulsive behaviors, and cognitive and perceptual abnormalities. The etiology of BPD is complex, involving genetic, neurobiological, and psychosocial factors. Among neurobiological factors, neuroimaging studies have consistently reported inconsistent findings regarding amygdala volume in BPD patients-some MRI studies demonstrate a 15% increase, while others show a reduction. Such discrepancies may reflect the impact of heterogeneous patient populations, comorbidities, or differences in imaging protocols. Notably, structural and functional abnormalities in BPD are not limited to the amygdala but also involve multiple brain regions, including the prefrontal cortex, hippocampus, anterior cingulate cortex, and insula, which collectively contribute to impaired emotion regulation, interpersonal dysfunction, and other core symptoms. A systematic search was conducted on studies investigating brain neuroimaging differences between BPD patients and healthy controls (HC). Studies meeting the inclusion criteria were selected, and coordinate-based meta-analysis (CBMA) of brain structural and functional changes was performed using seed-based d mapping (SDM) software to explore potential abnormal brain structures and functions in BPD patients. After screening, a total of 26 studies were included. By integrating meta-analytic findings from four neuroimaging modalities-diffusion tensor imaging (DTI), structural magnetic resonance imaging (sMRI), functional magnetic resonance imaging (fMRI), and resting-state functional magnetic resonance imaging (rs-fMRI)-this study systematically summarized the characteristic changes in brain structure and function in BPD patients. Study results demonstrated that the neurobiological basis of BPD primarily involves structural and functional dysregulation of the frontolimbic system, particularly in brain regions linked to core mental functions like emotion regulation, self-cognition, and impulse control.

Daily activities, work, and health are closely intertwined. We closely followed 45 participants aged 50-66 years working across different sectors in a year-long study, who completed a range of baseline, weekly, and monthly Participant Reported Outcome Measures (PROMs). Participants self-reported on work-related aspects using the Brief Job Stress Questionnaire (BJSQ) and Workplace Wellbeing Question Bank (WWQB); wellbeing using the Warwick-Edinburgh Mental Wellbeing Scale (WEMWBS); and sleep using the Pittsburgh Sleep Quality Index (PSQI). Additionally, they provided wrist-worn actigraphy data collected over three periods (each period ~ 35-40 days). In total, we collected 1901 PROMs entries and 5258 days of actigraphy data. We computed 55 actigraphy measures broadly assessing physical activity, sleep, and diurnal variability characteristics. We explored statistical associations between pairs of PROMs items and between PROMs items with actigraphy measures using correlations and cross-correlations to assess similarities. We built mixed-effects models to associate PROMs items and actigraphy measures with global PSQI and total WEMWBS. We found very strong associations (>|0.5|) between BJSQ items with total WEMWBS and global PSQI, highlighting certain work aspects affect sleep and overall wellbeing, whereas actigraphy analysis provided new insights uncovering sleep quality problems including disturbances and awakenings for most participants. Additionally, the mixed-effects models revealed that actigraphy-derived sleep measures are strongly associated with total WEMWBS and global PSQI providing complementary information to PROMs. Integrating longitudinal work-related self-reports and actigraphy can provide useful personalized wellbeing- and health-insights, and should likely be considered in future smart-health monitoring systems to promote healthy aging.

Tackling the global burden of mental health conditions and substance misuse is an international priority. In recent years, strategic work has begun to develop mental health services in Ethiopia and strengthen human rights protection for people with mental health conditions. To inform mental health service planning in the Somali region of Ethiopia, the extent of mental health conditions and substance misuse requires quantification.

We aimed to investigate associations between problematic khat use and mental health conditions in Ethiopia's Somali Regional State (SRS).

We carried out a quantitative household survey of 844 randomly selected residences in two cities in Ethiopia's SRS: the regional capital, Jigjiga (55.1%, n=465), and third largest city, Kabridahar (44.9%, n=379). We used the culturally validated Problematic Khat Use Screening Test and Mini International Neuropsychiatric Inventory to assess the prevalence and factors associated with mental health conditions and problematic khat use.

Out of 844 participants, 18.6% (n=156) met criteria for major depression, 11.1% (n=92) met criteria for post-traumatic stress disorder (PTSD) and 5.7% (n=48) expressed suicidal ideation. The combined prevalence of these mental health conditions was 21.8% (n=186). Men reported more aggregated mental health conditions than women (30.6%, n=97 vs 16.9%, n=89). Adjusted regression analyses showed that people with problematic khat use had more than twice the prevalence of major depression (prevalence ratio (PR) 2.5, 95% CI 1.7 to 3.5), recurrent depression (PR 2.8, CI 1.8 to 4.4), suicidal ideation (PR 2.4 CI 1.9 to 5.3), PTSD (PR 3.1, CI 1.9 to 5.3) and any mental health condition (PR 2.4, CI 1.7 to 3.4) compared with people without problematic khat use.

This study provides the first data regarding population mental health needs and harms associated with problematic khat use in the SRS, to inform the design, development and prioritisation of mental health services and substance regulation and policy.

Associations between problematic khat use and a range of poor mental health outcomes demonstrate the importance of targeted services for this population. Further research is needed to explore causal pathways underlying these associations.