Atypical neurocognitive functioning is consistently reported in adults with obsessive-compulsive disorder (OCD), while studies in childhood/early-onset OCD show smaller and more selective effects. Neurobiological models of OCD implicate aberrant activation within cortico-striato-thalamo-cortical (CSTC) circuits, while related executive function (EF) alterations have been proposed as potential mechanisms underlying OCD symptomatology. However, neurocognitive correlates of treatment response in pediatric OCD have not been examined across different psychotherapeutic interventions in a randomized design.

130 children with OCD (aged 8-17 years) were randomized 1:1 to 14 sessions of family-based psychotherapy with either cognitive-behavioral therapy (CBT) or psychoeducation and relaxation training (PRT) and assessed with a comprehensive neurocognitive test battery before randomization (baseline) and at end-of-treatment (week 16). Of those, 90 children with relevant neurocognitive data were included in the present study. An age- and sex-matched control group of 87 children with no psychiatric diagnoses were assessed at the same time points.

Children with OCD showed moderate improvement after treatment, relative to controls, on one pre-selected outcome (decision-making; generalized eta squared (ges) = .020) and small improvement on one exploratory outcome (processing speed; ges =.010). However, there was no differential effect of treatment type (CBT versus PRT) and no association between neurocognitive change and OCD symptom alleviation. Symptom alleviation was neither predicted nor moderated by baseline neurocognitive performance.

These findings indicate that psychotherapeutic interventions may be associated with modest and selective changes in neurocognitive performance in pediatric OCD on a group level. However, the selective effects, together with the lack of differential treatment effects and the absence of association with symptom alleviation, raise questions about the clinical relevance of these changes and whether performance-based neurocognitive differences represent clinically meaningful mechanisms underlying pediatric OCD symptoms or their alleviation with treatment.

Obsessive-compulsive disorder (OCD) includes heterogeneous presentations, despite the disproportionate research and clinical attention on contamination and symmetry symptoms. Colloquially coined "schizophrenia OCD", obsessional fears of having or developing a psychotic disorder (or "going crazy") and associated compulsions have received growing recognition within psychoeducational contexts and patient communities. This preliminary study examined the prevalence and associated factors of fears of psychosis among a university student sample (N = 154). Participants completed an online questionnaire that included symptom checklists assessing psychosis-related unwanted intrusive thoughts and compulsive behaviours, alongside a series of validated measures. Fears of psychosis were commonly endorsed: 77.9% endorsed lifetime unwanted intrusive thoughts, 70.1% endorsed associated compulsive behaviours, and 83.1% reported at least one psychosis-related unwanted intrusive thought or compulsive behaviour. Fears of losing control of your thoughts or actions was the most frequently endorsed intrusive thought (50.6%), whereas fear of developing a psychotic illness (18.3%) was rated most distressing. The most frequently endorsed compulsive behavior was replacing "bad thoughts" with better thoughts (53.2%). Supporting our hypothesis, individuals meeting OCD symptom cut-offs were more likely to endorse psychosis-related fears. Finally, hierarchical regression analyses indicated that health anxiety and negative beliefs about losing control predicted psychosis-related unwanted intrusive thoughts, over and above demographic factors, OCD severity, or other clinically relevant variables. Findings underscore the need for recognition of fears of mental health issues in individuals with OCD and suggest that interventions targeting health anxiety and perceptions of loss of control may be particularly relevant.

Low self-esteem can be disabling for young individuals, negatively impacting school performance, relationships, and mental or physical health. Cognitive-behavioral conceptualizations and treatments for low self-esteem exist but have not been applied or evaluated in a young adult population.

To address this gap, this study evaluated a novel Internet-based CBT (ICBT) for young adults (18-25 years) suffering from low self-esteem in a randomized controlled trial.

Eighty-six participants were recruited and randomized to either seven weeks of therapist-guided ICBT (n = 43) or a wait-list control condition (n = 43). Measures of self-esteem, self-compassion, depression, anxiety, and quality of life were assessed pre-and post treatment. Roseberg self-esteem scale (RSES-10) was the primary outcome.

The results suggest that therapist-guided ICBT can be an effective way to strengthen self-esteem in young adults, revealing a large between group effect size in favor of the treatment group (RSES-10; d = 1.24). Statistically significant results were also found on the secondary measures, resulting in moderate to large effect sizes.

This study indicates that ICBT can be an effective way to treat low self-esteem in young adults. The results are preliminary and warrants further evaluation and replication.

Apathy is a multidimensional neuropsychiatric syndrome involving cognitive, emotional, and behavioral domains. Cognitive impairment and apathy are both associated with reduced social functioning, but how specific apathy dimensions relate cognition to social functioning across neurodegenerative diseases remains unclear.

This study compared multidimensional apathy profiles across Parkinson's disease (PD), Alzheimer's disease-like mild cognitive impairment (AD-like MCI), and normal controls (NC), and investigated whether specific apathy dimensions mediate the association between cognitive function and social functioning.

A total of 297 participants were enrolled, comprising 96 PD, 66 AD-like MCI, and 135 NC. All participants provided demographic information and underwent neuropsychological tests, a multidimensional apathy measure, and a social functioning measure. Depressive symptoms, sex, age, and education were included as covariates. Mediation analyses were conducted using PROCESS Model 4 with bootstrapping.

A coherent triadic association among cognitive function, apathy, and social functioning was observed exclusively in the PD group. Hierarchical regression showed that cognitive and social motivation (CSM) independently predicted social functioning beyond executive function and covariates. Mediation analysis demonstrated that mental shifting was indirectly associated with social functioning through CSM (indirect effect = -.014, 95% CI [-.033, -.002]), with a non-significant direct effect. This pattern was not observed in the AD-like MCI or NC groups.

These findings reveal a PD-specific pattern of associations among impaired mental shifting, CSM, and reduced social functioning. Its absence in AD-like MCI suggests distinct apathy mechanisms across neurodegenerative diseases and highlights CSM as a potential intervention target.

A migrant is any person who moves across an international border or within a State, away from their habitual place of residence. Migrants may be at greater risk of experiencing loneliness. However, no comprehensive meta-analysis has examined this association. This study aimed to explore the levels of loneliness among migrants compared to non-migrants based on quantitative studies.

The review followed PRISMA 2020 guidelines. PsycINFO, PubMed, Scopus, and Web of Science databases were searched from inception to March 2025. Methodological quality of studies was assessed using the Joanna Briggs Institute Checklist for cross-sectional and cohort studies. A random-effect model was used to estimate the pooled effect size. Heterogeneity was assessed using the Q and I² statistics. Publication bias and potential moderators (sex, age, and loneliness scale used), were also examined.

Initially, the literature search yielded 2196 records. Forty studies were included in the systematic review, of which 30 were eligible for the meta-analysis, comprising 258,387 participants (18.6% migrants). After controlling for moderators, the random-effects model indicated a significant positive association between migration and loneliness (g = 0.21; 95% CI [0.13, 0.30], z = 4.92, p < .01), with migrants reporting higher levels of loneliness than non-migrants. Substantial between-study heterogeneity was observed. Moderator analyses revealed no statistically significant effects.

The present meta-analysis provides evidence of a positive association between migration and loneliness. Understanding how migration processes shape experiences of loneliness is essential for policies that promote social integration and well-being among the migrant population.

Reliable data on suicidal ideation, attempts, and deaths are essential for effective suicide prevention. However, prior research indicates that up to one-third of individuals inconsistently recall past self-injurious thoughts and behaviors, raising concerns about underestimation of suicide risk. Evidence on the prevalence and correlates of inconsistent reporting of suicidal ideation and attempts in large population-based cohorts, particularly among men, remains limited.

To estimate the prevalence and identify correlates of inconsistent reporting of lifetime suicidal ideation and attempts among Australian men.

Data were drawn from Ten to Men: The Australian Longitudinal Study on Male Health. Our primary analyses focused on 1,880 men who reported lifetime suicidal ideation and 508 who reported lifetime suicide attempt at Wave 1 and followed up at Wave 2. Inconsistent reporting was defined as endorsing lifetime suicidality at Wave 1 but not at Wave 2. Modified Poisson regression was used to investigate correlates of inconsistent reporting, based on broad set of sociodemographic, psychosocial, and clinical characteristics. Wave 3 analyses were conducted as exploratory sensitivity checks.

At Wave 2, 17.3% (95% CI: 15.6%-20.6%) of those who had reported suicidal ideation and 34.6% (95% CI: 30.5%-38.7%) of those who had reported a suicide attempt no longer reported these histories. Wave 3 analyses showed similar patterns. Depressive symptoms were associated with lower likelihood of inconsistent reporting of suicidal ideation (PR=0.54, 95% CI: 0.38-0.76, p<0.001). Other hypothesized factors were not significantly associated with inconsistent reporting.

Inconsistent reporting of suicidal ideation and attempts is common among Australian men. Findings highlight the need for improved measurement strategies in longitudinal suicide research.

Limited data exist on suicidality among non-treatment-seeking individuals with opioid dependence in low- and middle-income countries. The objectives of the study were to assess the prevalence and correlates of suicidality and perceived burdensomeness among community-dwelling individuals with opioid dependence and to assess association of socio-clinical factors with suicidality and perceived burdensomeness.

This cross-sectional study utilized baseline data from a prospective community-based cohort study conducted in an urban socioeconomically disadvantaged area of Delhi, India. Adult males meeting ICD-10 criteria for opioid dependence and not engaged in treatment for at least 6 months were recruited using snowball sampling. Suicidality was assessed using the Ask Suicide-Screening Questions (ASQ). Depressive symptoms (using Patient Health Questionnaire-9), anxiety symptoms (Generalized Anxiety Disorder-7), severity of opioid dependence (Leeds Dependence Questionnaire), and high-risk behaviors were evaluated. Logistic regression analyses were conducted to identify factors independently associated with suicidality and perceived burdensomeness.

Among 396 male participants, 24.5% screened positive for suicidality (presence of either suicidal ideations in past week or self-harm attempt in the past), and 32.8% endorsed perceived burdensomeness (either wish to die or feeling of burden on family). Suicidal ideation was reported by 20.2% (n = 80), among whom 56% (n = 45) had engaged in at least one past self-harm attempt. Significant factors associated with suicidality included younger age at onset of opioid use, injection drug use, concurrent alcohol use, history of family discord, and depressive symptoms (p < .05).

Suicidality is highly prevalent among non-treatment-seeking individuals with opioid dependence in community settings. Co-occurring depressive and anxiety symptoms significantly contribute to suicide risk, underscoring the critical importance of integrated mental health screening within opioid use disorder services. Early identification and intervention targeting psychiatric comorbidity may reduce suicide risk in this vulnerable dual diagnosis population.

Postoperative delirium is linked to increased morbidity, mortality, and prolonged hospitalization; however, its short-term consequences after major emergency abdominal surgery remain insufficiently studied.

This prospective cohort study included 752 patients undergoing major emergency abdominal surgery at Copenhagen University Hospital, Herlev, from 2021 to 2022. Delirium was identified via systematic screening and record review. The primary outcome was Comprehensive Complication Index (CCI). Secondary outcomes included Intensive Care Unit (ICU) admission, length of stay, discharge destination, and 30-day mortality. Multivariable logistic regression identified risk factors. The timing of complications relative to delirium onset was examined.

Delirium occurred in 175 (23%) patients and was associated with higher CCI (median 44 vs. 9) and longer stay (13 vs. 6 days), more ICU admissions (36% vs. 13%), and higher 30-day mortality (22% vs. 8%) (all p < 0.001). Delirium was associated with more frequent discharge to long-term care. Risk factors for delirium included higher age, higher degree of frailty, intraperitoneal contamination, and damage control surgery. The incidence rate of complications was significantly lower than in the pre-delirium period (IRR = 0.49, 95% CI: 0.39-0.60, p < 0.001), with the highest rate observed on the day of delirium onset (0.72 events per patient-day at risk).

Delirium was strongly associated with worse short-term outcomes after emergency abdominal surgery. Delirium onset coincided with the highest complication rate, underscoring the systemic physiological stress associated with delirium. These findings support the importance of early detection of delirium and possible prevention strategies.

Variants that disrupt pre-mRNA splicing represent a historically underrecognized proportion of pathogenic alleles in Mendelian neurological disorders, accounting for an estimated 15-30% of disease-causing variants. Conventional clinical genomic pipelines frequently overlook these variants because analysis and reporting have traditionally focused on protein-coding regions, with intronic and synonymous positions assigned lower priority. The central practical problem this review addresses is therefore not whether splicing matters in neurogenetic disease - that is well established - but how a splice-altering variant identified on a diagnostic report can be reliably identified, experimentally validated, and translated into a clinical diagnosis or therapeutic decision. Deep learning-based splice prediction tools such as SpliceAI and Pangolin, RNA sequencing, long-read transcriptomics, and minigene functional assays have collectively improved diagnostic yield in previously unsolved neurogenetic cohorts, particularly by identifying deep intronic pseudoexon variants and leaky canonical splice-site alleles. Nevertheless, accurate variant classification remains challenging: the Pathogenic Very Strong 1 (PVS1) criterion of the American College of Medical Genetics and Genomics/Association for Molecular Pathology (ACMG/AMP) framework requires careful gene- and variant-specific adaptation when applied to splicing, prediction tools disagree with one another and are least reliable outside the core splice-site consensus, and RNA-based validation is constrained by the tissue- and developmental-stage-restricted nature of splicing itself. This review synthesizes the molecular basis of splice-altering variants, current standards for their nomenclature and computational prediction, the practical strengths and limitations of RNA-level validation, and their contribution to epilepsy, hereditary neuropathy, ataxia, dystonia, mitochondrial disease, neuromuscular disorders, and the newly recognized spliceosomal small nuclear RNA (snRNA) neurodevelopmental disorders. We place particular emphasis on the diagnostic and therapeutic decisions that depend on getting this interpretation right, on the unresolved limitations of current prediction and validation tools, and on priorities for embedding RNA-level diagnostics more routinely into clinical neurogenetic practice.

Electroconvulsive therapy (ECT) is highly effective for severe and treatment-resistant mental disorders, but concerns about cognitive side effects and enduring stigma continue to hinder its broader acceptance. Although treatment response and cognitive tolerability are both clinically important, their systematic assessment and documentation remain challenging in routine clinical practice. To address this gap, we developed the Clinical Global Impression-Stimulation Outcome Monitoring Tool (CGI-STIM), a pragmatic clinician-rated tool that integrates both domains into a single clinically interpretable outcome classification.

We retrospectively analyzed 21 ECT series in 15 patients. Two independent clinicians applied the CGI-STIM using routine clinical documentation to classify treatment outcomes based on clinical response and cognitive tolerability. Feasibility and interrater agreement were evaluated.

The CGI-STIM was successfully applied to all 21 ECT series. Outcome classification was feasible in all cases using routinely available clinical information. Average completion time was approximately 5 min. Interrater agreement was excellent (quadratically weighted Cohen's κ = 0.84). The resulting classifications reflected varying combinations of clinical improvement and cognitive tolerability, illustrating the instrument's ability to capture multidimensional treatment outcomes.

In this preliminary retrospective evaluation, the CGI-STIM was feasible to apply to routine clinical documentation and showed strong interrater reliability. These findings do not establish validity, prospective reliability, sensitivity to change, or clinical utility. Future prospective studies in larger ECT samples are required to evaluate these measurement properties and the potential utility of the CGI-STIM for routine outcome monitoring.