Mental health problems occur frequently in the perinatal period and timely identification is key for appropriate support to be offered. Women are routinely asked about their mental health and may undergo formal screening as part of healthcare services in the perinatal period. The aim of this review was to explore women's views and experiences of being screened for mental health problems and to identify which aspects of this screening process they considered to be important. A systematic search was conducted across five electronic databases for potentially eligible studies published up to July 2025. A meta-ethnographic approach was used to synthesise the findings extracted from the thirty-eight papers included in the final analysis. Reciprocal translation resulted in a line of argument synthesis incorporating three over-arching themes. These were 'Opportunities presented by screening' 'Difficulties with screening' and 'Context and constraints'. Identification of salient aspects of the screening process revealed that preferences for how screening is conducted were varied, but more important than the specific method/mode used was the value that women placed on the concept of screening. Nevertheless, several process related factors, such as women's knowledge and expectations of screening, the screening method and environment, were found to be influential. An important implication for clinical care is that perinatal mental health screening can offer impactful and positive opportunities for women when they see value in the process and when this is facilitated by well validated, person-centred, and flexible screening approaches. Questions regarding suicide/self-harm specifically, presented difficulties, and there is an urgent need to examine how this can be made more acceptable to women.

Previously we reported ultrastructural abnormalities of capillaries, microglia and oligodendrocytes in the prefrontal cortex in schizophrenia. We aimed to estimate the ultrastructural changes of pericapillary microglia (PCapMg), perioligodendrocyte microglia (POlMg) and oligodendrocytes adjacent to microglia in the head of the caudate nucleus (CN) in schizophrenia.

Electron microscopy and morphometry of microglia and oligodendrocytes in the head of the CN were performed in 21 schizophrenia cases and 20 normal controls.

We found age-related lower volume fraction (Vv) and the number (N) of mitochondria in PCapMg, POlMg and in oligodendrocytes and higher Vv and N of lipofuscin in PCapMg in the schizophrenia group as compared to the control group. Area of lipofuscin granules in PCapMg positively correlated with Vv and N of lipofuscin granules in POlMg in the schizophrenia group but not in the control group. Vv and N of mitochondria in PCapMg positively correlated with Vv of mitochondria in POlMg, and Vv and N of mitochondria in oligodendrocytes positively correlated with Vv of mitochondria in POlMg in the control group but not in the schizophrenia group.

These data suggest that disturbed interactions between PCapMg, POlMg and oligodendrocytes in schizophrenia are associated with altered energy and lipid metabolism, mitochondria deficit and accelerated aging of PCapMg in schizophrenia. These changes might contribute to a disturbance of blood-brain barrier in the head of the CN in schizophrenia.

Borderline Personality Disorder (BPD) is a complex and debilitating condition characterized by limited treatment response and high dropout rates across treatments, even in leading therapeutic approaches, such as Dialectical-Behavioral Therapy (DBT). Given the heterogeneity of BPD symptomatology and the current shift toward dimensional assessments of personality disorders, this study investigates whether dimensional measures according to the DSM-5's Alternative Model for Personality Disorders (AMPD) may serve as additional markers of treatment outcome and dropout. Eighty-five participants with BPD were recruited from a naturalistic inpatient DBT program. Associations between BPD symptoms (Borderline Symptom List, Borderline Personality Disorder Severity Index), personality functioning (Level of Personality Functioning Scale - Brief Form 2.0), and dysfunctional personality traits (Personality Inventory for DSM-5 and ICD-11 - Brief Form Plus) were examined at baseline, as well as their sensitivity to change after DBT. At baseline, both personality functioning and dysfunctional personality traits, except antagonism, were associated with BPD symptoms (all r ≥ 0.4). After 10 weeks of DBT, parallel improvements were observed in personality functioning and dysfunctional personality traits, with significant reductions in negative affectivity and detachment. Elevated baseline levels of negative affectivity and psychoticism were associated with less BPD symptom change. DBT dropout was linked to higher impairment in negative affectivity and anankastia at admission. Personality functioning showed greater sensitivity to change throughout DBT compared to dysfunctional personality traits. These findings emphasize how AMPD may yield benefits beyond categorical BPD diagnoses, potentially contributing to more personalized and effective treatment planning and preventing dropouts.

BackgroundMental health nurses represent only 1.03% of the global nursing workforce, contributing to persistent workforce shortages. Undergraduate nursing students demonstrate limited interest in mental health nursing (MHN), often associated with negative attitudes toward MHN and individuals with mental illness. Understanding factors influencing these attitudes and career intentions is essential to inform targeted educational interventions.ObjectivesThis integrative review aimed to identify factors influencing undergraduate nursing students' attitudes and career interest in MHN and evaluate the impact of MHN education on these outcomes.MethodsGuided by Whittemore and Knafl's framework, a rapid integrative review was conducted across CINAHL, EMBASE, ScienceDirect, PubMed, and PsycINFO for English-language studies published between 2000 and October 2025. Of 362 records identified, 113 underwent screening, and 22 met inclusion criteria following full-text review. Quality appraisal employed CASP and JBI tools. Data were analyzed using constant comparison, with findings organized into structured matrices.ResultsFour themes emerged: (1) attitudes toward MHN varied widely, with more negative perceptions among first-year students; (2) overall career interest in MHN remained low to neutral; (3) influencing factors included attitudes toward mental illness, clinical exposure, and perceived preparedness; (4) MHN education improved attitudes but did not significantly increase career interest.ConclusionsAlthough MHN education enhances attitudes, it does not translate into increased career interest. Strategies such as extended clinical placements, lived-experience education, problem-based learning, and simulation may improve interest. Further rigorous research, including randomized controlled trials, is required to establish causality and inform workforce development strategies.

Late-life depression (LLD) and chronic low back pain frequently co-occur and exacerbate one another. Outcomes with antidepressant treatment in this population are often suboptimal. Pharmacogenetic factors may help explain variability in antidepressant response. Building on prior findings suggesting that SLC6A2 variation predicts venlafaxine response in LLD, we examined whether such genetic associations extend to older adults with chronic low back pain in the ADAPT study (Addressing Depression and Pain Together).

Older adults with LLD and chronic low back pain received venlafaxine treatment over 20 weeks. The primary analysis focused on the SLC6A2 rs2242446 variant, whereas secondary analyses evaluated 37 variants across 14 candidate genes implicated in depression or pain. Outcomes included percentage improvement in PHQ-9 scores, remission, and time to remission.

Genotype data were available for 101 participants. Primary analyses showed no association between SLC6A2 rs2242446 and any outcome measure. In secondary analyses, the serotonin 1A receptor gene (HTR1A) variant rs6295 emerged as the most consistent nominal genetic signal.

Previously reported pharmacogenetic signal involving SLC6A2 did not extend to a more clinically complex population, whereas exploratory serotonergic variation showed a nominal association. Findings inform pharmacogenetic research in late-life depression with comorbid pain.Clinical trial registration identifier is NCT01124188.

Rates of mental illness in young people are increasing, whereas the development of novel mental health treatments has not significantly progressed. Psychedelic-assisted therapy, using substances such as psilocybin and 3,4-methylenedioxymethamphetamine (MDMA), has shown potential in the treatment of mental illnesses in the adult population, including depression, anxiety and post-traumatic stress disorder. Interest has been growing around the potential use of psychedelic-assisted therapy to treat mental illness in adolescents. We present here a comprehensive review of all research focusing on children and young people, from experimental research of the 50s to observational and retrospective research focusing on traditional and Western non-medical use. The limited available research so far suggests that psychedelics appear to be safe overall and may have the potential to improve mental wellbeing in young people. However, young people may be at more risk of experiencing anxiety, challenging experiences and ego dissolution, but more thorough clinical research is warranted. Moving forward, we suggest that psychedelic-assisted therapy for young people should be administered within a rigorous ethical framework, where education of both the young people and their families is incorporated. Family involvement should be considered as part of the therapeutic framework. Lastly, avenues within the psychedelic space should be considered for young people, like the use of lower doses (psycholytic approach), which might lower the potential risks that are seen with high doses.

Severe mental illness (SMI) accounts for over a third of all mental disorders globally, significantly reducing life expectancy and quality of life. Trends in SMI vary, with recent Danish studies reporting both stable and rising rates in the 2000s. This study examines the prevalence (1996-2018) and incidence (2000-2018) of SMI in Denmark, analyzing age- and sex-specific trends using nationwide health registry data.

The study included individuals aged ≥18 years with a psychiatric hospital diagnosis of SMI, recorded in the Danish National Patient Registry (1995-2018). SMI was defined as moderate to severe depression, bipolar disorder, or psychotic disorder based on ICD-10 classifications. We estimated five-year prevalence (2000-2018) and one-year incidence (1996-2018), stratified by age and sex.

Between 2000 and 2018, the crude prevalence of depression more than doubled, while bipolar and psychotic disorders increased by 89.6% and 35.0%, respectively. All SMIs increased among individuals aged 18-29. From 1996 to 2018, depression and bipolar disorder incidence rose by 137.5% and 45.1%, respectively, while psychotic disorder incidence declined by 9.5%. The largest incidence increase occurred in the 18-29 age group. Bipolar and psychotic disorder prevalence declined in those ≥70 years. Depression was the most prevalent disorder among individuals ≥90 years.

SMI prevalence and incidence in Denmark have risen over the past two decades, particularly among younger adults. However, professional, cultural, administrative, and societal factors must be considered before concluding an actual increase in SMI cases.

Therapeutic alliance ruptures represent critical moments that, if properly addressed, may become opportunities for therapeutic change. Although various models and evidence exist regarding rupture repair, no prior scoping review has systematically mapped clinical recommendations using a replicable methodology. This review aimed to map clinical recommendations for repairing therapeutic alliance ruptures in psychotherapy with adults, focusing on therapist competencies, patient characteristics, and theoretical frameworks underpinning these recommendations. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines, articles were retrieved from Web of Science, PsycINFO, and Scopus, supplemented by secondary searches. Conceptual and empirical publications addressing rupture repair in individual psychotherapy with adults were included (n=25). The review maps two complementary sets of recommendations. Empirical studies appear to converge on strategies organized around rupture recognition, expressive repair (focused on exploring the rupture experience), and immediate repair (focused on corrective task and goal adjustments). Theoretical and conceptual contributions highlight the influence of cultural, contextual, and trauma-related factors on rupture and repair processes, emphasizing the need for sensitivity to patient-specific, cultural, and contextual factors. Overall, the findings suggest that the literature on rupture repair is evolving toward greater contextual sensitivity, with personalization and responsiveness emerging from an integrative reading of the findings as central challenges for clinical practice and future research.

Baseline personality pathology may shape both everyday functioning and engagement in psychotherapy. This study tested whether maladaptive personality trait domains and borderline symptom severity were associated with psychosocial functioning at intake and whether these variables were related to subsequent psychotherapy dropout within the same clinical pathway. Participants were 124 young adults (M age = 20.81, SD=2.30; 51.6% male and 48.4% female) assessed at intake in a youth mental health early intervention service in Milan, Italy (2024-2025). Measures included the Personality Inventory for the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (PID-5), the Borderline Symptom List-23 (BSL-23), and the Social and Occupational Functioning Assessment Scale (SOFAS). SOFAS was examined using stepwise multiple linear regression including PID-5 domains, BSL-23, sex, and age. Dropout was examined using Bayesian logistic regression and model comparison in the psychotherapy-only subsample (n=63; 13 dropouts, 20.6%). In the full sample, the final regression model retained only BSL-23, F(1, 122)=5.57, p=.020, R2=.04, indicating that higher borderline symptom severity was associated with lower functioning (B=-2.86, β=-.21, 95% CI [-5.27, -0.46]). For dropout, inclusion evidence was strongest for disinhibition (Bayes factor for inclusion [BF_inclusion] = 3.36), followed by BSL-23 (2.39) and SOFAS (2.23), although model-averaged 95% credible intervals (CrIs) included zero for all predictors. Clinically, these findings suggest that disinhibition and borderline severity may be better understood as markers of relational intensity requiring a structured yet reflective therapeutic stance rather than as straightforward dropout risks.

Mental disorders (MDs) pose a important global health challenge, with a complex pathogenesis complicating treatment development. Nutritional interventions, particularly polyunsaturated fatty acids (PUFAs), have gained attention as potential therapeutic options.

This Mendelian randomization (MR) meta-analysis aimed to evaluate the potential causal relationship between PUFAs and MDs.

Genome-wide association study data were utilized to analyze the association between PUFAs (including omega-3, omega-3 percentage [omega-3%], omega-6, omega-6 percentage [omega-6%], and omega-6 to omega-3 ratio) and 12 major MDs.

Two-sample MR technology was used to assess the role of PUFAs in MDs.

The MR analysis revealed that genetically predicted omega-3 was causally linked to MDs, such as obsessive-compulsive disorder, bipolar disorder, schizophrenia, and major depressive disorder. Omega-3% exhibited protective effects against emotional personality disorder. Conversely, omega-6 was inversely correlated with attention-deficit/hyperactivity disorder risk, while a high omega-6 to omega-3 ratio was associated with an increased risk of depression and other mood disorders.

High omega-3 levels and omega-3% may reduce the risk of MDs, whereas a high omega-6:omega-3 ratio may elevate the risk. These findings highlight the potential of PUFAs, particularly omega-3, in MD prevention and treatment, while underscoring the need for further research into the complex interactions between omega-3 and omega-6. The study provides a scientific foundation for future clinical trials and dietary intervention strategies.

PROSPERO no. CRD42024598472.