Parent-child conflict is a key source of parental stress, and mindful parenting may serve as a protective moderator. However, little is known about how these associations unfold at both the within-person (daily) and between-person levels. This study examined how daily fluctuations and individual differences in parent-child conflict were associated with parental stress, and whether baseline mindful parenting buffered these links. Seventy-three Chinese parents (M = 37.89, SD = 3.62, 86.3% mothers) of children aged 5-6 years completed a baseline measure of mindful parenting and a 14-day diary on daily parent-child conflict and parental stress. Multilevel structural equation models revealed that parent-child conflict was positively associated with parental stress at both within-person (i.e. higher same-day stress) and between-person (i.e. higher overall stress) levels. Furthermore, mindful parenting significantly moderated these associations at both levels in distinct ways. At the within-person level, the positive association between daily conflict and parental stress was weaker for parents with higher levels of mindful parenting compared to those with lower levels. At the between-person level, this positive association between average conflict and parental stress was significant only among parents with higher mindful parenting, and not among those with lower levels. These findings highlight the distinct roles of mindful parenting at different levels of analysis. While it buffers daily stress responses to conflict (within-person), it may also sensitize parents to chronic conflict (between-person). This dual role underscores the need for tailored interventions targeting both daily variations and enduring individual differences to promote family well-being.

People living with schizophrenia often experience high levels of stigma and are consistently at risk of internalizing it. Internalized stigma has a negative impact on several clinical and recovery outcomes in people with schizophrenia, but the effect of internalized stigma on important patient reported outcomes that are gaining increasing scientific and clinical relevance, such as life engagement, has not yet been extensively investigated.

This study aims to investigate the relationship between several different socio-demographic, clinical, functional and medication-related variables and life engagement, with the hypothesis that internalized stigma, alongside other factors, could represent an individual predictor of reduced life engagement.

Ninety-four participants diagnosed with schizophrenia were included in this cross-sectional study and were investigated with validated instruments assessing life engagement, schizophrenia symptoms severity, global clinical severity, internalized stigma, psychosocial functioning, antipsychotic-related side effects, attitude toward medications, and subjective well-being. Predictors of life engagement were assessed using a stepwise multivariate linear regression analysis.

Greater global clinical severity (β = .685, p < .001), fewer years of education (β = -.240, p < .001), and greater stigma endorsement (β = .180, p = .005) emerged as individual predictors of reduced patient life engagement, explaining a large proportion of the observed variance (Adjusted R² = .649, p = .001).

Internalized stigma, among other well-recognized variables, appears to represent an individual predictor of worse patient life engagement in people living with schizophrenia. This finding should strengthen the notion that stigma, and internalized stigma in particular, represent important dimensions and treatment targets in the clinical management of schizophrenia, also in the perspective of improving patient-reported outcomes.

The incidence of mental health concerns is growing, and demand for support is exceeding service capacity. Digital tools can provide additional support but risk causing harm if not delivered safely.

We aimed to establish real-world evidence of the impact of an artificial intelligence-based mental health conversational agent (Wysa) on depression and anxiety in patients waiting for Talking Therapies treatment.

A mixed-methods randomized controlled trial was conducted with patients referred to Talking Therapies in the Central and Northwest London NHS Foundation Trust. The primary outcome was change in depression severity over 12 weeks between groups; secondary outcomes included anxiety severity, quality of life, safety, engagement, and app usage. Comparative analyses used linear regression; thematic analysis was conducted on qualitative data.

2,161 patients were screened, 625 were invited, 99 consented, and 76 were randomized (2:1). Thirty patients were lost to follow-up. Descriptive analysis found that mean differences in depression were similar between arms, but with large standard deviations (M = 2.62, SD = 5.07 and 6.56 for Wysa; M = 2.59, SD = 4.38 and 3.82 for control). Results were similar for secondary outcomes. Wysa was potentially helpful, easy to use, and appreciated as an accessible source of support, but limitations with the conversational agent negatively affected engagement.

Although sample size limited the analysis, participant feedback highlighted its potential to supplement clinical services. Our study findings suggest that the change of depression score is similar in both arms thus indicating that there is no evidence that Wysa treats depression in this study. However, limited sample size could have influenced this. Key lessons to improve the quality of effectiveness studies of digital health technologies were identified.

Data on the prevalence of Multiple Sclerosis (MS) in Tunisia come back more than twenty years ago. Our study aimed to determine the prevalence of MS in Tunisia and to discuss the determining factors of its current status. The results suggested a trend towards an increase in the prevalence of MS in Tunisia reaching 58.3 per 100 000 inhabitants in 2020. It ranks Tunisia in a high prevalence MS zone but is still lower than that in the western countries and some MENA countries. The determining factors of this new MS prevalence need to be investigated to insure better management of healthcare resources.

To measure disability and frailty and assess measurement properties of the HIV Disability Questionnaire (HDQ) in outer regional Australian people living with human immunodeficiency virus (HIV).

This cross-sectional, validity and reliability study included community-dwelling outer regional Australian adults with HIV. Participants completed the self-reported World Health Organization Disability Assessment Schedule 2.0 (WHODAS; scored 0-100), 5-Question Frail Scale (scored 0-5) and HDQ (scored 0-100). Median scores (Q1, Q3) for disability (WHODAS) and frailty (Frail Scale) were reported. HDQ validity was tested based on 16 a priori hypothesized relationships between WHODAS, Frail Scale and HDQ scores (threshold ≥75% confirmed), and HDQ internal consistency with Cronbach's alpha (acceptability threshold ≥ 0.70). Seven days after the initial completion, the HDQ was re-administered for test-retest reliability (intraclass correlation coefficient, acceptability threshold ≥ 0.75).

Fifty participants were recruited, with a median age 55. Eighty-eight percent were male, and 38 participants completed the second HDQ. The median (Q1, Q3) scores were: WHODAS 9 (3,17), with domain scores ranging from 0 to 56. Pre-frailty (score 1-2) and Frailty (score 3-5) were present in 27% and 13% of participants, respectively. The HDQ demonstrated construct validity (81% hypotheses confirmed), internal consistency (Cronbach's alpha ≥ 0.79), except in the Episodic scale-Social inclusion domain (alpha = 0.34), and good test-retest reliability for all Presence and Severity domains (ICC range: 0.77-0.94).

Disability, frailty and pre-frailty exist in this sample of outer regional Australians living with HIV. The HDQ showed acceptable construct validity, internal consistency and test-retest reliability to measure disability in this population.

Australian New Zealand Clinical Trials Registry (ACTRN12623000090617).

Mental disorders represent a major public health challenge among women of childbearing age (WCBA, 15-49 years), yet comprehensive evidence on long-term trends, socioeconomic disparities, and future trajectories remains limited. Using data from the Global Burden of Disease (GBD) 2021, this study aimed to quantify the burden of mental disorders among WCBA from 1990 to 2021 and to project future trends.

Incidence, prevalence, and disability-adjusted life years (DALYs) of mental disorders among WCBA were obtained from GBD 2021. Temporal trends from 1990 to 2021 were assessed using joinpoint regression analysis. Bayesian age-period-cohort (BAPC) modeling was applied to forecast the burden of ten major mental disorders for the next 15 years. Analyses were stratified by age group, geographic region, country, and socio-demographic index (SDI).

In 2021, mental disorders imposed a substantial global burden among WCBA, with depressive and anxiety disorders accounting for the majority of cases. Marked geographic and socioeconomic disparities were observed, with consistently higher burdens in high-SDI regions. Age-specific patterns differed by disorder, with anxiety disorders peaking in younger women and depressive disorders peaking in midlife. Trend analyses revealed a decline in burden indicators between 2005 and 2010, followed by a pronounced rebound after 2019. Projections indicate that the incidence and prevalence of depressive and anxiety disorders will continue to rise, whereas the burden of bipolar disorder and schizophrenia is expected to stabilize or decline.

The burden of mental disorders among WCBA shows substantial inequalities across regions and SDI levels and is projected to increase further for common disorders. These findings highlight the need for forward-looking, equity-oriented mental health policies, with targeted prevention, early intervention, and resource allocation strategies tailored to high-risk populations and regions.

Neuroinflammation is increasingly recognized as a core pathophysiological mechanism in schizophrenia and can be indirectly assessed through peripheral inflammatory markers. Therefore, this pilot study investigated the impact of antipsychotic treatment on inflammation in patients with first-episode psychosis (FEP) who were antipsychotic-naive at study entry.

Thirty-three drug-naïve FEP patients provided blood samples upon admission (V0) and follow-up (V1), from which peripheral inflammatory markers-i.e., neutrophil/lymphocyte ratio (NLR), monocyte/lymphocyte ratio (MLR), platelet/lymphocyte ratio (PLR), and systemic immune-inflammation index (SII)-were calculated. Antipsychotic doses during continuous hospitalization between V0 and V1 (34 days, IQR: 21-49 days) were converted into cumulative chlorpromazine equivalents (cCPZ).

In multiple regression models adjusting for sex, age, BMI, DUP, and clozapine use, cumulative antipsychotic exposure significantly predicted reductions in ΔNLR (p = 0.048), ΔMLR (p = 0.041), ΔPLR (p = 0.028), and ΔSII (p = 0.028). All associations remained significant following false discovery rate adjustment (pFDR = 0.048 for all outcomes).

These findings suggest a consistent dose-dependent anti-inflammatory effect during early antipsychotic treatment in FEP. Given the exploratory nature of this study, larger studies are needed to confirm these findings.

Telepsychiatry has emerged as a valuable modality to bridge mental health gaps. Despite its huge potential in Nepal, it remains understudied. This study described the profiles and experiences of the patients using the free videoconferencing-based telepsychiatry service initiated at Patan Hospital, a public tertiary care center in Nepal, over four years.

A retrospective review of clinical records and patients' feedback about the videoconferencing-based telepsychiatry service from May 2021 to May 2025 from the existing service was conducted. Data were analyzed for descriptive statistics using Microsoft Excel 2016.

A total of 430 consultations were provided to 145 patients, with a mean age of 34.88±15.27 years; 79 (54.48%) were male, and 123 (84.83%) patients were from outside the Kathmandu Valley. 47 (32.41%) patients had anxiety disorders, followed by psychotic disorders in 44 (30.35%), depression in 18 (12.41%), and bipolar disorder in 14 (9.66%) patients. 69 (47.59%) patients used benzodiazepines, followed by second-generation antipsychotics (46.21%) and SSRIs (40.69%). A subset also received non-pharmacological interventions (21.38%). 49 (81.67%) patients preferred videoconferencing-based telepsychiatry service over face-to-face visits for the initial consultation, and 57 (95.0%) for follow-up visits. However, only 35% followed up.

Our study highlights that implementing a videoconferencing service in a public hospital setting in Nepal is possible and it is preferred by psychiatry patients.

Anxiety disorders in the pediatric population represent a highly prevalent mental health concern whose pharmacological management has been consolidated through the use of selective serotonin reuptake inhibitors (SSRIs). Among these agents, sertraline is one of the most frequently prescribed; however, its efficacy and safety in children and adolescents exhibit substantial interindividual variability, largely attributed to clinical, physiological, and genetic factors. This review aimed to analyze the current evidence on the efficacy, safety, and optimization strategies for sertraline therapy in pediatric patients, with a particular focus on pharmacokinetic and pharmacogenetic determinants that modulate therapeutic response. Available evidence indicates that genetic variants in CYP2C19, CYP2D6, and ABCB1 significantly influence hepatic metabolism, plasma exposure, and drug tolerability. These differences support the integration of pharmacogenetic testing as a clinical tool to individualize dosing and prevent adverse effects. In addition, population pharmacokinetic modeling has emerged as a valuable approach to design personalized therapeutic regimens, especially for patients with medical comorbidities or atypical metabolic profiles. In conclusion, the integration of clinical, genetic, and pharmacokinetic information into pediatric psychiatric practice may facilitate the advancement of precision medicine, promoting safer, more effective, and individualized sertraline-based treatments for anxiety disorders in children and adolescents.

The network theory describes mental disorders as a network of interacting symptoms. While most research on the network theory is based on network analyses of symptom data, little is known about mental health professionals´ attitudes towards this theory. Clinical expertise could offer a valuable additional perspective on the validity of the theory and its applications to clinical practice.

Mental health professionals rated their agreement with propositions of the network theory regarding the phenomenology, aetiology, and treatment of mental disorders in an online survey. Further, the acceptability and appropriateness of possible applications were evaluated. We calculated descriptive statistics and examined associated factors with regression analyses.

The participating psychotherapists (n = 183), specialized physicians (n = 45), and clinical psychologists (n = 29, total n = 257) largely agreed with the network theory's propositions regarding the phenomenology of mental disorders and treatment effects. Appraisal of the network theory regarding the aetiology of mental disorders, regarding important treatment targets, and regarding acceptability and appropriateness of possible applications was mixed. A theoretical background in cognitive behavioural therapy and previous knowledge of the network theory were associated with a stronger agreement in most domains.

The fundamental assumptions of the network approach seem to resonate with mental health professionals, while the consequences for the diagnosis and treatment of mental disorders were questioned. Our findings indicate that the general conceptualization of mental disorders as symptom networks seems to align with mental health professionals' perceptions but, at the same time, emphasizes the novelty and limited specificity of the theory's implications for clinical practice.