Depression is a common and chronic mental health problem, and the diagnosis and management of depression require continuous monitoring. In this review study, sensor-based digital tools for the diagnosis and management of depression were examined. The effectiveness, usability, and limitations of these tools were evaluated and discussed.

This systematic review was conducted in November 2025 using databases including IEEE, PubMed, Scopus, and Web of Science. The search was performed in accordance with PRISMA guidelines. Peer-reviewed studies that had used digital technologies for the diagnosis, monitoring, or intervention in depression were identified. Eligible articles were included in the study after full-text assessment.

In total, 41 studies met the inclusion criteria. Sample sizes in the studies ranged from 5 to 3936 participants. The study populations covered a wide range, from adolescents to older adults. Most investigations addressed various depressive disorders; some also referred to bipolar disorders or psychological distress. Overall, digital tools were categorized into smartphones, wearables, hybrid systems, and innovative platforms. These tools often used sensors such as global positioning systems (GPS), accelerometers, and heart rate monitors. Speech and facial analyzers were also employed. Data collection was carried out through active and passive monitoring of behavior, physiology, and mood.

Sensor-based digital tools have the capability to monitor and record the complex symptoms of depression. These data can also be used for personalized care. However, robust and standardized validation is required for clinical implementation. Future research should focus on long-term engagement and scalability of these tools while maintaining confidentiality and sensitivity, with an emphasis on specific types of depression.

Pediatric medico-legal cases, encompassing injuries and other unnatural events, pose a significant public health burden, particularly in low- and middle-income countries like Nepal. Lack of comprehensive, localized data on the spectrum of these cases presenting to emergency departments hinders the development of targeted prevention and management strategies. This study aimed to describe the pattern of medico-legal cases among pediatric patients at a tertiary care center in Nepal.

A retrospective cross-sectional study was conducted by reviewing the medical charts of pediatric patients (under 18 years) registered as medico-legal cases in the Emergency Department of Tribhuvan University Teaching Hospital from December 2022 to January 2023. Data on demographics, case type, and clinical details were extracted and analyzed using descriptive statistics.

Out of 2,936 total medico-legal cases, 297 (10.11%) were pediatric cases. Based on types of incidents, there were 109 (36.70%) road traffic accidents, 68 (22.89%) suicide and self-harm, 47 (15.82%) falls, and 46 (15.49%) physical assaults. Adolescents aged 14-17 years accounted for 147 (49.49%) cases, and males accounted for 182 (61.15%) cases. There were 57 (83.8%) suicide attempts with poisoning, and 10 (52.63%) accidental poisonings with pesticides. Males accounted for 77 (70.64%) of road traffic accidents and 34 (73.91%) of physical assaults, while females accounted for 39 (57.35%) of suicide/self-harm cases.

Road traffic accidents and suicide/self-harm are the leading causes of pediatric medico-legal presentations in this tertiary care setting. The distinct patterns observed across different age and gender groups underscore the need for targeted, evidence-based interventions in injury prevention, mental health support, and public safety to protect this vulnerable population in Nepal.

An open-label, single-arm pilot study evaluated the efficacy of the combined melatonin and memantine preparation (Miladean) as add-on therapy in 20 children and adolescents (aged 8-15 years) with cognitive and behavioral impairments within hyperkinetic conduct disorder (F90.1, n=7), schizotypal disorder (F21, n=10), and schizophrenia (F20, n=3). All patients received stable background therapy, to which Miladean was added (2 tablets sublingually at bedtime) for 8 weeks. Cognitive tests (Raven's Progressive Matrices, Stroop test, computerized Go/No-Go task), sleep quality questionnaire (modified Spiegel scale), and ADHD symptom scales (SNAP-IV) were used to assess outcomes. The drug demonstrated a favorable safety and tolerability profile. A statistically significant reduction in symptoms of inattention and hyperactivity-impulsivity on the SNAP-IV scale (p<0.001), improved sleep quality (p=0.002), and increased reaction speed in the Go/No-Go task (p=0.001-0.033) were observed. A trend towards improved performance on the intelligence test (Raven's Progressive Matrices, p=0.067-0.077) was noted. The preliminary data obtained at this study indicate the potential efficacy of Miladean in correcting cognitive and behavioral impairments in children across various diagnostic categories and justify conducting further double-blind, placebo-controlled studies.

Numerous observational studies have suggested a relationship between neuropsychiatric disorders and constipation. However, the specific causal relationships remain unclear. Mendelian randomization (MR) serves as a proven strategy for examining the causal relationships between genetic exposures and outcomes. In the present study, we used a two-sample Mendelian randomization (TSMR) analysis to thoroughly explore the potential bidirectional genetic causal effects between neuropsychiatric disorders and constipation.

We utilized the R11 data from Finnish genome-wide association studies (GWAS) to examine the association between twelve common neuropsychiatric disorders and constipation using TSMR analysis. To establish this causal link, we applied the random-effects inverse variance weighting (IVW) method. Additionally, we conducted various sensitivity analyses, including MR-Egger analysis, weighted median analysis, and leave-one-out analysis, followed by heterogeneity testing. Finally, reverse MR testing was performed to further elucidate the potential causal relationship between constipation and neuropsychiatric disorders.

The forward MR results indicated that anxiety (IVW OR = 1.133; 95% CI: 1.021-1.258; p = 0.020) and depression (IVW OR = 1.149; 95% CI: 1.071-1.232; p = 0.000) may increase the risk of constipation. Reverse MR testing further confirmed that constipation increased the risk of anxiety (IVW OR = 1.273; 95% CI: 1.116-1.452; p = 0.000) and depression (IVW OR = 1.207; 95% CI: 1.095-1.331; p = 0.000) and was positively correlated with epilepsy (IVW OR = 1.331; 95% CI: 1.103-1.607; p = 0.003) and trigeminal neuralgia (IVW OR = 1.897; 95% CI: 1.225-2.936; p = 0.004). No pleiotropy or heterogeneity was observed in the MR analysis.

Our research elucidates the underlying bidirectional causal relationship between twelve common neuropsychiatric disorders and constipation. These findings emphasize the importance for clinical practitioners to prioritize the identification and management of constipation symptoms in patients with neuropsychiatric conditions, aiming to enhance their overall health and quality of life.

Recovery Colleges are adult education initiatives supporting personal recovery for individuals with mental health difficulties. We characterised a national (England) inception cohort of mental health service users, students from the Recovery Colleges Characterisation and Testing 2 programme, and compared those attending different Recovery College types on sociodemographic, clinical, service use and student-reported outcomes over the 4 months prior to enrolment. Mixed-effects regression models were used to assess differences.

The cohort comprised 498 students from 36 Recovery Colleges across England; 77.7% attended strengths-oriented Recovery Colleges. Mean age was 39 years (s.d. 12); most were female (72.1%) and White (81.5%). Common diagnoses were mood (31.3%) and anxiety disorders (29.7%). No significant differences were found between students attending strengths- versus community-oriented Recovery Colleges.

Strengths- and community-oriented Recovery Colleges have similar service user student populations. Certain groups that may be underrepresented in Recovery Colleges and Recovery College research include older adults, men, those with developmental disorders and ethnic minority populations.

Unpredictability in the child's environment has recently emerged as a significant and unique form of early life adversity (ELA). Cross-sectional studies have linked childhood unpredictability with increased post-traumatic stress disorder (PTSD) symptoms in adults; however, no prospective studies have tested the link between childhood unpredictability and PTSD risk in later life, nor what processes, such as increased anhedonia symptoms, might mediate such risk. Here, we leveraged three distinct prospective, longitudinal cohorts to test the hypothesis that unpredictability during childhood contributes to adult PTSD via worsening anhedonia symptoms.

Participants were male service members (n=314), adult females (n=170), and adolescents (n=137) recruited for separate longitudinal investigations. All completed dimensional assessments of anhedonia symptoms and PTSD; childhood trauma and childhood unpredictability were measured by the Questionnaire for Unpredictability in Childhood (QUIC). Pearson correlations tested relations between QUIC, anhedonia symptoms, and PTSD symptoms. Mediational models tested whether the link between childhood unpredictability and PTSD is mediated by increased anhedonia symptoms by estimating indirect effects via bootstrapped path analysis.

Childhood unpredictability was associated with increased adult PTSD symptoms in all three cohorts (rs>.19, ps<.016). Further, in all three cohorts, the relationship was partially mediated by higher anhedonia symptoms (bs>0.046, 95% confidence intervals = 0.01-0.12). All effects remained significant when controlling for levels of childhood trauma and removing anhedonia-related PTSD items.

Unpredictability during childhood may confer risk for adult PTSD, and this increased risk may occur via alterations in anhedonia symptoms. Efforts to increase predictability during childhood could enhance resilience to later traumatic events.

The demand for children and adolescent mental health crisis services has risen dramatically in recent years, yet evidence on real-world implementation models remains limited. Rapids is a community-based crisis intervention service developed within Lambeth Children and Adolescent Mental Health Services (CAMHS) at South London and Maudsley NHS Foundation Trust. The primary aim of this study was to examine how clinical presentations, risk profiles, and service outcomes changed over time among children and adolescents accessing Rapids over a 6-year period. We also aimed to describe the characteristics of individuals accessing Rapids.

This service evaluation used routinely collected clinical data from all children and adolescents up to 18 years who accessed Rapids between January 1, 2019, and December 31, 2024. Sociodemographic, diagnostic, pharmacological, and risk-related variables were evaluated. Diagnoses were coded using International Classification of Diseases, 10th Revision (ICD-10) criteria. Descriptive and inferential analyses were conducted to assess changes in clinical presentations and service outcomes.

In total, 325 children and adolescents were included (mean age = 15.5 years, 61.8% females, 64.6% non-White). Anxiety disorders (29.5%), depressive disorders (42.2%), and autism spectrum disorder (33.5%) were the most common diagnoses. Inpatient admissions increased (1.5%-5.8%, p = 0.043), and high risk to self also rose notably (19.5%-31.7%, p < 0.001). Referrals accepted to adult services decreased significantly over time (38.5%-16.8%, p < 0.001). Diagnostically, eating disorders increased (3.7%-10.0%, p = 0.032), whereas emotionally unstable personality disorder traits decreased (14.1%-7.4%, p = 0.049).

Rapids has evolved into an established model of crisis care within CAMHS, addressing acute needs through timely community-based interventions. We observed meaningful temporal changes in the clinical acuity, diagnostic profile, and service use outcomes of young people presenting to our community-based CAMHS crisis service. Our findings support the feasibility and scalability of intensive community-based crisis care and highlight the need for sustained investment in culturally responsive, multidisciplinary service models.

This study evaluated a culturally adapted Acceptance and Commitment Therapy (ACT) intervention, enhanced with Virtual Reality (VR) and Confucian values, for psychological distress in Chinese financial employees. In a randomized controlled trial, 82 financial employees were assigned to either the culturally adapted ACT intervention or a standard internet-based ACT control group. Assessments of distress (DASS-21), work/social adjustment (WSAS), and psychological flexibility (AAQ-II) were conducted at baseline, post-intervention (10 weeks), and 8-week follow-up. Both groups reported significant improvements on all measures. However, the intervention group demonstrated significantly greater and more sustained positive effects over time. Specifically, these effects included greater reductions in overall psychological distress (DASS-21), stress, and work/social adjustment impairment (WSAS), as well as greater improvements in psychological flexibility (AAQ-II) at the 8-week follow-up. This integration of familiar cultural values and immersive VR technology suggests a method for enhancing the therapeutic efficacy and longevity of ACT for specific, high-stress populations. Trial registration: Chinese Clinical Trial Registry, https://www.chictr.org.cn,ChiCTR2400092105.

Diagnostic agreement influences treatment outcomes, but studies on persistent diagnostic disagreement (PDD) in functional movement disorder (FMD) are lacking. The authors propose a definition for PDD and identified associated factors in a clinical cohort of patients with FMD.

The authors retrospectively reviewed clinical data of 158 FMD patients seen in an integrated movement disorders program from July 2019 to December 2021. Patients self-reported diagnostic agreement before an initial assessment (as disagree, unsure, or agree). PDD status was determined by a specialist assessment on the basis of observable behaviors. Exploratory logistic regression and a least absolute shrinkage and selection operator (LASSO) model were used to examine associations of demographic and clinical features with PDD. Alignment between referring clinician impressions and patient self-reports was also evaluated.

Of 158 patients, 116 had complete data for both baseline self-reports and specialist PDD determination. Forty-seven patients (41%) were classified as having PDD. PDD was observed for 52% (N=15 of 29) of those who self-reported disagreement, 71% (N=17 of 24) who self-reported ambivalence, and 24% (N=15 of 63) who self-reported agreement. Variables associated with PDD included low agency, cluster B traits, lower readiness to change, inability to notice symptom variability, and lower self-reported agreement; only low agency was retained in the LASSO analysis. Among 78 patients with complete data including referring physician impressions, concordance with patient self-reported disagreement was low (weighted κ=0.21, p<0.001).

PDD was common in FMD, was not accurately identified by referral impressions or patients' self-reports, and may be linked to modifiable psychological processes.

Surgical intervention is recommended in idiopathic intracranial hypertension (IIH) for fulminant or treatment-refractory cases, yet data on outcomes remain limited, particularly regarding indication-specific effects. This study evaluated outcomes and indications for surgery in IIH, aiming to identify predictors of favorable or adverse results.

A retrospective multi-center study was conducted by the Danish-Austrian IIH Consortium (DASH-IIH). Databases from three centers (Vienna, Odense, Copenhagen) were screened for persons with IIH (pwIIH) fulfilling revised Friedman criteria who underwent surgery and had ≥ 6 months of follow-up. Outcomes at 6 months included visual function, headache improvement (≥ 50%), papilledema resolution, and severe adverse events. Multivariable regression was used to adjust for confounders.

Of 1310 pwIIH, only 3.6% required surgery overall. Thirty-six pwIIH were included (100% female; mean age 32.5 years; median BMI 37.0; median CSF opening pressure 41 cmH₂O). Of these, 27 (75%) underwent CSF diversion and 9 (25%) optic nerve sheath fenestration (ONSF). The primary indication for surgery was acute visual deterioration in 83.3% and refractory headache in 16.7%. Visual function improved in 41.7%, papilledema resolved in 89.7%, and headache improved in 30.6%. No significant differences in outcomes were found between CSF diversion and ONSF. Importantly, no visual improvement occurred in cases operated for headache alone, and the odds of headache improvement were significantly lower in this group (OR 0.11, p = 0.012).

CSF diversion and ONSF are effective in IIH with acute visual threat, improving vision and, to a much lesser extent, headache. Refractory headache alone appears insufficient indication for surgical intervention.