Bulimia nervosa (BN) is a clinically heterogeneous eating disorder. Variability in clinical presentation and treatment response suggests differences in underlying neurobiology. Neuroimaging studies have reported inconsistent findings of widespread brain structural alterations in BN, which may reflect unrecognized neuroanatomical subtypes. Identifying such subtypes could inform targeted treatment approaches.

81 treatment-naïve female Han Chinese patients with BN and 72 healthy controls from a single center underwent T1-weighted MRI. Computational Anatomy Toolbox 12 was used to quantify regional gray matter volumes (GMVs). The heterogeneity through discriminative analysis (HYDRA) algorithm was applied to identify neuroanatomical subtypes. Neuroanatomical characteristics of the subtypes were compared, and clinical characteristics were compared in 55 patients with available clinical assessments.

Two distinct BN subtypes with divergent GMV aberrations and clinical characteristics were identified. Subtype 1 exhibited widespread GMV reductions mainly involving the cerebellum, prefrontal, temporal, parietal, and occipital cortices, insula, and limbic regions. It was characterized by higher depressive symptoms, younger age, and lower estimated total intracranial volume (eTIV), with eTIV negatively correlated with eating disorder psychopathology, particularly weight and shape concerns. Subtype 2 showed relatively preserved GMV, with alterations restricted to the right cerebellum. In this subtype, emotion dysregulation showed a subtype-specific association with eating disorder psychopathology.

Two neuroanatomical subtypes of BN are characterized by distinct structural patterns and clinical profiles. Subtype 2 patients may benefit from emotion regulation-focused interventions, while those with Subtype 1 may benefit from more comprehensive treatment. These implications remain hypothetical and require validation in longitudinal interventional studies.

Adolescents with anorectal malformations (ARM) or Hirschsprung disease (HD) often experience physical and psychosocial challenges. It remains unclear to what extent PedsQL-Generic Core Scales (PedsQL-GCS) and symptom-specific quality of life (QoL) measures reflect psychiatric symptom burden. This study aimed to investigate differences in patient-reported QoL between adolescents with and without a psychiatric diagnosis and associations between psychiatric symptom burden and QoL in adolescents with ARM or HD.

Sixty-eight adolescents (31 ARM, 37 HD; median age 14 years; 45 males) were assessed using the Child Assessment Schedule (CAS), the PedsQL-GCS and the PedsQL Gastrointestinal Symptoms Module (PedsQL-GSM) questionnaires. Group differences and associations were examined.

Nineteen adolescents (28%) had a psychiatric diagnosis (11 ARM, 8 HD). Adolescents with a psychiatric diagnosis reported lower PedsQL-GCS total scores (median 85.0 vs 92.0; p <.01) and PedsQL-GCS psychosocial scores (median 83.0 vs 92.0; p < .01). PedsQL-GSM total score was also lower (median 78.0 vs 97.0; p < .01) in those with a psychiatric diagnosis. Higher CAS symptom scores were moderately associated with lower PedsQL-GCS scores (ρ= -0.51, p< .001), whereas the association with PedsQL-GSM scores was weaker (ρ= -0.33, p=0.021).

Both generic QoL and gastrointestinal symptom scores were lower in adolescents with ARM or HD and a psychiatric diagnosis. Regardless of psychiatric diagnosis, psychiatric symptom burden was moderately associated with reduced PedsQL-GCS, including psychosocial domains. Incorporating PedsQL-GCS alongside PedsQL-GSM into long-term follow-up may help identify adolescents with psychosocial difficulties who may benefit from further mental health assessment and follow-up.

To examine Chronic Overlapping Pain Conditions (COPC) prevalence in Urologic Chronic Pelvic Pain Syndrome (UCPPS) patients and assess the independent contributions of specific COPCs and pairwise COPC combinations to severity of UCPPS and non-urological symptoms, health-related quality of life (QOL), and psychological distress.

Cross-sectional baseline data were collected from 152 UCPPS patients (M_age 43 yrs; 83% female) enrolled in an NIH-funded clinical trial. Participants completed validated instruments assessing COPCs as well as severity of UCPPS symptoms; physical and mental QOL; nonurological symptoms; overall pain intensity, distribution, quality and interference in daily life; as well as psychological distress.

Patients reported a mean of 1.9 COPCs. Individual COPCs were most consistently associated with broader pain distribution, reduced physical functioning, and greater fatigue; endometriosis demonstrated the most extensive pattern of statistically significant relationships. In analyses of 36 possible COPC dyads, migraine-containing pairs were frequently represented among the top 10 combinations and were linked to greater pain intensity, fatigue, pain interference, and poorer physical functioning. Emotional distress, pain catastrophizing, and UCPPS symptom severity showed weak associations with COPC load across analyses.

COPCs load is substantially associated with greater illness burden in UCPPS, with the most pronounced effects on physical functioning, fatigue, pain distribution, and overall pain intensity. Migraine-containing dyads were associated with the highest illness burden. These findings warrant consideration of brief COPC screening in patients with centralized pain phenotype refractory to peripherally directed therapies.

Dry eye disease is a common condition associated with mental health. Daily simulated laughter for eight weeks has been shown to alleviate symptoms and signs of dry eye disease. However, the underlying mechanisms remain unclear. This study aimed to evaluate the immediate effects of laughter on tear film lipid layer thickness and tear meniscus height.

This was a single-center, self-controlled before-after trial. Participants aged 18 to 45 years with ocular surface disease index scores above 13 and non-invasive tear film break-up time below 8 s were included in the dry eye disease group. The healthy group comprised individuals with no history or current diagnosis of dry eye disease. Baseline tear film lipid layer thickness (LLT) and tear meniscus height (TMH) were first obtained with the participant's facial muscles relaxed. Participants subsequently performed a 20 s simulated laughter; LLT was measured during the laughter, and TMH was acquired immediately upon completion.

A total of 71 participants (mean age 28.5 ± 6.1 years; 55% [39/71] female) were enrolled, including 40 patients with dry eye disease and 31 healthy controls. A 20 s laughter increased the TMH (0.27 ± 0.11 mm vs. 0.23 ± 0.08 mm, P < 0.001) and improved the LLT-Min (56 ± 21 nm vs. 48 ± 18 nm, P < 0.001), LLT-Max (74 ± 20 nm vs. 66 ± 22 nm, P < 0.001), and LLT-Average (63 ± 21 nm vs. 55 ± 21 nm, P < 0.001).

Laughter immediately increases TMH and tear film LLT in both dry eye disease patients and healthy individuals, suggesting that mechanical eyelid compression and other physical effects may contribute to the beneficial effects of simulated laughter in dry eye disease.

Despite growing recognition of fathers' involvement in caregiving, paternal mental health during the perinatal period remains insufficiently explored. Recent evidence indicates that fathers may experience perinatal affective symptoms through externalizing behaviors, somatization, and addictive tendencies, which can negatively affect father-infant interactions and partner relationships. This study aims to validate the Perinatal Assessment of Paternal Affectivity (PAPA), previously validated in the prenatal period, in a sample of Italian fathers postnatally. Data from 221 fathers (mean age = 36.02 years, SD = 5.66, range 22-63 years) with children aged 1 to 15 months (mean age = 7.55 months, SD = 4.60) were collected through an online survey administered via Qualtrics. The survey included different validated self-reports, comprising the PAPA, the Edinburgh Postnatal Depression Scale, the Perceived Stress Scale, the Brief Coparenting Relationship Scale, and the Infant Behavior Questionnaire. Confirmatory analyses supported the one-factor structure of PAPA with good internal consistency. The instrument showed evidence of validity based on relations to other variables, with associations in the expected direction with criterion measures. Overall, findings support the PAPA as a reliable and valid instrument for assessing postnatal paternal affective symptoms, with potential clinical utility in identifying fathers at risk.

Schizophrenia (SCZ) is a complex psychiatric disorder involving disruptions in neural signaling and neurovascular function that are incompletely characterized by single-modality imaging. This systematic review evaluates how concurrent electroencephalography (EEG) and functional magnetic resonance imaging (fMRI) can advance understanding of brain dynamics underlying SCZ, focusing on neurovascular coupling and large-scale network abnormalities. A systematic search of three online databases identified 16 English-language studies of individuals with SCZ or related psychosis spectrum conditions using simultaneous EEG-fMRI. Inclusion criteria covered original research reporting relationships between electrophysiological (Event-Related Potentials, oscillatory) events and fMRI-derived Blood Oxygen Level-Dependent signals, with clinical or cognitive endpoints. EEG findings implicate impaired sensory gating and cognitive processing, including abnormal P50 suppression, reduced P300 amplitudes, and dysregulated gamma and beta oscillations. fMRI results demonstrate reduced activity and altered network connectivity, notably within the default mode network. Recent studies suggest altered fMRI responses to EEG events, raising the hypothesis of neurovascular decoupling. However, methodological heterogeneity limits interpretation, and findings should be regarded as hypothesis-generating rather than conclusive. In summary, concurrent EEG-fMRI provides valuable insights into neural and neurovascular disruptions in SCZ. Advancing this field will require standardization and large-scale, reproducible studies to translate multimodal findings into clinical biomarkers and novel therapies.

The Brief Psychosomatic Symptom Scale (BPSS) has shown promising psychometric properties in adults, but its performance in adolescents remains under-examined. This study evaluated the BPSS in Chinese adolescents, estimated an empirical screening cutoff, and examined psychosocial factors associated with elevated psychosomatic symptom burden.

The BPSS was administered to 4665 school-based Chinese adolescents. Internal consistency evidence, associations with the 26-item Psychosomatic Symptoms Scale (PSSS), the Patient Health Questionnaire-15 (PHQ-15), and the Generalized Anxiety Disorder-7 (GAD-7), and construct validity via confirmatory factor analysis (CFA) were examined. Receiver operating characteristic (ROC) analysis was used to estimate a BPSS cutoff relative to a study-defined high somatic-symptom-burden criterion based on a modified PHQ-15. Multivariable logistic regression examined psychosocial correlates of BPSS-defined elevated symptom burden.

The BPSS showed good internal consistency (Cronbach's α = 0.885) and strong positive associations with the PSSS, PHQ-15, and GAD-7 (all p < 0.001) providing convergent evidence while requiring caution because of scale derivation and symptom-content overlap. The correlated two-factor CFA showed excellent global fit (CFI = 0.998, RMSEA = 0.037), but the factor correlation was very high (r = 0.95), indicating limited empirical separation between the factors. A cutoff of ≥8 was selected in the total sample and in both male and female subsamples. Depression, poor family functioning, bullying, personal distress, and loneliness were significantly associated with elevated BPSS scores.

The BPSS showed promising internal-consistency and screening performance in this school-based sample. A score of 8 may be useful as an empirical screening threshold relative to the study-defined criterion, but it should not be interpreted as a diagnostic cutoff. The psychosocial findings represent cross-sectional associations rather than causal risk factors, and further validation in independent and more diverse samples is needed.

Obsessive-compulsive (OC) symptoms are usually associated with obsessive-compulsive disorder but they are also present in the general population. It has been reported that OC symptoms can involve atypical olfactory experiences, but their impact on mental health and wellbeing is poorly understood. We have investigated the prevalence of OC symptoms in a representative sample (n = 996) of the adult Czech population aged 18-50. We investigated to find out whether the severity of OC symptoms is associated with odour awareness, olfactory irritability, disgust sensitivity, and trait anxiety. A total of 12.3% of respondents reported moderate or elevated OC symptoms, with the highest prevalence observed in individuals aged 18-30 years. We also found that trait anxiety and olfactory irritability positively predicted the severity of OC symptoms, but, interestingly, disgust sensitivity was not a significant predictor of the severity of OC symptoms in our sample. Overall, these findings highlight a complex link between OC symptoms and atypical olfactory experiences in a non-clinical adult population.

A work group representing the U.S. Department of Veterans Affairs (VA) and U.S. Department of Defense (DoD) prepared a new VA/DoD clinical practice guideline (CPG) for tobacco use treatment. This article provides a synopsis of the 2026 CPG, which addresses use of commercially available tobacco and nicotine products.

A multidisciplinary work group developed 19 key questions on clinical topics of highest priority for the VA and DoD populations. Published literature from 1 January 2014 to 10 December 2024 was systematically reviewed using the PICOTS (population, intervention, comparator, outcomes, timing of outcomes measurement, and setting) framework. Recommendations were made by consensus and informed by evaluation using the GRADE (Grading of Recommendations Assessment, Development and Evaluation) method, which assesses quality of evidence and balances benefits and harms, patient preferences, and feasibility. The final document incorporated input from peer review by an external group of experts.

The 2026 guideline includes 32 recommendations across 10 topic areas. Key recommendations for increasing abstinence from combustible tobacco include recommending motivational interviewing to increase engagement in treatment of tobacco and nicotine use (strong) and use of U.S. Food and Drug Administration-approved pharmacotherapies (strong), with varenicline recommended over monotherapy with other agents (strong), combination nicotine replacement therapy ([NRT] for example, patch plus lozenge) recommended over NRT monotherapy (single agent) (strong), and extending use of bupropion sustained release beyond 12 weeks (weak). Other key recommendations include varenicline for increasing abstinence from smokeless tobacco (strong) and electronic nicotine delivery systems (weak) and use of NRT or varenicline to increase quit attempts and abstinence in patients not ready to quit in the next 30 days (weak).