This study examined therapists' assessments of post-traumatic stress disorder (PTSD) symptoms and disturbances in self-organization (DSO), the additional symptom cluster that distinguishes complex PTSD (CPTSD) from PTSD in ICD-11. We investigated how these dimensions, together with patient dissociation, shape therapists' affective responses and in-session disconnection, considering both patient (CADS; observer rated) and therapist (DES; trait) dissociation. Therapists (N = 60) completed measures referring to one selected patient. Measures included PTSD and DSO symptoms, personality organization, self-concept clarity, adverse childhood experiences, interoceptive awareness, patient dissociation, therapist affective responses, therapist dissociation and therapist in-session disconnection. Correlational analyses, MANOVA and hierarchical regressions were conducted. DSO and PTSD showed distinct profiles of functioning. DSO was associated with broader structural vulnerabilities, including impaired personality organization, adverse childhood experiences, reduced interoceptive awareness and higher dissociation, whereas PTSD was primarily associated with reduced self-concept clarity. DSO predicted therapists' feelings of helplessness, whereas patient dissociation predicted overwhelmed/disorganized responses and reduced positive engagement. Patient dissociation and therapist dissociation independently predicted therapists' experiences of in-session disconnection, while their interaction was not significant. Findings highlight distinct relational correlates of DSO and PTSD and identify dissociation as a central mechanism of therapeutic disconnection. Dissociation operates as a shared field phenomenon, with clinical implications for monitoring and addressing in-session relational 'drifts'.

Mental disorders among adolescents and young adults (AYA) are a serious public health concern, particularly in low- and middle-income countries. Despite the growing impact, access to conventional mental healthcare remains limited, leading to high traditional medicine (TM) reliance. However, correlates of TM utilization by AYA with mental health challenges remain underexplored in academic literature. In this study, we investigated the correlates of TM utilization among students with self-reported mental disorders in central and eastern Uganda.

In this cross-sectional study, we analyzed secondary data from a subsample of 302 students with self-reported history of a mental health disorder out of a sample of 1970 who completed the survey. In the primary study, stratified random sampling was used to select schools, and participants were selected proportionally. We used modified Poisson regression to examine the factors independently associated with TM use including demographic characteristics and the presence of emotional or behavioral disorders. Statistical significance was set at a p-value of less than 0.05.

Most participants were female (53.31%) and aged between 15 and18 years (71.6%). The majority of the participants had completed ordinary level of secondary education (92.54%), from the Central region (74.5%) and attended schools in urban areas (54.04%). The median monthly family income was $83.3, with over half earning ≤$100 monthly (58.8%). Nearly half of the participants reported a family history of mental health disorder (49.8%), and a notable percentage had at least one behavioral disorder (25.8%) or emotional disorder (21.2%). The adjusted model suggested that rural school attendees had a 1.3 times higher prevalence of TM utilization [aPR:1.30(1.01-1.68), p = 0.04] compared to urban ones, and those with parents or guardians who completed college/university had a 38% lower prevalence [aPR:0.62 (0.41-0.94), p = 0.025] of TM utilization compared to those with parents or guardians without formal education.

A large proportion of the students utilized TM, largely influenced by rural residence, and parents' education status. The high prevalence of TM use underscores the need for leveraging TM providers as a link to timely biomedical healthcare utilization and improving access to comprehensive treatment for mental health disorders with a focus on socio-economic disparities.

Depression is a highly heterogeneous disorder with a similarly heterogeneous neurobiological background. Understanding separate depressive phenotypes, driven by distinct aetiological pathways like early trauma and neurobiological contributors, can improve treatment. Furthermore, sex differences must be considered, as both the development and treatment of depression may be sex-specific. We aimed to investigate the sex-dependent association between polygenic risk for chronotypes, childhood traumas, and depression.

In a discovery sample of 273,033 participants GWASs were ran and polygenic risk scores (PRS) were calculated in a target sample of 25,476 participants, separately for morning and evening chronotypes. Effects of chronotype-PRS in interaction with childhood adversities were analysed.

We identified 39 significant lead-SPNs (single nucleotide polymorphisms) and 44 genes associated with morning chronotype, and 69 significant lead-SNPs and 76 genes for evening chronotype. Heritability was comparable, at 12.1% for morning and 11.8% for evening chronotypes. No significant main effect of either chronotype-PRS was found on depressive symptom scores, however, in interaction with childhood traumas, morningness-PRS showed a significant effect on depressive symptom scores in women.

Our findings highlight important sex differences in the aetiological role of known risk factors for depression, such as chronotype or early trauma, and may have implications in the prevention of mood disorders in those genetically vulnerable and exposed to early risk factors.

MicroRNAs (miRNAs) play crucial roles in regulating gene expression and have been implicated in the pathophysiology of depression. Among them, miR-124-3p is one of the most abundant brain-enriched miRNAs and has emerged as a potential therapeutic target for mood disorders. This study aimed to evaluate the antidepressant-like effects of an acute administration of miR-124-3p and to identify associated molecular and neuronal changes across key brain regions. Female C57BL/6 mice received intracerebroventricular injections of a miR-124-3p mimic or a control oligonucleotide. Affective-like behavioural responses were assessed using the Porsolt swim test (PST) and the light-dark box test (LDB). Proteomic alterations in the hippocampus, hypothalamus and prefrontal cortex were analysed by liquid chromatography-tandem mass spectrometry (LC-MS/MS), and stress-related neuronal activity was evaluated using c-Fos immunofluorescence. Mice treated with the miR-124-3p mimic exhibited reduced immobility in the PST, indicative of an antidepressant-like effect and enhanced active stress coping. Proteomic profiling revealed region-specific changes, including downregulation of immune- and stress-related proteins in the hypothalamus and hippocampus, and upregulation of synaptic and metabolic proteins in the prefrontal cortex. c-Fos analyses showed decreased stress-induced neuronal activation in the hypothalamic paraventricular and periventricular nuclei, alongside increased activity in the hippocampal dentate gyrus. Collectively, these findings suggest that miR-124-3p mimic treatment is associated with antidepressant-like effects by reducing neuroimmune activation and enhancing neuronal plasticity. Our results support a model in which miR-124-3p promotes stress resilience through coordinated modulation of inflammatory and plasticity-related processes across distinct brain circuits.

Mental health issues are an increasing challenge for public health, affecting all populations, especially women. This population-based cross-sectional study was conducted to estimate the prevalence of and factors associated with depression, anxiety, and stress symptoms among reproductive-aged women. This study was conducted on a sample of 376 Iranian women aged 20-50. Socio-demographic status, dietary intake, physical activity, mental health status, and anthropometric status were assessed using a general demographic questionnaire, a food frequency questionnaire, the International Physical Activity Questionnaire-Short Form, Depression, Anxiety, and Stress Scale (DASS-42) questionnaire, and a digital scale and wall-mounted stadiometer, respectively. To assess the association of mental problems with potential factors, binary logistic regression was used. The prevalence of depression, anxiety, and stress symptoms was 47.6%, 52.4%, and 38.3%, respectively. In the adjusted analysis, a higher wealth index (OR = 0.28, 95% CI: 0.12-0.66) and higher dietary diversity (OR = 0.24, 95% CI: 0.12-0.46) were associated with lower odds of depression. Larger household size (OR = 1.71, 95% CI: 1.06-2.74) and higher dietary diversity (OR = 0.32, 95% CI: 0.17-0.61) were associated with anxiety, while overweight (OR = 2.12, 95% CI: 1.28-3.49) and higher dietary diversity (OR = 0.46, 95% CI: 0.24-0.87) were associated with stress. Findings revealed a high prevalence of mental health issues among Iranian women. Several factors, especially dietary quality, can influence mental health. Further studies with larger sample sizes and a prospective cohort design are necessary to understand this relationship better.

Stress-related mental disorders, including depression, anxiety, and post-traumatic stress disorder, represent a major global health burden, yet their underlying biological mechanisms and effective therapeutic strategies remain incompletely understood. Growing evidence from both preclinical and clinical studies indicates that alterations in gut microbiota composition and function are closely associated with the onset and progression of these disorders. A central role of the gut microbiota is the biotransformation of dietary and host-derived substrates into diverse metabolites that enter systemic circulation and influence host physiology. In this review, we highlight gut microbiota-driven metabolites. short-chain fatty acids, amino acid-related metabolites, bile acids, and monoamine-related metabolites, as key mediators of gut-brain communication that influence neural, immune, epigenetic, and endocrine processes involved in stress-related mental disorders. We summarize emerging microbial and metabolic signatures identified in animal models and human studies. Furthermore, we discuss microbiome-targeted strategies for the prevention and treatment. However, the complexity of the gut microbiota and pronounced inter-individual variability limit causal inference from current clinical studies. Consequently, translating these findings into clinical practice will require standardized study designs, longitudinal clinical investigations, and the integration of multi-omics approaches to advance precision microbiome-based interventions for psychiatric disorders.

To examine the regional alterations of mandibular trabecular bone microarchitecture in RA patients using the analysis of panoramic radiographs based on the fractal dimension (FD)' and to assess the effect of the duration of glucocorticoid (GC) treatment․ METHODS: In this retrospective study' 96 RA patients and 96 controls were recruited․ The FD of four standardized regions of interest (ROIs) was measured using ImageJ: the condyle' the mandibular angle' the two trabecular areas of the corpus (including the area anterior to the mental foramen)․ Group comparisons were performed using non-parametric tests and multivariable logistic regression' adjusted for age and sex․ A subgroup analysis based on age (≥ 40 years' respectively) was used to rule out residual confounding by age․ RESULTS: FD was considerably lower in the RA group compared to the control group in all regions of interest (p < 0․001)․ The differences in the condylar region and the trabecular region anterior to the mental foramen had the largest differences and retained their importance after controlling for other factors․ These findings were similar in the age-restricted subgroup analyzes and did not have an important association (p > 0․05) with GC duration of use․ CONCLUSION: RA is associated with site-specific deterioration of mandibular trabecular microarchitecture' particularly in the condylar region and the trabecular region anterior to the mental foramen․ FD analysis of panoramic radiographs may be a useful imaging biomarker for detecting skeletal involvement in the RA population․.

Acute bacterial meningitis (ABM) is a neurological emergency that requires prompt and appropriate antibiotics and corticosteroids. Previously fluid restriction was recommended in the treatment of ABM in view of studies reporting hyponatremia which was due to elevated antidiuretic hormone (ADH) levels.

The primary objective was to study the effects of adjuvant fluid restriction in patients of ABM on mortality, neurological and audiological parameters.

Electronic search was performed on the PubMed, Medical Literature Analysis and Retrieval System Online (MEDLINE), Excerpta Medica Database (EMBASE), Epistemonikos, Web of science, Cochrane Central Register of Controlled Trials (CENTRAL) and Clinical trial registry for studies published from 1946 to 6th Feb 2024. The systematic review included all studies that were Randomized controlled trials (RCT) wherein fluid restriction was employed in patients with ABM. Data were uploaded into the rayyan tool, and the review authors independently screened the articles. Quality of the studies was assessed using the Cochrane 'Risk of bias 2' (ROB2) tool. Risk ratios (RR) with 95% confidence intervals (CI) were used to measure treatment effect and the GRADE framework was used to evaluate the certainty of evidence for each outcome.

Two articles with 407 participants were included in the meta-analyses and both of them had children less than 7 years old. Fluid restriction probably had little or no difference on mortality at admission compared with normal fluid maintenance (RR:1.19; 95% CI 0.77 to 1.85) and also on neurological sequalae (RR 1.31, 95% CI 0.74 to 2.30). A single study reported on mortality and neurological sequelae based on hyponatremia status and there was no difference in between the fluid restricted group and standard maintenance groups.

There are only two studies on the efficacy of Fluid restriction as an adjuv-ant therapy in the treatment of acute bacterial meningitis. Fluid restriction does not appear to significantly alter the mortality or neurological sequelae compared to maintenance therapy.

Prospero id: CRD42024533368.

Methamphetamine use disorder (MUD) poses significant public health risks, with individuals often exhibiting heightened impulsivity. Traditional electroencephalography (EEG) spectral analyses have yielded inconsistent findings, potentially due to the conflation of periodic and aperiodic activities. The aperiodic component, quantified by the exponent and offset parameters, reflects excitatory/inhibitory (E/I) balance and broadband neural activity, which may be disrupted in addiction. However, its association with impulsivity in MUD remains unexplored.

This study aimed to examine aperiodic activity in individuals with MUD and its correlation with impulsivity, using the FOOOF algorithm to decompose EEG signals.

The study included 47 male MUD patients and 41 healthy male controls. Resting-state EEG was recorded, and aperiodic components (exponent and offset) were extracted via the FOOOF algorithm. Clinical assessments included the Barratt Impulsiveness Scale (BIS-11), Zung Self-Rating Anxiety/Depression Scales, and visual analogue scales for craving.

The aperiodic exponent (t = 3.617, p < 0.001) and offset (t = 2.762, p = 0.007) were significantly reduced in the MUD group compared to controls. Both parameters showed negative correlations with impulsivity measures (e.g., exponent vs. BIS-11 total score: r = -0.345, p = 0.019; offset vs. BIS-11 total: r = -0.389, p = 0.008) and years of methamphetamine use (exponent: r = -0.394, p = 0.023).

Reduced aperiodic activity in MUD suggests E/I imbalance, likely associated with dopaminergic dysfunction. The correlations with impulsivity highlight the potential of aperiodic components as biomarkers for behavioral dysregulation in addiction. These findings underscore the transdiagnostic relevance of E/I balance in impulse control.

There is a gap in knowledge regarding self-esteem in US adolescents in the context of depressive symptoms and overweight and/or obesity status. Self-esteem can potentially play a role in the relationship between obesity and depressive symptoms, which are both increasing in prevalence in US adolescents. The aim of this scoping review was to understand the extent of evidence in relation to self-esteem in this context.

Using the Arksey and O'Malley framework, a total of 717 articles were identified from seven databases, 593 unique studies were screened after duplicates, 86 full text articles were retrieved and assessed for eligibility, and 37 articles were included in the review. Two independent reviewers screened each article, and a third reviewer served as a tiebreaker.

Several factors were associated with self-esteem in this context, including family dynamics, puberty, teasing, sports participation, eating disorders, stressors, and body satisfaction.

School-based screening and interventions can be conducted by school nurses, counselors, physical educators, food services, mental health team members, and other school health professionals. These professionals can also help to create a supportive environment in which bullying is not tolerated, physical activity and sports participation are promoted, and healthy food is provided.

Future research is needed to better understand the link between self-esteem and depressive symptoms and weight status. When caring for children with obesity or overweight status and depressive symptoms, school health professionals should assess for low self-esteem, family dynamics, and cohesion.