To examine peer victimization, internalizing symptoms, and psychiatric disorders in underweight and obese clinically referred youth versus normal-weight peers.

Cross-sectional study of 161 children aged 7-17 (51 underweight, 57 normal-weight, 53 obese). Victimization was measured using the Olweus Bully/Victim Questionnaire, depressive and anxiety symptoms with the CDI and STAI-C trait, and psychiatric diagnoses with the K-SADS-PL.

Peer victimization and anxiety disorders were higher in underweight and obese than normal-weight children (p < .001 and p = .005, respectively). Trait anxiety symptoms were elevated in both groups (p < .001), whereas depressive symptoms did not differ. Victimized youth had higher rates of anxiety (p = .009) and depressive disorders (p = .001). In adjusted models, underweight predicted anxiety disorder (OR 5.03, p = .010), underweight (OR 4.19, p = .003) and obesity (OR 9.00, p < .001) predicted victimization, and victimization predicted depressive disorder (OR 3.03, p = .016).

Weight extremes in clinically referred children are linked to peer victimization and internalizing problems, supporting routine psychosocial screening in clinical practice.

IntroductionIn Quebec, the P-38.001 Act (P-38) allows police officers or crisis workers, under exceptional circumstances, to bring individuals at risk of harming themselves or others to the Emergency Department (ED) against their will. Data on the application of this Act remains limited.ObjectivesWe aimed to determine the prevalence of P-38 use among ED patients with mental health presentations and to compare their characteristics, clinical course, and outcomes with those who sought care voluntarily.MethodsWe conducted a retrospective cohort study using a Public Health Agency of Canada-approved mental health database. Patients aged ≥14 years presenting to 5 EDs for mental health reasons in 2020-2021 were included. The main outcome, enforcement of P-38, was abstracted from medical charts. Information on care trajectory and management was also collected. Relative risks (RR) were estimated using modified Poisson regression with robust variance.ResultsAmong 15,021 mental health-related ED visits, 860 (5.7% [95% CI: 5.4-6.1]) involved enforcement of the P-38 Act. Mean age was 41.1 ± 16.5 years, with 46.1% aged 25-44, and 54.4% being male. Most lived independently (85.4%), arrived by ambulance (80.5%), and had a documented mental health history (92.2%). A higher proportion were materially deprived (P = 0.020). Compared with patients who voluntarily consulted in the ED, those under P-38 were more likely to be restrained (RR: 1.68 [95% CI: 1.45-1.94]), placed under preventive confinement (RR 3.41 [95% CI: 2.96-3.93]), receive multidisciplinary assessment (RR: 1.70 [95% CI: 1.59-1.80]), and be hospitalized (RR: 1.36 [95% CI: 1.24-1.48]).ConclusionEnforcement of P-38 accounted for nearly 6% of mental health-related ED visits, disproportionately affecting materially deprived individuals in early to mid-adulthood with prior mental health disorders. Our findings suggest a reliance on coercive and short-term measures, underscoring the need for targeted policy efforts to expand community-based crisis intervention alternatives for this vulnerable population.

Mental toughness (MT) may contribute to within-athlete rowing performance variation, yet longitudinal evidence remains sparse. This pilot study examined within-athlete associations between MT and 2K ergometer performance across a competitive season in Division II female rowers. Twelve athletes (age 20.8 ± 2.1 years) completed the mental toughness index (MTI) before four standardized 2K time trials. Performance was modeled using a linear mixed-effects model with a random intercept for the athlete. The MTI was decomposed into within- and between-athlete components, with the timepoint as a categorical covariate. Small-sample inference used CR2 cluster-robust standard errors with Satterthwaite degrees of freedom. Performance improved mid-season relative to baseline (Timepoint 3: -7.29 s; 95% CI [-13.29, -1.29]; p = 0.023). The within-athlete MTI association was small and imprecise (β = -0.48 s/point; 95% CI [-1.56, 0.59]; p = 0.311), and the between-athlete MTI was unassociated with performance (β = 0.70; p = 0.667). Stable between-athlete differences dominated over variability (ICC = 0.946; R²_m = 0.033; R²_c = 0.948). The within-athlete MTI estimate was small and imprecise; given the wide compatibility interval, both the direction and magnitude of the association remain highly uncertain, and this inconclusive finding should not be interpreted as evidence of absence. Future studies with larger samples and key covariates (e.g., training load and illness/injury) are needed to confirm these preliminary estimates.

Despite significant biomedical advances in the prevention of mother-to-child transmission (MTCT) of HIV, residual transmission and suboptimal maternal outcomes persist across Europe. The challenge is no longer primarily virological but structural: aggregated ART coverage indicators mask important discontinuities across the perinatal care pathway. This scoping review maps evidence on clinical and psychosocial dimensions of the perinatal HIV pathway among adult women living with HIV (WLHIV) in Europe, and identifies key gaps in their integration across the continuum of care. Following PRISMA-ScR guidelines, five databases were searched for studies published between 2010 and 2026. Of 1881 records identified, 109 met inclusion criteria. Findings were synthesized thematically using an inductively developed framework spanning preconception through long-term postpartum outcomes. MTCT rates declined from approximately 1-1.2% in the mid-2000s to below 0.5% in recent data, and vaginal delivery rates increased markedly with sustained viral suppression. However, persistent inequalities remain among younger women, migrants, and those with histories of injecting drug use. Stigma, migration-related vulnerability, mental health difficulties, constrained disclosure, and socioeconomic insecurity shape engagement with care, influencing treatment continuity, retention, and virological outcomes, particularly during the postpartum period. Equitable perinatal HIV outcomes require integrated care models that combine clinical HIV and obstetric services with mental health support, social needs screening, and migration-sensitive services to address the structural conditions shaping care trajectories. A substantial proportion of WLHIV in Europe originate from high-prevalence regions, making perinatal HIV in this context a direct interface between global infectious disease burden and migration health. Addressing care in European settings therefore contributes to broader global health equity goals in HIV elimination. The protocol was pre-registered on Open Science Framework with registration number: 10.17605/OSF.IO/9BZGY.

Psilocybin-producing mushrooms exhibit considerable biochemical diversity, yet the extent of variability among strains within a single species under standardized conditions remains insufficiently characterized. In this study, we quantified psilocybin, psilocin, baeocystin, norbaeocystin, aeruginascin, and norpsilocin in the fruiting bodies of 14 distinct strains of Psilocybe cubensis. The mushroom strains were cultivated, dried, extracted, and analyzed under uniform laboratory conditions. Despite strict methodological standardization, total tryptamine concentrations varied by more than 7.8-fold among strains (from 2.62 to 20.65 mg/g), with psilocybin consistently emerging as the dominant compound. Analysis of individual fruiting bodies within the selected strains revealed substantial intra-strain variability, with coefficients of variation for psilocybin ranging from 12.81% to 23.39% between individual fruiting bodies. These findings demonstrate that both inter- and intra-strain biochemical heterogeneity persist even under controlled conditions, underscoring the challenges of standardizing whole mushroom preparations for research or therapeutic use. Our results highlight the importance of strain selection, rigorous chemical profiling, and dosing precision in future pharmacological and clinical applications of P. cubensis.

Background: Influenza-associated encephalopathy, encephalitis, and acute necrotizing encephalopathy (ANE) are rare but potentially life-threatening neurological complications of influenza. Adult cases remain poorly characterized because the available literature is largely limited to isolated case reports and small case series. Methods: A PRISMA-guided scoping review of the MEDLINE database was conducted through 31 May 2026. Published adult cases of influenza-associated encephalopathy, encephalitis, and ANE were identified and analyzed for demographic characteristics, clinical presentation, neuroimaging findings, treatment, and outcomes. Results: Eighty-three adult cases reported between 1958 and 2026 were included. The mean age was 45.6 ± 17.8 years, and 57.8% were male. Two-thirds did not have any underlying comorbidities. Neurological symptoms developed a mean of 4.6 days after influenza onset, with influenza A accounting for 80.7% of infections. Fever (91.6%), altered mental status (86.7%), and seizures (36.1%) were the most common manifestations. Encephalitis was the predominant presentation (44.5%), followed by encephalopathy (31.3%) and ANE (24.1%). MRI most frequently demonstrated cerebral hemispheric lesions (53.0%) and bilateral thalamic involvement (36.4%), while EEG abnormalities were reported in 69.6% of patients. Overall mortality was 22.9%, highest among patients with ANE (45.0%). Among survivors, 28.9% experienced persistent neurological sequelae. Conclusions: Influenza-associated encephalopathy, encephalitis, and ANE are rare in adults but are associated with substantial morbidity and mortality. This review represents the largest adult cohort reported to date and provides important insights into the clinical spectrum, neurodiagnostic findings, and outcomes of these uncommon complications. This review highlights significant gaps in knowledge and the need for collaborative multicenter studies to improve the diagnosis, treatment, and outcome of these severe complications of influenza infection.

Background: Maternal postpartum hospital readmissions represent profound implications for maternal health outcomes and potential gaps in quality of maternal care. Objective: This study aims to synthesise evidence on risk factors for maternal postpartum hospital readmissions within 42 days of discharge following birth hospitalisation. Methods: An electronic database search utilised CINAHL, EMBASE (Ovid), and MEDLINE for relevant studies published from 1 January 2010 to 30 June 2024. The studies that investigated the prevalence and risk factors for 42-day postpartum maternal readmission and reported risk estimates, published in English, were included. The risk of bias was assessed using the Newcastle-Ottawa Scale (NOS) for case-control studies and cohort studies. The PRISMA guidelines were followed in reporting this review. The review protocol was registered on PROSPERO (CRD42023442269). Results: A total of 7758 articles were retrieved, ultimately including 60 studies. The rate of maternal postpartum readmissions varied from 0.1236‱ to 26%. Significant risk factors were extracted and categorised into five groups: maternal demographic and socio-economic factors; behavioural and lifestyle factors; health institution structural factors; obstetric and delivery characteristics; as well as maternal morbidity The most frequently cited risk factors which contributed to maternal postpartum hospital readmissions were age, race/ethnicity, substance use, caesarean delivery, length of maternal hospital stay, premature birth, and all maternal morbidities, especially mental health disorders, severe maternal morbidity, and hypertensive disorders of pregnancy. Conclusions: This systematic review identified complex and diverse risk factors associated with maternal postpartum hospital readmissions within 42 days after discharge following birth hospitalisation. This helps our understanding of the risk factors and the strength of association with maternal postpartum hospital readmissions. Future research should develop a multidimensional risk assessment framework to guide clinical practice in adopting holistic individualised approaches for postpartum risk evaluation, thereby reducing readmission rates and improving maternal health outcomes.

Cardiovascular disease is the leading cause of death in women, yet prevention and management have historically relied on male-centered models. Sex and gender critically influence risk, clinical presentation, and outcomes. Depression, anxiety, and psychosocial stress, more prevalent in women, act as key amplifiers of cardiovascular risk. We conducted a clinically oriented narrative review based on a broad, non-systematic search of major databases, integrating evidence selected for relevance and methodological robustness to clarify biological and psychosocial mechanisms linking mental health and cardiovascular disease in women. Affective disorders and stress contribute to cardiovascular risk through interconnected pathways, including hormonal fluctuations, autonomic and neuroendocrine dysregulation, inflammation, endothelial dysfunction, and heightened platelet reactivity. These mechanisms interact with gender-related exposures such as caregiving burden, occupational stress, and interpersonal violence. Stress-related phenotypes, including mental stress, induced ischemia and takotsubo syndrome, exemplify the heart-brain axis and its clinical implications. Incorporating mental health into cardiovascular risk assessment is essential for precision prevention in women. A women-centered approach should include systematic psychosocial evaluation, multidisciplinary care, and tailored strategies to improve risk control, adherence, and outcomes.

Psychiatric illnesses and intellectual disabilities commonly occur in the criminal justice system and may impair an individual's ability to participate effectively in legal proceedings. Fitness to stand trial (FST) is an important safeguard for ensuring fair trial processes. This retrospective chart review examined the demographic, clinical, and legal profiles of 159 court-referred individuals assessed for FST at a major tertiary forensic psychiatry centre in New Delhi (India) between January 2017 and December 2022. Data on sociodemographic variables, ICD-10 diagnoses, current mental status, alleged offences, and FST outcomes were analysed using chi-square/Fisher's exact tests and multivariate logistic regression. The sample was predominantly male (81.1%) with a mean age of 37.9 years (SD 14.2). Psychotic disorders were the most frequent diagnosis (35.2%), followed by bipolar affective disorder and intellectual disability. Violent offences constituted 62.9% of alleged crimes. Overall, 54.7% were found fit to stand trial. Active psychiatric symptoms (adjusted OR 47.2, 95% CI 6.1-365.3) and organic mental disorder or intellectual disability (adjusted OR 22.5, 95% CI 4.8-105.6) independently predicted unfitness. Active psychopathology and cognitive impairment were the strongest determinants of unfitness, highlighting the need for structured assessment tools and restoration programmes under the Bharatiya Nagarik Suraksha Sanhita 2023.

ObjectiveTo examine the utility and limitations of remote supervision in a rural psychiatry training program through narrative review and dual reflective accounts.ConclusionsConsistent, well-structured remote supervision can nurture clinical expertise, ensure good clinical governance, improve patient safety, and promote graded trainee autonomy. Limitations can include reduced opportunity for direct observation, challenges processing complex relational dynamics, and heightened trainee isolation. Clear pedagogical structures, reliable technology, and a strong local multidisciplinary team are key to remote supervision providing effective containment and supporting progressive independence; and a hybrid model incorporating regular onsite and in-person contact deepens professional development and relational quality.