Real-world evidence on major depressive disorder (MDD) management in children and adolescents is limited in Japan. This study aimed to evaluate the antidepressant treatment persistence rate in this population.

This study evaluated the antidepressant treatment persistence in children and adolescents (aged 6-18 years) with MDD who had claims data from 6 months before to 1 year after the index date between 2012 and 2017 using a large-scale Japanese claims database. Treatment persistence was defined as the absence of a prescription gap beyond 30 days. Factors associated with it were examined using a Cox proportional hazards model (JMP ver.18).

In total, 1,582 patients on the index date were included. The treatment persistence rate for any antidepressant was 62.6% on the 30th postindex day, 46.1% on the 60th postindex day, 22.3% on the 180th postindex day, and 10.2% on the 365th postindex day. The most frequently prescribed initial antidepressant was sulpiride (30.0%). By drug class, selective serotonin reuptake inhibitors (SSRIs) were the most frequently prescribed (39.9%), followed by tricyclic or tetracyclic antidepressants (TCAs) (18.3%) and serotonin and norepinephrine reuptake inhibitors (SNRIs) (6.3%). The significant factors associated with treatment discontinuation with any antidepressant were treatment initiation with sulpiride, noradrenergic and specific serotonergic antidepressants, serotonin antagonist and reuptake inhibitors, or TCAs, as well as consultations with nonmental health specialists.

Antidepressant treatment persistence rates in children and adolescents with MDD were low. However, the rate varied depending on the first prescribed antidepressant and mental health specialist involvement. Relatively high persistence was observed among those prescribed SSRIs or SNRIs as their initial antidepressant treatment and those who received clinical interventions provided by mental health specialists. Given the claims data and no clinical severity measures, these findings should be interpreted with caution.

The impostor phenomenon (IP) is an individual's internal experience of intellectual phoniness, characterized by an inability to internalize success, leading to self-doubt and fear of being exposed as a fraud. We examined IP among Croatian and Bosnian- Herzegovinian undergraduate dental students.

A cross-sectional study (n = 679) was conducted at the School of Dental Medicine, University of Zagreb (n = 355), and the Faculty of Dentistry, University of Sarajevo (n = 324). We aimed to assess the risk associated with certain predictors, such as sociodemographic characteristics, substance use, quality of life, physical and mental health, social interactions, mental health issues, and academic and non-academic stressors, in relation to a clinically relevant level of impostorism measured by the Clance Impostor Phenomenon Scale (CIPS).

Dental schools in Sarajevo and Zagreb had similar average CIPS scores, 58.5 versus 58.7. Females had significantly higher average scores than males (Sarajevo: 60.1 vs. 53.7; Zagreb: 60.0 vs. 52.4). Every second student had a clinically relevant level of impostor feelings. Transitional years, 1st, 4th, and 6th, exhibited the highest average scores. Alcohol consumption, smoking, parental expectations, PHQ-9 scores, and lower quality of life increased risk, while social inclusion in the broader community reduced risk.

IP is highly prevalent and influenced by internal and external factors. This study was the first to examine IP among Croatian and Bosnian and Herzegovinian dental students. Dental schools should implement targeted interventions and psychological support into curricula to build student resilience.

Recent studies have focused on characterising the brain's intrinsic connectivity networks during fear learning, going beyond traditional brain activation analyses, to study the acquisition of fearful associations as a model for clinical anxiety onset.

Given the sharp increase in prevalence of affective disorders during puberty, a period marked by heightened affective sensitivity and fronto-amygdala circuitry development, the current study compares the connectivity within and between the salience network, executive control network and default mode network throughout fear learning, between young adults with and without mild mixed affective complaints. We hereby aim to identify potential neural targets for promising novel treatment options, such as functional magnetic resonance imaging (fMRI)-guided neurofeedback or transcranial magnetic stimulation.

Generalised psychophysiological interaction analysis was used to assess connectivity changes within and between the salience network, executive control network and default mode network during an fMRI fear-conditioning paradigm (habituation, early, mid and late acquisition phase). Results were compared between healthy controls (n = 44), spider phobics (n = 44) and a group with subclinical mixed psychopathology (n = 52; 21 males), all aged 16-25 years.

Task-induced changes in functional connectivity were specifically found in the default mode network (F(6, 792) = 4.170, p < 0.001). Overall, the default mode network showed less functional connectivity during conditioned threat stimulus than neutral 'safe' stimulus trials. Notably, a subset of connections within the default mode network of the subclinical mixed psychopathology group failed to differentiate between the stimuli (F(27, 377.39) = 2.01, false discovery rate-adjusted p-value = 0.014), which is in line with fear-conditioning research showing impaired (behavioural) stimuli differentiation in affective disorders.

Stimulus-specific temporal dynamics of the default mode network during fear learning differentiated young adults with and without mild psychopathology. These results add up to a growing body of research identifying deficient default mode network functionality in affective disorders.

The Health of the Nation Outcome Scales (HoNOS) are the most widely used psychiatric clinical outcomes tool in the UK. Nonetheless, HoNOS scores and their change during treatment for people with anorexia nervosa have not been investigated. We retrieved clinical data from the Clinical Records Interactive Search register from 234 with an anorexia nervosa or an eating disorder diagnosis, a body mass index (BMI) <18.5 kg/m² and with available HoNOS, BMI and C-reactive protein (CRP) data at admission.

From admission to discharge, patients showed a significant moderate improvement in HoNOS total score (mean±s.d.) from 14.30±6.23 to 10.11±4.81, and a significant moderate-to-large increase in BMI from 14.15±1.45 kg/m² to 16.22±2.56 kg/m². CRP levels >2 mg/L on admission were significantly associated with age, a personality disorder diagnosis, agitation and hallucinations in the HoNOS.

In-patient treatment for anorexia nervosa improves health and social functioning.

Peer-supported self-management at discharge from early intervention in psychosis services (EIPS) has received limited attention. The MyPREPED (My Personal Recovery Plan for Early Discharge) trial will evaluate a co-designed, digital and paper-based, peer-delivered recovery and self-management focused intervention, tailored for young people exiting EIPS.

This protocol describes a hybrid type 2 effectiveness-implementation trial designed to assess MyPREPED's impact, feasibility, real-world implementation and cost-utility.

This multi-site, mixed-method, two-arm (1:1), parallel-group, randomised controlled trial (MyPREPED versus treatment as usual) trial will be delivered across eight Australian EIPS that deliver ultra-high risk and/or first-episode psychosis streams, using a hybrid type 2 implementation-effectiveness design. Eligible participants are young people aged 16 years and over within 6 months of planned discharge from EIPS. Peer coaches will deliver up to ten sessions of using a self-management plan (modules: discharge, recovery, well-being, relapse prevention, goal-setting, service navigation). Co-primary outcomes include (a) mental health recovery (Recovery Assessment Scale - Domains and Stages; effectiveness outcome) and (b) feasibility (Feasibility of Implementation Measure; implementation outcome). Secondary outcomes assess broader effectiveness domains (mental health quality of life, clinical and functional outcomes) and other implementation outcomes. A cost-utility analysis will estimate incremental costs and quality-adjusted life-years associated with MyPREPED, alongside a secondary cost-effectiveness analysis. Analyses will follow intention-to-treat principles, using mixed-effects models.

This study will provide the first rigorous test of a co-designed, peer-delivered recovery and self-management focused intervention specifically targeting EIPS discharge.

Psychiatry on call occupies a distinct and formative space within mental health services, shaped by moments of uncertainty, responsibility, and relational decision-making. In Ireland, non-consultant hospital doctors continue to deliver the majority of out-of-hours emergency psychiatric care, often as the sole on-site psychiatric clinician, working across multiple settings and managing high levels of clinical and organisational risk. This paper situates contemporary psychiatry on call within its wider clinical, societal, and service context, drawing on the College of Psychiatrists of Ireland's 2025 position paper and emerging evidence on emergency mental health care. We argue that emergency psychiatry differs from other acute specialties, being characterised by distress rather than disease, uncertainty rather than diagnosis, and time-intensive relational work rather than protocol-driven intervention. Rising demand reflects broader systemic pressures, including unmet social need, reduced inpatient capacity, uneven crisis alternatives, and increasing regulatory burden. We examine the service-user experience of out-of-hours care, highlighting issues of environment, equity, trust, and safety, particularly for marginalised groups. While high-quality supervision and training remain essential, we contend that sustainable improvement requires system-level reform, including strengthened multidisciplinary crisis responses, clearer role delineation, and coordinated investment in and also beyond mental health services. Attending to psychiatry on call offers a critical lens through which to understand and improve emergency mental health care for both clinicians and service users.

Concerns over postoperative opioid use after open spinal fusion continue to rise. Many randomized controlled trials (RCTs) have sought to reduce postoperative opioid consumption; however, the influence of sociodemographic variables on this consumption remains underappreciated. This study evaluated the extent to which sociodemographic characteristics are reported in RCTs assessing postoperative opioid consumption following lumbar fusion surgery.

A structured literature search (Medline via PubMed, 2015-2025) was conducted to identify English-language RCTs focused on postoperative opioid use after open lumbar fusion. Exposures of interest included demographics, insurance status, education level, and prior opioid use; the primary outcome was postoperative opioid consumption. Following full-text review of 321 articles, 63 RCTs met inclusion criteria for data extraction. Reported variables included sex (96.8%), age (93.7%), preoperative opioid history (19.0%), race (6.3%), psychiatric comorbidity (6.3%), employment (3.2%), and insurance status, ethnicity, and education (1.6% each). Reporting of preoperative opioid history was associated with North American or European trial settings (adjusted p = 0.017).

Sociodemographic underreporting limits interpretability of postoperative opioid outcomes in lumbar fusion RCTs. Greater inclusion of patient-level variables is needed to advance interpretability of postoperative opioid consumption in lumbar fusion RCTs.

Objective: To analyze the association between fine particulate matter (PM_2.5) exposure and dyslipidemia, and the potential modifying role of dietary factors in children and adolescents in rural China. Methods: A multi-stage cluster random sampling method was applied to conduct questionnaire survey, biochemical measurements, and physical examination in children and adolescents aged 8 to 15 years in 103 key surveillance counties where the Nutrition Improvement Program for Rural Compulsory Education Students was conducted. The average PM_2.5 concentration in previous 3 years was used as the long-term exposure level. The linear mixed-effect model was used to evaluate the association between PM_2.5 exposure and dyslipidemia. Stratified analyses by dietary factors were conducted to analyze their potential modifying effects. Results: A total of 10 788 children and adolescents were included, including 5 391 boys (49.97%) and 5 244 primary school students (48.61%). The annual PM_2.5 exposure level was (30.36±10.62) µg/m³, and the prevalence rate of dyslipidemia was 21.84%. Higher PM_2.5 exposure was significantly associated with the increased risk for dyslipidemia (OR=1.501, 95%CI: 1.028-2.192), with stronger associations observed in boys, junior high school students, and those attending schools in county towns. Stratified analyses indicated that no significant association was observed between high PM_2.5 exposure and dyslipidemia in children and adolescents with greater vegetable intake diversity. Conclusions: High level of PM_2.5 exposure increased the risk for dyslipidemia in children and adolescents. Greater diversity of vegetable intake might play a modifying role in the adverse association between PM_2.5 exposure and dyslipidemia.

Depression is a leading global health concern and is projected to become one of the major contributors to the global burden of disease in the coming decades. Increasing evidence highlights the role of social determinants-including socioeconomic conditions, social relationships, life stressors, discrimination, and environmental influences-in shaping the risk and clinical expression of depressive disorders. This study aimed to investigate social determinants associated with the presence and severity of depressive symptoms in Italian general population.

A cross-sectional survey was conducted among 1,036 adults from the Italian general population, recruited through personal networks and online platforms using snowball sampling. Participants completed a structured questionnaire assessing sociodemographic characteristics, social support, stressful life events, quality of life, minority stress experiences, social media use, environmental and societal concerns, substance use, and mental health symptoms. Comparative analyses were performed between individuals reporting a clinician-diagnosed depressive disorder (n = 143; 13.8%) and those without a diagnosis (n = 893).

Participants with a depressive disorder reported significantly higher exposure to multiple adverse social determinants. They were more likely to experience stressful life events, reduced perceived social support, poorer quality of life, minority stress, and negative psychosocial effects related to social media use. Concerns regarding broader socio-environmental issues, including political instability and climate change, were also more prevalent in the diagnosed group. These social vulnerabilities were accompanied by greater severity of depressive symptoms, anxiety-related manifestations, impulse-control difficulties, aggressive behaviors, and the use of substances as a coping strategy (all p ⩽ .003).

The findings support social determinants framework for understanding depression, highlighting the contribution of social adversity, environmental stressors, and relational factors to the development and severity of depressive symptoms. Population-based surveys can help identify vulnerable groups and inform preventive strategies and public health interventions aimed at addressing the social conditions that contribute to depression.

Numerous explanations have been provided for recent increases in mental distress and poorer well-being. One avenue of research has linked specific beliefs about emotions with poorer psychological outcomes, including heightened mood and anxiety symptoms and lower levels of life satisfaction. The current project builds on this prior work by developing a new measure of beliefs that the experience of negative emotions can cause physical or psychological harm, akin to ingesting a toxic substance and exploring its association with various psychological outcomes in three large independent samples (N_total = 1,849) collected from 2023 to 2025. In Sample A (N = 954), we describe the initial development of the Beliefs That Negative Emotions Are Toxic Scale (B-NETS). In Samples B (N = 419) and C (N = 476), we validate the B-NETS and link higher B-NETS scores with greater irritability, depression, and anxiety. These associations remained significant even after accounting for existing emotion belief, emotion regulation, and experiential avoidance measures. If replicated, especially in non-U.S. samples with greater racial and ethnic diversity, these findings suggest this new measure may provide unique information about mental health beyond existing measures. (PsycInfo Database Record (c) 2026 APA, all rights reserved).