Trichotillomania is a disorder affecting 1-2% of the population during their lifetime and is characterised by recurrent hair-pulling that often leads to distress, low self-esteem, social ostracism, and lowered relationship satisfaction. Despite the availability of effective therapies, individuals with trichotillomania frequently report dissatisfaction with clinical care. This qualitative study explored the experiences of 20 adults with trichotillomania, focusing on their interactions with mental health practitioners. Using reflexive thematic analysis of semi-structured interviews, we constructed two themes: feeling (mis)understood and therapeutic (dis)connections. Participants described significant challenges in finding knowledgeable, compassionate practitioners, often encountering practitioners with dismissive attitudes, inaccurate assumptions, or misunderstanding of their condition. A common frustration involved practitioners conflating hair-pulling with self-harm, which many participants viewed as invalidating. However, some participants reported supportive therapeutic relationships that fostered acceptance and coping. Positive experiences were marked by practitioner empathy, validation, and tailored advice. These findings highlight the critical role of therapeutic alliance and practitioner compassion in treatment satisfaction and engagement. Greater awareness of trichotillomania and sensitivity to individuals' explanatory models among practitioners are essential for improving clinical outcomes.

Communication challenges are key barriers for people with intellectual disabilities in accessing palliative care. However, no studies to date have closely analysed the communication between people with intellectual disabilities and palliative care staff.

To assess feasibility and acceptability of conducting a Conversation Analysis study with people with intellectual disabilities and hospice staff.

A small-scale Conversation Analysis pilot study was conducted. Hospice consultations between people with intellectual disabilities and staff were recorded, transcribed, and analysed.

Three consultations with three people with intellectual disabilities, one paid carer, three hospice nurses, and one welfare officer were video-recorded in a UK hospice between April and May 2025.

Study procedures were deemed feasible and acceptable, enabling data collection. Most hospice patients with intellectual disabilities lacked capacity to consent and/or received in-home hospice care. This hindered recruitment due to data collection being restricted to hospice premises, and the Research Ethics Committee disallowing people who lack capacity to participate. Pain assessment was identified as a phenomenon of interest. Analysis showed an assessment involving multiple questions aimed at assessing frequency, severity, and management of the person's pain. The analysis displayed communicative challenges around brief patient answers with limited elaboration and how these were navigated by staff.

The Conversation Analysis pilot study was deemed feasible and acceptable. Analyses of pain assessments provided in-depth detail of the communication challenges and strategies employed to navigate them. This type of study and evidence can inform future communication and assessment guidelines.

Childhood trauma increases the risk for psychosis. However, mechanisms underlying this relationship remain unclear. In the present study, we aimed to investigate whether negative cognitive self-schemas or basic self-disturbance mediate the association between childhood trauma subtypes (abuse and neglect) and psychotic experiences in patients with psychotic disorders, unaffected siblings, and healthy controls.

This study was performed in a subsample of 110 patients, 120 siblings, and 48 healthy controls within the Genetic Risk and Outcome of Psychosis (GROUP) study. Parallel mediation models were used while correcting for age and sex. Abuse and neglect were measured with the childhood trauma questionnaire (CTQ), psychotic experiences with the Community Assessment of Psychic Experiences (CAPE), self-disturbance phenomena with the Self-Experience Lifetime Frequency Scale (SELF), and negative self-schemas with the Brief Core Schemas Scale (BCSS).

In patients, negative self-schemas fully mediated the association between abuse and psychotic experiences, whereas self-disturbance partly mediated the effect of neglect on psychotic experiences. In siblings, both negative self-schemas and self-disturbance fully mediated the association between abuse/neglect and psychotic experiences. In controls, only negative self-schemas mediated the association between abuse and neglect and psychotic experiences.

Our findings suggest that negative self-schemas and self-disturbance phenomena are relevant factors in explaining the association between childhood trauma and psychotic experiences across illness liability groups. Further research is needed to explore the causal pathways between trauma, negative self-schemas, self-disturbance phenomena, and psychotic experiences.

Individuals with schizophrenia spectrum disorders (SSDs) frequently exhibit low levels of physical activity (PA) and mood disturbances, both of which contribute to functional impairment and poorer long-term outcomes. Despite growing evidence linking PA and affective regulation, little is known about the real-time, bidirectional relationship between these domains in SSD.

In this multicenter observational study (DiAPAson project), 120 patients with SSD and 113 age- and sex-matched healthy controls (HC) underwent a 7-day ecological assessment combining smartphone-based Ecological Momentary Assessment (EMA; 8 prompts/day) and continuous wrist-worn actigraphy. We analyzed the dynamic associations between PA and mood using generalized linear mixed models (GLMMs) and Bayesian models with lagged temporal structures.

GLMMs revealed significantly lower daily mood in SSD compared to HC (estimate = -0.33, 95% CI: -0.53 to -0.12; p = .002), but no significant day-level association between PA and mood. In contrast, Bayesian models uncovered robust within-day, bidirectional associations in HC such that higher PA levels were followed by higher subsequent mood and, conversely, better mood predicted higher subsequent PA (PA → mood: posterior probability = 99.9%; mood → PA: 89.6%). In SSD, these within-day couplings were attenuated and more heterogeneous across individuals (PA → mood: 87.2%; mood → PA: 67.5%).

PA and mood are dynamically and bidirectionally linked within short temporal windows throughout the day, with stronger coupling in HC than in SSD. The substantial individual variability observed in SSD highlights the need for personalized, sensor-informed interventions, as aggregated analyses may obscure clinically relevant microtemporal dynamics.

Due to the increased survival and stable prevalence rates of preterm birth, every clinician, regardless of the patient population or practice setting, has cared for someone born preterm. Unfortunately, most healthcare teams fail to consider preterm birth as a risk factor to adult health, missing a critical opportunity to mitigate risk in this vulnerable population. The purpose of the study was to explore the health status and health experience of adults born preterm with comparisons between birth year cohorts and gestational age categories.

The study utilized a cross-sectional, quantitative descriptive comparative design, augmented by qualitative analysis of open-ended questions.

The health status and health experience survey was developed in collaboration with leaders of an advocacy group for adults born preterm and based on the available research. Convenience, snowball sampling among members of the advocacy network and other preterm birth groups provided an international sample of participants (N = 80).

Chronic conditions or symptoms, representing health status, were reported by 85.7% of participants, with 75% of those participants taking medications for the condition. Participants born less than 32 weeks of gestation reported experiencing health conditions significantly more than those born at later gestations (91.8% vs. 62.5%, p = 0.008); there was no difference in birth year cohort. The most commonly reported conditions were respiratory, mental health, neurodevelopmental, and musculoskeletal. Two-thirds of participants reported never being asked about preterm birth history by healthcare teams. Healthcare experiences were described as ambivalent or dismissive among those who chose to disclose preterm birth status to providers.

Chronic and comorbid conditions associated with preterm birth are common among adults born preterm. These conditions are responsive to prevention and mitigation strategies and, as such, failure to identify adults born preterm as a population susceptible to chronic health conditions results in unidentified, unmanaged risk.

Functional impairment in psychosis often persists despite symptomatic remission. There is a paucity of research examining early-course psychosocial functioning trajectories, and none has been conducted to examine relationship between the trajectories and prospective long-term functional outcomes in early psychosis sample.

We conducted 12-year follow-up of a randomized controlled trial on extended early intervention for first-episode psychosis to identify early-course social-occupational functioning trajectories and their baseline predictors and associations with 12-year outcomes. Participants who completed Social and Occupational Functioning Scale (SOFAS) scores at three or more timepoints between baseline and 3-year follow-up were included in the study. Premorbid adjustment, illness characteristics, symptom severity, functioning, and treatment profiles were assessed. Latent growth mixture modeling was employed to derive early-course social-occupational functioning trajectories based on SOFAS scores over 3-year follow-up.

A total of 148 participants were included in this study, with 106 patients having completed the 12-year follow-up. Our results identified four distinct trajectories, including persistently-good class, gradually-improved class, suboptimal-stable class, and persistently-poor class. Patients in persistently-poor class had more severe negative symptoms at baseline compared to patients in persistently-good class. Patients with persistently-poor trajectory had worse long-term outcomes than those with other classes in the majority of functional measures at 12-year follow-up.

The majority of patients were classified in early-stage suboptimal or poor functional trajectories. Above one-fourth of the participants exhibited persistently-poor social-occupational functioning trajectory, which predicted worse functional outcomes at 12-year follow-up. These findings highlighted the importance of tracking functional changes during the initial years of illness.

Adolescents seeking treatment for scoliosis often present with comorbid mental health concerns. Yet, standardized screening, evaluation, and care protocols remain lacking. This study examines pediatric orthopedic providers' perceptions of patient mental health burden and screening practices in spine deformity care.

Fifty-four pediatric spine surgeons from a multi-center AIS registry were anonymously surveyed. Closed-ended responses were tallied, and sentiment analysis was applied to open-ended responses.

Twenty-eight surgeons (52%) responded, most with over ten years of experience in high-volume practices. Many estimated that up to half of their patients face mental health challenges, noting a slight increase in burden. Despite this, only 12 (42%) reported structured screening (e.g., SRS, PROMIS) and 6 (21%) used informal methods (observations, conversations). Among the 16 (57%) screening, PROMIS and depression/suicide screens were most common. Few reported reliable follow-up: only 2 (7%) indicated their teams "probably" follow up on low scores, while 11 (39%) felt follow-up was unlikely. Most (64%) believed they were not adequately addressing concerns. Referrals were typically prompted by positive screens or observations, but barriers, like limited provider availability, access issues, and insurance constraints, often hindered them. When made, referrals were usually directed in-house.

Significant gaps exist in addressing mental health in pediatric scoliosis care. While providers report to recognize the burden, few conduct routine screenings, and follow-up and referrals remain inconsistent. Findings highlight the need for standardized protocols and improved access to mental health resources within scoliosis care.

IV.

The Brief Assessment of Impaired Cognition (BASIC), and the Brief Assessment of Impaired Cognition Questionnaire (BASIC-Q) are new case-finding tools for cognitive impairment and dementia which are increasingly being used in clinical settings as alternatives to the Mini-Mental State Examination (MMSE). The objective of this study was to develop bi-directional crosswalk tables for conversion between the three instruments for patients 60 years and older.

Patients from memory clinics and general practice ≥ 60 years of age who completed assessment with BASIC, BASIC-Q, and MMSE were included. The equipercentile equating method with log-linear pre-smoothing of data was applied to create conversion tables between instruments.

A total of 394 patients completed assessment with BASIC and MMSE, 355 of which also completed BASIC-Q. We present bi-directional conversion tables between the three instruments.

The study presents bi-directional crosswalks between BASIC, BASIC-Q and MMSE enabling comparison and synthesis of test results, facilitating communication between clinicians, and potentially helping to inform clinical and policy decision making.

Nurses are routinely exposed to high emotional demands associated with illness, disability, and death. Prolonged exposure may deplete nurses' capacity for compassion, contributing to compassion fatigue. Compassion fatigue not only erodes emotional resources but may also adversely affect professional functioning and mental health. To date, several studies have developed prediction models for nurses' compassion fatigue, but the methodological quality of these studies remains uncertain.

This systematic review will comprehensively summarize published prediction models for nurses' compassion fatigue and describe their key characteristics, predictors, performance, and risk of bias.

Using a prespecified search strategy, we will systematically search seven databases: PubMed, Web of Science, Cochrane Library, Embase, CINAHL, PsycINFO, and CNKI. Two reviewers will independently conduct study selection, data extraction, and quality assessment according to prespecified inclusion and exclusion criteria. The data extraction form will be developed in accordance with the CHARMS checklist, and the risk of bias of the included models will be assessed using the PROBAST tool. Results will be presented in tables to facilitate qualitative comparisons across models. The systematic review will be reported in accordance with the PRISMA 2020 statement. The protocol has been registered in INPLASY (registration number: INPLASY202530051).

This review will identify and compare existing models for predicting compassion fatigue in nurses and will inform future model development, validation, and application.

Are Swedish oocyte donors comparable to an age-matched control group of women with regard to medical conditions, drug prescription, and hospitalization both before and up to 15 years after their donation?

Compared with age-matched controls, Swedish oocyte donors exhibited higher outpatient healthcare utilization and medication use, were more frequently diagnosed with genitourinary disorders, and, among donors born in 1973 or later, had mental and nervous disorders.

During the donation process, oocyte donors self-assess their health as good, but longitudinal studies based on objective data are scarce.

Longitudinal study initiated in 2005 following identity-release oocyte donors' health from 1995 until 2023.

In total, 170 women recruited and accepted as identity-release oocyte donors in a non-commercial setting between 2005 and 2008 were included in this national register study. Of these, 21 women were directed donors, donating to a known recipient couple. For each donor, four age-matched controls from the general population were identified to form a control group of 680 women. Data from the National Patient Register, the Prescribed Drug Register, and Cause of Death register were used to obtain information on diagnoses using the ICD classification, medications, and hospitalizations from 1995 until 2018.

Before donation, ∼10% of donors had received specialized healthcare for neoplasms, mental disorders, respiratory disorders, digestive disorders, or skin disorders. Genitourinary disorders were common, with 50% of donors diagnosed prior to donation. With post-donation period included, this proportion increased to almost 80%, which is markedly higher than among controls (58%, P < 0.001). The younger oocyte donors, born from 1973 onwards, were more often than the matched controls diagnosed with mental disorders due to psychoactive substance use, neurotic and stress-related disorders, and behavioural syndromes associated with physiological disturbances (all P < 0.05). Oocyte donors had approximately twice as many outpatient visits compared to the controls, even after excluding visits related to genitourinary disorders (mean number of visits/SD 17.9/20.6 versus 10.1/17.1, P < 0.001). The oocyte donors had also more often received prescribed medications, including systemic hormonal preparations, excluding sex hormones and insulins (73.5% vs 34.7%, P < 0.001) and drugs related to the nervous system (75.9% vs 65.0%, P < 0.012). More than 40% of the oocyte donors had used antidepressants, and 37% had used sedatives. Hospitalization rates did not differ between donors and controls. Directed donors had more outpatient visits than non-directed donors and were also more often treated for anxiety and depression.

National register data.

This study of the health of oocyte donors is limited by the difficulty in retrieving information on primary care from national registers in Sweden. Consequently, a potential underestimation of healthcare use and of health diagnoses must be taken into consideration when interpreting the results.

A society that accepts gamete donation must strive to ensure rigorous medical and psychological assessments. The pre-donation assessment of health status and hereditary disease risk does not appear to reliably identify women with a lower predisposition to future disease or need for medication.

The study was financed by grants from the Swedish state under the agreement between the Swedish government and the county councils, ALF Grants, Region Östergötland, and from the Swedish Research Council (2013-2712; 2021-03174).

None of the authors have any competing interest to report in relation to the current study.

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