The MIND diet supports healthy cognitive aging. Yet, a challenge remains to identify individuals who do not adhere to the MIND and could be at risk for accelerated cognitive decline. A multi-metabolite biomarker panel could facilitate population screening.

To determine and validate a blood metabolomics signature of MIND adherence in a large cohort of older adults, and to estimate its association with subsequent cognitive decline.

Participants were older adults (≥65 years) from the population-based three-City (3C) cohort, free of dementia at study baseline and followed for up to 12 years for cognition, who were included in two case-control samples on cognitive decline nested within two centers (Bordeaux and Dijon cities, n = 838).

155 diet-related serum metabolites measured with a multianalyte metabolomics platform.

The primary outcome was adherence to the MIND diet, assessed in a subsample of 344 participants from Bordeaux center (which underwent the dietary surveys, 24 h recall and food-frequency questionnaire). A metabolomics signature of MIND diet adherence was characterized with penalized regression and a metabolomics score ("metaboscore") reflecting the overall MIND biological fingerprint was calculated. The secondary outcome was cognitive decline status (coded as binary: accelerated, vs. null or minimal decline) over follow-up, assessed using repeated cognitive measures in the two case-control samples. The metaboscore was reconstructed and linked to the odds of cognitive decline.

Eight metabolites were identified: three were associated with higher MIND adherence (3-hydroxyhippuric acid, 5-hydroxyindole-3-acetic acid, betaine - phenolic acids and amino acid related to plant foods) and five with lower MIND adherence (1-methylhistidine from red meat; cyclo(L-leucyl-L-prolyl) from coffee; tartaric acid from wine; myristoyl-carnitine and dehydroepiandrosterone sulfate, endogenous). The French-MIND metaboscore was linked to lower odds of cognitive decline, although replication was not statistically significant after multivariable adjustment.

A novel metabolomic signature of the MIND diet was characterized, which may help screen older adults at risk of poor brain nutrition and could support personalized dietary prevention strategies.

Comorbidity between Eating Disorders (ED) and Emotionally Unstable Personality Disorder (EUPD) is high. This comorbidity is also linked with worse outcomes for traditional evidence-based treatments. We aimed to improve mental health service experience for adults with comorbid EUPD and ED by: (1) understanding the service-user experience of receiving and accessing care; (2) identifying areas of unmet need; and (3) creating recommendations for improving care for this population.

The project comprised semi-structured interviews with nine service-users within the UK National Health Service. Reflexive Thematic Analysis was used to generate themes, which informed clinical recommendations and a framework for improving care to meet local needs, with implications beyond.

Service-users described long waits and disjointed care, often feeling pressured to prioritise one difficulty over another in ways that did not align with their own goals. Many reported that their needs were only recognised at crisis point, highlighting a gap between clinician understanding and personal experiences. Six themes were derived from patient interviews. Psychoeducation about the links between EUPD and ED was seen as helpful, as well as the need for more consistent individualised care that better reflects service-users' goals and needs.

The project increased understanding of the experiences of mental health service use in adults with comorbid ED and EUPD, and produced a set of recommendations, aimed at improving care for these individuals. These included a thorough assessment of comorbidity, consideration of service-user choice, alongside appropriate service adaptations to best meet service-users' goals and needs.

Interpersonal functioning has a complex, bidirectional relationship with mental disorders such as anxiety and depression. The Inventory of Interpersonal Problems (IIP) assesses aspects of interpersonal functioning, including general interpersonal distress and interpersonal styles. In this study, we aimed to better understand how these aspects relate to anxiety and depression by (1) comparing interpersonal distress and style in individuals with current, past, and no lifetime anxiety and/or depression, and (2) examining how interpersonal styles relate to the comorbidity and chronicity of anxiety and depression.

Participants (N = 1800) were drawn from the 9-year follow-up of the Netherlands Study of Depression and Anxiety. Diagnostic data from baseline until the 9-year follow-up were used to determine diagnoses and chronicity. General interpersonal distress and style were derived from the IIP using the Structural Summary Method. Participants were grouped into four interpersonal style subtypes corresponding to the quadrants of the interpersonal circumplex.

Currently diagnosed participants reported higher general interpersonal distress and a more submissive style than those with past and no lifetime anxiety/depression. As predicted, a cold-submissive style was associated with greater comorbidity and chronicity, also after adjusting for demographics.

This study extends prior research on how patients' interpersonal style relates to psychopathology by using longitudinal, transdiagnostic data of individuals across different symptomatic stages. Our findings indicate that a cold-submissive style is relatively common in more comorbid and chronic anxiety and depressive disorders. This highlights the clinical value of integrating interpersonal assessment into treatment planning.

BackgroundMigraine is frequently comorbid with depression and anxiety, conditions that amplify disease burden and may impair preventive treatment response. Calcitonin gene-related peptide (CGRP)-targeted therapies have demonstrated robust efficacy in reducing migraine frequency, with emerging evidence suggesting concurrent improvements in psychiatric symptom burden. However, findings derive from heterogeneous study designs and outcome instruments, limiting conclusions regarding consistency and magnitude of these effects.MethodsWe conducted a systematic review and meta-analysis of studies reporting changes in depressive and anxiety symptoms in adults with migraine receiving CGRP-targeted preventive therapies. PubMed, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), and PsycINFO were searched from inception through July 2026. Eligible studies included randomised controlled trials, post hoc analyses, and real-world observational studies reporting validated self-report or clinician-rated symptom measures at baseline and follow-up. Risk of bias was assessed using the Jadad Scale for randomised trials and the Newcastle-Ottawa Scale for observational studies. Standardised mean differences with 95% confidence intervals were calculated using random-effects models.ResultsTwelve studies (n = 3603; 63% female) published between 2020 and 2026 met eligibility criteria, of which nine contributed to quantitative synthesis. Pooled analyses demonstrated consistent reductions in depressive symptoms across instruments at 3 months: Hospital Anxiety and Depression Scale - Depression subscale -1.35 points (95% CI, -1.63 to -1.07), Hamilton Depression Rating Scale -3.73 points (95% CI, -5.76 to -1.71), and Beck Depression Inventory -3.70 points (95% CI, -4.92 to -2.48). Anxiety outcomes improved similarly: Hospital Anxiety and Depression Scale - Anxiety subscale -1.50 points (95% CI, -2.45 to -0.55), Hamilton Anxiety Rating Scale -1.64 points (95% CI, -3.21 to -0.07), and Beck Anxiety Inventory -4.36 points (95% CI, -5.24 to -3.48). In the single placebo-controlled subgroup analysis, fremanezumab was numerically superior to placebo for depressive outcomes, though this difference did not reach statistical significance.ConclusionsCGRP-targeted therapies were consistently associated with reductions in depressive and anxiety symptom scores across multiple validated instruments, with improvements appearing to correlate with effective migraine control, although current study designs cannot differentiate between direct and indirect effects on psychiatric symptoms. Placebo-controlled evidence remains insufficient to draw firm conclusions, and adequately powered randomized controlled trials with psychiatric outcomes as prespecified endpoints are warranted before the nature and magnitude of these effects can be definitively characterized.

Due to the constant exposure of nurses to clinical errors and their ethical and professional consequences, this group is exposed to the experience of second victim, which could affect their mental health. The aim of this study was to investigate the longitudinal relationships between psychological flexibility and psychological distress, considering the mediating role of the second victim experience and the moderating role of self-compassion. This longitudinal study was conducted with two waves of data from 270 nurses in six private hospitals in Tehran (mean age 25.22 years, SD=± 6.78). Data were collected with standardized questionnaires and analyzed using structural equation modeling and cross-sectional panel analysis. The results showed that psychological flexibility and self-compassion negatively predicted psychological distress, while the secondvictim experience positively predicted psychological distress. Mediation analysis showed that low levels of psychological flexibility in the first wave predicted the second victim experience in the second wave, which may contribute to increased psychological distress. Also, self-compassion significantly attenuated the relationship between the second victim experience and psychological distress. The findings suggest that lower levels of psychological flexibility could lead to increased psychological distress in nurses through the second victim experience, while self-compassion plays an important protective role in this relationship.

Schizophrenia is characterized by heterogeneous clinical symptoms, which may arise from disruptions in brain network connectivity. This study aimed to characterize alterations in white matter networks, and to investigate their associations with symptom dimensions in schizophrenia. We conducted probabilistic tractography in 61 schizophrenia and 63 matched healthy controls. Whole-brain structural connectomes were constructed using the Desikan-Killiany atlas, which comprises 82 regions. Network-Based Statistics identified significantly altered subnetworks, followed by graph-theoretical analyses to assess their topological properties. Symptom dimensions were derived from the Positive and Negative Syndrome Scale, and regression analyses were performed to examine associations between network alterations and symptom severity. Individuals with schizophrenia showed weakened connectivity in a subnetwork comprising 13 connections across cortical and subcortical regions (threshold edge t > 3.50, component p < 0.001, familywise error corrected). This subnetwork was primarily characterized as frontal-temporal-insular-cingulate connectivity, with limited hippocampal and thalamic contributions. Within this subnetwork, Connectivity intensity(p < 0.001) and global efficiency(p < 0.001) were significantly lower in schizophrenia relative to healthy controls. Exploratory regression analyses (adjusting for potential confounders) revealed that distinct connections were associated with different affective and cognitive symptom dimensions; global efficiency was associated with negative symptom dimensions (all p < 0.05, uncorrected). The analyses identified reduced structural connectivity of cortical networks with limited hippocampal and thalamic involvement among individuals with schizophrenia relative to healthy controls, and provided preliminary evidence linking this subnetwork to clinical heterogeneity in schizophrenia.

Identifying subtypes within autism spectrum disorder (ASD) has often been attempted to better understand the significant heterogeneity within the spectrum. Profiles of cognitive functioning have frequently been investigated as possible subtype definitions, but most studies have relied on relatively small sample sizes and higher-functioning samples, and few have used advanced statistical techniques to obtain estimates of underlying profiles of IQ in ASD. The purpose of this study was to use latent profile analysis to identify possible subgroups of children with ASD and other neurodevelopmental disabilities using the Wechsler Intelligence Scale for Children-5th Edition (WISC-V) across a range of ability levels.

We used latent profile analysis with a clinical sample of 727 youth (ages 6-16) referred for neurodevelopmental evaluations. We also completed a multigroup bifactor confirmatory factor analysis of the clinical sample compared to the WISC-V standardization sample.

We did not find distinct cognitive profiles based on the WISC-V index scores; results indicated a continuum of the g factor of intelligence instead of distinct patterns of strengths and weaknesses across IQ subscales. A multigroup bifactor confirmatory factor analysis revealed partial strong invariance when comparing the two clinical groups to the WISC-V standardization sample, but full strong invariance within the neurodevelopmental groups and substantive explained variance of the processing speed index above and beyond FSIQ.

Alternative methods and measurements are needed to identify potential cognitive subtypes of children with autism and other neurodevelopmental disabilities. Processing speed (but not other WISC-V indexes) may be of unique clinical interpretability above and beyond FSIQ.

The 2025 International League Against Epilepsy (ILAE) seizure classification introduced a basic version for nonspecialists, but its usability is untested. We evaluated whether a multidisciplinary frontline workforce in South Africa could apply it, how consistently, and whether performance improved after self-directed exposure.

In a prospective, single-arm, paired pre-post study, 50 clinicians in neurology, internal medicine, emergency medicine, and nursing each classified the same 25 vignettes (37 seizure types) before and after self-directed reading of the 2025 practical guide, serving as their own controls and generating 3700 classifications. Free-text responses were scored against a two-epileptologist consensus reference at two nested levels: the main seizure class (Layer 1) and the class plus basic seizure type (Layer 2). Mixed-effects models with crossed random intercepts for participant and seizure-type unit estimated change; agreement used Fleiss kappa and Gwet AC1.

Layer 1 accuracy rose from 39.2% to 54.4% and Layer 2 from 14.9% to 34.1% (odds ratio [OR] = 2.57, 95% confidence interval [CI] = 2.18-3.03 and OR = 2.76, 95% CI = 2.40-3.18; both p < .001). All four disciplines improved, and Layer 2 gains were greater outside neurology (ratio of cumulative ORs = 1.44, 95% CI = 1.09-1.91; p = .011), although neurologists remained the most correct and nurses the least. Experience, sector, and first language showed no independent association. Agreement improved only modestly; participants became more often correct without becoming more alike. Two thirds of classifications still missed the seizure type, and generalized onset seizures misclassified as focal, the error most likely to prompt inappropriate treatment, rose from 13.9% to 18.9%.

This is the first evaluation of the 2025 ILAE classification in a sub-Saharan African context, and the first anywhere to include the multidisciplinary workforce that classifies most seizures. Unsupported exposure produced measurable improvement, showing the framework is learnable; yet accuracy and consistency remained low, and the most consequential error became more common. These findings support deliberate training, dissemination built for nonspecialists, and translation into the languages in which seizures are described.

Child abuse constitutes a significant public health issue that adversely affects individuals' physical and mental health, with consequences that can persist throughout the lifespan. Accordingly, child abuse has received considerable scholarly attention and has been extensively studied. However, existing studies have reported substantial variations in prevalence rates among Chinese children and adolescents, thereby hindering a comprehensive understanding of its prevalence in this population. To address this issue, the present study systematically analyzed 117 studies, comprising 373 effect sizes and 681,699 Chinese children and adolescents. Results indicated that the pooled prevalence rates were, in descending order: neglect (33.3%), psychological abuse (21.9%), physical abuse (15.9%), and sexual abuse (8.6%). Significant moderating effects were found for publication-related factors (i.e., publication status and year), sample characteristics (i.e., age and geographic region), and study design characteristics (i.e., measurement and time frame). These findings suggest that child abuse remains a pressing issue among Chinese children and adolescents, highlighting the need for continued efforts to improve the child protection system in China. Concurrently, greater emphasis should be placed on standardizing research designs and promoting the adoption of more standardized and validated measures.