A growing number of studies highlight the observed effects of natural light exposure on health and bodily functioning, as well as its added value for the performance of daily activities. Although natural light exposure is gaining increasing recognition as a determinant of health and well-being, it remains underrepresented in the field of lifestyle medicine and should be considered as a potential new pillar alongside a healthy diet, physical activity, restorative sleep, stress management, positive social relationships, and the avoidance of risky substances. This narrative review aims to synthesize the main findings of the literature and relevant conceptual frameworks that support the inclusion of daily exposure to natural light as a component of lifestyle medicine and its integration into clinical practice. Further research is required to better characterize the effects of natural light exposure on physical and mental health and the overall evidence presented in this article supports continued investigation in this field.

Collaborative Decision Skills Training (CDST) is a promising group intervention for adults with serious mental illness (SMI) intended to increase collaborative decision-making (CDM) at the patient-clinician level. CDST previously underwent a systematic, community-engaged mixed methods adaptation to increase fit and feasibility for Veterans with psychosis at VA Psychosocial Rehabilitation and Recovery Centers (PRRCs). This qualitative study applies the Practical, Robust Implementation and Sustainability Model (PRISM) framework to identify the fit and feasibility of the adapted version of CDST within VA PRRCs for Veterans with psychosis.

Nine Veterans with psychosis and two clinicians who participated in a CDST pilot trial at a VA PRRC provided feedback about CDST in qualitative interviews. PRISM-mapped guides were used to administer semi-structured interviews and develop qualitative codes. Following the initial coding of interviews, four analysts applied a systematic thematic approach to identify themes within each PRISM domain, inclusive of the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) evaluation framework housed within PRISM. Identified themes were then reviewed by three analysts who reached consensus on the final themes to be presented in this paper.

Five cross-cutting themes were identified across PRISM domains, capturing CDST's conceptual alignment with PRRCs and the recovery model; variability of Veteran and clinician interest despite fit or effectiveness; the need for structural integration for sustainability; mixed perceptions of CDST's virtual format; and challenges with at-home practice completion. Additional themes were identified under PRISM Intervention Characteristics, Implementation and Sustainability Infrastructure, Recipients, and all RE-AIM outcomes which inform Veterans' and clinicians' implementation viability and sustainability.

Application of the PRISM framework facilitated identification of multilevel determinants for CDST feasibility. CDST shows promising alignment with the recovery model and the structural approach to care at PRRCs, but delivery mode and auxiliary practice group require adjustment to support CDST's sustainability.

To develop and test the relevance of a program theory underpinning a continuing professional development (CPD) program designed to support primary care nurses in adopting evidence-based mental health assessment practices.

Primary care nurses play a key role in identifying and responding to mental health needs, yet often report limited confidence and support in conducting assessments. A CPD program grounded in reflective practice and clinical supervision was co-created to address these gaps. Program design included a program theory representing the selected training processes and their expected outcomes.

Theory-driven evaluation using relevancy testing with a mixed-methods approach.

Data collection included questionnaires based on the Ability, Motivation and Opportunity (AMO) framework at baseline, post-training, and 4-6 months follow-up; semi-structured interviews; observational field notes; and a logbook. Research team members analyzed qualitative data thematically and quantitative data descriptively.

Fourteen primary care nurses from two healthcare centres in Quebec participated (n = 13 completed). The program enhanced nurses' ability (knowledge, skills), motivation (confidence and professional engagement), and perceived opportunities at the individual level. Participants reported integrating new practices, including systematic screening, goal-setting, and follow-up, indicating behavioural change. Results suggest reflective and clinical supervision mechanisms that may have explained these outcomes and that enrich the initial CPD program theory.

A CPD program integrating reflective practice and clinical supervision can strengthen conditions for evidence-based mental health assessment in primary care. Sustained practice change, however, requires alignment with organizational support processes.

Current clinical practice often assumes that gut microbiome assessment before selecting probiotic species, assuming a 'test-then-match' strategy yields better outcomes. However, routine testing has limited predictive value for probiotic efficacy, and many commercial probiotics fail to achieve sustained clinical improvement.

In this Hypothesis and Theory article, we propose a novel, testable hypothesis: prioritize remodelling the gut environment using metabolically potent probiotics, (i.e., strains with high capacity to produce beneficial metabolites such as short-chain fatty acids, bioactive peptides, and organic acids) without prior microbiome assessment-a 'condition-then-attract' strategy. Our hypothesis is motivated by preclinical studies demonstrating the metabolic potency of specific strains of Lactobacillus helveticus and Lactobacillus fermentum (e.g., NS8 and NS9 originally isolated from Mongolian fermented koumiss).

We derive several directly testable predictions from this framework, including that a randomized controlled trial comparing 'test-then-match' versus 'condition-then-attract' strategies would show that prior gut assessment does not improve outcomes, and that metabolically potent probiotics will outperform less active strains regardless of species identity.

We contend that refocusing from species-level matching to strain-level metabolic potency may offer a more effective and simpler alternative. Future research should prioritize metabolic potency over colony-forming unit counts and reconsider the necessity of routine pre-intervention gut assessment. Our framework does not rely on a single metabolite but embraces diverse mechanisms-proteolysis, carbohydrate fermentation, pH modulation-that collectively restore gut homeostasis.

Lifestyle Medicine leverages evidence-based health behaviors: nutrition, physical activity, restorative sleep, stress management, social connection, and avoidance of risky substances to prevent, treat, and often reverse chronic disease. Nutrition is underutilized in routine care. A growing body of evidence demonstrates that a whole-food, plant-predominant diet (WFPD) confers broad benefits across cardiometabolic, reproductive, and mental health domains. Mechanistic and clinical studies link WFPDs to reduced risk of cardiovascular disease, diabetes, cancer, and depression through improved microbiome diversity, increased short-chain fatty acid production, reduced oxidative stress and inflammation, and enhanced insulin sensitivity. Beyond disease prevention, plant-forward diets improve psychological well-being via nutrient pathways that modulate neurotransmitter synthesis and the gut-brain axis. Some patients can benefit from protein intakes above the Recommended Daily Allowance (RDA) of 0.8g/kg/day for adults in a variety of settings. Well-planned plant-based diets can achieve significantly higher levels of protein intake, achieved through diverse sources such as legumes, soy, grains, nuts, and seeds. Adequate and well-distributed protein supports fertility, fetal growth, lactation, and preservation of lean mass through perimenopause and aging. Implementing WFPDs with individualized protein guidance can extend health span, enhance functional independence, and reduce medication dependence, reaffirming wholesome food as a cornerstone of modern medicine.

Treatment-Resistant Schizophrenia (TRS) in males with agitation/excitement poses a clinical challenge. The pathophysiological mechanisms of agitation/excitement in Male TRS remain unclear. This study explores these mechanisms and investigates potential biomarkers for agitation/excitement.

180 Male TRS patients and 100 healthy controls were enrolled. Psychiatric symptoms and agitation/excitement were assessed using the Positive and Negative Syndrome Scale 5-factor model (PANSS-5F) and the PANSS-Excited Component (PANSS-EC). Patients were divided into Male TRS with agitation/excitement (n=80) and without agitation/excitement (n=100). Demographic data and lipid profiles (triglycerides, total cholesterol, high-density lipoprotein, low-density lipoprotein) were collected for both groups. Statistical analyses assessed the relationship between lipid profiles and agitation/excitement.

A negative correlation was found between total cholesterol (TC) levels and agitation/excitement in Male TRS. Those with agitation/excitement had worse educational and marital status and more severe cognitive impairment. TC levels and hypercholesterolemia were higher in Male TRS compared to healthy controls.

Lower TC levels in Male TRS with agitation/excitement are associated with higher agitation/excitement risk. TC may be an associated factor for agitation/excitement in this population.

https://chictr.org.cn, identifier ChiCTR2200063407.

Eating disorders-including anorexia nervosa (AN), bulimia nervosa and binge-eating disorder-are clinically distinct but exhibit symptom overlap and diagnostic crossover. Genomic analyses have mostly examined AN. Here we conducted a genomic meta-analysis of case-control studies of binge-eating behavior (BE; 39,279 cases, 1,227,436 controls), alongside analyses of AN (24,223 cases, 1,243,971 controls) and its subtypes (all European ancestries). We identified six BE-associated loci, including loci associated with a higher body mass index and impulse-control behaviors. AN genome-wide association studies yielded eight loci, validating six loci. Subsequent polygenic risk score analysis demonstrated an association with AN in two East Asian ancestry studies. BE and AN exhibited similar positive genetic correlations with psychiatric disorders but opposing genetic correlations with anthropometric traits. Most of the genetic signal in BE and AN was not shared with body mass index. We have extended eating disorder genomics beyond AN; future work will incorporate multiple diagnoses and global ancestries.

Law enforcement (LE) personnel have one of the most stressful jobs, and LE in the United States face a particular set of stressors that merit investigation. LE personnel regularly encounter some of the worst aspects of human nature, which elevates their risk for mental and physical health problems. This population needs viable, accessible methods for stress management and healthy lifestyle education. Integrative and mind-body practices represent one such solution. This structured review aims to assess the effectiveness and promise of integrative health interventions studied in US LE, provide researchers with a resource for conducting future studies, and draw attention to the need for wellness resources for LE personnel in the US.

PubMed was searched for studies published in 2000 or later that examined an integrative or mind-body health intervention with US LE personnel, including yoga, mindfulness, diet, exercise, or any combination thereof. We reviewed the measures, outcomes of interest, and intervention methodology used across studies.

We identified 21 eligible studies encompassing six major intervention categories: mindfulness, self-regulation, wellness programs, sleep, yoga, and detoxification approaches. Outcomes of interest fell into 10 categories: stress and burnout, mental health, physiological and physical, anger and aggression, job satisfaction and performance, sleep, positive psychology, cognitive, health behaviors, and social. We also compiled the measures used across studies into two overarching categories: survey and qualitative measures, and physical/physiological measures (e.g., sleep duration, strength, BMI).

The results of this review can be used to inform future studies on this population and help formulate wellness programs for LE. Mindfulness interventions generally improved mental health, burnout, mindfulness, and organizational stress; the single study measuring aggression found a significant improvement. Self-regulation interventions improved some physical/physiological outcomes but not others, with no change in sadness, anger, or anxiety. Wellness program interventions showed promise for improving health behaviors, particularly eating habits, tobacco use, strength, and avoidance coping. Yoga was beneficial for global mood and perceived stress. Results were mixed both between and within studies of the same intervention type. Future research with this population should focus on determining the most efficient and effective interventions for US LE personnel.

Early detection of individuals at risk for clinical deterioration in first-episode psychosis (FEP) remains a vital challenge in psychiatric care. Emerging evidence indicates that immune dysregulation might play a crucial role in the pathophysiology and progression of psychotic disorders. This study examined associations between a plasma cytokine and chemokine panel and clinical stage transition in FEP patients.

Using multiplex immunoassays, plasma samples from a small cohort of 35 FEP patients were screened for the quantification of 21 analytes. Participants were clinically assessed at baseline and follow-up and classified according to a validated staging model. Data were used to assess associations with clinical stability over a 12-month follow-up period.

IL-17A was increased in transitioning patients (uncorrected p = 0.045; adjusted p = 0.64 after correction for multiple comparisons). A logistic regression model combining IL-17A, IFN-γ and MIP-3α discriminated between groups with an AUC of 0.853 in this exploratory cohort.

These findings highlight the potential relevance of neuroimmune mechanisms in the development of psychotic disorders and suggest that immunological markers may merit further consideration within staging-based models of care, pending external validation. Incorporating cytokine profiling into clinical practice may potentially inform personalized treatment strategies and lead to better long-term outcomes for individuals with FEP.

We investigated maternal emotion dysregulation and profiles of newborn neurobehavior as predictors of infant temperamental negative affect and toddler psychopathology risk among 385 mother-infant dyads from birth to 18-months postpartum. Our findings show support for multiple mechanisms by which transdiagnostic risk develops in early childhood. For infants in the low arousal, high lethargy newborn neurobehavior profile, infant negative affect was a pathway by which maternal emotion dysregulation was associated with toddler socioemotional difficulties. In contrast, maternal emotion dysregulation was directly associated with toddler behavior dysregulation for infants in the high arousal, high stress neurobehavior profile at birth. Newborns in the high attention, moderate regulation neurobehavior profile were buffered against the effects of maternal emotion dysregulation on infant negative affect and toddler psychopathology risk. Our findings highlight the importance of examining the combination of newborn neurobehaviors with maternal mental health to understand the development of psychopathology risk in early childhood.