Tinnitus refers to the subjective abnormal auditory perception occurring without external sound stimuli, characterized by prominent clinical heterogeneity and complicated pathophysiological mechanisms, which severely impair patients' mental health and quality of life. Adopting a standardized literature retrieval procedure, this paper systematically sorts out the epidemiological characteristics, clinical classifications and diagnostic criteria of tinnitus, and deeply analyzes its dual pathological mechanisms involving peripheral auditory damage (hair cell injury, auditory nerve lesions) and abnormal central nervous system plasticity (auditory cortex remodeling, neurotransmitter imbalance, abnormal activation of the limbic system). It systematically summarizes mainstream Western medical interventions and critically evaluates the clinical efficacy and inherent research limitations of pharmacotherapy, sound therapy, cognitive behavioral therapy, repetitive transcranial magnetic stimulation and other neuromodulation techniques. Meanwhile, it integrates the traditional theories, neuromodulatory mechanisms and available clinical trial evidence of acupuncture for tinnitus treatment. Existing basic and clinical studies indicate that acupuncture can alleviate tinnitus symptoms and regulate autonomic nervous disorders to a certain extent by improving cochlear microcirculation, upregulating the expression of inhibitory GABA neurotransmitters, and remodeling functional connectivity of the brain's default mode network. Nevertheless, clinical trials on acupuncture are plagued by remarkable methodological flaws: acupoint prescriptions and acupuncture manipulation protocols are highly heterogeneous, outcome assessment indicators are inconsistent, most studies adopt single-center small-sample designs, long-term follow-up data exceeding one year are scarce, psychological placebo effects cannot be fully isolated, and efficacy reports vary widely across studies. At present, unified high-quality evidence is still lacking to confirm its stable clinical efficacy. As a narrative review, this paper abandons one-sided positive narratives and applies consistent evaluation criteria to balance the comparison of merits and drawbacks of all Chinese and Western therapeutic interventions. It fully discloses the procedures of literature retrieval, screening and synthesis, aiming to provide objective and reproducible theoretical and clinical references for standardized comprehensive diagnosis and treatment of tinnitus as well as interdisciplinary basic mechanistic research.

Depression is a common mental health comorbidity among individuals with seizure disorders. The emergence of depression results from the complex interplay of clinical, psychological and social factors.

To identify clusters of risk factors associated with depressive symptoms in adults with seizure disorders. This study uses exploratory factor analysis (EFA) to model a range of variables and investigate their interactions and influence on depressive symptoms.

Cross-sectional observational study.

A retrospective examination of medical records identified 121 patients with seizures and moderate depressive symptoms. Demographic, clinical and psychosocial data were extracted and modelled using EFA. Factor structure was determined by adhering to standard fit criteria: CFI ⩾0.90, TFI ⩾0.90, RMSEA ⩽0.08 and latent factor loadings ⩾0.4.

The mean age of the cohort was 31.3 ± 10.0 years (range of 18-64), comprising 68 males (56.2%) and 53 married individuals (43.8%). Qataris constituted the largest nationality at 48 (39.7%), and the most prevalent diagnosis was right temporal lobe epilepsy (28.9%). Moderate depressive symptoms were the most common PHQ-9 classification (42.1%), with an average score of 14. EFA yielded a three-factor solution (χ² = 71.9, df = 52, RMSEA = 0.06, CFI = 0.96, TFI = 0.92) with the first latent factor incorporating age and social variables, the second encompassing medications and cognitive abilities, and a final factor encapsulating seizure-related items.

Exploratory factor analysis elucidates the intricate relationships between variables that impact depressive symptoms in individuals with seizure disorders. It highlights how clusters of variables emerge, providing insight into how depressive symptoms develop in this population. These findings offer new potential avenues for the management and treatment of depression in people experiencing these debilitating events.

Due to a demonstrated relationship between Adverse Childhood Experiences (ACEs) and a range of psychological, physical, and social risks, there has been a growing movement to integrate routine ACEs screening in pediatric settings. As screenings have increased, there has also been a call for research to uncover areas for improvement in the implementation of these screenings. The Pediatric ACEs and Related Life Events Screener (PEARLS) is one common tool used for screening that has demonstrated construct validity in identifying three domains of adversity: maltreatment, household challenges, and social context. A second version of PEARLS (PEARLS v2) was adapted and refined in response to feedback collected from public health professionals, physicians, clinical psychologists, mental health specialists, and patients in a variety of settings, including clinics, state advisory boards, and health equity counsels. To ensure acceptability, this study examines caregiver feedback on PEARLS v2 through semi-structured interviews with 13 caregivers of child patients in Federally Qualified Health Centers. Using Rapid Qualitative Analysis, results highlight caregiver feedback on the addition of a written introduction to the screener and overall implementation preferences (i.e., location, length of time). Results also underscore caregiver feedback and suggestions on item clarity and acceptability, the addition of strength-based questions, perspectives on caregiver honesty in completing the screener, and preferences regarding provider response and resources. Findings support PEARLS v2 adaptations and provide caregiver-driven feedback to address acceptability and implementation of the screener in pediatric settings.

Adverse childhood experiences (ACEs) are highly prevalent among youth requiring psychiatric hospitalization and are associated with complex clinical presentations. However, evidence regarding how cumulative ACE burden influences inpatient treatment processes and post-discharge outcomes remains limited, particularly in non-Western settings. This retrospective cohort study included 76 consecutive children and adolescents discharged from a psychiatric inpatient unit in Japan. ACE exposure was retrospectively assessed at discharge using clinician-integrated multidisciplinary evaluations based on the original 10-item ACE framework. Global functioning was measured using the Children's Global Assessment Scale (CGAS) at admission, discharge, and at 6 and 12 months post-discharge. Multivariable regression and linear mixed-effects models were used to examine associations between ACE burden and length of stay, use of seclusion and physical restraint, longitudinal CGAS trajectories, treatment discontinuation, and re-hospitalization, after adjusting for sex, neurodevelopmental disorder status, and age at admission. Higher ACE scores were independently associated with longer hospital stays and greater odds of seclusion and physical restraint use. CGAS scores improved substantially from admission to discharge and remained above baseline at 6 and 12 months. In the primary analysis, ACE burden was not significantly associated with longitudinal CGAS scores. ACE burden was also not significantly associated with treatment discontinuation or re-hospitalization within 12 months. Cumulative ACE burden is associated with greater inpatient clinical complexity but was not significantly related to short-term functional trajectories or post-discharge outcomes in this study. These findings highlight the importance of trauma-informed inpatient care and continued post-discharge support for youth exposed to adversity.

Universal trauma-informed screening is increasingly recommended across pediatric settings, yet it remains unclear which forms of adversity most accurately and equitably identify youth at risk for psychopathology. In response, the current study tested whether defining maltreatment by cumulative quality (i.e., number of subtypes) versus cumulative frequency (i.e., number of experiences regardless of subtypes), as well as potential differences within each subtype, yielded more accurate and fair predictions of trauma-related psychological distress. Participants included 839 adolescents from the LONGSCAN study (50.5% identified as female; 55.2% identified as Black) who completed self-reports of maltreatment exposure and psychological distress at ages 12, 16, and 18. Statistical accuracy was assessed via statistical discrimination (area-under-the-curve [AUC]) and calibration (Spiegelhalter's Z; calibration curves), while statistical fairness was evaluated through differences in accuracy across adolescent subgroups (i.e., gender; race/ethnicity). Results across cumulative risk models revealed equivocal results regarding accuracy, while demonstrating important patterns of unfairness. In contrast, analyses by maltreatment subtype identified emotional abuse quality and frequency as both accurate (AUC > 0.64; non-significant Spiegelhalter's Zs; 95% confidence intervals for intercept and slope included 0 and 1, respectively) and statistically fair in identifying concurrent risk for trauma-related distress. Cumulative frequency and emotional abuse frequency also demonstrated accuracy and potential fairness in predicting risk at age 16, whereas no indicators demonstrated clinical utility at age 18. Overall, findings suggest that emotional abuse may be useful in screening for concurrent psychological distress, while adding to the literature questioning the continued reliance on cumulative ACEs scores in clinical and public health contexts.

The online version contains supplementary material available at https://doi.org/10.1007/s40653-025-00767-1.

Sexual and gender minority individuals experience higher rates of adverse childhood experiences (ACEs) than heterosexual individuals. Yet, the general ACE framework ignores unique ACEs faced by SGM individuals (i.e., cisheterosexism during childhood). The Sexual and Gender Minority ACE (SGM-ACE; Schnarrs et al., 2022, 2023) framework fills this gap by accounting for ACEs that are unique for SGM individuals resulting from systems of oppression (i.e., cisheterosexism during childhood). However, past studies employing this framework were conducted in the U.S. context, limiting the understanding of the prevalence of SGM-ACEs and their associations with psychological outcomes in other contexts such as Hong Kong where LGBTQ+ policies and laws are still progressing. Furthermore, prior research has rarely explored how SGM-ACEs adversely affect psychological outcomes through impeding capacities for compassion of SGM individuals. Therefore, utilizing data from 736 SGM individuals in Hong Kong, this study addressed these important gaps by exploring the prevalence of SGM-ACEs and examined the association between SGM-ACEs and psychological distress among Hong Kong SGM individuals. Moreover, self-compassion and fear of receiving compassion from others were tested as mediators of the effects of SGM-ACEs on psychological distress. Results show that a large proportion of SGM individuals in Hong Kong have experienced SGM-ACEs (89.3%) and these traumatic childhood experiences were significantly linked to higher psychological distress in adulthood. Both self-compassion and fear of compassion from others significantly mediated this relationship. This study demonstrates the significance of considering ACEs specifically related to SGM identities. Findings offer critical insights into practice, clinical treatment, psychoeducation, and policies.

Older patients following percutaneous coronary intervention (PCI) face long-term health risks such as in-stent restenosis. Life-space serves as a valuable clinical indicator for assessing and predicting the overall health of patients. Monitoring changes in life-space can facilitate early detection of health status changes. This study aimed to identify the trajectories and associated factors of life-space among older patients following PCI, thereby prompting timely intervention and improving cardiac rehabilitation outcomes.

A total of 236 patients were enrolled. During hospitalization, patients' general information was assessed. At 1, 3, and 6 months after discharge, the patients' life-space was assessed firstly, followed by semi-structured interviews with voluntary participants via outpatient or telephone. Purposive sampling selected 10 patients from the low-to-medium trajectory groups for qualitative analysis based on information sufficiency. Latent class growth model was used to analyze life-space trajectories, and multinomial logistic regression analysis was conducted to examine their associated factors. Conventional content analysis method was used to provide additional possible factors hindering patients from achieving high-level life-space trajectory.

The life-space of older patients following PCI showed an upward trend within 6 months of discharge, with an initial rapid increase followed by a slower progression. Three trajectory subgroups of life-space were identified: low-level persistently restricted group (18.14%), medium-level gradually improving group (47.55%), and high-level unrestricted group (34.31%). Factors associated with trajectory membership included times of PCI, single stent implantation, outings due to family affairs, exercise endurance, depression, and self-efficacy. Additionally, qualitative analysis revealed 4 categories of factors associated with achieving a high-level life-space: physical symptom fluctuation factors, psychosocial adaptation factors, information-cognitive coordination factors, and external environmental interaction factors.

There were three distinct heterogeneous trajectories, including one with persistently restricted life-space. Factors associated with life-space trajectories include physiological, psychosocial, disease cognition, and environmental factors. Targeted interventions such as symptom management, psychological counseling, health education, and supportive external environment may promote life-space expansion.

In areas with a long history of conflict, like South Sudan, children and their parents can suffer from cumulative, ongoing, and intergenerational trauma. This can have serious consequences for their present and future well-being. Still, mental health care - also for children - is not prioritized by schools or NGOs. This paper describes the design and main conclusions of a trauma-informed mental health and psychosocial support intervention. The intervention targeted young children (aged 5 to 7) and their parents/caregivers in four remote and conflict-affected areas in South Sudan. The intervention comprised 12 group sessions for children with parallel sessions for parents that were delivered by lay community counsellors after a short training. It aimed to improve emotion recognition, regulation and communication, through storytelling and experiencing. The theory of change consisted of five theoretical principles: 1) sense of safety, 2) psychoeducation, 3) connectedness, 4) empowerment, and 5) body-mind connection. Feedback gathered during and after three pilot cycles led to new insights and adaptations. Overall, the intervention appeared to be effective and was well received. The theory of change and the feasibility study might inspire those working on MHPSS with young children in adverse circumstances.

Noncommunicable diseases (NCDs) are the leading global cause of death and are driven by modifiable behaviors, such as tobacco use, harmful alcohol consumption, unhealthy diet, and physical inactivity. Recognizing that emergency department (ED) visits represent a unique opportunity to promote behavior change, this trial evaluated a digitally augmented, theory based general health promotion approach, combining a brief telephone-based intervention with mobile instant messaging support, to help discharged ED patients abstain from health risk behaviors.

This assessor-blinded randomized controlled trial was conducted in a major public hospital ED in Hong Kong. Adults (18-65 years) triaged as semi-urgent or non-urgent and with ≥1 health-risk behavior and smartphone access were randomized to receive a digitally augmented, theory‑based general health‑promotion intervention consisting of a brief telephone‑based AWARD‑model intervention (Ask, Warn, Advise, Refer, and Do-it-again) followed by weekly WhatsApp or WeChat messages for 6 months, or to a control group receiving brief telephone advice only. The primary outcome was self-report abstinence from ≥1 health-risk behavior at 6 months; secondary outcomes included the proportion of participants who achieved self-reported abstinence from ≥1 health-risk behavior at 12 months and reduction in the number of behaviors at 6 and 12 months. Of the 2,134 screened patients, 572 were enrolled (286 per group). At 6 months, 30.1% of the intervention participants versus 19.9% of the controls achieved self-reported abstinence (RR = 1.51; 95% CI, 1.13-2.02; P = 0.006). The intervention also significantly increased the likelihood of fewer risky behaviors at 6 (RR = 1.54; P = 0.01) and 12 (RR = 1.48; P = 0.02) months. Physical inactivity showed the greatest improvement at 6 months (31.7% versus 16.2%; P < 0.001). The effects attenuated after cessation of booster messaging. Limitations include reliance on self-reported outcomes, the single-center study design, and loss to follow-up, which may have affected the generalizability of the results.

A digitally augmented, theory-based general health promotion strategy delivered at ED discharge through brief telephone intervention and mobile instant messaging support demonstrated short-term benefits in promoting self-reported abstinence and reducing health-risk behaviors at 6 months. However, the absence of a sustained effect at 12 months suggests that extended support or maintenance strategies may be required to maintain these improvements over time. Multicenter trials with longer follow-up are warranted to evaluate long-term effectiveness.

ClinicalTrials.gov (Registration No: NCT06077565).

Individual socioeconomic position is known to affect the progression of disease and mortality after disease onset. Existing studies generally focus on single diseases, making it unclear whether this is a universal pattern or a common characteristic across disease classes. The objective of this study is to examine educational and income inequalities in life expectancy after diagnosis of noncommunicable diseases. Based on full population Danish registers (N = 4 420 226), we created multistate models for 64 noncommunicable diseases according to education, income, age and sex. Transition probabilities from healthy to sick and deceased were estimated with a multinomial logit model and used for the construction of life tables from which we estimated life expectancy after diagnosis. We observed education and income inequalities in life expectancy after diagnosis across all noncommunicable diseases studied for both men and women. For example, a woman diagnosed with cirrhosis of the liver at age 50, has a life expectancy of almost 17 years if she has a high education and 14 years if she has a low education. For men, life expectancy after diagnosis of cirrhosis is 13 years for the high educated and 10 years for the low educated. Our findings show that socioeconomic inequalities in life expectancy after disease onset are consistent across a wide range of noncommunicable diseases. In terms of policy, our study highlights the need for interventions that reduce the accumulation of risk before individuals become patients, and strengthen the healthcare system's ability to mitigate inequalities.