To assess physical and mental symptoms by ethnicity of a UK Armed Forces cohort.

A retrospective, pooled cross-sectional analysis.

Self-report questionnaire collected between 2004-2023.

Three samples of UK Armed Forces, including a Gurkha (n=254), Fijian (n=112) and a heterogeneous sample of British ethnic minority personnel (n=178) were compared with a sample of white British participants (n=254).

Physical and mental health symptoms were measured using individual items from the Patient Health Questionnaire, Post-traumatic Stress Checklist (Post-Traumatic Stress Disorder Checklist-Civilian Version) and General Health Questionnaire (GHQ-12) drawn from four phases of cohort data. Ethnic samples were matched by military role and veteran or active service status.

Based on their first assessment, 60 white British participants (24.2%) met GHQ criteria for common mental disorder, significantly higher than found for the other three groups (χ² (3, n=782)=25.03, p<0.001). Across all measures, Gurkha participants were the least symptomatic, though Gurkha and Fijian participants reported more symptoms of post-traumatic stress. British samples reported more somatic reports. Different patterns of post-traumatic and somatic symptoms may be explained by differential levels of traumatic exposures, recruitment profiles and culturally nuanced expressions of distress.

Patterns of mental and physical symptoms warrant further investigation to inform prevention, more precise diagnosis and tailored care and treatment for specific ethnic groups.

Academic and clinical medicine place different, but equivalently exacting demands on their practitioners. Physician educators in Hong Kong (HK) must straddle both of these environments simultaneously, and also negotiate unspoken culturally nuanced workplace expectations, contributing to the high stress and turnover rate within this population. Limited literature exists regarding psychological distress among physician educators in an Asian context more broadly, and HK more specifically, making it difficult to design culturally appropriate interventions to mitigate their distress.

To examine the risk and protective factors associated with psychological distress among physician educators affiliated with one of two medical schools in HK, and to investigate the mediating role of resilience in relation to these factors.

A cross-sectional survey study.

One medical school in HK.

333 physician educators who were full-time, part-time or honorary clinical academic staff at one HK medical school and who were involved in teaching medical learners, trainees and/or physicians. Most participants were male (71.5%), married (76.3%), Chinese (94.6%) and aged 40-49 (34.5%).

Well-being, resilience and psychological distress were measured using three validated instruments: the 5-item WHO Well-Being Index (WHO-5), the 2-item Connor-Davidson Resilience Scale (CD-RISC2) and the 9-item Physician Well-Being Index-Expanded (ePWBI-9), respectively.

A path analysis for physician educators' psychological distress (Tucker-Lewis Index=0.99; Normed-Fit Index=0.99; Comparative Fit Index=1.00; root mean square error of approximation=0.03; standardised root mean-square residual=0.02) indicated that resilience partially mediated the relationship of well-being with psychological distress ([Formula: see text]=-0.50, 95% CI -0.57 to -0.41, p=0.002). Average working hours had a positive direct effect on distress ([Formula: see text]=0.29, 95% CI 0.20 to 0.37, p=0.001). However, age, relationship status and years as an educator were not significantly associated with either resilience or psychological distress among HK physician educators.

The risk and protective factors identified in this study, including the partial mediating role of resilience, provide preliminary insights into factors associated with psychological distress among clinical physician educators in this HK setting. The findings suggest the importance of well-being interventions, coupled with strategies to address prolonged working hours, as potential mechanisms to mitigate psychological distress in similar contexts.

Saharan Africa is experiencing a rapid increase in the burden of diabetes, accompanied by increasing rates of microvascular, macrovascular, and pregnancy-related complications. This Series paper synthesises current evidence on diabetes-related complications in sub-Saharan Africa and examines shared cardiometabolic risks, mental health comorbidities, and interactions with communicable diseases through a multiple long-term conditions lens. Widespread late diagnosis and inadequate control of key cardiometabolic risk factors (eg, hypertension, dyslipidaemia, obesity, and hyperglycaemia) drive high complication rates-whereas mental health disorders and infectious disease comorbidities further exacerbate susceptibility. Although risk factor reduction is central to preventing diabetes complications in sub-Saharan Africa, progress is impeded by multilevel barriers spanning individual, interpersonal, health system, societal, and policy domains. To address this growing complexity, we identify priorities for research and implementation, including the development of context-specific guidelines, scalable integrated care models, strengthened surveillance systems, and long-term cohorts co-designed with communities, health-care providers, and policy makers.

Type 2 diabetes (T2D) places substantial physiological and psychological demands on patients and is independently linked to an elevated risk of depression. Intellectual developmental disability (IDD) is likewise associated with metabolic disorders and a high prevalence of mood disturbances, yet communication barriers often delay diagnosis. Whether coexistence of IDD further amplifies the likelihood of new-onset depression in people with T2D remains unclear. We aimed to investigate the association between IDD and incident depression among Korean adults with T2D.

We analyzed 1,819,869 adults (≥ 20 years) with T2D who underwent the 2015-2016 Korea National Health Screening Program. Participants were classified as either IDD (n = 3665) or non-IDD groups. The primary outcome was new-onset depression identified up to 31 December 2022 following the health-screening date. Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for incident depression.

Participants with IDD were younger (mean age: 49.2 vs. 58.0 years) and had a lower proportion of men (55.9% vs. 61.8%) than those without IDD. Over a median follow-up of 5.8 years, 14.8% developed depression, with an elevated risk in the IDD group (HR 1.65, 95% CI: 1.53-1.77). This association was consistent across IDD severity and was especially marked in individuals under 65 and with T2D duration under five years.

Coexisting IDD and T2D are linked to higher depression risk. Our finding underscores the need for tailored interventions, improved caregiver awareness, and enhanced screening to address mental health disparities.

Depression affects more than 300 million people worldwide and is a leading contributor to the global disease burden. Traditional diagnostic methods, such as structured clinical interviews, are reliable but impractical for frequent or large-scale screening. Self-report tools like the Patient Health Questionnaire-8 (PHQ-8) require disclosure and clinician oversight, limiting accessibility. Recent artificial intelligence-based approaches leverage multimodal behavioral cues (linguistic, acoustic, and visual) for automated depression detection but remain constrained by limited adaptability, scarce annotated data, weak emotional expression in real-world settings, and the high computational cost of deployment of socially assistive robots (SARs).

This study introduces Depression Social Assistant Robot (DEPRESAR)-Fusion, a lightweight multimodal depression detection framework designed for natural interactions with emotion-aware SARs. The objective of this study was to enhance detection accuracy in everyday conversations while addressing the challenges of data scarcity, weak emotional cues, and computational efficiency.

DEPRESAR-Fusion integrates acoustic, linguistic, and visual features with an emotion-aware response module powered by large language models to adapt conversational strategies dynamically. To stimulate richer emotional expression, participants were exposed to emotionally evocative videos before SAR interactions. To overcome data scarcity, we augmented training with (1) public depression-related social media corpora and (2) synthetic samples generated via large language models. The proposed multimodal fusion architecture was evaluated on benchmark clinical datasets for both binary depression classification and PHQ-8 regression tasks. Performance was compared against prior multimodal baselines using root mean square error, mean absolute error, and standard classification metrics.

Participants who viewed emotional stimuli before interacting with SARs exhibited significantly higher emotional expressiveness, leading to improved model performance. Regression tasks showed lower root mean square error and mean absolute error, while classification tasks achieved significantly higher accuracy than the nonstimulus condition. DEPRESAR-Fusion outperformed prior multimodal baselines across multiple benchmark datasets, achieving state-of-the-art performance in both binary classification and PHQ-8 regression. The system maintained a lightweight architecture suitable for real-time deployment on SARs.

DEPRESAR-Fusion demonstrates that integrating emotion induction, data augmentation, and lightweight multimodal fusion can enable accurate and scalable depression detection in naturalistic SAR interactions. By bridging the gap between structured clinical assessments and everyday conversations, this approach highlights the potential of SAR-based systems as nonintrusive, artificial intelligence-driven tools for proactive mental health support.

Individuals with schizophrenia or bipolar disorder face a significantly elevated risk of obesity, primarily due to weight gain associated with psychiatric medications and lifestyle factors. While digital self-monitoring tools offer scalable solutions, their application remains underexplored in psychiatric populations. To address these gaps, this type 1 hybrid effectiveness-implementation study investigates the preliminary effectiveness and implementation feasibility of a mobile health-assisted weight management intervention for patients with severe mental illness.

This study aims to evaluate the preliminary effectiveness and implementation feasibility of a mobile health-assisted weight management intervention for patients with severe mental illness transitioning from inpatient care to community-based recovery.

This single-center, open-cohort stepped-wedge cluster randomized trial with a 2-month step duration will recruit 204 patients from 6 clinical units. Clusters are randomized into 2 waves, with staggered transitions to a digital intervention, including smart scales, health apps, and biweekly educational modules, over a 6-month observation period. The design evaluates the intervention across the transition from inpatient care to community-based recovery. The primary outcome is the proportion of participants achieving ≥5% weight loss at month 6. Implementation feasibility is assessed through device technical success and intervention adherence (defined as ≥50% completion of weekly weigh-ins and daily dietary logs).

Participant data collection began in May 2023 and was completed by June 2025 with a total of 204 participants. The publication of key findings and results is anticipated in late 2026.

This protocol describes a pragmatic, technology-supported intervention designed to address metabolic side effects in a tertiary psychiatric setting. By bridging the gap between acute hospitalization and community recovery, this hybrid stepped-wedge cluster randomized trial provides a crucial framework for integrating digital metabolic monitoring into routine clinical workflows for vulnerable populations.

Depression is the most common mental health disorder worldwide and frequently leads to workplace absence. As face-to-face treatment can be difficult to access, app-based interventions are a popular solution, although their effectiveness in working populations and their mechanisms of action are unclear. Deficits in executive function may contribute to the onset and maintenance of depression, and executive function training is proposed to improve symptoms by enhancing executive function. Responders to cognitive behavioral therapy (CBT) show improvements in executive function, suggesting that this may be one mechanism of action.

This study investigated the effectiveness of app-based interventions (executive function or CBT-based) for reducing depressive and anxiety symptoms and improving workplace well-being, and assessed whether changes in executive function mediated improvements.

A total of 228 participants (147 female participants) with mild-to-moderate symptoms of depression and anxiety were recruited online and randomly assigned to a waitlist control group, an executive function training group (NeuroNation app, Synaptikon GmbH), or a self-guided CBT group (Moodfit app, Roble Ridge LLC) for a 4-week intervention period. Participants assigned to the active intervention groups were asked to use their apps a minimum of 21 times during the intervention. Participants completed measures of depressive symptoms, anxiety symptoms, and workplace well-being, and a working memory task at baseline, postintervention, and follow-up (12 weeks).

Executive function training reduced anxiety (β=-2.79; P=.004) and depressive (β=-2.77; P=.02) symptoms at follow-up but not at postintervention, and it did not affect workplace well-being. There were no reductions in depressive or anxiety symptoms in the self-guided CBT group, though workplace well-being was improved at postintervention (β=3.72; P=.02) and follow-up (β=4.46; P=.02). Improvements in executive function did not mediate intervention-related changes in symptoms or workplace well-being. Self-reported adherence rates were high (executive function training: 48/54, 89%; self-guided CBT: 52/54, 96%), although attrition was high at follow-up (58% missing).

These results suggest that app-based executive function training may be effective at managing symptoms of anxiety and depression in a working population, while self-guided CBT apps may improve workplace well-being. However, improving executive function did not appear to be a mechanism of action of either intervention.

This study examines the agreement in youth self-report (YSR) and parent report (PR) on five maladaptive personality traits as measured with the Personality Inventory for DSM-5 in an outpatient mental health care sample (N = 292). Age differences in YSR-PR agreement (i.e., age 12-17, years; n = 129 versus 18-24 years; n = 163) are investigated as well as associations of YSR-PR agreement with youth's self-reported satisfaction with life (SWL). The combined sample demonstrated significant differences between YSR and PR for all maladaptive traits, except for Detachment. However, effect sizes of these differences are small. For all traits except Antagonism, YSR exceeded PR. YSR-PR differences did not differ between age groups, except in the case of Psychoticism, with better agreement in the older age group. Furthermore, results indicated higher SWL when YSR < PR and a lower SWL when YSR > PR. Theoretical and clinical implications are discussed.

Human Immunodeficiency Virus, the retrovirus that causes Acquired Immune Deficiency Syndrome, is a major global public health threat. This chronic viral infection diminishes the immune system by attacking CD4 cells. The principal treatment is antiretroviral medication (ART), which significantly increases the life expectancy of HIV patients. However, ART does not address psychological issues, including depression, anxiety, and stress. Psychosocial factors are known to influence HIV disease progression through activation of stress-related biological pathways, including the hypothalamic-pituitary-adrenal (HPA) axis, inflammatory cytokine responses, and monoamine neurotransmitter dysregulation. Mind-body practices such as yoga may modulate these pathways by reducing physiological stress, improving emotional regulation, and enhancing overall well-being. The current trial aims to assess the effectiveness of yoga as an adjunct therapy on psychological parameters (depression, anxiety, and stress), quality of life, and medication adherence of people living with HIV on antiretroviral therapy at a tertiary care hospital in AIIMS, New Delhi, India.

This study is a two-arm, parallel-group, open-label, blinded-endpoint, single-center, randomized controlled trial investigating the effects of a yoga therapy as an adjunct therapy in people living with HIV (PLHIV). Participants (n = 192) will be randomized to either 12 weeks of a Yoga therapy program (n = 96) or an Active control group, i.e., a prescribed brisk walk (n = 96). Both groups will receive standard treatment. The primary outcome is anxiety and depression scores (HADS-A and HADS-D), and the secondary outcomes are Stress (PSS), quality of life (WHOQOL-HIV BREF and SF-36 QoL), and medication adherence.

The findings of this RCT will help shed light on yoga intervention to address the psychosocial dimensions of HIV. If shown to be effective, yoga as an adjunct intervention may promote a transition in HIV care from a predominantly biomedical framework to a holistic, patient-centered approach encompassing mental health and overall well-being. The study is approved by Institute Research Board Ethics (AIIMSA2969/03.01.2025, RP-46/25, OP-16/02.05.25, OP-18/05.12.2025) and is registered at Clinicaltrials.gov (CTRI/2025/03/081645). CTRI Link- https://www.ctri.nic.in/Clinicaltrials/pmaindet2.php?EncHid=MTIyNjUx&Enc=&userName=HIV,%20Yoga.

Health anxiety is a common yet underrecognized concern among medical students, who are routinely exposed to illness-related content and academic pressure. This study aimed to estimate the prevalence of clinically significant health anxiety among Saudi medical students and identify its predictors. Secondary objectives were to examine its association with quality of life and explore disease-related fears.

A descriptive, cross-sectional study was conducted across multiple Saudi universities between November 2024 and April 2025. Participants were recruited via convenience sampling, and data were collected using a structured online questionnaire. The instrument included sociodemographic items, the Short Health Anxiety Inventory (SHAI), a self-perception of illness question, and the SF-12 to assess quality of life. Descriptive statistics, Chi-square tests, Mann-Whitney U tests, Pearson correlation, and logistic regression analysis were used to analyze the data.

A total of 650 students completed the survey. Clinically significant health anxiety was reported in 30% of participants. Health anxiety prevalence was higher among females compared to males (36.3% vs. 25.8%), as well as among students in their second academic year, rural residents, private university students, and those with personal or family psychiatric history. Logistic regression identified several significant predictors: female students demonstrated 2.3-fold higher odds of health anxiety compared to males (AOR = 2.33, 95% CI: 1.51-3.62), rural residence, private university enrollment (AOR = 6.14, 95% CI: 3.66-10.5), and psychiatric history. A significant negative correlation was found between health anxiety and quality of life (r = -0.25, p < 0.001). Students with health anxiety reported notably lower quality of life scores. Additionally, a network analysis of disease-related fears revealed cancer as the most frequently reported concern, followed by cardiovascular and endocrine conditions. These fears clustered into somatic, chronic, and neuropsychiatric domains.

Clinically significant health anxiety affects nearly one-third of Saudi medical students and is associated with key sociodemographic and academic risk factors, as well as poorer quality of life. These findings underscore the need for mental health support systems and preventive strategies within medical education environments to address and manage health-related anxieties early.