Major depressive disorder (MDD) as one of the disabling mental disorders has turned into one of the significant challenges for health systems worldwide. Although fluoxetine has been successfully applied to over 6-year-old individuals with MDD, its utility for younger patients has not been investigated yet. The current pilot study aims to assess fluoxetine use in 4-6-year-old children diagnosed with MDD.

The current double-blinded randomized clinical trial has been conducted on 40 four-to-six-year-old children with MDD who were assigned to one of the treatment groups with 0.7 mg/kg daily fluoxetine (n = 20) or placebo (n = 20) for 60 days. Preschool Feelings Checklist-Scale (PFC-S) and the antidepressant side effect checklist (ASEC) were assessed at study initiation, within 30 and 60 days after the intervention.

The PFC-S score significantly decreased in the fluoxetine-treated group (P value < 0.001), while those who received placebo revealed no change (P value = 0.317). The comparison of fluoxetine versus placebo treatment revealed a remarkable difference between the scores of PFC-S among the groups (P value < 0.001). Besides, the PFC-S scores were statistically lower among those treated with fluoxetine compared with placebo-treated ones in both 30 days (P value < 0.001) and 60 days (P value < 0.001) assessments. None of the patients presented any fluoxetine-related side effect.

Based on the findings of this study, fluoxetine was a safe and efficient agent to manage depression in very young children; however, data in this regard are limited and inconclusive. Further studies are strongly recommended.

With the deep integration of artificial intelligence into daily life, AI-addiction-like tendencies have emerged as a potential form of behavioral dependency among university students. Focusing on high-frequency AI users on campus, this study examined risk stratification of problematic AI use, real-life impacts, and the preliminary pre-post improvements following exercise-based interventions. A cross-sectional survey assessed AI usage patterns and functional impacts, identifying a substantial proportion of students with at least mild risk of problematic AI use. Problematic AI use was associated with reduced academic performance, social engagement, physical health, personal interests, and emotional well-being. A six-month structured exercise intervention delivered to at-risk student was associated with reductions in problematic AI use risk and improvements in daily functioning. These findings provide preliminary support for conceptualizing AI addiction as a multidimensional behavioral dependency potentially distinguishable from traditional Internet addiction and suggest that structured exercise may hold potential as a non-pharmacological approach for mitigating maladaptive AI use in university settings.

Multidomain lifestyle interventions have been demonstrated to benefit cognitive function but it is unknown whether they reduce risk for clinically significant cognitive impairment sCI (mild cognitive impairment or dementia).

The Action for Health in Diabetes administered repeated cognitive assessments in adults who had been enrolled in a 10-year clinical trial of a multidomain Intensive Lifestyle Intervention (ILI) versus Diabetes Support and Education (DSE).

N = 3655 underwent at least one assessment of cognitive status during 12-14 years of post-trial follow-up. The relative impact of ILI on sCI incidence varied by baseline body mass index (BMI, interaction p = 0.004): hazard ratio (HR) = 0.64 [0.46,0.89] for BMI 25-29 kg/m², HR = 0.98 [0.85,1.16] for BMI 30-39 kg/m², and HR = 1.40 [1.01,1.93] for BMI ≥ 40 kg/m².

A long-term multidomain lifestyle intervention may markedly reduce the risk of incident sCI among adults with type 2 diabetes and overweight but not obesity.

Climate change represents a growing threat to global mental health, generating traumatic stress exposures directly through climate-related disasters and indirectly through social networks and pervasive media coverage. This paper provides an overview of the symposium "The Mental Health Effects of Climate Change Across Diverse Global Settings," presented at the 41st Annual Meeting of the International Society for Traumatic Stress Studies, which examined psychological responses to climate change across varied sociocultural and geopolitical contexts. The symposium presented findings from four studies. First, research conducted in a representative sample of Lake County, California, residents (N = 813) exposed to catastrophic wildfires investigated associations among climate change anxiety, anticipatory climate disaster stress, and disaster preparedness. Second, a probability-based representative U.S. sample (N = 4,356) was leveraged to examine the association between climate change worry and mental health within the context of concurrent cascading collective stressors, with constructs from social and health psychology evaluated as moderating factors. Third, a community-based study in Samoa estimated how rising temperatures and extreme heat influenced mental health symptoms among children over time (N = 429, age 10-13 years). Fourth, survey data from young adults in Ukraine (N = 235) explored the interrelationships among climate change anxiety, war-related fears, and perceived ecological catastrophe threats, highlighting the importance of evaluating climate-related distress within conditions of ongoing trauma. These studies are used to illustrate broader themes within the current field of climate change and mental health literature. We discuss methodological considerations, clinical implications, and key directions for future inquiry.

In response to the sustained decline in academic psychiatry posts and infrastructure across the UK, the Royal College of Psychiatrists' Academic Strategy proposes seven strategic pillars to rebuild workforce capacity through collaboration and innovation, and argues for revitalising the discipline that is essential for scientific leadership, excellence and mental healthcare.

Adverse childhood experiences are critical contributors to the development of psychiatric disorders. Despite its pervasive impact on mental health, childhood neglect remains underexplored. Here, we performed a first comprehensive synthesis of the association between neglect subtypes and psychiatric disorders.

The primary aim was to quantify the overall association between neglect and psychiatric disorders, by estimating the odds ratios from clinical and control groups. The secondary aim was to examine the association between unspecified, physical and emotional neglect, and specific psychiatric disorders.

Studies were systematically selected from three databases (PubMed, EMBASE and PsycINFO), focusing on adult populations with diagnosed psychiatric disorders and corresponding control groups. Meta-analyses assessed overall associations between neglect and psychiatric disorders, as well as subtypes-specific associations with distinct psychiatric conditions. Multiple meta-regressions were performed to explore moderating factors.

Strong associations were found between neglect and psychiatric disorders across all subtypes (unspecified neglect: odds ratio 3.63, 95% CI 2.19-6.01; physical neglect: odds ratio 3.27, 95% CI 2.51-4.25; emotional neglect: odds ratio 3.36, 95% CI 2.58-4.38). Subgroup analyses showed the strongest associations between unspecified neglect and bipolar disorder, physical neglect and schizophrenia spectrum disorders, and emotional neglect and major depressive disorder. Other associations emerged, although their interpretation was limited by a small number of studies and high heterogeneity levels.

Neglect is significantly associated with psychiatric disorders, with distinct patterns across neglect subtypes and mental health outcomes. These findings highlight the need for early identification and tailored interventions to mitigate neglect's long-term burden on mental health.

This study examines how extreme violence in Gaza is experienced and interpreted by women who survived the destruction of entire kin networks. Grounded in postcolonial and decolonial psychology, the research investigates how exterminatory violence, domicide, and spatiocide shape trauma beyond individual clinical frameworks. The study addresses the following questions: how do Gazan women narrate the psychological consequences of losing entire families, and how does the destruction of homes, space, and burial practices shape experiences of trauma and mourning? Participants were 30 displaced Gazan women (aged 19-60) living in shelters and camps in Rafah during the recent escalation of violence. Data were collected through semi‑structured qualitative interviews and written testimonies conducted in person or remotely depending on security conditions. Interviews were transcribed in Arabic and analyzed using inductive thematic analysis. Analysis identified six interconnected themes: (1) instantaneous erasure of entire family lines; (2) the emotional and social burden of losing dozens of relatives; (3) traumatic identification of bodies under conditions of mass death; (4) mass graves and disrupted mourning practices; (5) surviving as the sole remaining family member; and (6) fear of lineage erasure and memory loss. Findings indicate that trauma in Gaza is cumulative, relational, and spatially embedded, as the destruction of homes and neighborhoods collapses kinship structures, social roles, and intergenerational continuity. The study contributes to violence and trauma scholarship by demonstrating that psychological harm in contexts of mass violence cannot be separated from the political and spatial destruction of collective life. Clinical and psychosocial responses must therefore move beyond individual symptom frameworks and incorporate relational, community‑based, and justice‑oriented approaches that address disrupted mourning, survivor guilt, and the loss of social continuity.

Many people presenting to emergency departments after self-harm do not receive adequate care, even in well-resourced health systems.

To identify patterns of health care service use across two periods: (a) during and (b) up to 1 year after an index emergency department self-harm presentation.

A retrospective population-based cohort study including 4668 individuals aged ≥9 years who presented to the Royal Melbourne Hospital emergency department for self-harm between January 2012 and December 2019. Linked administrative data captured >1.3 million records across primary care, pharmacy, specialist mental and physical health services and emergency departments. Sequential pattern mining identified longitudinal service-use clusters. Multinomial regression explored associations with demographic, clinical, psychosocial and presentation characteristics. Cox proportional hazards models assessed associations between clusters and all-cause and suicide mortality.

Emergency department self-harm presentations triggered short-term increases in multi-sector contacts. However, most (68.7%) reverted to the same service-use cluster observed prior to their index presentation. Suicide risk was highest within 1 year, particularly among those in the specialist mental health services cluster (4.5% of the cohort).

A small subgroup engage intensively with specialist mental health services yet remain at high suicide risk, while one in ten remain disengaged altogether, suggesting that an acute presentation of self-harm often fails to alter patients' care trajectories long-term. Policy alignment with national recommendations for integrated, community-based care could improve sustained, evidence-based support beyond acute crises.

The loss of a family member can trigger diverse emotional responses shaped by the type of death and cultural context. Grief may follow a gradual terminal decline or a sudden death, influencing how it is experienced. This qualitative study examines the lived experiences of Iranian families facing both loss types. Using a phenomenological approach guided by Colaizzi's method, 22 bereaved participants were interviewed. Analysis identified 49 meaning units and 13 themes, organized into four overarching clusters representing a temporal grief trajectory: (1) Acute grief (emotional rupture, embodied distress), (2) Mid-term turmoil (self-blame, existential despair), (3) Cultural and relational mediation (attachment, social support), and (4) Continuing bonds and meaning reconstruction (enduring connection, adaptive/spiritual acceptance). Findings suggest sudden losses produce intense acute and mid-term distress, while gradual losses allow preparation and movement toward acceptance and meaning making. These insights emphasize the value of culturally sensitive, individualized grief interventions in Iranian contexts.

The gut microbiota is increasingly recognised as a therapeutic target for mental disorders, with nutritional supplements providing a direct approach to modulating the gut microbiota. However, existing evidence largely focuses on single nutrients or phytochemicals, highlighting the need for novel multi-component interventions. This pilot study evaluated the feasibility and tolerability of a dietary supplement powder derived from Musa sp. pseudo-stem core that contains a combination of microbiota-modulating nutrients and phytochemicals.

We recruited 30 healthy adults, aged between 18 and 65 years, from the community to a triple-blinded, 4-week randomised placebo-controlled pilot trial. Participants were randomised to receive either 10 g/day of the Musa sp. pseudo-stem core powder or maltodextrin placebo. Supplement feasibility was defined as consuming at least 80% of the allocated supplement along with habitual diet. Tolerability was defined as no changes in gastrointestinal (GI) symptoms and stool consistency compared with placebo. Exploratory outcomes included psychological symptoms, quality of life, urinary hippurate measured using nuclear magnetic resonance spectroscopy, and stool gut microbiota profiling using 16S rRNA sequencing.

At the end of the study, 86% of the participants in the supplement group met the 80% consumption threshold, demonstrating intervention feasibility. There were no observed differences in the changes in GI symptoms or stool consistency between the supplement and placebo groups over the period of the study, indicating supplement tolerability. There were no observed differences in the changes in psychological symptoms, quality of life, and urine hippurate levels between groups at week 4. The weighted UniFrac distance showed a structural difference of the gut microbiota community between the supplement and placebo groups at week 4, although no observed differences were found in alpha diversity. Differences in the changes of two bacterial taxa each belonging to the family Anaerovoracaceae and Prevotellaceae were observed in the supplement group compared with the placebo group at week 4.

Our pilot study showed that Musa sp. pseudo-stem core powder was feasible and well-tolerated as a dietary supplement, with potential for modulating the gut microbiota. Future adequately powered trials are warranted to evaluate its effect on mental health and to elucidate underlying biological mechanisms.

The trial was registered with the Australian New Zealand Clinical Trials Registry (ACTRN12623000454673) on 2 May 2023.