Most neuroimaging studies in schizophrenia (SCZ) focus on static brain activity, with limited attention to its temporal dynamics. We hypothesized that integrating static and dynamic measures of local neural activity would reveal complementary alterations associated with clinical symptoms and cognitive deficits in SCZ.

Resting-state functional magnetic resonance imaging data were acquired from 63 SCZ patients and 46 healthy controls. Static and dynamic regional homogeneity (s/dReHo) and fractional amplitude of low-frequency fluctuations (s/dfALFF) were calculated. Partial correlation analyses examined associations between altered imaging metrics, symptoms severity (Positive and Negative Syndrome Scale), and cognitive performance (MATRICS Consensus Cognitive Battery).

SCZ patients exhibited reduced static and dynamic local activity in sensorimotor, visual, and middle temporal regions, alongside increased activity in the striatum, superior frontal gyrus, hippocampus, and temporal pole (all p_voxel < 0.001, p_cluster < 0.05, GRF corrected). dfALFF in the postcentral gyrus was negatively associated with negative symptoms (r = -0.333, p = 0.048). General psychopathology was positively associated with sfALFF in the putamen (r = 0.287, p = 0.048) and both sReHo (r = 0.314, p = 0.048) and dReHo (r = 0.312, p = 0.048) in the temporal pole. Additionally, sReHo in the middle temporal gyrus was positively associated with visual learning (r = 0.330, p = 0.042), while dReHo in the temporal pole was negatively associated with verbal learning (r = -0.398, p = 0.042).

Integrating static and dynamic indices reveals dissociable patterns of local brain dysfunction in SCZ, linking sensorimotor and striatal-temporal abnormalities to specific symptom dimensions and cognitive deficits.

Olfactory cues play a crucial role in peri- and postnatal development and are thought to be involved in basic processes, like parent-child bonding or the establishment of the breastfeeding relationship. These processes are highly important for the physical and mental health of the developing child. However, little attention has been given to monitoring and maintaining the olfactory environment of preterm (PI) and term (TI) infants in the hospital. This environment differs fundamentally from that of healthy neonates because the patients are exposed to odors from clinical interventions while the natural olfactory input is limited. In this article, we summarize examples of how PI and TI respond to olfactory signals and how olfactory stimulation can positively influence feeding, stress, and pain management or even stabilize breathing. Although different studies have investigated the positive effects of maternal odors and demonstrated that PI and TI respond highly sensitively and distinctly to them, hardly any comparable studies exist for paternal odors. Also, the knowledge about the role of other natural or artificial odorants is very sparse. Future work should focus on investigating the role of these odorants and on optimizing olfactory stimulation strategies using objective odor analysis techniques.

Intravenous ketamine has emerged as a rapid-acting antidepressant intervention that has shown promising effects in patients with treatment-resistant depression, although evidence remains heterogeneous and less well established across diagnostic subtypes. Nevertheless, real-world data comparing diagnostic subtypes and sex-related differences remain limited. This observational study examined the antidepressant efficacy, tolerability, and dissociative effects of intravenous ketamine in patients with treatment-resistant unipolar depression (TRD) and treatment-resistant bipolar depression (TRBD) in a naturalistic clinical setting.

Ninety-seven adult patients meeting DSM-5 criteria for unipolar or bipolar depression received racemic intravenous ketamine at a university psychiatric center. Depressive symptoms and global clinical severity were assessed at baseline and up to three months using the Montgomery-Åsberg Depression Rating Scale (MADRS) and the Clinical Global Impression-Severity scale (CGI-S). Dissociative symptoms were measured with the Clinician-Administered Dissociative States Scale (CADSS). Longitudinal outcomes were analyzed using mixed-effects models.

Both groups experienced significant reductions in depressive symptoms over time. Patients with bipolar depression demonstrated a faster and greater improvement than those with unipolar depression, with differences emerging from week 2 and persisting through three months. CGI-S scores showed a comparable pattern. The dissociative symptoms showed no change throughout the study and they appeared at the same level in all diagnostic categories. Sex-stratified analyses revealed no differences in antidepressant efficacy, although women with unipolar depression exhibited higher dissociative symptoms at three months.

Intravenous ketamine is effective in real-world treatment-resistant depression, with superior and more sustained antidepressant effects in bipolar compared with unipolar depression.

Gambling Dual Disorder (GDD) is a proposed clinical construct describing the co-occurrence of Gambling Disorder (GD) with other psychiatric conditions. Although preliminary evidence supports this model, clinical data remain limited. This multicenter, cross-sectional Italian study aimed to further characterize GDD by comparing patients with GD only and those with co-occurring psychiatric disorders.

A total of 227 outpatients diagnosed with GD were consecutively recruited from two specialized psychiatric clinics in Milan. Patients were stratified into two subgroups: GD-only and GDD (i.e., GD plus ≥1 additional DSM-5 psychiatric disorder). Sociodemographic and clinical variables were collected, including the distribution of lifetime comorbidities. Psychometric questionnaires were used to assess gambling severity and key psychopathological dimensions.

Among the total sample, 137 patients (60.4%) met criteria for GDD. Compared to the GD-only group, GDD patients were significantly older (44.35 ± 14.85 vs. 36.76 ± 15.03 years; p < .05) and reported a later onset of gambling behavior (33.16 ± 13.13 vs. 26.03 ± 11.58 years; p < .005). The GDD group showed higher rates of lifetime suicidal ideation and suicide attempts, along with significantly greater emotional dysregulation. Personality disorders and mood disorders emerged as the most frequent psychiatric comorbidities.

This study confirms that psychiatric comorbidities are highly prevalent among patients with GD and are associated with distinct sociodemographic and clinical features. These findings support the clinical relevance of the GDD model and underscore the importance of recognizing and integrating this model into clinical practice to enhance diagnostic accuracy, improve therapeutic strategies, and guide future investigations in refining the management of gambling-related disorders.

Cross-disorder research and replication of neuroimaging findings remains scarce. Social dysfunction is an early manifestation across diverse neuropsychiatric disorders that may relate to altered default mode network (DMN) integrity. This study aimed to replicate previous findings linking social dysfunction with diminished resting-state DMN functional connectivity and altered task-based DMN functional activation in response to emotional faces across schizophrenia (SZ), Alzheimer's disease (AD), and healthy controls (HC), and to extend these findings to major depressive disorder (MDD). Resting-state fMRI and task-based fMRI data on implicit facial emotional processing were acquired in an overlapping cohort (resting-state fMRI: N=167; SZ=32, MDD=44, AD=29, HC=62. Task-based fMRI: N=152; SZ=30, MDD=42, AD=26, HC=54). Additionally, mega-analyses (N=317 for resting-state fMRI; N=291 for task-based fMRI) of the current and a prior independent sample were conducted. Social dysfunction was indexed with the Social Functioning Scale (SFS) and the De Jong-Gierveld Loneliness (LON) scale. The association between higher mean SFS+LON social dysfunction scores and diminished DMN connectivity within the dorsomedial prefrontal cortex across SZ/AD/HC participants was replicated, and extended to MDD patients. Similar observations within the dorsomedial and rostromedial prefrontal cortex were found in the mega-analysis. Associations between social dysfunction and DMN activation in response to sad and happy faces were not replicated or found in the mega-analysis. To conclude, diminished dorsomedial prefrontal cortex DMN connectivity emerged as a transdiagnostic neurobiological marker for social dysfunction, suggesting a potential treatment target for precision medicine approaches. DMN functional responses to emotional faces may not be a sensitive biomarker for social dysfunction.

Patients with advanced thoracic cancers undergoing standard radiotherapy (RT) have a high risk of experiencing performance declines and poor quality of life (QOL). Exercise programs may improve objective and subjective performance; yet, adherence remains poor. Including family caregivers as active intervention, participants may improve adherence and thus efficacy. Thus, this clinical trial seeks to examine the efficacy of a patient-caregiver dyadic yoga intervention relative to a dose-matched education/support (ES) intervention.

Patients with lung or esophageal cancer undergoing at least 5 weeks of RT and their family caregivers were randomly assigned to either a 15-session yoga or ES comparison intervention. Patients and caregivers were assessed at baseline (T1), the last day of RT (T2) and 1 (T3), 2 (T4), and 3 (T5) months later. Patients completed the 6-minute walk test (6MWT; primary outcome) and both patients and caregivers completed a validated QOL measure (secondary outcomes).

A total of 222 participants were randomly assigned. For the 6MWT, patients in the yoga group performed significantly better than those in the ES group across T2-T5 (least squared means [LSMs] in meters: yoga = 469 v ES = 441, P = .03). Patients in the yoga group also reported improved physical (LSMs: yoga = 44.7 v ES = 41.6, P = .03) but not mental QOL scores across T2-T5 compared with those in the ES group. As exploratory outcomes, patients in the yoga group also reported improved sleep (P = .01) and coping efficacy (P = .02).

Yoga significantly improves functional capacity and subjective physical QOL in patients undergoing thoracic RT. Involving a family caregiver may improve intervention adherence.

Group Radical Openness (GRO) is a group therapy for the treatment of costly and harmful overcontrol. The COVID-19 pandemic necessitated the remote delivery of GRO, notwithstanding its highly interpersonal therapeutic focus. Based on positive service user feedback, the option to attend remotely was maintained after the pandemic. This service review evaluates this continued provision, through an assessment of the comparative effectiveness of GRO within in-person and videoconferencing (VC) formats.

A retrospective naturalistic evaluation of routine pre- and post- clinical outcome data was conducted at a not-for-profit mental health service in Ireland. The in-person and VC-GRO comparison groups arose organically in the context of responsiveness to service user preference.

The sample consisted of 101 GRO participants (72 in-person and 29 VC), aged between 18 and 68 years (M = 41.2 years, SD = 13.00). Based on main effect interpretations from ANOVAs, the overall effectiveness of GRO was supported for both primary outcomes: difficulties associated with overcontrol (F (1, 100) = 84.92; p < 0.01); and general psychological distress (F (1, 100) = 44.32; p < 0.01). There were no significant differences between the in-person and VC groups for any of GRO's primary or secondary outcomes. Concerns that more avoidant participants might opt for VC-GRO over in-person attendance were also not supported, as the groups presented similarly in terms of clinical and demographic characteristics at baseline.

These preliminary and naturalistic findings support the effective delivery of GRO both in-person and remotely. This should allay any concerns surrounding the potential unhelpful impact of delivering GRO remotely. These findings are applicable to similar VC therapy groups.

Psychosocial risk assessment is a cornerstone of mental health care, yet remains resource-intensive and inconsistently delivered across domains such as suicide, intimate partner violence (IPV), and substance misuse. Recent advances in large language models (LLMs) raise the possibility of scalable, conversational agents capable of detecting and evaluating psychosocial risk. Across three interlinked studies, we evaluated the performance of LLMs in this context. Study 1 benchmarked GPT-4 and Claude 3 Sonnet against vignettes constructed from participants' lived-experience, finding high accuracy in detecting risk domains and substantial agreement with participant-rated severity, though suicidality proved more challenging than IPV or substance misuse. Study 2 examined participants' perceptions of LLM-generated responses, revealing that most judged them accurate, empathic, and clinically useful, with no differences across models or domains. Study 3 implemented a supervised, three-agent GPT-4o-based chatbot system integrating one chatbot as a therapeutic agent, a supervisor for risk detection, and a JSON-based assessor for structured evaluation. The therapeutic agent chatbot was successfully completed full risk assessments most of the time while maintaining therapeutic quality. Together, these studies suggest that LLMs can contribute to psychosocial risk detection and structured assessment under controlled conditions, while underscoring the need for careful supervision, rigorous validation, and clearly defined boundaries before consideration of real-world clinical deployment.

Applying established frameworks for cultural adaptation of evidence-based programs (EBPs) is essential to ensure cost-effectiveness, adoption, and sustainability while advancing health equity. However, adaptation processes often lack systematic approaches, particularly outside academic contexts.

This study explores how cultural adaptation processes of prevention programs are delivered to address adolescent substance use and common mental health issues, from the perspective of the main stakeholders involved in these processes. In parallel, it aims to empirically refine and specify the 11 stages synthesized in prior work that integrated insights from multiple cultural adaptation processes and frameworks.

A qualitative analysis was conducted using content analysis of 22 semi-structured interviews with stakeholders from the quadruple helix model: 6 from Academia, 6 from Non-governmental organizations (NGOs), and 10 from Public administration, selected globally. Stakeholders were identified via brainstorming and purposive-convenience sampling, based on their roles in adapting, implementing, evaluating, or funding prevention programs addressing adolescent substance use and mental health issues. Despite extensive recruitment efforts, no representation from the Business helix was achieved, as only one business contact agreed to be interviewed, which was not considered sufficient for inclusion.

The qualitative analysis refined and expanded the stages of a cultural adaptation sequence that reflects how cultural adaptation processes are conducted in practice: building synergies, local needs assessment, program selection, initial cultural adaptation, advisory group consultation, staff training, piloting, program refinement and readiness for implementation, implementation, monitoring and evaluation, and dissemination and sustainability. Notably, not all stakeholders followed or applied the steps uniformly. Furthermore, academics were the only group to report using formal cultural adaptation models, while NGOs and the Public administration relied on experiential and contextual knowledge.

Findings underscore the importance of translating scientific knowledge into practice contexts while ensuring continuous evaluation, dissemination, and sustainability of adapted EBPs targeting adolescent substance use and mental health issues. Collaborative efforts and co-creative strategies are crucial to maintaining cultural relevance. This study contributes by offering empirical refinement and operational specification of an 11-step cultural adaptation sequence identified in a prior scoping review. Linking evidence from prior literature with practice provides greater clarity and applicability for implementers seeking to culturally adapt prevention programs across diverse contexts.

Problematic pornography use (PPU) has attracted increasing interest due to its reported associations with psychological distress, sexual difficulties, and relationship concerns in a subset of users. Several psychotherapeutic interventions have been proposed. Still, there is no widely accepted, evidence-based, standardized protocol for its treatment.

This scoping review aimed to identify and synthesize intervention protocols based on cognitive behavioral therapy (CBT) for the treatment of PPU, published between 2019 and 2024.

A systematic search was conducted in the PubMed, Scopus, and PsycINFO databases, using predefined terms such as "cognitive behavioral therapy," "pornography," "PPU," and "problematic pornography use." Empirical studies presenting CBT-based protocols for PPU, published in English, Portuguese, or Spanish between 2019 and 2024, were included. Two independent reviewers conducted double-blind screening of the studies, with discrepancies resolved by consensus. Extracted data included participant characteristics, study design, intervention components, session structure, and outcomes.

The initial search identified 437 studies. After removing duplicates and full-text screening, 11 studies met the inclusion criteria. Interventions varied in therapeutic approach, including CBT alone, ACT, mindfulness-based practices, and hybrid protocols, integrating CBT techniques with ACT-based or mindfulness-based strategies. Delivery modalities included in-person (n = 5), online (n = 5), and mixed (n = 1). Most protocols addressed emotional regulation, cognitive restructuring, craving management, and relapse prevention. Although all studies reported reductions in the frequency of PPU and associated symptoms, interventions that combined CBT with other techniques tended to report larger effect sizes. No studies reported complete abstinence, and there were high dropout rates in self-guided interventions.

Despite promising findings, current CBT-based protocols for treating PPU lack standardization and methodological rigor. The field would benefit from consensus on diagnostic criteria, therapeutic goals, outcome measures, and additional randomized clinical trials that integrate mental health and sexual health.