Biological aging may contribute to the pathogenesis of major depressive disorder (MDD). However, whether and how peripheral transcriptomic aging increases the risk of MDD onset remains unclear.

Transcriptomic age was estimated using peripheral blood RNA sequencing data from 141 individuals with MDD and 134 healthy controls. The residuals of transcriptomic age regressed on chronological age were calculated to indicate transcriptomic aging acceleration. Enrichment analysis was performed to explore potential biological mechanisms underlying aging- and MDD-associated transcriptomic alterations. Associations between transcriptomic aging and clinical, neurocognitive, environmental, genetic, and neuroimaging phenotypes were examined.

Participants with MDD exhibited significantly accelerated transcriptomic aging both before (t = 2.06, P = 0.040) and after adjusting for chronological age and sex (t = 3.72, P < 0.001). Enrichment analysis revealed shared terms in innate immune-related inflammation, ribosome biogenesis, and mitochondrial energy metabolism, while telomere length maintenance was specifically enriched in aging but not in MDD. No significant associations were found between transcriptomic aging and clinical symptoms, neurocognitive functions, childhood trauma exposure, or polygenic risk score. Neuroimaging analyses demonstrated that transcriptomic aging was associated with structural (t = -3.30, P = 0.001) and functional (t = 2.64, P = 0.009) alterations in the right insular cortex. Further analyses indicated that insular abnormalities partially mediated the impact of transcriptomic aging on MDD vulnerability.

Transcriptomic aging may represent a novel risk factor for MDD. Disruption in the insular cortex may serve as a critical neural substrate through which accelerated transcriptomic aging increases vulnerability to MDD.

Effective communication is central to psychiatric evaluation and treatment. Patients with acquired communication impairments, such as post-stroke aphasia, are at increased risk for misdiagnosis, delayed care, and suboptimal treatment. We aim to better understand the unique needs of psychiatric patients with communication difficulties, common pitfalls in their care, and ways to improve clinical assessment, diagnosis, and treatment of their mental health conditions. We present the case of a 49-year-old woman with a history of major depressive disorder, generalized anxiety disorder, post-traumatic stress disorder, functional neurological symptom disorder, and a left middle cerebral artery ischemic stroke resulting in non-fluent aphasia. She was admitted to an inpatient psychiatric unit for suicidal ideation in the context of significant post-stroke functional decline. Her hospitalization was complicated by limited verbal communication and reliance on nonverbal modalities, cognitive fatigue related to communicating, persistent depression symptoms, as well as fluctuating reports of perceptual disturbances. Communication barriers significantly impacted assessment of mood, suicidality, and perceptual symptoms, contributing to diagnostic uncertainty and complex medical decision-making. This case highlights how expressive aphasia can obscure psychiatric assessment, increase reliance on interpretation by clinicians and caregivers, and contribute to potential misunderstanding of symptoms. It also underscores the importance of multimodal communication strategies and interdisciplinary collaboration. Psychiatric patients with communication impairments require tailored assessment approaches to reduce diagnostic error, gain greater understanding of the patient's clinical presentation, and improve overall patient care. Increased awareness and structured communication strategies may mitigate disparities in this vulnerable population.

Background Healthcare workers (HCWs) faced substantial psychological pressure during the COVID-19 pandemic. Evidence from Indian tertiary care settings during the acute phase of the outbreak remains limited. This study examined the prevalence of anxiety, depression, and stress among doctors and nurses at a New Delhi tertiary care hospital during the early pandemic period. Methods An anonymous, cross-sectional online survey was conducted among 100 HCWs (84 doctors, 16 nurses) at Moolchand Hospital, New Delhi. The Depression, Anxiety and Stress Scale-21 (DASS-21) was used to quantify psychological morbidity. Sociodemographic and occupational data, including infection-control training adequacy, trust in personal protective equipment (PPE) supply, and perceived social support, were collected via a structured questionnaire. Descriptive statistics were used to characterise the cohort and the prevalence of psychological symptoms. Results The cohort comprised 53 (53.0%) male and 47 (47.0%) female participants; the majority (40, 40.0%) were aged 31-40 years. Anxiety was the most prevalent psychological outcome (65, 65.0%), followed by depression (20, 20.0%) and stress (15, 15.0%). Insomnia was the most frequently reported individual symptom (43, 43.0%). Participants commonly reported inadequate infection control training, limited trust in PPE adequacy, and self-imposed isolation from family members to reduce transmission risk. Fear of infecting family members and perceived stigma were recurrent qualitative themes. Conclusions Psychological morbidity, particularly anxiety, was highly prevalent among doctors and nurses at a New Delhi tertiary hospital during the acute phase of the COVID-19 pandemic. Modifiable factors such as infection control training, PPE provision, and social support emerged as important considerations for institutional response. These findings contribute to the evidence base informing mental health preparedness frameworks for future infectious disease outbreaks, particularly in lower-middle-income country settings.

Given the importance of the link between mental and other medical conditions, JCPP Advances organized a special issue on the topic; yet since then, very few papers have focused on this area. As such, this editorial perspective aims not only to highlight the link between mental and other medical conditions, but also to (1) explore the origins of the divide between mental and "physical" health, (2) provide evidence that this so-called divide does not exist in actuality, (3) highlight the harms of maintaining such a divide, and (4) discuss strategies to bridge this divide to address this monumental mistake, which has been perpetuated throughout medicine.

Meaningful involvement of young people in mental health research ensures that it is relevant and has impact. Traditional approaches to patient and public involvement often fail to provide sustainable and reciprocal engagement. We reflect on our experiences of working with an apprenticeship model as an alternative approach to involving young people in mental health research.

We describe working with the Bradford Healthy Minds Apprentices, a group of 16- to 24-years-olds engaged in a year-long paid apprenticeship scheme. This partnership involved coproduction activities to develop the Youth Mental Health Evidence Synthesis Hub (Y-MHESH), including workshops, website design and short videos. We focussed on relationship-building and provided clear feedback to demonstrate how the research team had acted and adapted in response to input from the Apprentices.

Working with the Apprentices offered distinct benefits to both researchers and the young people, including community engagement, flexible collaboration and opportunities for future working. The Apprentices were an established and externally supported group which facilitated relationship-building. Their professional status fostered a more equal and reciprocal partnership. The Apprentices themselves gained research skills and were able to choose their level of involvement in Y-MHESH. Through regular feedback they felt their contributions were valued by the researchers, engendering trust. Challenges included adapting to group dynamics and preferred ways of working, limited availability, funding limitations, and unfamiliar payment processes.

Partnerships with groups like the Healthy Minds Apprentices, who are paid and supported within a relevant organisation, can support reciprocal coproduction and community-linked, bottom-up research. We suggest that a similar university-based apprenticeship model could offer a way to sustainably involve young people in mental health research, as well as providing developmental opportunities for young people. While requiring institutional buy-in and flexibility, this approach to involving young people aligns closely with the university's commitment to public good.

Brief emotion-focused family therapy (EFFT) interventions have demonstrated numerous positive outcomes across the domains of child mental health and parent psychosocial well-being. However, there is limited research examining interpersonal processes at the family-level of analysis following 2-day EFFT programs.

This study explored family functioning in the year following a virtual, parent-focused EFFT intervention (n = 159 caregivers, representing 124 families and 264 children). Caregivers completed the General Functioning subscale of the Family Assessment Device at 6 timepoints from baseline to 12-month post-intervention. Multilevel modeling was used to complete growth curve analysis, exploring post-intervention changes in family functioning over time. This allowed for the exploration of between versus within family differences pre- to post-intervention in the study sample.

Variance in family functioning was attributable to stable differences between caregivers (level 2; 59%) and change over time (level 1; 41%), including measurement error. Growth curve analysis identified positive changes in family functioning post-intervention, with a cubic trajectory of improvement. Higher COVID-19 disruption, caregiver psychological distress, and parenting stress significantly predicted lower baseline family functioning, but did not significantly interact with change over time.

These results suggest that there is a general pattern of non-linear change following EFFT workshops, specifically relating to family interpersonal dynamics. Overall, the study findings expand the evidence base for this promising, brief, relational intervention, now available in virtual formats, thereby increasing access for busy families.

Children in care have historically been under-represented in mental health research, despite high levels of need. Consequently, there is a lack of high-quality empirical evidence to drive advocacy, practise, and policy, and the direct voice of children in care is often absent. In this Editorial Perspective, we outline three key areas of consideration, that must be understood and addressed to maximise the success of primary mental health research with this group of children. Specifically, we focus on: capacity issues in children's social care and partnership working; consent and assent procedures; and supporting children in care through mental health research. The paper is informed by the ReThink Project, a longitudinal mixed-methods study involving 450 care-experienced young people across 13 local authorities in England and Wales. The issues and solutions we discuss have implications for future study design, including timelines and funding.

Young people with Developmental Language Disorder (DLD) are at increased risk of mental health difficulties but often face barriers to accessing traditional talking therapies such as Cognitive Behavioral Therapy (CBT). Co-production offers a way to create more accessible interventions by involving those with lived experience as well as practitioners. However, co-producing with young people with DLD remains rare due to high language demands and inaccessible formats.

To explore how experienced-based co-design (EBCD) methodologies could be shaped to include young people with DLD, in the context of adapting a set of psychoeducational videos for depression and anxiety.

The UK-based project team consisted of 4 adolescents with DLD, their parents, and six Educational Mental Health Practitioners and 3 academic researchers. A five-stage process included recruiting team members, identifying therapy adaptations, selecting key psychoeducational concepts, developing scripts and videos, and reflecting on the process. Meetings were adapted to maximize accessibility through simplified language, visual aids, pre-meeting preparation videos, asynchronous tasks, and post-meeting summaries.

Ten adapted psychoeducational videos were co-produced. Key adaptations included slowed pacing, simplified vocabulary and concrete examples. Team members reported that the process felt inclusive and flexible, and that the final materials were more meaningful and relevant. Challenges included balancing parental input with young people's voices, managing conflicting feedback, and ensuring tasks were not overly demanding. Researcher reflexivity and flexibility was critical to maintaining engagement.

This project demonstrates that, with appropriate adaptation, co-production with young people with DLD and practitioners is both feasible and valuable. The process resulted in more accessible therapeutic materials and offers a starting point for further research involvement.

Psychological distress is highly prevalent among people living with HIV (PLHIV) and may impact healthcare utilization patterns. However, the relationship between mental health status and healthcare utilization inequity in this population remains poorly understood, particularly in resource-limited settings. This study aimed to examine the association between mental health status and healthcare utilization inequity among PLHIV using robust methodological approaches.

This cross-sectional study included 418 PLHIV receiving antiretroviral therapy (ART) at major HIV treatment centers in southwestern China. Mental health status was assessed using validated Chinese versions of the Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder-7 (GAD-7) scales. Healthcare utilization measures included self-rated health (SRH), 2-week morbidity, chronic disease prevalence, and hospitalization rates. Inverse probability treatment weighting (IPTW) was employed to minimize confounding, and concentration indices (CIs) were calculated to assess healthcare utilization inequity. Decomposition analysis identified key contributors to observed inequities.

After IPTW adjustment, participants who were symptom-positive (48.3%) demonstrated significantly poorer health outcomes compared to those who were symptom-negative (51.7%). The symptom-positive group showed higher rates of poor SRH (52.6% vs. 37.5%;p < 0.110), 2-week morbidity (56.7% vs. 47.6%; p = 0.010), and chronic disease (49.0% vs. 41.6%;p = 0.030). Paradoxically, despite worse health status, this group had lower hospitalization rates (82.1% vs. 88.2%;p = 0.010). CIs revealed pro-rich inequities across all outcomes, with particularly pronounced disparities in hospitalization (CI = -0.2379,). Decomposition analysis identified drug use history (-1.1×10¹%, p < 0.001), physical activity patterns (1.4×10⁰%, p = 0.0099), and health record establishment (3.1×10⁰%, p < 0.001) as key contributors to healthcare utilization inequities.

PLHIV with symptom-positive experience significant disparities in health outcomes and healthcare utilization, characterized by poorer health status but lower healthcare service utilization. While pro-rich inequities exist across all outcomes, the patterns and magnitude of these inequities differ for symptom-positive individuals compared to their counterparts. These findings highlight the need for integrated mental health and HIV services, systematic healthcare management, and targeted interventions to address healthcare barriers in this vulnerable population.

With the global rise in dementia diagnoses and no available cure, there is an urgent need for accessible, enjoyable, and holistic interventions that support people experiencing dementia to live well. Nature engagement has been shown to offer wide-ranging benefits, including improved mental health, physical activity, cognitive stimulation, and social connection, but many people with dementia face barriers to accessing natural environments due to mobility challenges, cognitive changes, poor environmental design, and dementia-related stigma. Innovative approaches are needed to make nature more accessible and meaningful for this population. One promising solution is the use of living labs: real-world, user-centred environments where researchers, service providers, people with dementia, and care partners can co-create and test solutions. Living labs are grounded in principles of collaboration, inclusivity, and continuous feedback, and they offer a dynamic space for innovation tailored to the living experiences of those involved. Living labs have been applied in dementia care research, although much of this work has focused on indoor settings, technological tools, and aged care systems. How living labs have been used to help people living with dementia access the outdoors and connect with nature is an underexplored area, but one which holds exciting potential to improve the lives of people with dementia. This mini review summarises the available academic literature examining the nexus between living labs, nature, and dementia and offers suggestions for future work in this area.