Restrictive practices (RPs) encompass interventions that limit an individual's freedom, such as restraint, seclusion, and enforced treatment. While widely studied in acute mental health settings, their use within inpatient eating disorder services remains underexplored despite evidence of high prevalence. In addition to these formal restrictive interventions, eating disorder inpatient wards commonly employ structured behavioural rules as part of nutritional rehabilitation programs, including enforced rest periods, supervised meals, locked bathrooms, and limits on fluids or activity. A scoping review methodology following a five-step framework was implemented. Four databases (CINAHL, MEDLINE, Embase, and PsycInfo) were searched. The analysis involved both numerical and narrative synthesis in line with the framework. Thirty-six studies were included. Most originated from the UK, focused on anorexia nervosa, and used quantitative designs, with a substantial proportion conducted in child and adolescent inpatient settings. Common RPs included nasogastric tube feeding under restraint, involuntary admission, and physical restraint. Prevalence varied widely, with a small subset of patients accounting for most RP episodes. RPs were primarily applied in response to medical or nutritional risk rather than aggression, differentiating them from acute psychiatric contexts. Evidence regarding outcomes such as weight restoration, length of stay, and mortality was inconsistent, and RPs were frequently described by patients and staff as distressing, coercive, and potentially traumatic. Findings highlight the distinct nature of RP use in eating disorder settings and the need for context-specific policies, ethical guidance, and intervention strategies to minimize harm while ensuring patient safety.

Significant weight gain is a concerning adverse effect of antipsychotic medications experienced by patients with schizophrenia spectrum disorders (SSDs). Its high prevalence and significant contribution to cardiometabolic morbidity in this population warrant better consensus on the management of antipsychotic-induced weight gain and related comorbidity.

To evaluate the association between pharmacological interventions and changes in body weight among antipsychotic-treated patients with SSDs.

Ovid MEDLINE, Embase, PsycINFO, the Cochrane Central Register of Controlled Trials (CENTRAL), CINAHL, ClinicalTrials.gov, and the International Clinical Trials Registry Platform (ICTRP) Search Portal were searched up to December 5, 2025.

Randomized clinical trials examining any pharmacological intervention for weight reduction in antipsychotic-treated patients with SSDs were included. No restrictions to study duration were applied.

A systematic review and frequentist random-effects network meta-analysis was conducted. Certainty in the evidence was assessed using the Confidence in Network Meta-Analysis (CINeMA) tool. The first round of data analysis took place between May 2025 to November 2025 and was updated in December 2025.

The primary outcome was change in body weight following treatment with pharmacological agent vs placebo or standard care. Secondary outcomes included other anthropometric and metabolic parameters.

A total of 95 studies examining 39 individual pharmacological interventions were included in this review (pooled N = 5898). The network meta-analysis found that semaglutide (mean difference [MD], -10.98 kg; 95% CI, -13.33 to -8.62; k = 3; moderate certainty), liraglutide (MD, -5.43 kg; 95% CI, -8.54 to -2.33; k = 2; moderate certainty), topiramate (MD, -3.95 kg; 95% CI, -5.89 to -2.02; k = 5; moderate certainty), metformin (MD, -3.86 kg; 95% CI, -5.02 to -2.70; k = 16; moderate certainty), and exenatide (MD, -2.97 kg; 95% CI, -5.83 to -0.11; k = 3; moderate certainty) were associated with the most significant reductions in body weight compared to placebo. Other interventions including ramelteon, nizatidine, and aripiprazole were also found to be associated with weight-reducing effects but with very low certainty of evidence. Clinically meaningful weight change of 5% or greater was observed with semaglutide and metformin. Beneficial effects on other metabolic outcomes were also noted with several of the medications, and there were no major concerns with gastrointestinal adverse effects or leaving the study early (ie, dropouts) between interventions.

This systematic review and network meta-analysis found substantial variability in weight-related outcomes across pharmacological interventions for antipsychotic-treated individuals with SSDs. Semaglutide, liraglutide, topiramate, metformin, and exenatide were associated with the greatest reductions in body weight and were supported by the highest-certainty evidence, providing guidance for clinicians managing antipsychotic-associated weight gain.

Dyspnea, or shortness of breath, is frequently reported among individuals with autonomic nervous system dysfunction, or dysautonomia. Currently, there are no validated dyspnea-specific patient-reported outcome measures for this population.

We conducted a patient-reported outcomes study to evaluate the internal consistency, reliability, and concurrent criterion-related validity of three PROMIS^® instruments: Dyspnea Characteristics v1.0, Dyspnea Functional Limitations 10a, and Global Health v1.2 in a cohort of adult individuals with dysautonomia. These instruments assess the prevalence of dyspnea, general quality of life, and dyspnea-related functional limitations.

Of the 617 participants enrolled in this study, 414 individuals without comorbid conditions causing dyspnea were included in the primary analysis. The PROMIS^® Dyspnea Characteristics v1.0 and PROMIS^® Dyspnea Functional Limitations 10a instruments demonstrated good to excellent internal consistency reliability (Cronbach's alpha = 0.896-0.909; McDonald's omega total = 0.911-0.912). The PROMIS^® Global Health v1.2 instrument demonstrated good overall internal consistency (Cronbach's alpha = 0.846, McDonald's omega total = 0.852), although reliability varied among the Global Physical Health and Global Mental Health summary scores (Cronbach's alpha = 0.640-0.759; McDonald's omega total = 0.664-0.767). Confirmatory factor analysis supported a unidimensional structure for both the PROMIS^® Dyspnea Characteristics v1.0 and Dyspnea Functional Limitations 10a instruments and a two-factor structure (Global Physical Health and Global Mental Health) for the Global Health v1.2 instrument. The indices demonstrated a good to excellent model fit (Comparative Fit Index = 0.983-1.00). Analyses demonstrated strong concurrent criterion-related validity for the PROMIS^® Dyspnea Functional Limitations 10a instrument (r = 0.59063) and weak-to-moderate concurrent validity for the Global Health v1.2 instrument (r = -0.17763 to -0.35034).

These findings support the use of the PROMIS^® Dyspnea Functional Limitations 10a and Global Health v1.2 instruments in clinical and research settings to assess symptom burden, functional limitations, and quality of life in adults with dysautonomia.

The embodied self emerges from dynamic interactions between internal bodily signals and external sensory inputs, including those of social origin. Interoception (the perception and interpretation of internal bodily states) plays a central role in bodily self-consciousness and social cognition. Although socially salient contexts have been shown to modulate interoceptive accuracy (IAcc), the influence of passive social presence remains largely unexplored. In this study, we examined how the social exteroception modulates cardiac interoceptive accuracy using a heartbeat counting task in a Cave Automatic Virtual Environment (CAVE). Neurologically healthy participants (N = 32; ages 19-45) completed the task under both social and non-social exteroceptive conditions. Results showed that the mere presence of social exteroceptive cues significantly decreased IAcc. These findings indicate that even minimal social cues can influence internal bodily awareness, supporting the view that the embodied self is inherently relational and dynamically influenced by its social environment. This effect may reflect attentional competition between interoceptive and exteroceptive processes, consistent with predictive coding and attentional switching models. By leveraging immersive virtual reality, we created ecologically valid yet precisely controlled social contexts, minimizing the confounds of real-life physiological coregulation. Beyond theoretical implications, this study raises methodological considerations regarding the potential influence of social context, including experimenter presence, on interoceptive performance, and may inform clinical research on mental health conditions characterized by altered interoceptive and social processing.

Dependent older patients show high risk of adverse health outcomes when admitted to the emergency department (ED). The prompt identification of ED use risk factors in such population is hence needed. While frailty and cognitive impairment are a known clinical risk factors, biomarkers of most prevalent dementias have been scarcely investigated as possible ED use predictors. Within this framework, this prospective study explored whether plasma phospho-tau181 (ptau181) and cerebrovascular burden provide additional predictive value for 6-month ED use in elderly dependent patients, beyond frailty and age.

We collected baseline clinical and laboratory data to validate a 32-item frailty index, while assessing cognitive impairment through the Mini-Mental State Examination. Biomarkers of cognitive impairment included plasma ptau181 and cerebrovascular burden, i.e., the Fazekas Scale. Binomial and Cox regression models tested the biomarkers of cognitive impairment as predictors of ED use, adjusting for frailty and age. The interaction between cognitive impairment biomarkers was explored.

Of the 102 recruited patients, 38 visited the ED. In the binomial models, the frailty index (OR = 1.69, p = 0.011) and the Fazekas Scale (OR = 3.57, p = 0.007) predicted ED use. At lower p-tau181 levels, ED admission risk increased only with higher cerebrovascular burden. Conversely, higher p-tau181 levels predicted ED use (OR = 4.90, p = 0.037) irrespective of cerebrovascular burden. No significant predictors of time to ED use emerged.

Beyond measures of clinical frailty, the routinary employment of cognitive impairment biomarkers may contribute identifying dependent older patients at short-term high risk of ED use, possibly reducing adverse health outcomes in such population.

A dysfunctional bi-directional signalling of plural neural networks expresses distinct metabolic disruption with mental health consequences in obesity, anorexia nervosa and bulimia nervosa. Maladaptive brain-gut connectivities lead to multifactorial contributing factors raising the interest of researchers in an effort to address their neurobiological, psychological and metabolic factors to improved mental health outcomes. The first aim of this review was to collate clinical evidence on brainstem-hypothalamus pathways in obesity, anorexia nervosa and bulimia nervosa. Further, it sought to describe the chief brain-based interactions within both the brain-gut and brain-gut-adipose axis in these conditions. Another aim was to explore the interactions of prominent peptides within the brain-gut and brain-gut-adipose axes. The final aim was to integrate the knowledge of maladaptive neural, peptide and hormonal signalling interactions with the mental faculty. According to integrative review guidelines, the multileveled information was grouped into three superordinate themes: the brain neurofeedback, the stomach neurofeedback and the sympathoadrenal neurofeedback, with seven subordinate themes: brain stem, lateral nucleus of the hypothalamus, arcuate nucleus of the hypothalamus, mechanism of appetite regulation, short-term satiety and long-term satiety signalling as well as the mechanisms of glucoprivation and lipoprivation, presented in Table 1. Their interconnectivites are synthesised in seven Figures, presented at each subtheme section. This paper augmented our understanding of brain maladaptive interactions with gut peptides and hormones among people with obesity and eating disorders and may serve a roadmap to neurobiological and metabolic influences on physical and mental health. Limitations identify qualitative areas of research towards evidence-informed psychiatric and health counselling support.

Cancer is a major stressor leading to a wide range of emotions. Emotions, also negative emotions, are essentially adaptive, in the sense that they help patients cope with cancer. Emotions can also be maladaptive, if they are disproportionately severe or persistent, or interfere with functioning. Our overall goal was to explore whether disturbance of life goals provides a fruitful framework for developing indicators that can distinguish between adaptive and maladaptive emotions.

To test the hypotheses that (1) goal disturbance and emotional symptoms are reciprocally and positively associated to each other; and (2) the association between goal disturbance and emotional symptoms is stronger in patients with maladaptive emotions as compared to patients with adaptive emotions.

Patients with (non)metastasized disease who recently started systemic treatment (n = 132) filled out Ecological Momentary Assessments 5 times per day for 14 consecutive days in which emotional symptoms and activities related to life goals were documented. The importance of life goals in six domains was assessed with an interview (work/study, disease-related health, lifestyle health, social activities, religious, spiritual and intellectual activities, and leisure). Patients were grouped as having adaptive or maladaptive emotions based on a reference standard (a psychiatric diagnostic assessment, or the subjective need for professional mental healthcare). Linear mixed models were built in R, with either goal disturbance or negative emotional symptoms as dependent variable.

Goal disturbance for social activities and leisure activities was significantly associated with more emotional symptoms. Goal disturbance for disease-related health activities was significantly associated with less emotional symptoms. No significant association was found for other activities (with one exception). With negative emotions as outcome variable, goal disturbance was more strongly associated with more emotional symptoms in patients with maladaptive emotions than patients with adaptive emotions for social, leisure and lifestyle health activities.

Further research is warranted to develop an indicator of maladaptive emotions in patients with cancer based on the extent of goal disturbance of social, leisure and lifestyle health activities.

There is an urgent necessity for research on the mental health of Black college-aged women attending Predominantly White Institutions (PWI's). Due to disparities in the rising rates of suicide, challenges with depression for Black women, and the adversities experienced in higher education, protective factors to support Black women's psychological well-being are vital. Optimistic thinking patterns have been found to be protective against depression and suicide ideation. However, limited studies have intentionally examined these constructs exclusively within a sample of Black women. The current study aims to examine the moderating effects of optimism on the relationship between depression and suicide ideation. 89 (M _age = 21) cisgender African American/Black women were surveyed, and results indicated that when Black women have higher levels of optimism, it may weaken the link between feeling depressed and having thoughts of suicide. Future research and clinical implications are discussed.

Medical students appear to be at risk for psychological problems. Therefore, we examined factors influencing depression and loneliness in this specific group, focusing on socio-demographic, psychological, somatic variables, and empathy as a protective factor.

We included 507 medical students at the Faculty of Medicine in Belgrade, Serbia. Each participant completed a written questionnaire comprising a socio-demographic questionnaire, the Toronto Empathy Questionnaire (TEQ), the UCLA Loneliness Scale, and the Patient Health Questionnaire (PHQ-9).

The sample was predominantly female (75.1%) with a mean age of 22.11 (SD 1.6). Higher empathy scores were observed among female students, younger participants, those with lower academic performance, and students who attended psychotherapy. Higher loneliness and depression were reported by students with psychiatric problems, those using psychiatric medication, and those with unstable socio-economic status. Loneliness was positively associated with depression and negatively associated with empathy in our regression model.

Significant differences in psychological variables exist among medical students in relation to the analyzed socio-demographic, health, and behavioral characteristics, highlighting the need for tailored interventions aimed at fostering social connection and empathy.

Alzheimer's disease (AD) and depression are two prevalent conditions in the elderly population, both of which may impact the structure or function of the visual pathway. This study simultaneously investigated the effects of AD and depression on optic nerve head and macular parameters using Optical Coherence Tomography (OCT) imaging.

This cross-sectional study included two groups: 50 individuals with mild to moderate AD and 50 age-matched healthy controls (HCs). All participants underwent the Patient Health Questionnaire-9 (PHQ-9) and Mini-Mental State Examination (MMSE). Comprehensive ophthalmic examinations were performed, and individuals with significant refractive errors or ocular pathologies were excluded. Peripapillary RNFL (pRNFL) and macular layer imaging were conducted using Heidelberg OCT.

Compared to HCs, AD patients showed significant thinning of pRNFL in the supra temporal (HC: 136.38 ± 17.68 μm vs. AD: 127.45 ± 16.08 μm, P = 0.010) and infra temporal (HC: 139.46 ± 20.88 μm vs. AD: 127.99 ± 17.06 μm, P = 0.003) quadrants, while temporal and nasal sectors were not significantly different. Inner macular layers were also significantly reduced in the AD group: GCL volume (1.043 ± 0.073 vs. 0.981 ± 0.083 mm³, P < 0.001), IPL volume (0.872 ± 0.061 vs. 0.834 ± 0.048 mm³, P = 0.001), and GCC (2.832 ± 0.181 vs. 2.671 ± 0.192 mm³, P < 0.001). Depression severity correlated negatively with GCL volume (ρ = - 0.260, P = 0.009). In stepwise regression analysis, MMSE score was more strongly associated with GCL volume than depression status and entered the model as the main predictor (β = 0.489, P < 0.001). The MMSE × depression interaction term was also significant (β = -0.213, P = 0.020), indicating that depression modified the association between cognitive impairment and GCL thinning.

AD and depression in the elderly can influence the thickness of inner retinal layers, with dementia appearing to have a more pronounced effect than depression. These retinal changes may have important implications not only for the early diagnosis and monitoring of AD, but also for the accuracy of OCT-based detection of early glaucoma in patients with coexisting neuropsychiatric disorders-particularly in those with AD, where reliable visual field testing may also be challenging.