Mental health is an urgent public health issue with social and economic relevance. Business families play a key economic role, yet their specific mental health challenges remain underexplored. High performance expectations, succession pressures and the wish for discretion may obscure psychological stress. The WIFU-GESUND study addresses this gap by conducting the first representative mental health survey among adult members of business families in Germany.

This cross-sectional study targets adults with legal ownership in German family businesses. A representative sample will be drawn from the MARKUS database of Creditreform, supplemented by a voluntary sample via the WIFU Foundation. Data will be collected via computer-assisted web interviewing/computer-assisted telephone interviewing using validated brief self-report screening measures, including depression (Patient Health Questionnaire), anxiety (Generalised Anxiety Disorder), somatic complaints and selected single-item symptom indicators from the International Statistical Classification of Diseases and Related Health Problems, 10th Revision (ICD-10) Symptom Rating and alcohol use (Alcohol Use Disorders Identification Test) and drug use (Drug Use Disorders Identification Test). Predictors include chronic stress (Trier Inventory for Chronic Stress-Short Screening Scale for Chronic Stress), family functioning (Experience in Social Systems), self-efficacy (ASKU), impostor feelings (Impostor Phenomenon Short Scale), physical activity and business-related contextual factors. As the study does not include diagnostic assessments, it estimates positive screening results for probable mental health problems and related self-reported mental health indicators rather than diagnostic prevalence. Analyses will include descriptive statistics, comparisons with population-based reference values, regression models and exploratory analyses. Missing data will be handled using multiple imputation.

Ethics approval was granted by the Ethics Committee of Witten/Herdecke University (Application No. 26/2023). Independent data collection is ensured by USUMA GmbH. Findings will be shared via peer-reviewed publications, conferences and practice-oriented formats. OPEN SCIENCE FRAMEWORK PREREGISTRATION: https://osf.io/7pcdr.

Poor family communication can worsen early psychosis and substance use outcomes. While families find communication skills valuable, which components to offer in resource-limited settings remain unclear. This study identified communication strengths/areas of improvement, conversations families wanted to practise, and their communication happiness with their relative versus people generally.

Family members (N = 36) of relatives with early psychosis and substance use participated in communication coaching. Strengths/areas of improvement and role-play content were rated from session recordings and progress notes. Self-report items assessed communication happiness.

Participants aimed to improve being brief (44%), specific and clear (39%) and offering help (36%). Role-plays focused on independence (44.1%), substance use (29.4%) and mental health treatment (17.6%). Participants reported greater communication happiness with others than with their relative (p < 0.05).

Families wanted to improve communication, brevity, clarity and effectively offer help, particularly to foster independence with their relative with early psychosis and substance use.

People with chronic obstructive pulmonary disease (COPD) and interstitial lung disease (ILD) experience chronic breathlessness and reduced quality of life (QOL). Specialised singing programs for people with lung disease may improve QOL and symptoms.

A randomised controlled trial conducted in Australia to determine the feasibility and effectiveness of 12 weeks of online, guided group singing on QOL (primary outcome, as measured by SF36), as compared to usual care in people with COPD or ILD.

anxiety, depression, dyspnoea and loneliness. Intervention effectiveness was assessed using mixed effects linear regression.

One hundred and one participants were randomised (50 singing, 51 control; 64 COPD, 37 ILD; mean age 69.6 years; 74% women; 42% mMRC = 2, 58% mMRC ≥ 3). The results of the primary endpoint were a mean treatment effect (MTE) of singing of 2.5 points (95% CI -1.9 to 6.8; p = 0.266) on SF-36 mental health score (MCS) and 2.6 points (95% CI -0.9 to 6.1; p = 0.138) on the physical component score (PCS), neither of which were statistically or clinically significant. In the per-protocol analysis, significant improvement in MCS was detected in participants who attended 8 or more sessions (MTE:4.8; 95% CI 0.1 to 9.5; p = 0.047). No significant effects on secondary outcomes were detected. No adverse events were reported.

This RCT demonstrated that online group singing is a feasible intervention for people with COPD or ILD and breathlessness. Although the intention-to-treat analysis did not demonstrate effectiveness, per-protocol analyses suggest that singing may improve mental health components of QOL in people with COPD or ILD.

Postpartum depression (PPD) is a mental disorder that occurs in a special period of time, but its pathophysiological mechanism is still unclear. Although hypericin has been shown to have therapeutic effects in previous studies, the underlying mechanisms of its treatment of PPD, especially its interaction with the gut-brain axis, remain to be explored. The aim of this study was to investigate the mechanism of hypericin in the treatment of PPD.

The PPD rat model was established by ovariectomy and hormone withdrawal after simulating pregnancy. Postpartum depression-like behavior was assessed by sucrose preference test and open field test. We integrated 16S rRNA sequencing, targeted plasma bile acid metabolomics, brain tissue transcriptomics, histopathology and molecular biology to explain the mechanism.

Hypericin intervention significantly improved the postpartum depression-like behavior of PPD model rats. This effect was abolished by depletion of the microbiota induced by antibiotic sweeps, thus establishing that the involvement of the gut microbiota is required for the efficacy of hypericin. Hypericin can reverse the abnormal changes of gut microbiota, bile acid metabolism and inflammatory response observed in PPD model, so as to play a role in the treatment of PPD.

Hypericin plays an antidepressant role in PPD model, mainly by restoring gut microbiota homeostasis, thereby correcting bile acid metabolism disorders. In this study, the "gut microbiota-bile acid" axis is the key pathological feature and therapeutic target of PPD, and hypericin is expected to become a therapeutic candidate based on the gut microbiota.

Sleep is a multidimensional physiological state, and it is increasingly recognized as a core determinant of cardiovascular (CV) health. This review summarises the CV health attributes of important sleep dimensions, including sleep duration, regularity, timing, quality, efficiency, and napping. New device-measured data continue to demonstrate the importance of both direct and synergistic effects of sleep with movement and dietary lifestyle behaviours in relation to CV risk. Emerging adoption of the 24-hour framework by guidelines highlights the importance of addressing sleep, as part of the broader cluster of lifestyle-related health behaviours, for a more comprehensive understanding of health risks and intervention opportunities. The reviewed literature indicates that sleep, both independently and through its interrelationships with other lifestyle behaviours, plays an important role in shaping CV health. We identified potential interconnected mechanisms through which poor sleep may influence risk of cardiovascular disease (CVD), including heightened sympathetic drive, altered neuroendocrine activity, inflammatory and immune changes, metabolic dysregulation, and weight gain. Large-scale device-based prospective studies capturing multidimensional sleep characteristics are needed to further delineate causal pathways linking sleep dimensions to CV risk. Such an evidence base will advance holistic CVD prevention through better clinical interventions and public health policy.

While both frailty and sarcopenia have been linked with the Alzheimer's disease (AD) clinical phenotype, their association with AD pathophysiology is unclear. This review aimed to identify current evidence of relationships between frailty, sarcopenia and AD biomarkers.

Four databases (Ovid MEDLINE, Embase, PsycINFO, Web of Science) were searched for articles that explored relationships between frailty or sarcopenia and AD biomarkers. AD biomarkers (fluid, tissue, neuroimaging) were defined by the 2024 criteria for diagnosis and staging of AD: Alzheimer's Association Workgroup. Assessment of frailty and sarcopenia were by use of a method/tool defined by the authors of the study.

8187 articles were screened, with 49 studies included (31 frailty, 22 sarcopenia, 4 both). For frailty, the main AD biomarkers evaluated were hippocampal volume (35%) and beta-amyloid [Aβ] positron electron tomography (PET) (29%). For sarcopenia, the most common AD biomarkers evaluated were hippocampal volume (36%) and Aβ PET (55%). The findings were limited by the heterogeneity of the available evidence, in particular, the variability in frailty/sarcopenia definitions, AD biomarker assessments and the predominance of cross-sectional studies. Potential associations were identified across some studies, but these associations were not consistent across all studies.

Conclusions are limited by substantial heterogeneity in the assessment of frailty, sarcopenia, AD biomarkers, and a lack of longitudinal data. Future studies are needed that include longitudinal analyses, consensus in AD biomarker, frailty and sarcopenia assessments, and incorporation of novel AD biomarkers, in particular tau and neuroinflammation, to help clarify these relationships.

The current study combined behavioral and EEG measures to investigate variations in attentional state during comprehension of spoken stories in a clinical sample that included participants with several major mental health disorders that often feature attentional control difficulties.

Participants with schizophrenia (N=62), bipolar disorder (N=44), major depressive disorder (N=51) and psychiatrically healthy controls (N=82) completed a story-listening task and were periodically interrupted by attention probes. Attention probes assessed three different states of engagement via self-reports: on-task attention, partially off-task split-attention, and fully off-task lapsed attention. EEG was recorded to examine corresponding changes in periodic alpha-band (8-13 Hz) power.

We found that all patient groups reported significantly less time fully on-task during story listening than did control participants, but that individual patient groups reported distinct patterns of off-task attention. Whereas reports of fully-lapsed attention dominated off-task reports for participants with schizophrenia, participants with major depressive disorder reported a higher incidence of experiencing a distracted or split attentional state. The EEG results provided additional evidence that the three self-report attention probe categories tapped into biologically distinguishable attentional states, with split attention and fully lapsed attention associated with distinct neural signatures relative to on-task attention. Periodic alpha power was modulated by attentional state in all groups, although there were significant group differences.

Our results demonstrate distinct behavioral and neurophysiological attentional control profiles in schizophrenia and major depressive disorder compared to control participants during language comprehension.

Depression is highly prevalent among older adults, and impairs both mental and physical health. However, whether and how gender influences the development of depressive symptoms in older adults is unclear. The current study systematically examined the gender-specific development of depressive symptoms in national data. Participants were 5683 older adults (47.9% older women; M_age= 66.8 years) from the China Health and Retirement Longitudinal Study. Depressive symptoms were assessed by the center for epidemiological studies depression scale in 2015 (T1) and 2018 (T2). Gaussian graphical model (GGM) networks, Bayesian networks and cross-lagged panel networks (CLPNs) were used to examine the association between depressive symptoms from a comprehensive perspective. Cross-sectional networks (i.e., GGM and Bayesian networks) with T1 data suggested strong connections between loneliness and inability to get going for women while a strong relationship between the everything was an effort and feeling depressed for men. In CLPNs, the feeling bothered at T1 was positively associated with feeling depressed at T2 and the loneliness showed a bidirectional longitudinal association with inability to get going across time for women, while the everything was an effort at T1 was related to feeling depressed at T2 and the feeling depressed at T1 was associated with loneliness at T2 for men. These findings may suggest that older men with depressive symptoms were more likely to experience somatic fatigue, while depressive symptoms in older women were associated with social isolation. Recognizing these gender-specific symptom profiles may inform the development of tailored mental health policies and prevention strategies.

Historically, the field of psychiatry has relied on descriptive categories, as outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM) or International Classification of Diseases (ICD). However, with increasing knowledge of molecular processes that contribute to mental disorders, the descriptive approach has been criticised. The current descriptive diagnostic categories lack sensitivity and specificity; as such, diagnostic heterogeneity remains a challenge for clinics and research. The search for more homogeneous patient groups is fuelled by both the molecular background, looking into molecular processes, pleiotropy, transdiagnostic, and diagnosis-specific markers, as well as from the phenotypic perspective. Immune-related molecular endophenotypes, as well as deep phenotyping, have been suggested as an approach to reduce the challenge of heterogeneity. This literature review focuses on functional immunogenomics, deep clinical phenotyping, and other approaches currently being discussed to resolve the burden of heterogeneity for mental disorders and provides a multidisciplinary perspective and roadmap towards reducing the impact of heterogeneity for research. With the current literature at hand, we provide evidence for the thesis that functional immunogenomics combined with deep clinical phenotyping offers a viable strategy to reduce the influence of heterogeneity.

Implantable medical devices (IMDs) increasingly integrate continuous monitoring with autonomous therapeutic functions, transforming clinical practice while raising significant ethical concerns. As these technologies expand - particularly among vulnerable populations such as individuals with substance use disorders - the tension between patient safety and autonomy intensifies. This article examines the ethical and legal implications of IMDs, emphasizing ongoing consent, data governance, and neurorights.

We conducted a narrative and normative bioethical analysis grounded in interdisciplinary literature. Empirical and conceptual studies on IMDs, neurotechnologies, and opioid overdose interventions were reviewed alongside regulatory frameworks, including the European General Data Protection Regulation (GDPR), Brazil's General Data Protection Law (LGPD), and the United States Health Insurance Portability and Accountability Act (HIPAA).

Highly autonomous IMDs challenge traditional informed consent models, particularly regarding revocation, device deactivation, and continuous data processing. Vulnerable populations may face stigma and expanded secondary uses of sensitive data, while existing regulations leave gaps in neural and biometric data protection.

Ethical implementation requires patient-centered frameworks ensuring ongoing consent, secure data governance, and protection of mental privacy.