Older adults with multimorbidity (OAMM) commonly receive depression and pain management through primary care, where symptoms are typically assessed through retrospective recall. Even with validated questionnaires, recall bias has been reported in younger populations for both depression and pain. However, recall bias for depression and pain has not been explored in OAMM. We examined discrepancies between prospectively measured and recalled symptoms of depression and pain among OAMM.

We analysed data generated from a 14-day pilot feasibility trial of ecological momentary assessment (EMA) in OAMM (N = 18, age range 67-95). We examined discrepancies between retrospectively assessed depression and pain intensity over two weeks compared to follow-up, baseline characteristics correlated with discrepancies, and recency effects.

We found overreporting across most symptoms, with the largest discrepancies between prospectively recorded and recalled symptom scores for pain intensity and fatigue (d = .49). There was no association between recalled and EMA-measured items for appetite and trouble sleeping. Pain intensity at day 14 was associated with discrepancies in recalled pain (r = -.52, p =.029), and both day 14 mood and negative self-thoughts were associated with discrepancies in trouble concentrating recall (r = -.67, p =.002 and p = -.72, p <.001, respectively) - suggesting recency effects.

We found preliminary evidence of recall bias among OAMM, including overreporting and recency effects of pain and depression symptoms. Given the reliance on recall during primary care visits, more research is needed.

Clinical care for adults with eating disorders in the Netherlands is under pressure due to limited capacity and long waiting times. Insight into bed capacity, occupancy, and waiting lists in specialized clinics and medical-psychiatric units (MPUs) is lacking.

To gain insight into clinical capacity in eating disorder care in the Netherlands METHOD: A nationwide telephone survey was conducted among 8 clinics and 31 MPUs. Data on capacity, occupancy, waiting lists, and admission criteria were collected between August&nbsp;26 and September&nbsp;9, 2025.

The clinics had 115 beds, with 103 occupied and 103 patients waiting. Length of stay ranged from months to longer. Some applied BMI thresholds: compulsory care was limited. MPUs had 40-45 beds, 25 occupied, and 20 waiting. Care ranged from acute somatic interventions to structured weight restoration and compulsory care.

Severe capacity problems, long waiting times, varying admission criteria, and limited compulsory care highlight the urgent need for expansion of capacity, national coordination and stronger collaboration.

To emphasize recovery from the very start of treatment, the recovery-oriented intake (ROI) was developed in Dutch mental health care. This approach places additional focus on the personal domain, alongside the usual attention to biological, psychological, and social factors. The question is whether this translates into intake documentation.

To compare ROI with intake as usual (IAU) regarding attention to abovementioned domains of mental health, the degree of integration into a case formulation, and the quality and focus of treatment goals.

In a retrospective file study, 60 intake reports (30 ROI, 30 IAU) were assessed using validated scales for level of detail per domain, integration of information, and quality of treatment goals.

ROI and IAU reports contained a similar level of detail for biological, psychological, and social domains. The personal domain appeared more often in ROI, though usually in isolation. Contrary to expectations, integration was rated higher in ROI. The quality of treatment goals did not differ significantly, but ROI goals more often addressed personal growth and symptoms (26,7% vs 6,7%), whereas IAU goals were more often limited to symptoms (36,7% vs 16,7%).

ROI provides more attention to the personal domain and shows greater integration, without reducing attention to other domains. Strengths are often mentioned in isolation, and social goals remain limited.

Self-injury behavior is a prevalent mental health problem among adolescents. Childhood maltreatment is closely associated with the development of alexithymia, impulsivity, and self-injury behavior in adolescents and young adults with mental disorders; however, the underlying mechanisms remain unclear. This study aims to classify psychiatric patients aged 12 to 24 years into psychological subtypes based on alexithymic and impulsive traits, to explore differences in self-injury behavior among these subtypes, and to examine whether different forms of childhood maltreatment are associated with specific psychological subtypes, thereby providing evidence for clinical intervention and prognosis improvement.

Clinical data of adolescents and young adults with mental disorders treated between 2021 and 2022 were retrospectively collected. Principal component analysis (PCA) was performed using 6 dimensions derived from the Toronto Alexithymia Scale (TAS)-20 and the Barratt Impulsiveness Scale (BIS)-11, including difficulty identifying feelings (DIF), difficulty describing feelings (DDF), externally oriented thinking (EOT), attentional impulsiveness, motor impulsivity, and non-planning impulsivity. Principal components with eigenvalues (λ) ≥1 were retained, and their scores were subjected to 2-step cluster analysis for automatic subtype classification. Differences among the subtypes were compared with respect to demographic characteristics, clinical features, and self-injury behavior-related characteristics. Multivariate Logistic regression models were subsequently used to examine associations between the identified psychological subtypes and different forms of childhood maltreatment.

A total of 634 adolescents and young adults with mental disorders were included, among whom 459 (72.4%) had a history of self-injury behavior. The diagnostic distribution comprised depressive disorders (n=295, 46.5%), bipolar disorder (n=136, 21.5%), anxiety disorders (n=61, 9.6%), schizophrenia (n=14, 2.2%), and other disorders (n=128, 20.2%), including personality disorders, obsessive-compulsive disorder, post-traumatic stress disorder, somatoform disorders, and eating disorders. PCA reduced the 6 dimensions related to alexithymia and impulsivity into 2 independent principal components (Z1 and Z2). Based on individual scores on Z1 and Z2, 2-step cluster analysis automatically classified participants into 3 clusters (K1, K2, and K3). The psychological characteristics of the K1 group were characterized by high motor impulsivity accompanied by marked difficulties in identifying and expressing emotions. The K2 group exhibited relatively low levels of impulsivity and alexithymia. The K3 group was characterized by high attentional impulsivity, high non-planning impulsivity, and externally oriented thinking. No significant differences were observed among the 3 groups in the distribution of primary psychiatric diagnoses (P>0.05). Comparisons of self-injury behavior-related characteristics showed that the K2 group had significantly lower rates of self-injury, lower self-injury frequency, lower self-injury addiction scores, and lower self-injury motivation scores than the other 2 groups (all P<0.05). No significant differences were found between the K1 and K3 groups in self-injury prevalence, self-injury addiction scores, and external emotion regulation motives (P>0.05). However, the K1 group scored significantly higher than the K3 group on the motivational dimensions of social influence, internal emotion regulation, and sensation seeking, while exhibiting a lower frequency of self-injury behavior (P<0.05) in the last year. Multivariable Logistic regression analysis revealed that childhood emotional abuse may be a risk factor for developing the K1 psychological subtype; childhood physical abuse may be a risk factor for developing both K1 and K3 psychological subtypes; and childhood emotional neglect was associated with the development of K1 and K2 psychological subtypes.

Adolescents and young adults with mental disorders can be classified into 3 distinct psychological subtypes based on alexithymia and impulsive traits. These subtypes differ in the prevalence and motivational characteristics of self-injury behavior, independent of clinical diagnosis. Furthermore, the development of different psychological subtypes may be associated with exposure to different forms of childhood maltreatment. These findings suggest that providing targeted emotional regulation and impulse-control interventions for adolescents exposed to specific childhood adversities may help reduce the occurrence and frequency of self-injury behavior.

Postherpetic neuralgia (PHN) is a common long-term complication of herpes zoster infection and severely impairs patients' quality of life. This study aims to compare the clinical efficacy of continuous radiofrequency (CRF) and pulsed radiofrequency (PRF) in the treatment of elderly patients with PHN.

A total of 181 elderly inpatients with PHN who underwent CRF (CRF group, n=101) or PRF (PRF group, n=80) treatment targeting the dorsal root ganglion (DRG) of the thoracic spinal nerve at the Department of Pain Medicine, First Affiliated Hospital of Xi'an Jiaotong University, between March 2020 and March 2022 were enrolled. Patients were followed up at 1 week, 1 month, 3 months, 6 months, and 12 months after treatment. Pain intensity was assessed using the Visual Analogue Scale (VAS), sleep quality using the Athens Insomnia Scale (AIS), anxiety using the Generalized Anxiety Disorder 7-item scale (GAD-7), and depression using the Patient Health Questionnaire-9 (PHQ-9). The incidence of complications and the rate of pain recurrence were also recorded and compared between the 2 groups.

At all follow-up time points after treatment, VAS, AIS, GAD-7, and PHQ-9 scores in both groups were significantly lower than those before treatment (all P<0.001). At 1 week postoperatively, there were no significant differences between the 2 groups in any of these scores (all P>0.05). However, at 1, 3, 6, and 12 months after treatment, VAS scores in the CRF group were significantly lower than those in the PRF group (all P<0.001). In addition, AIS, GAD-7, and PHQ-9 scores were also significantly lower in the CRF group than in the PRF group (all P<0.05). The incidence of postoperative localized numbness was higher in the CRF group than in the PRF group (P<0.05), whereas the 1-year pain recurrence rate was significantly lower in the CRF group (P<0.05).

Both CRF and PRF effectively alleviate pain and improve sleep quality, anxiety, and depressive symptoms in elderly patients with PHN; however, CRF demonstrates superior long-term efficacy compared to PRF.