When at rest, the mind becomes preoccupied with self-generated thoughts, commonly known as mind-wandering. While the social, autobiographical, and temporal features of these thoughts have been extensively studied, little is known about how frequently the wandering mind turns toward the interoceptive and somatic body. To map this underexplored component of "body-wandering," we conducted a large-scale neuroimaging study in 536 healthy participants, expanding a retrospective multidimensional experience sampling approach to include probes targeting visceral and somatomotor thoughts. Our findings reveal a robust interindividual dimension of body-wandering characterized by negative affect, high autonomic arousal, and a reduction in socially oriented thoughts. Despite this negative tone, individual differences in the propensity for body-wandering thoughts were associated with lower self-reported symptoms of ADHD and depression. Multivariate functional connectivity analyses further revealed that affective, body-oriented thoughts are related to a pattern of thalamocortical connectivity interlinking somatomotor and interoceptive-allostatic cortical networks. Collectively, these results demonstrate that self-generated thoughts exhibit core embodied features which are linked to the ongoing physical and emotional milieu of the visceral body.

To examine the incidence of antidepressant medication reinitiation following a ≥ 6-month gap as a proxy for relapse in patients with major depressive disorder (MDD) discharged from hospital and followed in primary care, and to assess patterns of antidepressant use before and after reinitiation, as well as associations with socio-demographic and clinical variables. We conducted a population-based cohort study using seven linked administrative health databases from Newfoundland and Labrador, Canada. Adults (≥18 years) with a first hospitalization for MDD between June 2017 and March 2023 and a post-discharge antidepressant prescription of ≥30 days were included. The primary outcome was reinitiation of antidepressant pharmacotherapy following a ≥ 6-month treatment gap. Antidepressant treatment groups were defined as SSRI monotherapy (reference), SNRI monotherapy, other monotherapy, two-medication combination therapy, and three or more medication combinations. Time-varying Cox regression models were used to assess associations with reinitiation risk, adjusted for age, sex, socioeconomic status (SES), and length of hospital stay. Sensitivity and exploratory age-stratified analyses were conducted. Among 2,734 patients, 61% reinitiated antidepressant treatment after a ≥ 6-month gap. SSRI monotherapy was the most common initial regimen (34.3%), followed by 2-medication combinations (18.1%). Combination therapy was associated with lower reinitiation risk compared to SSRIs: HR = 0.67 (95% CI: 0.50-0.90) for 2-medication combinations and HR = 0.49 (95% CI: 0.40-0.60) for 3 + medication combinations. SNRI monotherapy conferred modest protection (HR = 0.84, 95% CI: 0.72-0.99). Age, sex, and SES were independently associated with reinitiation. Younger adults, males, and individuals in both high and low-income quintiles were at increased risk. Reinitiation of antidepressants after a ≥ 6-month gap was common following hospitalization for MDD. Combination therapy maybe associated with reduced reinitiation risk compared to SSRI monotherapy, with age-specific treatment effects, although residual confounding cannot be excluded. Further research, ideally RCTs, is needed before informing clinical decision-making.

Major depressive disorder (MDD) is a prevalent mental disorder with a significant burden on individuals and society, and timely identification and intervention are essential for effective management. Voice data have been used as behavioral indicators of MDD, offering valuable insights into an individual's mental state. In this study, we collected voice data from 221 patients diagnosed with MDD at the inpatient ward of the Department of Psychiatry and Psychosomatics, Zhongda Hospital, Southeast University, alongside 113 healthy controls, to construct the Chinese depressive voice dataset. We proposed the cross-feature residual attention fusion network (CFRAFN), which leverages extended Geneva minimalistic acoustic parameter set features along with high-dimensional embeddings extracted from the pretrained VGGish model to effectively capture MDD-associated phonetic patterns. Specifically, CFRAFN utilizes differentiated residual blocks to maintain training stability in deep hierarchical structure. Furthermore, the self-attention fusion strategy dynamically weighted the significance of each feature modality, ensuring effective feature integration and consequently improving MDD prediction accuracy. Experimental results demonstrated that CFRAFN achieved an excellent predictive performance with an area under the receiver operating characteristic curve of 0.924 in an independent test set, and significantly outperformed 11 baseline models across 5-fold cross-validation.

Recent research has shown the widespread prevalence of psychological distress. Different aspects of religion can operate both as a resource and a barrier to good mental health. Religious beliefs about the causes of mental and emotional distress may be one such barrier-as such, this research examined whether religious/spiritual (R/S) attributions of emotional distress were associated with psychological distress and whether that relationship might be mediated by psychological flexibility. The study surveyed 620 online participants (Mean_age = 42.9; SD_age = 16.3) and 676 undergraduate students (Mean_age = 21.8; SD_age = 6.71) in the USA. Those in the online sample had negative associations between R/S attributions and psychological flexibility, which partly accounted for the association between R/S attributions and psychological distress. R/S attributions were not predictive of psychological flexibility or psychological distress in the undergraduate sample. Believing that emotional distress is a religious punishment or caused by sin may change interpretations of such distress, increasing experiential avoidance of those emotions. The findings have implications for clinical practice, emphasizing the importance of addressing R/S attributions in therapeutic settings. This research also highlights the need for a more detailed understanding of how religious beliefs and psychological flexibility interact in individuals' responses to uncomfortable emotions and thoughts.

Stage-based stepped care approaches aim to address gaps between prevention and specialized treatment for mental disorders by directing proportionate interventions in a timely manner. We examined whether increasing stage level, assigned after visitation of youths seeking help in a primary care municipal setting, reflected an increased risk of adverse outcomes after three years.

Help-seeking youths (6-16 years) were stratified into three stages of developmental psychopathology based on the severity and impact of parent- and self-reported mental health problems corresponding to following levels of need for actions: low-intensity intervention (Stage 1); moderate-intensity preventive intervention, (Stage 2); suggested referral to specialized mental health services (Stage 3). Information on diagnosed mental disorders and prescription of psychotropic medications over the following 3.6 years (median follow-up) was retrieved from the Danish National Registries. Outcomes were compared across the staged groups and compared to an age-matched population-based comparison group (N = 16,980, reference group).

Among 566 help-seeking youths, n = 74 (13%) were stratified to Stage 1, n = 436 (77%) to Stage 2, and n = 56 (10%) to Stage 3. Hazard ratios (95% confidence intervals) of receiving a psychiatric diagnosis during three years of follow-up were 3.2 (1.9-5.2) for Stage 1, 3.9 (3.2-4.8) for Stage 2, and 9.0 (6.2-13.3) for Stage 3. Similar stepwise increasing estimates were present regarding use of psychotropic medications, school absence and notifications of concern.

Increased risk of later psychiatric morbidity with increased stage level supports the clinical utility of the stage-based stratification-model for early detection and treatment in the primary care sector.

The nature and classification of dysregulated sexual behaviors remain widely debated. Compulsive Sexual Behavior Disorder (CSBD) and Problematic Pornography Use (PPU) are the two most commonly studied constructs in this area, each carrying significant implications for mental health, interpersonal functioning, and broader well-being. Although scientific output on these topics has expanded rapidly in the past decade, recent reviews have tended to focus on specific subthemes, single constructs, or narrow disciplinary perspectives. Accordingly, this review provides an updated and interdisciplinary overview of empirical and theoretical knowledge.

In this narrative review, we summarize current knowledge regarding CSBD and PPU, with contributions from diverse experts across multiple disciplines (e.g., psychology, psychiatry, sexology, addiction science, neuroscience). We provide research and clinical perspectives to ensure a comprehensive and balanced discussion.

We extensively summarize eleven key areas, namely historical context, conceptualization and symptomatology, assessment and measurement, epidemiology, co-occurring disorders, etiology, potential negative consequences, intervention, treatment, and policy considerations. Additionally, we consider underrepresented populations and contexts, including adolescents, LGBTQ+ (i.e., lesbian, gay, bisexual, trans, queer, and other diverse identities) individuals, women, and cultural factors. The review concludes with a critical discussion of prevailing controversies, methodological challenges, and key directions for future research.

By providing a comprehensive and integrative overview, this work aims to advance scientific discourse, promote interdisciplinary collaborations, inform clinical practice, and support public health initiatives in the field of CSBD and PPU.

This correspondence serves to critically evaluate the meta-analysis by Lin et al. regarding chatbot-led breast cancer education, focusing on specific methodological weaknesses that may undermine its core findings.

We performed a rigorous appraisal of the original study's methodology, specifically scrutinizing their data synthesis process, the inclusion criteria for trials, and the conceptual clarity of the outcome measures used to gauge chatbot performance.

Our analysis revealed three primary concerns: (1) the reliance on a mere six studies raises concerns about the generalizability of the results; (2) a major unit-of-analysis error occurred where multiple intervention arms from a single study were incorrectly "double-counted" as independent data points; and (3) there was a clear conceptual conflation between "usability" and "educational efficacy, leading to ambiguous interpretations of the chatbots' actual impact.

Given these identified flaws, the evidence presented in the meta-analysis remains inconclusive and should be approached with skepticism. To advance the field, we urge the development of larger-scale randomized controlled trials and the consistent application of validated instruments, such as the System Usability Scale (SUS), to ensure more reliable data in digital health research.

On 26 June 2023, National Health Service (NHS) England announced plans for a national lung cancer screening programme, sparking significant online discussion and debate. Whilst screening has been shown to improve mortality in lung cancer, uptake is lower than desired. We hypothesised that online public responses to national news articles may provide an honest insight into public perceptions of lung cancer screening, particularly among those who may be underrepresented in research. The aim of this study was to explore online attitudes to lung cancer screening, identifying potential barriers and facilitators to screening participation.

This qualitative content analysis involved a targeted online search of the major UK news outlets, and their affiliate social media sites for articles published between 19 June 2023 and 26 July 2023. Seventeen relevant articles were included, and 921 comments were extracted. Inductive content analysis was used to analyse the data.

A variety of attitudes and perspectives on the announcement of lung cancer screening were identified which were organised into four categories: Stigmatisation of smoking behaviour; Feasibility of NHS delivery; Eligibility and prioritisation; Scepticism and misinformation. Comments were often contextualised by personal health experiences, societal influences, and the politicisation of healthcare.

This study identifies a barrier to lung cancer screening participation that has not been reported in previous work - concern regarding NHS capacity. It builds upon previously identified themes including screening misinformation, and scepticism. The prevalence and strength of smoking-related stigma, and the associated internalised shame expressed by people who smoke, may help explain the reduced uptake of lung screening seen in this group. The inclusion of voices not previously captured in screening uptake research builds on existing knowledge from prior qualitative work and provides a fuller picture of the personal and societal barriers to lung screening attendance. Interventions aiming to improve informed participation in screening need to consider both individual- and societal-level barriers to engagement.

The data incorporated within this study are entirely derived from comments and opinions shared on social media and news outlet comment sections. Comments are anonymous, and hence sources cannot be traced, but commenters are likely to encompass eligible screening participants, relatives, and the general public. By utilising online comments, we aimed to capture voices not previously included in lung cancer screening uptake research, helping to identify novel perspectives on the screening programme.

Identifying childhood cancer survivors who are already at high risk of subsequent neoplasms and may also have an inherited genetic susceptibility is essential for effective surveillance and prevention. This trial evaluated the effectiveness of remote, centralized telehealth genetic services in increasing service uptake.

Childhood Cancer Survivor Study (CCSS) participants at the St. Jude Research Hospital, who were ≥18 years old and survivors of a CNS tumor, sarcoma, or more than one primary cancer, were recruited for the study. After completing a baseline survey, participants were randomly assigned to one of the two arms: remote telehealth genetic services (via phone or videoconference) or usual care. Uptake of genetic services was obtained through study records and the six-month Status Survey. This trial was registered with ClinicalTrials.gov (NCT04455698), and accrual has closed.

Of the 391 participants recruited, 262 were assigned to remote telehealth services (via phone or videoconference) and 129 to usual care. At six months, 43% (113/262) of participants in remote telehealth services received genetic services compared to 15% (19/129) in the usual care group (OR = 4.4, 95% CI: 2.5-8.0, p < 0.0001). Uptake of genetic counseling (42% vs. 15%, p < 0.0001) and genetic testing (19% vs. 9%, p = 0.020) were higher in remote telehealth services. Factors associated with higher uptake included not having high-deductible health insurance (OR = 1.67, 95% CI: 1.00-2.91, p = 0.049) and lower perceived cost of testing (OR = 1.51, 95% CI: 1.17-1.96, p = 0.0014). Top barriers included experiencing higher levels of depression (OR = 0.91, 95% CI: 0.85-0.98, p = 0.0067) and anxiety (OR = 0.93, 95% CI: 0.87-1.00, p = 0.036).

Remote telehealth genetic services improve genetic counseling and testing uptake in childhood cancer. Addressing remaining barriers could maximize their impact and ensure equitable access for childhood cancer survivors and their families.

National Cancer Institute (R01-CA237369, U24-CA55727).