Previous studies indicate that dental anxiety (DA) is associated with increased salivary cortisol and alpha-amylase, biomarkers of hypothalamic-pituitary-adrenal (HPA) axis and sympathetic-adrenal-medullary (SAM) activation. However, underlying molecular mechanisms remain unclear. This study aimed to explore whether peripheral blood mRNA expression levels of glucocorticoid receptor (GR), GR transcripts containing exons 1B (GR-1B), glutamate ionotropic receptor AMPA type subunit 1 (GRIA1), oxytocin (OT), oxytocin receptor (OTR), and Poly ADP-Ribose Polymerase 1 (PARP1), together with salivary cortisol and alpha-amylase levels, are associated with dental anxiety.

In this cross-sectional study, a total of 30 DA patients and 28 non-DA patients were included. The mRNA expression levels of GR, GR-1B, GRIA1, OT, OTR, and PARP1 in peripheral blood were determined by real-time quantitative polymerase chain reaction. Salivary cortisol and alpha-amylase concentrations were determined by enzyme-linked immunosorbent assay.

The expression levels of GR-1B mRNA were significantly higher in the DA group than in the non-DA group, whereas GRIA1 and OT mRNA expression levels were lower in the DA group. Concurrently, salivary cortisol and alpha-amylase levels were significantly higher in the DA group.

Dental anxiety may be associated with altered stress-related molecular expression and salivary biomarkers. These findings provide preliminary evidence of peripheral molecular and salivary changes associated with dental anxiety and may contribute to understanding its biological correlates.

The importance of the involvement of next of kin (NOK) in mental health treatment settings is widely recognized. Yet, interventions to involve NOK are not sufficiently implemented in clinical practice - a situation that the German-based collaborative-participatory research project "Involvement of Next of Kin in Psychiatric Care" (PazAng) aims to change. This overview intends to systematically collect and evaluate the existing evidence syntheses (=ES) on interventions, programs, and approaches for the involvement of NOK in the field of mental health care to create a foundation for their improved implementation in future.

The study follows a collaborative-participatory approach to ensure the grounding of the results in diverse and experiential perspectives throughout the research process. An overview of ES is conducted, focusing on the types of interventions and mental disorder for which NOK involvement has been evaluated, the types of outcomes assessed, and the inferences to be drawn on the effectiveness.

The search identified 1340 publications of which 50 ES were included after full text screening. Interventions were heterogenous in relation to their theoretical underpinnings, components, setting, delivery format, the delivering staff, duration, and frequency. The component most assessed was psychoeducation. Outcomes varied widely, especially for the NOK involved. Overall, positive effects on both NOK and PIT were reported.

The heterogeneity of NOK interventions relate to fundamental contingencies: first, to individuum-centrism of the mental health care system with a strong bias towards individualized over social-relational explanation models. Second, to a lack of research on multi-person setting interventions that also pay attention on how to renumerate and institutionally implement them in sustainable ways.

CRD42024595639.

Disruption and restoration of the self are theorized to be central to bereavement adjustment, yet previous interventions rarely address self-disruption directly. This study examined whether an online expressive writing intervention targeting self-disruption could alleviate grief symptoms in bereaved adults.

In a two-arm randomized controlled trial, 66 bereaved participants were randomly assigned to an intervention group (n = 35) or a waitlist control group (n = 31). The intervention consisted of six sessions (one psychoeducational session and five structured expressive writing sessions) over three weeks, focusing on four aspects of self-disruption, namely: Loss of Self-Direction, Self-Derailment, Self-Devaluation, and Disconnection of Relational-Self. Grief severity was assessed using the PG-13-R at baseline and post-intervention, with a six-month follow-up for the intervention group.

Compared with the waitlist control group, the intervention group showed a significantly greater reduction in grief severity (Cohen's d = - 0.93). Within the intervention group, the improvement remained stable at the six-month follow-up.

Online expressive writing targeting self-disruption in bereaved adults may provide an effective, low-cost, and scalable intervention for grief. However, in the absence of a validated measure of self-disruption, whether the intervention exerts its effects through changes in the self remains untested.

This trial was retrospectively registered with the Chinese Clinical Trial Registry (Registration Number ChiCTR2600120661, Date 18.03.2026).

To evaluate hippocampal subfield radiomics for identifying aggressive behavior in hospitalized patients with schizophrenia and to validate the incremental benefit and interpretability of a combined model integrating clinical variables, whole-brain structural MRI information, and hippocampal subfield radiomics.

This retrospective single-center cohort included 247 hospitalized patients with schizophrenia, randomly split (7:3) into training and test sets using outcome-stratified sampling. Aggression during hospitalization before discharge was assessed with the Modified Overt Aggression Scale (MOAS); clinically significant aggression was defined as a weighted total score ≥4. Whole-brain gray matter volume (GMV) features and hippocampal subfield radiomics features segmented using the FreeSurfer pipeline were each subjected to maximum relevance minimum redundancy (mRMR) and 10-fold least absolute shrinkage and selection operator (LASSO) for feature selection to derive sMRI-Radscore and Hip-Radscore, respectively. Three extreme gradient boosting (XGBoost) models were compared. Discrimination, incremental value, calibration, and net benefit were evaluated using area under the curve (AUC), net reclassification improvement/integrated discrimination improvement (NRI/IDI), Brier score, and decision curve analysis (DCA). SHapley Additive exPlanations (SHAP) was used to interpret the combined model.

Five GMV and nine hippocampal subfield radiomics features were retained. sMRI-Radscore showed lower discrimination (AUC = 0.681) than Hip-Radscore (AUC = 0.729). The combined model achieved the highest AUC (0.875), outperforming both single models, with the lowest Brier score (0.119) and higher net benefit across most threshold probabilities. SHAP indicated Hip-Radscore as the top contributor. Hip-Radscore and its key constituent features were significantly associated with aggression severity.

Hip-Radscore may help identify aggressive behavior risk in hospitalized patients with schizophrenia, and the combined model showed improved discriminative performance. These findings provide imaging-based evidence for early risk stratification and management during hospitalization.

Antenatal depression is a common but under reported complication of pregnancy and childbirth, particularly in low and middle-income settings. This study aimed to estimate the prevalence of antenatal depressive symptoms and identify associated obstetric and psychosocial factors among antenatal women attending public health clinics.

A multi-centre cross-sectional study was conducted in public health clinics. Participants completed self-administered questionnaire on sociodemographic characteristics, obstetric history and psychosocial factors. Depressive symptoms were assessed using the Edinburgh Postnatal Depression Scale (EPDS) with a score ≥ 12 was used to indicate probable antenatal depression. Data were analysed using R Software version 4.5.2.

A total of 572 women were included in the analysis, and prevalence of antenatal depression was 9.6%. In the multiple logistic regression adjusted for age, education, race and household income, antenatal depression was independently associated with unplanned pregnancy ( aOR 2.20, 95% CI 1.03 - 5.02), exposure to stressful event ( aOR 2.99, 95% CI 1.42 - 6.27), present of depressive symptoms in the past two weeks ( aOR 8.25, 95% CI 3.47 - 19.94) and self-perceived present of high worries ( aOR 4.56, 95% CI 1.84 - 13.18). Perceived maternal emotional support during upbringing was protective ( aOR 0.16, 95% CI 0.05 - 0.53).

Around one in ten women were screened positive for probable antenatal depression which was associated with unplanned pregnancy, stressful life events, recent depressive symptoms and high worry, while maternal emotional support from upbringing was protective. Finding support routine brief mental health screening practices that also considers other symptoms such as anxiety to improve case-finding and guide targeted support for women at higher risk, alongside interventions that build supportive relationships and break intergenerational cycles of distress.

Social determinants of health (SDoHs) are increasingly recognized as important contributors to the development, course, and outcomes of psychiatric disorders. However, their integration into clinical psychiatry and mechanistic models remains limited. This overview synthesizes emerging evidence on the biopsychosocial mechanisms through which SDoHs influence mental health. There is a need to distinguish between individual-level, clinically actionable health-related social needs and family-, community-, and society-level structural SDoHs, and to consider both adverse and protective social factors. Converging research demonstrates that social experiences are biologically embedded through interacting pathways, including exposomics, epigenetics, allostatic load, accelerated inflammaging, immune dysregulation, and gut-brain-microbiome signaling. These mechanisms influence neural circuitry underlying stress regulation, reward processing, and social cognition. Psychological processes-including individual differences in resilience, wisdom, compassion, and purpose in life-shape responses to SDoHs and are supported by identifiable neurobiological substrates. Social connection has emerged as a central, potentially modifiable SDoH that is strongly associated with whole health and longevity. Loneliness and social isolation have become major global public health challenges. The authors propose a biopsychosocial framework that integrates social exposures, biological mechanisms, neural systems, and psychological processes to better understand the risk, course, and prevention of mental illnesses. Clinical and public health implications include the need for routine assessment of SDoHs, incorporation of protective factors at individual and societal levels, and development of pragmatic, multidomain interventions. Finally, rapidly evolving digital technologies, including artificial intelligence, offer new opportunities but also require careful governance. Advancing toward human-centered "artificial wisdom" may enhance the capacity of technology to promote whole health in individuals with mental illnesses globally.

Anxiety and depression ('internalising symptoms') are common in autistic children and young people. For non-autistic youth, there are reciprocal relationships between internalising difficulties and parental mental health and peer victimisation, but it is unclear whether this holds for their autistic peers. This study investigates longitudinal and bidirectional relationships of parental mental health and peer victimisation with internalising symptoms in autistic children and young people.

Autistic children and young people in the Millennium Cohort Study (N = 560) were included. Measures were parent-reported. Random-Intercept Cross-Lagged Panel Models (RI-CLPMs) were estimated to examine bidirectional associations of internalising symptoms with parental mental health and peer victimisation across six timepoints (3- to 17-years-old).

Both the RI-CLPM of child internalising symptoms with parental mental health, and with peer victimisation, revealed autoregressive paths across timepoints. Greater peer victimisation at 5-years predicted greater internalising symptoms at 7-years, and these associations were unchanged after accounting for covariates. Parental mental health at 3- and 5-years predicted internalising symptoms at 5- and 7-years, and conversely, internalising symptoms at 14-years predicted greater parental mental health difficulties at 17-years. However, associations between parent mental health and internalising were attenuated after adjusting for covariates.

Peer victimisation may contribute to the development of internalising symptoms in autistic children from a young age. Targeting interventions for environmental factors may be a means to promote better mental health for young autistic people.

Interest in psychedelic drugs has increased rapidly because of their potential therapeutic role in psychiatric disorders. Impairments in the sociocognitive skills needed to build and maintain social relationships are prominent features of many psychiatric and neurodevelopmental disorders. Emerging evidence suggests that compounds such as 3,4-methylenedioxymethamphetamine (MDMA), lysergic acid diethylamide (LSD), and psilocybin may influence these impairments.

This review aimed to determine whether psychedelic drugs may modulate social cognition in individuals with psychiatric or neurodevelopmental disorders associated with cognitive impairment.

A search of the MEDLINE, PsycINFO, EMBASE, and Scopus databases was conducted. Twenty studies were identified that evaluated the effects of ketamine, MDMA, psilocybin, LSD, and ayahuasca in depressive disorders, anxiety disorders, autism spectrum disorder (ASD), and post-traumatic stress disorder (PTSD).

Findings included neural activation patterns suggesting that ketamine and psilocybin may modulate processes relevant to social perception, particularly facial emotion processing, in depressive disorders. Positive findings were also reported for MDMA in participants with PTSD, including improvements in self-reported psychosocial functioning, self-awareness, and self-compassion.

Current evidence suggests that psychedelic drugs may modulate processes relevant to social cognition in psychiatric disorders, although direct evidence of improved social-cognitive functioning remains limited.

Not applicable.