In research and clinical practice, the words chosen to describe others matter, particularly regarding race and ethnicity. Some terminologies are particularly problematic and should be avoided, given their tendency to distort cohorts of individuals based on presupposed common attributes and demographic characteristics. Racial taxonomy may unintentionally give rise to pejorative and potentially unsettling connotations. Hence, outdated racialised designations should be superseded by ethically and scientifically meaningful alternatives. The term Caucasian, as demonstrated in this manuscript, has persisted as a frequent terminology in Western biomedical parlance when referring to white individuals. The use of the term Caucasian represents a relic of an outdated and prejudiced racial classification system. In particular, the persistence of this terminology in the Australian healthcare setting is in disagreement with contemporary scientific and worldview values. Although the use of Caucasian as a descriptor has been challenged, given its inherent taxonomic and methodological flaws, several professional associations continue to include Caucasian as an acceptable category in racial classification systems, which suggests this time-worn term remains in wide use. It is likely, therefore, that the persisting use of Caucasian will continue to generate unreliable information and contribute to a misinterpretation of Australian populational composition. To the authors' knowledge, the persistent use of Caucasian as a demographic descriptor has never been questioned in the Australian scientific literature. It is hoped that the argument presented herein will prompt further debate and development regarding this critical issue.

The Millon Clinical Multiaxial Inventory-IV (MCMI-IV) is a psychological assessment tool commonly used in Veteran Affairs (VA) settings. However, no research has examined the MCMI-IV symptom validity scales in the veteran population, where high rates of response bias can occur. This study examined convergent validity of the MCMI-IV scales to the Minnesota Multiphasic Personality Inventory-2-Restructured Form (MMPI-2-RF) validity measures, identified base rates of invalid MCMI-IV validity scores in the veteran population, and explored alternative cutoff scores. All MCMI-IVs administered in the VA (04/2019 - 08/2024, N = 6,466), using data from the Corporate Data Warehouse, were examined. MCMI-IV protocols were correlated with same day administrations of the MMPI-2-RF (n = 1,401) using Spearman's correlations. Disclosure and Debasement positively correlated with overreporting validity scales and negatively correlated with underreporting scales on the MMPI-2-RF, while Desirability showed the opposite pattern (all p < .001). Additionally, the Inconsistency scale positively correlated with MMPI-2-RF non-content validity scales. Less than 1% of MCMI-IV of protocols met the test manual's criteria for invalidity, a significant departure from invalid rates reported on other measures administered to veterans. Diagnostic accuracy analyses suggested new cutoff scores, specifically that overreporting be identified by X Disclosure base rate score (BRS) ≥ 87 and Z Debasement BRS ≥ 84, and underreporting identified by X Disclosure BRS ≤ 49 and Y Desirability BRS ≥ 74. Results suggest that while the MCMI-IV validity indices measure intended constructs, more optimal cutoffs are presented for the veteran population.

AimOur study aims to explore the relationship between anxiety, depressive symptoms, and family functioning about quality of life in children diagnosed with neurofibromatosis type 1.MethodsA total of 51 participants, including 24 children in the neurofibromatosis type 1 group and 27 age- and gender-matched controls, aged between 8 and 18 years, were included. A pediatric neurologist confirmed each neurofibromatosis type 1 diagnosis. A semi-structured clinical interview (KSADS-PL) and psychometric evaluation were performed by a unique child psychiatrist. A sociodemographic form and psychometric scales assessing family functioning, quality of life, and children's anxiety and depressive symptoms were administered.ResultsAttention-deficit hyperactivity disorder and/or specific learning disorder were identified in 12 cases (50.0%). Parent-reported psychosocial subscores and total quality of life scores were significantly lower in the neurofibromatosis type 1 group compared with controls. Affective involvement subscores in family functioning were significantly higher in the neurofibromatosis type 1 group than in controls. The total quality of life scores reported by both children and parents, along with parent-reported psychosocial quality of life subscores, showed a moderate positive correlation with age at neurofibromatosis type 1 diagnosis. In contrast to the control group, problem-solving subscores in family functioning in the neurofibromatosis type 1 group showed a moderate positive correlation with depression scores and a moderate negative correlation with child-reported psychosocial quality of life subscores. Additionally, in the neurofibromatosis type 1 group, general family functioning exhibited a moderate positive correlation with total anxiety scores and a moderate negative correlation with child-reported psychosocial quality of life subscores.ConclusionsAddressing family functioning and integrating psychosocial support into neurofibromatosis type 1 management may enhance adaptation, mental health, and long-term quality of life for affected children and their families.

Community reintegration serves an integral role to enhance veterans' quality of life as they transition to civilian life. Unsuccessful reintegration after military separation may contribute to the relative increase in adverse outcomes such as homelessness and suicide in this population. Mild traumatic brain injury (TBI) has been linked to poor mental health, which, in turn, may compromise community reintegration; however, little is known about how the characteristics of mild TBI may impact community reintegration either directly or indirectly. The objectives of this study are to: (1) evaluate the association of the characteristics of mild TBI, including blast versus nonblast mechanism and combat versus noncombat deployment (i.e., outside of combat deployment) setting on community reintegration; (2) determine whether this association varies by the level of perceived social support; and (3) explore the potential mediation effect of mental health symptom levels. This cross-sectional analysis used data from the Long-term Impact of Military-relevant Brain Injury Consortium Chronic Effects of Neurotrauma Consortium (LIMBIC-CENC) Prospective Longitudinal Study on 2,177 service members and veterans (SMVs) who were registered for clinical care at a Department of Defense and/or Veterans' Affairs Medical Facility. The exposure of interest was the characteristics of each mild TBI, including from blast/nonblast mechanism, combat deployment/noncombat deployment setting, or lack of any lifetime mild TBI. The outcome was community reintegration measured by the Community Reintegration of Injured Service Members survey. Perceived social support was measured using the Deployment Risk & Resilience Inventory-2 Post-deployment Social Support Scale. Mental health symptoms (post-traumatic stress and depressive) were evaluated using the post-traumatic stress disorder checklist, DSM-5, and the Patient Health Questionnaire-9, respectively. Community reintegration among SMVs who sustained mild TBI(s) only with a nonblast mechanism outside of a combat deployment was better compared with those sustaining mild TBI(s) during a combat deployment or by blast mechanism. Those with no mild TBI history had a similar level of community reintegration as those who sustained nonblast mild TBI(s) outside of combat deployment. The level of perceived social support did not significantly alter these relationships; however, inclusion of variables to account for mental health symptoms in the models attenuated the results to nonsignificance, supporting potential mediation by mental health symptoms. This study found mild TBI sustained during combat deployment (either blast or nonblast mechanism) may be a risk factor for poor community reintegration. These results support clinical care processes that include identifying SMs with sustained mild TBI during combat deployment (particularly those with blast mechanism) for targeted interventions that may facilitate transition into the community. Future studies are needed to evaluate the mechanism through which mild TBI sustained during combat deployment for both blast and nonblast type injuries may impact community reintegration.

Movement disorders have recently emerged as important neurologic manifestations of the 22q11.2 microdeletion that affects nearly one in every 2000 live births.

We aimed to map the existing evidence regarding the spectrum, diagnosis and treatment, and etiopathogenesis of movement disorders associated with 22q11.2 microdeletion, highlight key gaps, and provide recommendations for future research.

We conducted a comprehensive search of MEDLINE, Embase, CENTRAL, and reference lists to identify relevant clinical and preclinical studies, and summarize data on clinico-pathologic features, risk factors, and pathophysiology of movement disorders associated with molecularly defined 22q11.2 microdeletions.

Forty-three (clinical: n = 41/43, 95%; preclinical: n = 2/43, 5%) studies met eligibility criteria. Most clinical studies (35/41, 85%) involved adults, of which 51% (21/41) were case series/reports, and the remainder observational studies. Key findings included: (1) emphasis on parkinsonism but emerging evidence for multiple other motor phenotypes, (2) non-specific findings on routine neuroimaging, albeit with promising early results of certain modalities (eg, volumetric analyses, molecular imaging) and fluid-based biomarkers, particularly for parkinsonism, and (3) multifaceted etiologic and pathophysiologic processes beyond those attributable to medication side effects. Prevailing gaps include research design limitations, heterogeneity of diagnostic methods, and limited systematic data on etiopathogenesis and treatments.

Current evidence supports an expanding spectrum of motor phenotypes associated with 22q11.2 microdeletion, with emerging data reporting potentially useful clinical markers and non-drug-related risk modifiers and underlying mechanisms. Addressing prevailing gaps will require enhanced research designs with up-to-date diagnostic and genetic methodologies, robust preclinical models, and cross-disciplinary collaborations.

[This corrects the article DOI: 10.3389/fpubh.2025.1594872.].

The co-occurrence of mental illness and substance use disorders (SUDs) presents a significant public health challenge with affected individuals facing compounded stigma that leads to poor health outcomes, social exclusion, and systemic neglect. Despite growing recognition of stigma as a social determinant of health in people with comorbid mental illness and SUDs, current responses remain largely confined to clinical and academic settings. This article argues that civil society, particularly groups led by individuals with lived experience, represents an underutilized yet powerful force in combating stigma. Drawing from historical movements such as HIV/AIDS activism and contemporary examples from peer-led movements, we highlight how civil society organizations (CSOs) have reshaped public discourse, influenced policy, and fostered inclusive research. We examine emerging efforts in low resource settings and explore the transformative potential of digital civil society spaces. We advocate for a shift in stigma reduction paradigms to those that center lived experience, supports cross-sectoral collaboration, and recognizes both physical and digital civil society as essential to inclusive and sustainable change. To addressing the complex and intersecting stigmas associated with comorbid mental illness and SUDs, we recommend investing in CSOs, especially those grounded in participatory, culturally relevant approaches, particularly in low- and middle-income settings.

Psychoactive substances, known for their acute impact on perception and cognition, are gaining attention for their potential therapeutic applications. Many of these substances are plant-derived with deep-rooted histories of use in non-medical contexts, where they have been viewed as either tools for social cohesion or sources of discord, depending on cultural and societal contexts. This review explores psychoactive substances; psychedelics, cannabis, and stimulants, in a legitimized medical context, focusing on the ethical considerations shaping research and the regulatory and prescribing challenges involved in translating these compounds into viable clinical treatments. It highlights the diverse voices; Indigenous, philosophical, psychiatric, and using communities advocating for careful consideration of their broader implications. Key issues include navigating the blurred boundaries between therapeutic benefit and potential misuse, ensuring rigorous scientific methodologies, and addressing the sociopolitical factors shaping public perception and policy. The article emphasizes the need for evidence-based frameworks that balance innovation with patient safety and calls for approaches that recognize the social and commercial determinants of health, extending ethical considerations beyond merely prescribing. By critically assessing the promise and limitations of repurposing these substances, the article contributes to the ongoing discourse on their role in contemporary psychiatric practice.

Youths experiencing a behavioral health crisis often have a long length of stay (LOS) in emergency departments (EDs) and on inpatient psychiatric units, with myriad negative consequences. This scoping review aimed to identify interventions that decrease LOS in these acute care settings and to characterize helpful practices.

MEDLINE, Embase, PsycInfo, and Web of Science were systematically searched. Peer-reviewed empirical articles that described interventions to decrease LOS in acute care hospitals for youths (up to age 18) with behavioral health concerns were included. Two screeners from a group of four independently reviewed each study, determined study eligibility, and extracted data.

Twenty-eight articles met inclusion criteria. Studies were primarily evaluated through same-setting pre-post designs and conducted in the United States. Interventions to address LOS in EDs and on inpatient psychiatric units included assessment protocols, adjustments to the continuum of care available to youths, disorder-specific clinical pathways, personnel restructuring, structural changes, technology implementation, evidence-informed treatments, and multiple strategies. Although no singular model for helpful intervention emerged, several categories of interventions had encouraging results.

Reducing LOS in acute care settings is a burgeoning area of research and is critically important given the ongoing youth behavioral health crisis. Continued research should prioritize rigorous study design, consistent reporting, the inclusion of representative samples, and intervention scalability.